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Significance of Anatomy for understanding knee injuries
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In today’s sports world, athletes are pushing themselves to the limits to accomplish a sound victory for themselves or their team. But sometimes they succumb to pushing themselves too hard and get injured. They put them in a position where the only option they have is getting an injury. Lots of injuries happen to the leg of the athlete, but the knee is where the most damage is. Although it does not happen often, a knee dislocation is a serious injury. Being different than a patellar dislocation which is where the patella relocates to another spot of the knee, a knee dislocation is where the tibia and femur are forcibly separated. Not only can one dislocate their knee, they also can also tear their anterior cruciate ligament, posterior cruciate ligament, and sometimes tear the medial collateral ligament or the lateral collateral ligament. As well with the ligaments be torn, blood supply and nerve blockage could happen making a dislocated knee very dangerous to the athlete who dislocates their knee. A dislocation is a medical emergency that usually ends up in surgery to fix not only the placement of the bones, but the ligaments as well. This injury can keep an athlete out for weeks or months depending on the severity of the dislocation making a long and painful rehab. Once back into play, unfortunately, the chances of them dislocating again increase making the management and rehab of the athlete even more important.
In order to know how bad a dislocated knee is, the anatomy of the knee should be known. The top bone in the joint is called the femur and the bone that is connected to is the tibia, which is distal it (Prentice, 20142013). Next to the tibia laterally is the fibula (Prentice, 20142013). These bones form the knee joint. I...
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...from http://www.mcnicholaskneeclinic.co.uk/kneedislocation.htm
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The anterior cruciate ligament (ACL) is one of the most important of your four major knee ligaments. The function of the ACL is to provide stability to the knee and minimize stress across the knee joint. It restrains excessive forward movement of the lower leg bone (the tibia) in relation to the thigh bone (the femur). It also limits rotational movements of the knee. “Greater external knee valgus and internal rotation moments have been shown to increase loading on the ACL in vitro and are thought to be associated with the increased risk of noncontact ACL injury” (Effects 2011). A tear to the anterior cruciate ligament results from overstretching of this ligament within the knee. It’s usually due to a sudden stop and twisting motion of the knee, or a “...
In spite of this the rate of ACL injury is almost equal through all levels of sports, from beginner, to recreational, to professional athletes. The most widely publicized incident of ACL damage has come from Theresa Edwards who was a top female athlete. She was a basketball player who went to the limit with sports. She went beyond her capability and her ligament couldn’t withstand the pressure and snapped. She is not the only but just one example of many who have suffered this same problem. As female athletes continue to become more competitive and aggressive, ACL damage continues to rise.
Ankle sprains have three degrees of injury ranging from 1-3. The level of the ankle sprain is determined by the amount that the ligament is torn or stretched. A grade one sprain is categorized as a slight stretching and damage to the fibers of the ligament. A grade 2 sprain is characterized as partial tearing of the ligament and abnormal laxity of the ankle. A grade 3 sprain is characterized by complete tear of the ligament if it can be pushed or pulled in certain movements there is gross instability. The movements of the ankle are abduction, adduction, plantar flexion, dorsiflexion, and inversion, eversion. The ligaments of the ankle hold the ankle bones and joint into position. These ligaments protect the ankle joint from abnormal movements such as twisting, turning, and rolling of the foot.
To understand the importance of the ACL, the knee as a whole must be examined. The knee is formed by the femur, the tibia, and the patella. Several muscles and ligaments control the motion of the knee and protect it from damage at the same time. Ligaments are dense structures of connective tissue that fasten bone to bone and stabilize the knee. Two ligaments on either side of the knee, called the medial and lateral collateral ligaments, stabilize the knee from side-to-side. The ACL along with the posterior cruciate ligament are of a pair of ligaments in the center of the knee joint that form a cross. T...
Nisell R. (1985) Mechanics of the knee: A study of joint and muscle load with clinical applications. Acta Orthop Scand 216; 1-42.
The Anterior Cruciate Ligament (ACL) attaches the femur, which is the thighbone, and the tibia, which is the shin, together (northstar). A torn ACL is one of the most excruciating experiences in an athlete’s life. It is the first thing that comes to mind when they hurt their knee on the field; for many it is their greatest fear. A torn ACL can sometimes mean the end of an athlete’s career. It can mean losing the chance to get that scholarship for young athletes, and it can also mean the end of those million dollar paychecks for those who have gone professional. A torn ACL can result in numerous surgeries, months of vigorous exercise and rehabilitation, and a sufficient amount of pain. It requires complete patience, for pushing too hard can result in further, more painful injury. Even after all that, an athlete is not guaranteed he or she will ever be able to play sports again.
Norvell, J. G. (2013, June 11). Tibia and Fibula Fracture Clinical Presentation. Retrieved from http://emedicine.medscape.com/article/826304-clinical
A 16-year-old, female high school soccer player, Lindsey Robinson, tore her anterior cruciate ligament (ACL) during a soccer game. Interestingly, she was not the only one in her team who injured her ACL, but several of her teammates have torn the same ligament as well during the soccer season. Lephart (2002) found that women involved in physical activity are more susceptible to acquiring the ACL injuries than men who are involved in the same physical activity (as cited in Ogden, 2002). According to “ACL Injury Prevention” (2004), the numbers of female ACL ruptures have increased for the past ten years. Over 1.4 million women have suffered from the ACL rupture, which is twice the rate of the previous decade.
Sports Medicine is a medical field that specializes with physical fitness, treatment and prevention of injuries related to sports and exercise. It was introduced around the early Greek and Roman era when the first modern Olympic Games took place. The Greek felt they could do something to help heal and prevent injuries that the athletes were receiving. Now in sports medicine, certain injuries can only be assessed and treated by specific physicians. These physicians can include physical therapists, athletic trainers, and strength and conditioning coaches. Although sports physicians are most commonly seen by athletes after they are hurt so they can be treated, there are some physicians that are seen before an injury occurs so that they can learn how to prevent injuries.
There are many injuries in general, but sports injuries? Sprains and Strains are the most common injuries in sports. “Sprains are injuries to ligaments, the tough bands connecting in a joint. Suddenly stretching ligaments past their limits deforms or tears them” (Hoffman 1). Ligaments are like springs in a sense that when you stretch a spring, it will return to it’s normal state unless they are
Anterior knee pain plagues the athletic community, the most common being runner’s knee or patellofemoral pain syndrome (PFPS). One point or another in an athlete’s career they have experienced this kind of pain. When comparing between male and female athletes and who has the higher chance of knee pain, female athletes have a higher prevalence than male athletes (Dolak KL). There are several different mechanisms of patellofemoral pain a few being: pes planus,an increased Q angle, weak, tight or an imbalance in the quadriceps or hip muscles. Recently in my clinic site as the spring sports such as, baseball, soccer and track and field the athlete’s perform a lot of squatting, running, and kneeling which load the patellofemoral joint. We are now starting to see several and treat several athletes with patellofemoral knee pain. Each of them experiencing the pain from a different mechanism. As an athletic trainer we want to treat not only the symptoms, but the mechanism of injury to prevent further injuries down the road. If patellofemoral pain syndrome is not properly treated it can develop into chronic diseases such as chondromalacia or arthritis, maybe eventually leading to a total knee plan. (Lee SE) Treatment while the athletes are young and symptoms aren’t severe is key to preventing further injury.
The majority of ACL injuries suffered during athletic participation are of the noncontact variety. Three main noncontact mechanisms have been identified planting and cutting, straight-knee landing and one-step stop landing with the knee hyperextended. Pivoting and sudden deceleration are also common mechanisms of noncontact ACL injury. Basketball, soccer, and volleyball consistently produce some of the highest ACL injury rates across various age groups. Other activities with a high rate of injury are gymnastics, martial arts, and running. In most sports, injuries occur more often in games than in practice. Many injuries have occurred during the first 30 minutes of play. One-reason physicians are seeing more ACL injuries in female patients that more women play sports, and they play more intensely. But as they continued to do more studies, they are finding that women's higher rate of ACL is probably due ...
In order to understand how the menisci can be injured, you must understand the basic anatomy of the menisci and why they are important. The menisci are two oval (semilunar) fibrocartilages that deepen the articular facets of the tibia and cushion any stresses placed on the knee joint. They enhance the total stability of the knee, assist in the control of normal knee motion, and provide shock absorption against compression forces between the tibia and the femur (Booher, 2000). Articular cartilage covers the ends of the bones that make up the joint. The articular cartilage surface is a tough, very slick material that allows the surfaces to slide against one another without damage to either surface. This ability of the meniscus to spread out the force on the joint surfaces as we walk is important because it protects the articular cartilage from excessive forces occurring in any one area on the joint surface, leading to degeneration over time (Sutton, 1999).
These types of injuries could take upwards to eighteen months to return to playing condition, and in this time an athlete will often fall behind in the sport that they love. This often causes the athlete to quit the sport they once loved because they can no longer truly compete amongst their peers. I know that there has to be a way to accelerate this process of recovery and get those athletes back on the field. This is where my passion for orthopaedics
The fibula is a leg bone located on the lateral side of the tibia, with which it is connected above and below. It is the smaller of the two bones, and the slenderest of all the long bones, and plays a significant role in stabilizing the ankle and supporting the muscles of the lower leg. The fibula is the smaller, non-weight bearing, of the two bones in the lower leg, while the tibia is the larger, weight bearing bone. The fibula and tibia moves very little relative to each other and the joints that it forms contribute significantly to the function of the lower leg. The joint it forms permit the fibula to adjust its position relative to the tibia, increasing the range of motion of the ankle. Fibular fractures are not often a severe injury, because the bone is supports only about 17% of the body weight.