The anatomy of the knee contains the femur, tibia and the patella. There are four main ligaments within the knee. Those ligaments are called medial collateral (mcl), lateral collateral (lcl), anterior cruciate (acl) and posterior cruciate (pcl). The anterior cruciate ligament (acl) is in the middle of the knee and prevents the shin from sliding. An anterior cruciate ligament tear is the most common harmed ligament, undergoing an estimate of 200,000 happenings yearly. Typically individuals who play sports such as football, basketball, skiing or soccer experience this injury.
Studies show that female athletes have a higher jeopardy of this trauma than males. Young children with acl injury who undergoes reconstruction creates a risk of damages
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to the growth plate and bone growth. This is because younger children have little muscle strength, physical condition and lower limb alignment. Almost half of anterior cruciate ligament injuries include a combination of damages to the meniscus, joint cartilage or other ligaments. This may also be known as the “unhappy triad”, occurring in majority of football players. Nearly ¾ of anterior cruciate ligament injuries come about through non conflict motions and 30 percent are from direct contact. Movements such as hyper extension, pivoting, sidestepping, dangerous frolic and unusual landings may initiate this injury. At the time of injury a popping sound is heard. Once the injury happens the person typically experiences painful sensations, enlargement and loss of firmness in the knee. Hours later swelling may occur along with loss of range in motion and tenderness will apply. Also the patient will have irritation and soreness while walking. Healing naturally, without surgery, can differ depending on the individual degree of injury and activeness (Vorvick, 2011). Grade one sprains is where the tendon is slightly injured also described as it being stretched faintly, however it is still capable of aiding the knee in joint stability. Grade two sprains expanses the muscle to a point of looseness, often spoke of as a partial tear of the ligament. Grade three sprains is generally described as a thorough tear of the ligament where the ligament has been divided into two portions causing the knee joint to be insecure (Vorvick, 2011). A partial torn anterior cruciate ligament will take a minimum of three months with aid from recovery and rehabilitation. Although this is so, some people still have trouble with stability of the knee. In opposition a full tear will take more time to ameliorate causing athletes to have a longer wait in order to participate in sports. Often when the injured person is seen by the physician, x-rays and MRI’s are used to observe the grade of the tear or other impairments. Also the examiner will normally carry through the Lachman's test. This test determines sagittal plane imbalance. It is done by bending the knee at 20 to 30 degrees while the individual is laying on their back. There are test that are precise and useful such as the Knee Outcomes Survey, the Global Rating of Knee Function, and the timed hop test. This aids the physical therapist recognize this group of patients. If by these test, you fall into this grouping, your doctor will strategize a unique physical therapy management program for you. This will most likely consist of electrical stimulus to the quadriceps muscle, cardiovascular reinforcement, traditional muscle reinforcement, and stability training. The Knee Outcome Survey (KOS) is a questionnaire for patients that delivers a proportion of incapacity during every day happenings or sports.
The higher the infirmity, the lower the percentage. Global rating of Knee Function scales deliver a technique of attaining statistics in a more quick, flexible, and efficient way. Although, with any conclusion quota important readings of outcomes can only be accepted with the thought of the clinometric assets, powers, and flaws of the tool. Single leg hop tests is a technique that your doctor may practice to define your aptitude to return to exercises, sports and events after knee surgery. It is generally practiced throughout the return to function stage in an anterior cruciate ligament restoration procedure. This is used to evaluate the useful firmness of your knee (Shen. W, …show more content…
2009). There are numerous approaches used to oversee the single leg hop tests. Some ways and means contain hopping in a straight line, others measure oblique hopping, and some calculate springing on one leg for a certain distance (Sears, 2013). To perform straight line single leg hop testing, find an area where you have ample room to move with no obstructions. A gymnasium is the best place to perform single leg hopping tests. For single leg hopping, position one foot with your toes after a noticeable line on the floor. Advance forward as far as possible, then touchdown on the equivalent foot from which you began on. Observe, record and note the space you hopped in centimeters (cm). Repeat the test twice for both legs, recording the distance hopped each time (Sears, 2013). To complete the straight line triple hopping the patient should stand on one foot with your toes behind a line marked on the floor. Following, the person should hop forward at their convince for three repeated hops. Then the person will observe and record the space you hopped in centimeters. Repeat the test twice for both legs (Sears, 2013).For diagonal triple hopping, spot a mark on the floor at approximately 6 meters long. This could be done by using paste tape. Next, the individual should stand on one foot and hop forward and over the line. Remain hopping in a zig-zag outline across the line for three hops. Lastly, Observes and note your space hopped in centimeters for your damaged leg and unharmed leg ( Sears, 2013). If the anterior cruciate ligament is torn there will be an inclined forward movement of the tibia along with a soft end.
It is recorded that over 85 percent of people will have a meniscus damage after the first injury. When undergoing surgery there are a bounty of grafts that can be used. The patella tendon auto graft consist of the middle third patella along with a bone form the shin and the kneecap. Surgeons usually call this the “gold standard” and is highly suggested for patients with jobs or sports that involve a great deal of kneeling.
However, these types of repair have a large amount of issues concerning pain in the back of the knee cap. Other problems such as pain with kneeling, stiffness may take place. The hamstring tendon autograft consist of the tendon on the inside of the knee. An additional tendon that may be used is called the gracilis. This creates a double or four strand tendon graft. The problems following this surgery are few including less stiffness, smaller slits and faster improvement?
The quadriceps tendon autograft is used in patients whose anterior cruciate ligament has already gone wrong. The parts used in this surgery are the middle third of the person’s quadriceps and bone from the superior part of the knee. The quadriceps tendon autograft has an increased hazard of front knee pain after procedure. Along with this, there is a lower jeopardy of the patella being
fractured. Allografts are also used as an alternative fixing for unsuccessful anterior cruciate ligaments. Allograft are formed from corpses. The benefits from this reconstruction consists of pain elimination, decreased surgery time and smaller incision. When preparing for surgery, the surgeon observes the knee along with a final observation to verify the tear in the anterior cruciate ligament. Then the tendon is cropped and the graft is prepped. Afterward, small incisions are made in the front of the knee. Damages to the meniscus and cartilage are repaired or trimmed down and the acl is removed (Shen. W, 2009). Bone tunnels are made into the tibia and the femur allowing a needle to go through. Surgical seams are then placed and the graft is pulled into place. Before completion the doctor will investigate the graft for accurate tension and stability. Also full range of motion will be tested. It is common for this surgery to be deemed an outpatient surgery. Complications such as infections, viral transmission, bleeding, numbness, stiffness, blood-clot, and knee cap pain and imbalance may occur. Rehabilitation includes physical therapy. This usually takes place shortly after the surgery. During the initial two weeks the area of the wound is kept dry and neat. Quadricep control and knee control is essential to stress early on. The knee should also be iced frequently for lower swelling and pain. Depending on the doctor a brace may be given as well as crutches for assistance. The goal for rehabilitation is to cut back swelling, gain full range of motion, up keep knee mobility and muscle strengthening. Athletes may return to playing sports after swelling and pain is absent. Also when full range of motion is restored and leg function is restored the individual can proceed with his daily deeds (Shen. W, 2009).
The incidence and prevalence rate of anterior cruciate ligament (ACL) injuries in female athletes continues to increase over time (Prodromos, Han, Rogowski, Joyce, & Shi, 2007). With the growing rate in the amount of young women participating in sports, data has shown that the rate of ACL injury increases linearly with this participation ("The Relationship Between Static Posture and ACL Injury in Female Athletes," 1996). This epidemic of ACL injuries in female athletes, young or old, continues to be problematic in the athletic world. This problem not only affects the athlete themselves, but also the coaches and the sports medicine community.
In order for athletes to save their active lifestyles they need understand the ACL. The ACL is the most important ligament in the knee because it provides stability to the knee. Athletes have to be aware of the importance of the ACL and know its functions in order to preserve the ligament. The ACL otherwise know as the anterior cruciate ligament is the ligament in the knee that connects the upper leg bone which is the femur to the lower leg bone which is the tibia. The anterior cruciate ligament crosses with the posterior cruciate ligament inside the center of the knee joint to stabilize to the knee in movement.
The most common knee injury in sports is damage to the anterior cruciate ligament (ACL) through tears or sprains. “They occur in high demand sports that involve planting and cutting, jumping with a poor landing, and stopping immediately or changing directions” (University of Colorado Hospital). The ACL is a ligament that runs diagonally in the middle of the knee and found at the front of the patellar bone. Its function involves controlling the back and forth motion of the knee, preventing the tibia from sliding out in front of the femur, and providing rational stability to the knee. Interestingly, women are more prone to ACL injuries than men. The occurrence is four to six times greater in female athletes.
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...
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.
Black D. 2010. Treatment of knee arthrofibrosis and quadriceps insufficiency after patellar tendon repair: a case report including use of the graston technique. International journal of therapeutic massage and bodywork. Volume 3, Issue 2:14-21
Children who are active recklessly engage in activities where injuries can occur. Nobody can predict when or how seriously anybody will get injured during an activity, however, the risks of children playing tackle football is prevalent where the dangers are imminent. The game of tackle football on a youth level is dangerous for children since they are developing physically and mentally. According to an article from The Atlantic, “America’s most dangerous football is in the peewee leagues, not the National Football League” (Barra, 2013). According to a journal article, “sports injuries account for approximately 23% of pediatric emergency department injury related visits” (Podberesky, Unsell & Anton, 2009). “Of these sports injury-related
Snap, crackle, pop. That is the horrific sound a baseball pitcher hears after throwing a pitch. The UCL tear used to haunt pitchers forever until 1974, when a man named Tommy John had a surgery to repair his UCL tendon and it was successful causing this surgery to transform baseball. Before his arrival, Tommy John Surgery was known as a “dead arm” injury (Tommy John Surgery). When doctors diagnose players with this injury, it’s no longer a total shock as today you are easily able to come back from this surgery as when 30 years ago, you couldn’t. In my paper I will talk about the basics of the injury, history of the UCL, ways to diagnose a UCL tear, and how to recover from Tommy John surgery along with some unbelievable facts about this distressing injury. This injury and surgery has revolutionized baseball and prolonged the careers of many great players in the MLB.
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.
The word patella comes from the great latin language meaning shallow pan or shallow dish. The description of that word could not be more correct, it was meant in reference to balance of food but in anatomy’s case a balance of the body. The patella is a small bone located in front of the knee joint where the thigh bone (femur) and shinbone (tibia) meet. It protects the knee and connects the muscles in the front of the thigh to the tibia. The patella is one of two sesamoid bones found in the body, roughly triangular shaped in size. It’s thick consistency allows for the articulation of the femur, which in turn allows for body support and balance. The patella has multiple body functions with the primary being knee extension. The patella is essential for basic body functions including locomotion;
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 ...
Orthopedic surgeons are responsible for mending and operating on the musculoskeletal system. “Orthopedics is a medical specialty that focuses on the diagnosis, care, and treatment of patients with disorders of the bones, joints, muscles, ligaments, tendons, nerves, and skin” (Career in Orthopaedics). Depending on the damage the patient has sustained determines how the orthopedic surgeon is able to correct the patient’s injury. In many cases there are multiple ways of correcting the patient’s injury such as; using medical, physical, and rehabilitative techniques to using complex surgical methods. “Typically, as much as 50 percent of the orthopedic surgeon’s practice is devoted to no surgical or medical management of injuries or disease and 50 percent to surgical management” (Career in Orthopaedics). The majority of surgeons, including orthopedic surgeons, prefer to choose the least invasive procedures such as; arthroscopy which is a technological advancement allowing orthopedic surgeons to use special cameras in order to diagnose and treat a joint with minimal cutting and trauma to...
In a case of an acute knee injury the best modality to apply would be an ice or cold whirlpool. Thermotherapy would only further aggravate the injury in the acute phase while cryotherapy would help reduce the symptoms and speed the healing process. The reasoning behind utilizing an ice or cold whirlpool would be partially because the knee can be slightly tricky as the surface is very irregular. Furthermore, a whirlpool can provide the deepest cold penetration out of the other modalities. A small whirlpool can be utilized by filling it with water and ice to obtain a temperature of 50°F-60°F and once the treatment is over, towels should be utilized to dry the injured leg. Furthermore, precautions should be taken by avoiding overcooling,
Hamstring strains are one of the most common injuries which occur in the thigh. There are 3 grades of different strains minor, partial or complete. In his condition Mr Southam has possibly partially strained or torn his hamstring. An athlete progresses at different rates depending on the severity of the injury and the athlete themselves. First making sure he is comfortable to start examining his injury Mr Southam is to be moved away from the field and sat in a suitable area. Ensuring that he does not stretch or move the injured area which could cause more stresses and injury. There are three healing/treatment stages which include PHASE 1 - acute stage (3-4 days), PHASE 2 - sub acute stage (10 days - 2 weeks) and PHASE 3 - final stage which