Chapter 18 The Knee Common Injuries Patellofemoral problems

Chapter 18: The Knee

Common Injuries § Patellofemoral problems § Patellar tendonitis § Fat pad syndrome § MCL sprain § LCL sprain § Torn ACL § Torn PCL § Meniscus tears § Epiphyseal injuries § Osgood. Schlatter condition § Iliotibial band syndrome § Fractures Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

Knee Treatments § The knee joint can suffer from either traumatic or overuse injuries.

Patella Taping § Apply cover roll skin tape across the patella and around the

Patella Taping (cont. ) § After tape is secured to the patella, use one hand to lift the medial leg muscles. Use a medially directed pull on the tape to glide the patella medially. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 5

Fat Pad Unloading § Place cover roll skin tape in a V along the inferior borders of the fat pad. § Lift the fat pad upward while applying tension to the two short pieces of stretch tape. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 6

Special Tests § Certain tests can be performed that aid in the evaluation of

Patellar Tendonitis Test § With the subject sitting on the edge of a table and the knee at 90 degrees of flexion, tap the patellar tendon 1 to 3 times rapidly. Sharp pain is a positive sign. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 8

Patellar Dislocation Apprehension Test § Use both thumbs to apply gentle pressure medially across the joint. A positive sign is contraction of the quadriceps. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 9

Fat Pad Compression Test § Apply pressure to the proximal patellar tendon with the quadriceps contracted. § Apply pressure over the proximal patellar tendon with a relaxed tendon. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 10

Valgus Stress Test § With the leg at full extension, press laterally at the knee while holding the ankle. Greater movement than the uninjured side may indicate MCL damage. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 11

Varus Stress Test § With the leg at full extension, press medially at the knee while holding the ankle. Increased movement compared to the uninjured side indicates LCL damage. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 12

Lachman’s Maneuver § With the subject in a supine position, place a knee under the subject’s knee, allowing a 20 degree flexion. Stabilize the femur and pull the proximal tibia forward. Excessive movement indicates ACL damage. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 13

Anterior Drawer Test § With the athlete supine and the knee bent at 90 degrees, apply an anterior force to the proximal tibia. Excessive movement indicates ACL damage. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 14

Meniscal Tears § With the subject supine, apply internal and external tibial rotation while moving the knee from flexion to extension. Feeling a “click” is a positive sign. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 15

Iliotibial Band Syndrome 1 § With the subject supine, passively flex and extend the knee while applying thumb pressure on the distal IT band. Pain at 20 to 30 degrees of flexion is a positive sign. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 16

Iliotibial Band Syndrome 2 § Have the subject lie on the unaffected side, lifting the upper leg and moving it in a bicycle pattern while the examiner presses down on the leg. IT band pain is a positive sign. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 17