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R E T P A H C K 20 1 0 /2 9 2 1/ N E E 9 IN U J R I S E INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 1

BONES OF THE KNEE 4 bones in the tibiofemoral joint § Tibia § Femur § Fibula § Patella 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 2

TIBIA • • • “Shin” bone Major weight bearing bone in the body. Named after a Greek aulos flute Parts to know: • • • Medial Condyle Medial Tibial Plateau Lateral Condyle Lateral Tibial Plateau Intercondylar Eminence Tibial Tuberosity Gerdy’s Tubercle Shaft of the Tibia Anterior Crest Medial Malleolus Fibular Notch • 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN Anterior View Posterior View 3

FEMUR • • “Thigh” bone Strongest bone in the body. Longest bone in the body. Parts to know: • • • • Greater Trochanter Head of the Femur Neck of the Femur Lesser Trochanter Shaft of the Femur Linea Aspera Lateral Condyle of the Femur Lateral Epicondyle of the Femur Medial Condyle of the Femur Medial Epicondyle of the Femur Patellar Surface Popliteal Surface Intercondylar Fossa 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 4 Anterior view Posterior view

PATELLA • • Largest sesamoid bone in the body. Enclosed in quadriceps femoris tendon. Illustration is of the right patella Parts to know: Base Apex Medial Facet Lateral Facet 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 5

LIGAMENTS AND CARTILAGE OF THE KNEE Ligaments of the Knee • Anterior Cruciate Ligament (ACL) • Posterior Cruciate Ligament (PCL) • Medial Collateral Ligament (MCL) • Lateral Collateral Ligament (LCL) Meniscus of the Knee • Medial Meniscus • Lateral Meniscus 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 6

RANGE OF MOTION Flexion Extension Medial Rotation Lateral Rotation 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 7

MUSCLES OF THE KNEE Rectus Femoris • Origin • Anterior Inferior Iliac Spine (AIIS) • Insertion • Action • • • Tibial Tuberosity via the patellar tendon Extend the knee Flex the hip 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 8

MUSCLES OF THE KNEE Vastus Lateralis • Origin • Lateral lip of linea aspera, gluteal tuberosity, and greater trochanter. • Insertion • Tibial Tuberosity via the patellar tendon. • Action • Extend the knee. 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 9

MUSCLES OF THE KNEE Vastus Intermedius • Origin • Anterior and lateral shaft of the femur. • Insertion • Tibial Tuberosity via the patellar tendon. • Action • Extend the knee. 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 10

MUSCLES OF THE KNEE Vastus Medialis • Origin • Medial lip of the linea aspera. • Insertion • Tibial tuberosity via the patellar tendon. • Action • Extend the knee. 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 11

MUSCLES OF THE KNEE Semimembranosus • Origin • Ischial tuberosity. • Insertion • Action • • • Posterior aspect of medial condyle of tibia. Flex the knee Medially rotate the flexed knee Extend the hip Assist in medially rotating the hip • Tilt the pelvis posteriorly 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 12

MUSCLES OF THE KNEE Semitendinosus • Origin • Ischial tuberosity. • Insertion • Action • • • Proximal, medial shaft of the tibia at pes anserinus. Flex the knee Medially rotate the flexed knee • Extend the hip • Assist to medially rotate the hip • Tilt the pelvis posteriorly 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 13

MUSCLES OF THE KNEE Biceps Femoris • Origin • • Long head: Ischial tuberosity. Short head: Lateral lip of the linea aspera. • Insertion • Head of the fibula. • Action • Flex the knee Laterally rotate the flexed knee Long head: extend the hip Long head: Assist to laterally rotate the hip Tilt the pelvis posteriorly • • 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 14

MUSCLES OF THE KNEE Sartorius • Origin • • • Anterior Superior Iliac Spine (ASIS) Insertion Proximal, medial shaft of the tibia at the pes anserinus Action Flex the hip Laterally rotate the hip Abduct the hip Flex the knee Medially rotate the flexed knee 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 15

MUSCLES OF THE KNEE Sartorius (posterior view) 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 16

MUSCLES OF THE KNEE Gracilis • Origin • Inferior ramus of the pubis • Insertion • Proximal, medial shaft of the tibia at pes anserinus • Action • • Adduct hip Medially rotate hip Flex the knee Medially rotate the flexed knee 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 17

MUSCLES OF THE KNEE Popliteus • Origin • Lateral condyle of the femur • Insertion • Action • • • Proximal, posterior aspect of the tibia Medially rotate the flexed knee Flex the knee 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 18

MUSCLES OF THE KNEE Gastrocnemius • Origin • Condyles of the femur, posterior surfaces • Insertion • Calcaneus via the Achilles tendon • Action • • Flex the knee Plantar flex the ankle 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 19

MUSCLES OF THE KNEE Plantaris • Origin • Lateral supracondylar line of the femur. • Insertion • Action • • • Calcaneus via the Achilles tendon Plantar flexion of the ankle Flexion of the knee 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 20

MUSCLES OF THE KNEE Tensor Fascia Latae and the Iliotibial Band • Origin • Iliac crest, posterior to the ASIS • Insertion • • • Iliotibial tract (which then inserts on the tibial tubercle on the lateral aspect of the proximal tibia) Action Flex the hip Medially rotate the hip Abduct the hip 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 21

ASSESSMENT TESTS Valgus Test Varus Test Anterior Drawer Lachman’s Test Posterior Drawer Test Godfrey’s Test/Posterior Sag Test 20 1 0 /2 9 2 1/ Mc. Murray’s Test Apley’s Compression Test Apley’s Distraction Test Patellar Apprehension Test Patellar Grind Test/Clarke’s Sign INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 22

KNEE INJURIES & CONDITIONS 20 20 9/ /2 11 Ligament Sprain MCL LCL ACL PCL Jumper’s Knee Osgood-Schlatter Disorder Quadriceps Strain Hamstrings Strain Patellar Subluxation/Dislocation Chondromalacia patella Meniscal Injuries Bursitis Iliotibial Band Friction Syndrome Osteochondritis Dissecans INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 23

MEDIAL COLLATERAL LIGAMENT SPRAIN Etiology MCL Injury Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 24

LATERAL COLLATERAL LIGAMENT SPRAIN Etiology LCL Injury Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 25

ANTERIOR CRUCIATE LIGAMENT SPRAIN Etiology ACL Injury Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 26

POSTERIOR CRUCIATE LIGAMENT SPRAIN Etiology PCL Injury Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 27

JUMPER’S KNEE (PATELLAR TENDINITIS) Etiology Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 28

PATELLA TENDON RUPTURE Etiology Patella Tendon Rupture Injury Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 29

OSGOOD-SCHLATTER DISEASE/SHINDING-LARSENJOHANSSON DISEASE Etiology Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 30

QUADRICEPS STRAIN Etiology Quad injury Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 31

HAMSTRINGS STRAIN Etiology Hamstring Injury Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 32

PATELLAR SUBLUXATION/DISLOCATION Etiology Patellar Dislocation Pathology Treatment Patellar Reduction 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 33

CHONDROMALACIA PATELLA Etiology Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 34

MENISCAL INJURIES Etiology Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 35

BURSITIS Etiology Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 36

RUNNER’S KNEE – ILIOTIBIAL BAND FRICTION SYNDROME Etiology Ober’s Test Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 37

OSTEOCHONDRITIS DISSECANS Etiology Pathology Treatment 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 38

FOR YOUR QUIZ Students should be able to: • Label the parts of the bones for the knee joint including the femur, tibia, patella and fibula. • Label the muscles that are involved with the knee joint. • Label the ligament and meniscal structures of the knee. • Identify the different knee assessment tests and what they are used for. • Identify the different knee injuries and conditions and be able to define them. • Identify the different bones and their respective parts on the models of the bones. 20 1 0 /2 9 2 1/ INTRODUCTION TO ATHLETIC TRAINING & SPORTS MEDICINE - MR. CRONIN 39