Locomotor: Sports Injuries Flashcards
Describe the main features of a walking gait
Think in terms of phases, support and significant moments
Main differences between a running gait and a walking gait?
- There is no duel support, instead this is replased by a float phase
- Greater upper body movement
- Faster velocity, shorter cycle time, greater stride
In children if they have been injured during activity and there was a popping sound what could this imply?
Apophyseal avulsion
What is apophyseal avulsion?
This is where a tendon of a child is overstrained. However usually the tendon is stronger than the apophysis hence it pulls of the boney structure (e.g. tuberosity) breaking the apophysis.
Usually occures acutely and accompanied by a “pop”
Treatment of apophyseal avulsion
Conservative:
Rest, protective weight bearing and stretching
Surgery rarely needed unless the displacement is extreme
What is apophysitis and what is the treatment?
A chronic injury injury of the apophysis due to overuse and stress
Treatment is conservative with activity modification, NSAIDs, rest and stretches
Three types of shoulder dislocation and the reasons they might occur
- Anterior to glenoid fossa, most common and occurs from sporting injuries
- Posterior is more uncommon and occurs from extreme muscle contraction during seizure or electrocution
- Inferior occurs from hyperabduction and only from high energy trauma making it extremely rare
Anterior shoulder dislocation presentation
Squared off shoulder and upper limb held in adduction and internal rotation
What is harder to spot in a radiograph:
Anterior or posterior dislocation
Posterior is harder to spot, it is often missed and a second view can be helpful
3 Injuries that can occur in an anterior shoulder dislocation?
- Hills-Sachs lesion
- Bankart lesion
- Surrounding soft tissue injury
Hills Sachs - ping pong ball injury - golf ball - played on hills found in sachs
Bankart lesion - break of plate - break the bank steal the art
What is a Hills-Sachs lesion?
This is where the posterior humeral head gets a compression fracture form the glenoid rim
Think a ping pong ball being pushed. Remeber by ping pong ball = golf ball = played on hill and carried in sacks
What is a Bankart lesion?
This compliments the Hills-Sachs and is where the anterior rim of the glenoid fossa is ripped by the humeral head
Treatment of an accute shoulder injury?
The 3 Rs
- Reduce
- Restrict
- Rehabilitate
- Where is the meniscus
- What is it made of
- What does it look like
- What are it’s functions?
- They sit above the condyles of the tibia
- Consists of tough fibrocartilage
- Looks like two Cs facing eachother - Coco Chenel Logo
- Functions are force transmissiona nd stability. Medial attaches to the MCL
What history and physical indications might suggest a meniscal tear?
- Twisting injury
- Slow onset of swelling (Immediate may indicate ACL/PCL)
- Locking (if the knee can’t fully extend this could indicate a displaced meniscal tear preventing the joint from extending)
- Clicking
Examination for a meniscal tear?
- Localised joint line tenderness
- Can try to pick up joint effusion (build up of fluid in the joint) with a sweep test (this is some physio thing where you stroke the knee or some shit)
- MRI is the gold standard
Meniscal tears management?
Conservative
- Physio
- NSAIDs
Surgical
- Repair first (aim to put it back in it’s anatomical position and let it heal)
- Consider partial removal if repair fails
- Full removal is bad and results in 100% cahnce of arthritis after 20years. If full removal is nessecary can consider a transplant
- What does the LCL stand for?
- Where is the LCL?
- What are it’s functions?
- Lateral Collateral ligament
- Extra-capsular
- Attaches at the lateral epicondyle of the femur and travel inferiorly to the lateral fibular
- Resists varus forces to the knee
- What does the MCL stand for?
- Where is the MCL?
- What are it’s functions?
- Medial Collateral ligament
- Extra-capsular
- Attaches a the medial epicondyle of the femur and travel inferiorly to the medial tibia
- Resists valgus forces to the knee
- What does the PCL stand for?
- Where is the PCL?
- What are it’s functions?
- Posterior cruciate ligament
- Attaches from the medial condyle of the femur and travel posteriorly to the posterior of the tibia
- Prevents posterior translation of the fibia against the femur e.g. sliding. Also prevents hyper extension of the knee
- What does the ACL stand for?
- Where is the ACL?
- What are it’s functions?
- Anterior cruciate ligament
- Intra-capsular
- Attaches from the posterior of the lateral condyle of the femur and travel anteriorly to the anterior tibial plateau
- Prevents anterior translation of the fibia against the femur e.g. slidng
What are the cruciate ligaments?
The are ligamnets supporting the knee
What is this abnormal movement of the knee joint?
Varus
What is this abnormal movement of the knee joint?
Valgus
What history and physcal presentations may indicate an ACL tear?
- Common injury from non-contact twisting e.g. wearing studded boots
- Acompanied by a pop
- Very quick swelling as the crcuiate ligamnets have their own blood supply resulting in a haemarthrosis
- Often occurs with a menical tear
ACL tear test?
Lachman’s test
What history and physcal presentations may indicate an PCL tear?
- Less common than ACL
- Direct blow to knee in flexion or forceful hyperflexion
- Pop and swelling
PCL tear tests?
- Can look for tibial sag (tibia miving back into place could be mistaken for an ACL injury)
- Can perform a quadracepts active test
MCL tear history and physical presentations?
- Valgus stress injury from contact/direct blow
- Swelling less imediate that cruciate tears as it has no direct blood supply
- Medial knee pain
LCL tear history and physical presentations?
- Varus stress injury from contact/direct blow
- Swelling less imediate that cruciate tears as it has no direct blood supply
- Lateral knee pain
- Often accompanies PCL tear
Furhter investigations of ligamnet tears?
- Radiograph primarily - can identify associated fractures
- Lead to MRI for further detail
What is a shin splint?
Is a colloqual term used to refer to three different pathologies:
- Tibial stress syndrome
- Tibial stree fracture
- Exertional compartment syndrome
What is tibial stress syndrome?
It is a traction periosteitis occuring at the point of muscle attachment on the tibia
Periosteitis is an inflamation of the periosteum
Reported as pain over the tibia worst following exercis
Common in runners and could lead to a stress fracture
What is exertional compartment syndrome?
It is a reversable compartment syndrome of the muscle compartments lower leg
It is reported as a burning pain/ itching in the lower leg compartment
Common in runners/ soldiers
Treated with activity modification but can also perform a faciotomy
