Sports Injuries Flashcards
functions of ligaments
read bone-bone
functions of tendons
read muscle-bone
transition tendinous areas prone to injury
musculotendinous areas
osteotendinous areas
common factors of sports injuries
- load to failure (stress fractures, tendons, ligaments)
- unique qualities determine resistance to failure
- adults: ligament/tendon > bone
- children: bone > lig/tendon
arrangement and orientation of ligaments and tendons
ligaments: random arrangement, weaving pattern
tendons: organized, parallel; long axis direction
what is crimping
- orientation of collagen in resting state
- folded, elongates upon contraction
non-linear response of tendons and ligaments
- toe region: crimping
- linear region: crimping unfolds and stretches
- yield/failure: limit to stretching = sports injuries
- stretching and warm up widens regions
what is viscoelastic response
- viscous = to be able to resist strain
- elastic = to be able to return to original state
- depends on magnitude, duration, and prior loading
- water: if tendon or ligament is hydrated, there is better viscoelastic response
types of viscoelastic response
creep, stress-relaxation, hysteresis
what is creep
- time-dependent tissue elongation when subjected to constant stress
- increasing deformation with constant load
- tendons will lengthen slightly, recruit more muscles
- joints will loosen
- “stretching”
what is stress-relaxation
- time dependent decrease in applied stress required to maintain a constant elongation/load
- tendons: stress will decrease with time
- ligaments: joints will loosen
what is hysteresis
- energy lost within tissue between loading and unloading
- subsequent use of the same force results in greater deformation
types of joints
- fibrous/synarthrodial: connected by ligament, no movement
- cartilaginous/synchrodroses: has limited movement
- synovial/diarthroses: free movement, housed by capsule
types of synovial joints
read
dislocations vs subluxations
- dislocation: when articulating surfaces have lost total contact with each other
- subluxation: still partial articulating contact
- joint congruence: total articulation between 2 surfaces
- loss on congruity: surfaces don’t match each other
most common shoulder dislocation type
anterior
pe of shoulder dislocations
- fullness of deltoid is lost
- acromion becomes prominent
- ap and lateral view
- xray ap view: acromion is very prominent, humeral head is ant to glenoid cavity
treatment for shoulder dislocation
- closed reduction: force in longitudinal axis and sling under axilla
what is a bankart lesion
- tear to the labrum within 3 o clock and 5 o clock position in front
treatment for bankart lesion
- first time: arm sling
- two or more: surgery (anchor sutures and tie torn labrum into rim of glenoid)
pathoanatomy of elbow dislocation
- fail on upper extremity (axial force) wherein elbow goes into valgus
- excessive valgus on elbow causes tear in medial collateral ligament
elbow dislocation xray
- ap and lateral view
- always described in terms of distal fragment (ex. posterior dislocation of distal fragment)
treatment of posterior elbow dislocations
closed reduction via:
- patient in prone: gentle traction and minimal extension to bring coronoid away from perching position on back part of trochlea
- patient in supine: flex humerus by pushing olecranon back into place
majority of sports injuries are __
knee injuries
extensor mechanism of the knee involves
- quadriceps muscle and tendon
- patella
- medial and lateral retinaculum
- patellar tendon
- tibial tubercle
- tibia
disruption = limitation of extension movement
acl injury tests
- lachman’s test (most sensitive): 30 deg
- anterior drawer’s test: 90 deg
- pivot shift (need anes)
< 5 mm displacement: grade 1
5-10 mm: grade 2
> 1 cm: grade 3
mechanisms of acl injury
- rotation + valgus stress
- hyperextension
acl bundles
- knee full extension = posterolateral bundle is tight
- knee full flexion = anteromedial bundle is tight
objective tests for acl injury
kt2000: more objective
- amount of pull
- > 2 mm difference reading
- translation without acl tear: avulsion of tibial spine
mri: objective
treatment of acl injury
- gold standard: arthroscopic acl reconstruction using bone patellar tendon bone plug
- bone to bone healing
- replaced by hamstring graft
disruptions in quads and patellar tendons
- disruption of patellar tendon = patella will have high riding position = patella alta
- disruption of quadricpes tendon = patella will be lower = patella baja
tears of the retinaculum
medial retinaculum and medial patellofemoral ligament = lateral dislocation of patella
meniscal tear
- meniscus = shock absorber
- mcmurray test (read!!)
treatment for meniscal tear
- only peripheral longitudinal tears in the outer third can be repaired (good blood supply)
- inner third = will not heal, debridement
- middle third = ?
stages after post-op
- range
- strengthening (2 mos)
- endurance exercises
