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KNSS 220 Athletic Therapy > Thigh and Knee > Flashcards

Thigh and Knee Flashcards

1
Q

Quad tendon is ____ the patella.

A

above

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2
Q

Patellar tendon is _____ the patella.

A

below

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3
Q

Collateral ligaments are always on the ______.

A

outside

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4
Q

Name and describe the collateral ligaments in the knee.

A
  • Medial​ ​collateral​ ​ligament​ ​is​ ​longer​ ​and​ ​bigger
  • Lateral​ ​collateral​ ​ligament​ ​has​ ​IT​ ​band​ ​running​ ​on​ ​top​ ​of​ ​it
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5
Q

Describe the ACL.

A
  • Anterior​ ​cruciate​ ​ligament​ ​(ACL)​ ​attaches​ ​on​ ​anterior​ ​of​ ​tibia​ ​and​ ​attaches​ ​on
    posterior​ ​of​ ​femur
  • Protects​ ​from​ ​any​ ​blow​ ​from​ ​behind
  • Hamstrings​ ​protect​ ​and​ ​prevent​ ​this​ ​movement
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6
Q

Describe the PCL.

A
  • Posterior​ ​cruciate​ ​ligament​ ​(PCL)​ ​attaches​ ​on​ ​the​ ​posterior​ ​of​ ​the​ ​tibia​ ​and attaches​ ​on​ ​the​ ​anterior​ ​of​ ​femur
  • Protects​ ​from​ ​blow​ ​to​ ​shin​ ​or​ ​back​ ​of​ ​the​ ​thigh
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7
Q

Describe the meniscus.

A
  • One​ ​on​ ​medial​ ​and​ ​one​ ​on​ ​lateral​ ​side
  • Donuts
  • Made​ ​of​ ​cartilage
  • Does​ ​not​ ​have​ ​very​ ​good​ ​blood​ ​supply
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8
Q

Where does the gastrocnemius attach?

A

above the joint line of the knee

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9
Q

Where do the hamstrings attach?

A

below the joint line of the knee

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10
Q

Why can we get knee injuries from simple forces?

A
  • Very​ ​unstable​ ​joint​ ​when​ ​looking​ ​at​ ​just​ ​the​ ​bony​ ​structure
  • Not​ ​very​ ​strong​ ​or​ ​supported​ ​by​ ​anatomy
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11
Q

The patella increases mechanical advantage of the ____.

A

quads

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12
Q

What are the 2 categories of patellar alignment?

A
  • Alta:​ ​patella​ ​sits​ ​up​ ​on​ ​the​ ​quad​ ​(too​ ​high)
  • Baja:​ ​patella​ ​sits​ ​too​ ​low​ ​towards​ ​tibia​ ​(too​ ​low)
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13
Q

What does patellar alignment affect?

A
  • Can​ ​affect​ ​flexion/extension
  • Affects​ ​quad​ ​strength
  • Contraction​ ​in​ ​quad​ ​can​ ​pull​ ​knee​ ​cap​ ​up​ ​higher
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14
Q

What are the 2 categories of tilt component of the patella?

A
  • Medial:​ ​muscles​ ​on​ ​medial​ ​side​ ​are​ ​tighter
  • Lateral:​ ​muscles​ ​on​ ​lateral​ ​side​ ​are​ ​tighter
  • muscles in leg affects which way it sits
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15
Q

What does having a tilt component of the patella do? How does it affect you?

A
  • Uncomfortable

- Decreased​ ​strength

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16
Q

What causes rotation of the patella?

A
  • Caused​ ​by​ ​muscles
  • Outside​ ​quads​ ​being​ ​tight​ ​can​ ​pull​ ​bottom​ ​lateral​ ​part​ ​of​ ​the​ ​patella up
  • Can​ ​also​ ​have​ ​it​ ​where​ ​medial​ ​side​ ​comes​ ​up​ ​(more​ ​rare​ ​because inside​ ​muscles​ ​are​ ​weaker)
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17
Q

What is Genu Valgum?

A
  • Pigeon​ ​toed

- Knees​ ​go​ ​into​ ​the​ ​centre​ ​towards​ ​each​ ​other

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18
Q

What is Genu Varum?

A
  • Bowlegged

- Knees​ ​push​ ​outward

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19
Q

What is Genu​ ​recurvatum?

A

hyperextended

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20
Q

What does having Genu Valgum, Varum, or recurvatum mean? When should we be concerned?

A
  • Everybody​ ​goes​ ​through​ ​all​ ​3​ ​stages​ ​when​ ​growing​ ​
  • need​ ​to​ ​be​ ​over​ ​the​ ​age​ ​of​ ​15​ ​to see​ ​any​ ​permanent​ ​alignment
  • Means​ ​you​ ​have​ ​malalignment​ ​or​ ​something​ ​that​ ​is​ ​tight​ ​or​ ​weaker
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21
Q

Wide hips = ______ Q angle

A

bigger

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22
Q

What is the normal Q angle for men?

A

5-10 degrees

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23
Q

What is the normal Q angle for women?

A

10-15 degrees

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24
Q

Describe the movements at the knee.

A
  • flexion/extension/hyperextension
  • Medial​ ​tibial​ ​rotation/lateral​ ​tibial​ ​rotation
  • Knees​ ​need​ ​to​ ​be​ ​able​ ​to​ ​squat
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25
Q

What is a functional test for the knees?

A
  • squat test
  • Squat,​ ​bounce,​ ​up
  • Shows​ ​leg​ ​and​ ​knee​ ​can​ ​weight​ ​bear
  • Shows​ ​that​ ​muscles​ ​all​ ​work
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26
Q

What is the MOI for a MCL sprain?

A
  • Always​ ​sprained​ ​from​ ​a​ ​blow​ ​coming​ ​in​ ​from​ ​the​ ​lateral​ ​side
  • Lateral​ ​blow​ ​=​ ​valgus​ ​force
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27
Q

What are the signs and symptoms for a MCL sprain?

A
  • clear swelling
  • Generally​ ​swelling​ ​with​ ​entire​ ​knee
  • Bruising​ ​will​ ​be​ ​over​ ​whichever​ ​structure​ ​you​ ​damaged
  • Bruising​ ​over​ ​top​ ​MCL
  • Pain
  • redness/heat
  • Deformity​ ​at​ ​grade​ ​2​ ​(can​ ​feel),​ ​deformity​ ​at​ ​grade​ ​3​ ​(may​ ​be​ ​able​ ​to​ ​see)
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28
Q

What can lots of swelling during a MCL sprain do?

A
  • can​ ​make​ ​it​ ​look​ ​like​ ​the​ ​knee​ ​cap​ ​is​ ​sitting​ ​in​ ​the​ ​wrong​ ​spot
  • Swelling​ ​can​ ​push​ ​patella​ ​up​ ​or​ ​to​ ​either​ ​side
  • Could​ ​be​ ​dislocated
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29
Q

In​ ​grade​ ​2​ ​or​ ​3​ ​MCL​ ​sprain, we​ ​can​ ​also​ ​have​ what accompanying the injury?

A
  • ​a​ ​muscle​ ​strain​ ​of​ ​adductors accompanying​ ​this (Adductors​ ​run​ ​on​ ​medial​ ​side,​ ​some​ ​run​ ​across​ ​knee)
  • meniscus injury (Pieces​ ​of​ ​MCL​ ​attach​ ​to​ ​medial​ ​meniscus)
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30
Q

How do we manage a grade 1 MCL sprain?

A
  • Walking,​ ​should​ ​be​ ​able​ ​to​ ​walk​ ​normal
  • Speed​ ​healing
  • Decreasing​ ​pain​ ​and​ ​inflammation
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31
Q

How do we manage a grade 2 MCL sprain?

A
  • Limping,​ ​physically​ ​lack​ ​of​ ​function
  • Need​ ​support,​ ​not​ ​too​ ​much
  • Going​ ​to​ ​have​ ​laxity​ ​to​ ​the​ ​inside,​ ​always​ ​feel​ ​like​ ​knee​ ​is​ ​caving​ ​in
  • May​ ​want​ ​crutches,​ ​depends​ ​on​ ​them​ ​and​ ​their​ ​level​ ​of​ ​function
  • Crutches​ ​to​ ​make​ ​gait​ ​pattern​ ​as​ ​normal​ ​as​ ​possible
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32
Q

How do we manage a grade 3 MCL sprain?

A
  • See​ ​a​ ​doctor
  • Get​ ​x-rays​ ​done
  • May​ ​need​ ​surgery​ ​(not​ ​common)
  • Needs​ ​lots​ ​of​ ​stability
  • Lots​ ​of​ ​adductor​ ​strengthening
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33
Q

Why is the LCL more difficult to sprain than the MCL?

A

IT bands support the outside

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34
Q

What is the MOI for a LCL sprain?

A
  • Blow​ ​from​ ​medial​ ​side

- Blow​ ​from​ ​medial​ ​side​ ​=​ ​varus

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35
Q

What are the signs and symptoms of a LCL sprain?

A
  • Pain
  • Clear​ ​swelling
  • Bruising​ ​over​ ​lateral​ ​side
  • redness/heat
  • Might​ ​see​ ​deformity​ ​of​ ​patella​ ​position​ ​based​ ​on​ ​how​ ​much​ ​swelling​ ​you​ ​have
  • Grade​ ​1,​ ​2,​ ​3
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36
Q

How do we manage LCL sprains?

A
  • Very​ ​rare​ ​to​ ​surgically​ ​repair​ ​because​ ​of​ ​IT​ ​band
  • Same​ ​as​ ​MCL
  • Decrease​ ​pain​ ​and​ ​inflammation
  • Get​ ​function​ ​back
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37
Q

What is the special test for MCL sprains?

A
  • valgus stress test

- ​​lateral​ ​force​ ​from​ ​lateral​ ​side

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38
Q

What is the special test for LCL sprains?

A
  • varus stress test

- medial force from medial side

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39
Q

What is the positive test for valgus and varus stress tests?

A
  • Grade​ ​1​ ​positive​ ​test:​ ​pain
  • Grade​ ​2​ ​positive​ ​test:​ ​pain​ ​and​ ​laxity,​ ​moves​ ​farther​ ​than​ ​it​ ​should
  • Grade​ ​3​ ​positive​ ​test:​ ​no​ ​pain,​ ​lots​ ​of​ ​laxity
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40
Q

What is the MOI for a ACL sprain?

A
  • Tibia​ ​going​ ​forward,​ ​femur​ ​going​ ​backwards
  • Somebody​ ​lands​ ​or​ ​hits​ ​you​ ​in​ ​calf​ ​going​ ​forward
  • Blow​ ​on​ ​femur​ ​going​ ​backwards​ ​with​ ​feet​ ​planted​ ​(less​ ​common)
  • Need​ ​failure​ ​of​ ​hamstrings​ ​to​ ​get​ ​this​ ​injury
  • may hear pop
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41
Q

More ___ get this injury than _____.

A

men>women

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42
Q

What are the signs and symptoms for a ACL sprain?

A
  • bloody inflammation
  • Bruising
  • redness/heat
  • Whole​ ​knee​ ​looks​ ​swollen​ ​and​ ​bruised
  • Grade​ ​1,​ ​2,​ ​3
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43
Q

What is bloody inflammation?

A
  • Blood​ ​vessel​ ​in​ ​middle​ ​of​ ​knee​ ​gets​ ​lots​ ​of​ ​blood​ ​supply
  • Swelling​ ​has​ ​blood​ ​in​ ​it
44
Q

How do we manage ACL sprains?

A
  • Commonly​ ​surgically​ ​repaired​ ​at​ ​grade​ ​2​ ​and​ ​3
  • Generally​ ​repaired​ ​with​ ​graft​ ​of​ ​hamstring​ ​or​ ​patellar​ ​tendon
  • Instability​ ​feeling
  • Feels​ ​like​ ​it’s​ ​dislocating​ ​when​ ​they​ ​walk/move
  • Hard​ ​to​ ​stabilize​ ​with​ ​tape​ ​or​ ​tensor,​ ​tends​ ​to​ ​be​ ​braced
  • Zimmer​ ​splints​ ​for​ ​the​ ​beginning
45
Q

What is the special test for ACL sprains?

A
  • ACL anterior drawer test

- hold back tibia and pull it forward

46
Q

What is the positive test for the ACL anterior drawer test?

A
  • Grade​ ​1:​ ​pain
  • Grade​ ​2:​ ​pain​ ​and​ ​laxity
  • Grade​ ​3:​ ​lots​ ​of​ ​laxity,​ ​very​ ​little​ ​pain
47
Q

What is the MOI of a PCL sprain?

A
  • Very​ ​difficult​ ​to​ ​sprain,​ ​backed​ ​up​ ​by​ ​the​ ​quads - Hyperflexion
  • Collision​ ​with​ ​people​ ​land​ ​on​ ​top
  • Feel​ ​pop
48
Q

What are the signs and symptoms of a PCL sprain?

A
  • Bloody​ ​swelling
  • Not​ ​as​ ​disabling​ ​as​ ​ACL
  • Knee​ ​moves​ ​more​ ​than​ ​it​ ​should​ ​in​ ​backwards​ ​ROM
  • Same​ ​signs​ ​and​ ​symptoms
49
Q

How do we manage a PCL sprain?

A
  • Very​ ​rarely​ ​surgically​ ​repaired

- May​ ​not​ ​have​ ​a​ ​big​ ​impact​ ​on​ ​daily​ ​activities

50
Q

What is the special test for PCL sprains?

A
  • Posterior​ ​sag​ ​test
  • Tibia​ ​displacing​ ​posteriorly​ ​into​ ​femur
  • Bend​ ​knee​ ​and​ ​observe
51
Q

Why do meniscus injuries have less chance of fully healing?

A

Less​ ​blood​ ​supply​ ​=​ ​less​ ​chance​ ​of​ ​full​ ​healing​ ​(less​ ​nutrition,​ ​less​ ​ability​ ​to​ ​take​ ​away
damaged​ ​tissue)

52
Q

What is the MOI of meniscus injuries?

A

Generally​ ​caused​ ​by​ ​a​ ​flexion​ ​force​ ​with​ ​rotation

53
Q

(inside/outside) meniscus tears are more common.

A

inside (medial)

54
Q

What are the signs and symptoms of meniscus injuries?

A
  • Knee​ ​catches,​ ​locks
  • Physically​ ​feels​ ​like​ ​knee​ ​won’t​ ​straighten​ ​or​ ​bend
  • Pain​ ​along​ ​joint​ ​line
  • Gradual​ ​swelling​ ​(2-3​ ​days)​ ​through​ ​their​ ​whole​ ​knee
  • Clear​ ​swelling
  • Will​ ​not​ ​like​ ​full​ ​flexion​ ​(weight​ ​bearing​ ​or​ ​not)
  • Chronic​ ​condition,​ ​swelling​ ​when​ ​aggravated,​ ​goes​ ​down
55
Q

How do we manage meniscus injuries with no surgery?

A
  • Sometimes​ ​there​ ​is​ ​no​ ​way​ ​to​ ​unlock​ ​or​ ​relax​ ​it​ ​(stuck​ ​in​ ​flexion​ ​or​ ​extension)
  • ​go to​ ​hospital,​ ​get​ ​anesthetic​ ​and​ ​loosen
56
Q

How do we manage meniscus injuries with surgery?

A
  • try​ ​to​ ​preserve​ ​as​ ​much​ ​of​ ​meniscus​ ​as​ ​possible
  • Sew​ ​up​ ​tear
  • Non​ ​weight​ ​bearing,​ ​immobilized​ ​for​ ​2-3​ ​weeks
  • Can​ ​put​ ​in​ ​false​ ​meniscus
  • Longer​ ​rehab​ ​with​ ​longer​ ​stitch​ ​up,​ ​or​ ​with​ ​taking​ ​parts​ ​of​ ​meniscus​ ​out
  • Non​ ​weight​ ​bearing,​ ​immobilized​ ​for​ ​12​ ​weeks
57
Q

What are the two special tests for meniscus injuries?

A
  • McMurray’s

- Apley’s

58
Q

What is the McMurray’s test?

A

​- force​ ​them​ ​together,​ ​move​ ​them​ ​around​ ​to​ ​make​ ​sure​ ​they’re​ ​are​ ​in tact

  • Need​ ​to​ ​be​ ​able​ ​to​ ​straighten​ ​leg
  • Click​ ​or​ ​pop​ ​deep​ ​in​ ​knee,​ ​generally​ ​not​ ​pain​ ​but​ ​uncomfortable
59
Q

What is the Apley’s test?

A
  • Pushing​ ​down​ ​on​ ​tibia,​ ​turning​ ​internal​ ​and​ ​external​ ​rotation​ ​to​ ​grind against​ ​bone
  • Test​ ​for​ ​when​ ​they​ ​cannot​ ​straighten​ ​leg
  • Click​ ​or​ ​pop​ ​deep​ ​in​ ​knee,​ ​generally​ ​not​ ​pain​ ​but​ ​uncomfortable
60
Q

What is the MOI of patellar tendinitis?

A
  • Breakdown​ ​of​ ​tendon,​ ​aggravated​ ​from​ ​jumping,​ ​deep​ ​squats​ ​etc.
  • Can​ ​get​ ​it​ ​from​ ​people​ ​who​ ​kneel​ ​on​ ​their​ ​knees​ ​a​ ​lot
  • Chronic​ ​condition
61
Q

What are the signs and symptoms of patellar tendonitis?

A
  • Start​ ​by​ ​only​ ​being​ ​painful​ ​after​ ​activity
  • Painful​ ​during​ ​last​ ​part​ ​and​ ​after​ ​activity
  • Starts​ ​affecting​ ​their​ ​performance​ ​(during​ ​activity)
  • Painful​ ​with​ ​everything
  • Bursa​ ​under​ ​patella​ ​(infrapatellar​ ​bursa)​ ​is​ ​inflamed​ ​(just​ ​under​ ​their​ ​knee​ ​cap), looks​ ​like​ ​their​ ​knee​ ​cap​ ​is​ ​huge
  • No​ ​inflammation​ ​in​ ​entire​ ​knee,​ ​only​ ​bursa
62
Q

How do we manage patellar tendonitis?

A
  • Activity​ ​modification
  • Limit​ ​activity​ ​that​ ​aggravates
  • Strengthen​ ​tendon
  • Ultrasound
  • Current
  • Laser
63
Q

What exercises can we do to strengthen the tendon after patellar tendonitis?

A
  • Unweighted​ ​drop​ ​squats​ ​(eccentrically,​ ​go​ ​down​ ​fast,​ ​come​ ​up​ ​slow)
  • Knee​ ​extension​ ​machine​ ​(eccentrically,​ ​load​ ​slowly down,​ ​normal​ ​speed up)
  • 1​ ​set​ ​of​ ​6
64
Q

What is the MOI for Osgood-Schlatter​ ​Disease?

A
  • Tibial​ ​tuberosity​ ​where​ ​patellar​ ​tendon​ ​attaches​ ​starts​ ​getting​ ​pulled​ ​when​ ​you start​ ​growing​ ​and​ ​a​ ​ossification​ ​(bump)​ ​forms​ ​on​ ​the​ ​front​ ​of​ ​tibial​ ​tuberosity
  • Generally​ ​happens​ ​at​ ​14-24​ ​years​ ​of​ ​age​ ​(growing,​ ​more​ ​active)
  • Tendon​ ​is​ ​exerting​ ​enough​ ​strength​ ​that​ ​it​ ​is​ ​pulling​ ​away​ ​from​ ​bone.​ ​In​ ​order​ ​to protect​ ​it,​ ​bone​ ​grows
65
Q

In who is Osgood-Schlatter disease more common?

A
  • Happens​ ​more​ ​commonly​ ​in​ ​males

- More​ ​common​ ​in​ ​people​ ​who​ ​do​ ​jumping​ ​sports

66
Q

What are the signs and symptoms for Osgood-Schlatter disease?

A
  • Both​ ​bump​ ​and​ ​tendon​ ​are​ ​painful​ ​to​ ​the​ ​touch
  • Local​ ​swelling
  • Bump​ ​will​ ​never​ ​go​ ​away
  • When​ ​they​ ​stop​ ​growing​ ​and​ ​aggravating​ ​it​ ​it​ ​will​ ​stop​ ​being​ ​painful
67
Q

What is Larsen-Johansson Disease?

A
  • Same​ ​thing​ ​as​ ​OS​ ​disease​ ​just​ ​at​ ​bottom​ ​of​ ​patella
  • More​ ​bone​ ​growth​ ​to​ ​hold​ ​onto​ ​tendon
  • Point​ ​tender​ ​at​ ​patellar​ ​attachment
68
Q

How do we manage Osgood-Schlatter Disease and Larsen-Johansson Disease?

A
  • Symptomatic​ ​relief
  • Can’t​ ​stop​ ​it
  • Current
  • Laser
  • Active​ ​bone​ ​growth​ ​=​ ​no​ ​ultrasound
  • With​ ​jumping,​ ​2-4​ ​years​ ​pain
  • With​ ​normal​ ​activity,​ ​few​ ​months​ ​of​ ​pain
  • After​ ​24,​ ​will​ ​not​ ​bother​ ​them​ ​anymore
69
Q

What is severs disease?

A

In calcaneus,​ inflammation of growth plate, ​can​ ​lead​ ​to​ ​OS​ ​disease

70
Q

What are the 4 quad muscles?

A
  • rectis femoris
  • vastus lateralis
  • interalis medialis
  • vastus medialis
71
Q

Where is the rectis femoris?

A
  • Only​ ​one​ ​that​ ​crosses​ ​both​ ​knee​ ​and​ ​hip

- Most​ ​superficial​ ​(most​ ​commonly​ ​damaged)

72
Q

Where is the vastus lateralis?

A
  • Outside

- Second​ ​biggest

73
Q

Where is the vastus medialis?

A
  • Halfway​ ​up​ ​thigh
  • Affected​ ​most​ ​with​ ​injuries​ ​to​ ​knee
  • Most​ ​important​ ​in​ ​balancing​ ​out​ ​patella
74
Q

Describe the 3 hamstrings.

A
  • weaker/less of them than quads
  • All​ ​3​ ​cross​ ​knees​ ​and​ ​hip
  • Lateral​ ​side,​ ​vastus​ ​femoris
  • Two​ ​little​ ​ones​ ​on​ ​inside​ ​semitendinosus, semimembranosus​ ​(attach​ ​at​ ​tibial tuberosity)
75
Q

The adductors are on the _______.

76
Q

Describe the adductors.

A
  • Longer
  • Pull​ ​everything​ ​in
  • From​ ​hip​ ​to​ ​knee
77
Q

The abductors are on the _______.

78
Q

Describe the popliteus muscle.

A
  • muscle right behind knee
  • Locks​ ​and​ ​unlocks
  • Knee​ ​bent​ ​=​ ​shortened​ ​position​ ​=​ ​tight
  • Physically​ ​painful
  • Holding​ ​bones​ ​too​ ​close​ ​together​ ​=​ ​knee​ ​is​ ​tight
  • Let​ ​leg​ ​hyperextend​ ​back​ ​(don’t​ ​push​ ​forward,​ ​don’t​ ​pull​ ​toes​ ​up,​ ​passive)
79
Q

What is the MOI for quad contusions?

A
  • Any​ ​blow​ ​to​ ​the​ ​quad​ ​(s)
  • Tends​ ​to​ ​get​ ​deeper​ ​blows​ ​than​ ​other​ ​muscles,​ ​can​ ​lead​ ​to​ ​complications
  • Ex.​ ​slapshot​ ​to​ ​leg,​ ​football​ ​helmet​ ​to​ ​leg,​ ​knee​ ​to​ ​leg
80
Q

What is compartment syndrome?

A
  • All​ ​muscles​ ​are​ ​covered​ ​by​ ​fascial​ ​tissue,​ ​creates​ ​bag​ ​with​ ​no​ ​exit​ ​valve
  • More​ ​and​ ​more​ ​bleeding​ ​=​ ​more​ ​pressure​ ​=​ ​more​ ​pain
  • No​ ​way​ ​to​ ​get​ ​blood​ ​out
81
Q

What does compartment syndrome feel like? What should we do?

A
  • Feels​ ​stiff,​ ​not​ ​easy​ ​to​ ​move,​ ​tight​ ​pressure​ ​in​ ​thigh
  • Hospital
82
Q

What are the signs and symptoms of a grade 1 quad contusion?

A
  • bump
  • Feels​ ​harder​ ​where​ ​they​ ​got​ ​hit
  • Muscle​ ​is​ ​spasming
  • Local​ ​bleeding
  • Hot
  • Red
  • Still​ ​full​ ​ROM​ ​at​ ​knee​ ​and​ ​hip
  • Can​ ​contract​ ​quad,​ ​may​ ​only​ ​have​ ​a​ ​little​ ​bit​ ​of​ ​pain
83
Q

What are the signs and symptoms of a grade 2 quad contusion?

A
  • Something​ ​bigger​ ​hit​ ​their​ ​leg
  • More​ ​tissue​ ​damage
  • More​ ​bleeding​ ​(bruising​ ​at​ ​site)
  • Bigger​ ​area​ ​of​ ​muscle​ ​spasm
  • 80%​ ​ROM​ ​at​ ​knee​ ​and​ ​hip
  • Feels​ ​very​ ​tight
  • Can​ ​contract​ ​quad​ ​but​ ​will​ ​be​ ​painful​ ​at​ ​site
84
Q

What are the signs and symptoms of a grade 3 quad contusion?

A
  • Rupture​ ​of​ ​tissues
  • Muscle​ ​splitting​ ​in​ ​the​ ​middle
  • Fair​ ​amount​ ​of​ ​bleeding​ ​through​ ​majority​ ​of​ ​thigh
  • Swolen​ ​(visibly​ ​able​ ​to​ ​see)
  • Uncomfortable​ ​to​ ​the​ ​touch
  • Can​ ​feel​ ​harder​ ​and​ ​thicker​ ​where​ ​it​ ​was​ ​injured
  • Lucky​ ​if​ ​they​ ​can​ ​bend​ ​knee​ ​to​ ​90​ ​degrees (90 degrees = functional, painful, tight)
  • Won’t​ ​be​ ​able​ ​to​ ​get​ ​them​ ​to​ ​hold​ ​quad​ ​contraction (painful, difficult)
85
Q

What are the signs and symptoms of a grade 4 quad contusion?

A
  • severe​ ​bleeding
  • Severe​ ​bruising
  • Indent​ ​where​ ​muscle​ ​split
  • Can’t​ ​contract​ ​or​ ​move​ ​anything
  • Severe​ ​pain
  • If​ ​they​ ​cannot​ ​bend​ ​knee​ ​to​ ​90​ ​degrees​ ​=​ ​immediate​ ​hospitalization
86
Q

What happens at the hospital with a grade 4 quad contusion?

A
  • Need​ ​to​ ​be​ ​monitored​ ​that​ ​they​ ​do​ ​not​ ​have​ ​compartment​ ​syndrome - No​ ​valve​ ​=​ ​cut​ ​it​ ​open
  • Need​ ​x-ray​ ​to​ ​check​ ​for​ ​femur​ ​fracture
87
Q

What can’t someone with a min. grade 3 quad contusion do?

A

fly on a airplane (cannot be in pressurized space)

88
Q

How do we manage quad contusions?

A
  • No​ ​heat
  • No​ ​massage
  • No​ ​ultrasound
  • Will​ ​create​ ​more​ ​bleeding,​ ​none​ ​for​ ​at​ ​least​ ​2​ ​weeks
  • Ice​ ​(in​ ​as​ ​flexed​ ​position​ ​as​ ​possible,​ ​expose​ ​as​ ​much​ ​muscle​ ​as​ ​possible)
  • Current​ ​to​ ​calm​ ​muscle​ ​spasm,​ ​swelling,​ ​pain
  • Can​ ​do​ ​very​ ​gentle​ ​stretching
89
Q

What is myositis ossificans?

A
  • Quad​ ​contusion​ ​with​ ​bone​ ​sent​ ​to​ ​repair​ ​damage
  • Bone​ ​in​ ​middle​ ​of​ ​quad​ ​muscle
  • Blow​ ​is​ ​so​ ​severe​ ​that​ ​body​ ​thinks​ ​femur​ ​is​ ​damaged,​ ​sends​ ​calcium​ ​to​ ​site
90
Q

How do we assess myositis ossificans?

91
Q

How can we accidentally create myositis ossificans?

A
  • Danger​ ​of​ ​this​ ​with​ ​grade​ ​1,​ ​2​ ​quad​ ​contusion​ ​if​ ​it​ ​is​ ​done​ ​wrong
  • Ultrasound,​ ​heat,​ ​massage​ ​at​ ​bad​ ​time​ ​=​ ​this​ ​injury
92
Q

What are the signs and symptoms of myositis ossificans?

A
  • Will​ ​impact​ ​ability​ ​to​ ​contract​ ​quad​ ​as​ ​well​ ​as​ ​strength​ ​of​ ​quad
  • Can​ ​affect​ ​ROM,​ ​bones​ ​don’t​ ​bend
93
Q

How do we manage myositis ossificans?

A
  • Can’t​ ​do​ ​anything​ ​about​ ​it
  • Can’t​ ​cut​ ​it​ ​out​ ​(body​ ​will​ ​send​ ​more​ ​bone)
  • Permanent
  • Protect​ ​from​ ​any​ ​further​ ​quad​ ​contusion​ ​(ie​ ​not​ ​playing​ ​sport​ ​anymore)
94
Q

In what muscle do muscle strains occur?

A
  • Can​ ​happen​ ​in​ ​any​ ​muscle
  • Quads
  • Hamstrings
  • Adductors​ ​(groin​ ​pulls)
95
Q

What is the MOI of a muscle strain?

A

Any​ ​extra​ ​force​ ​to​ ​a​ ​muscle​ ​(stretch,​ ​forceful​ ​contraction​ ​when​ ​the​ ​muscle​ ​wasn’t ready)

96
Q

What are the signs and symptoms of a grade 1 muscle strain?

A
  • Stretching,​ ​no​ ​tearing
  • Full​ ​function
  • Structure​ ​is​ ​still​ ​intact
  • Can​ ​contract
  • Can​ ​walk
97
Q

What are the signs and symptoms of a grade 2 muscle strain?

A
  • Some​ ​tearing
  • Lost​ ​some​ ​function
  • Structure​ ​is​ ​no​ ​longer​ ​intact
  • Can​ ​feel​ ​it​ ​as​ ​a​ ​hard​ ​contracted​ ​spot​ ​in​ ​muscle
  • Need​ ​to​ ​protect​ ​if​ ​they​ ​can​ ​still​ ​play,​ ​may​ ​not​ ​be​ ​able​ ​to​ ​play
98
Q

What are the signs and symptoms of a grade 3 muscle strain?

A

Feels​ ​like​ ​they​ ​got​ ​shot,​ ​instantaneous​ ​intense​ ​pain

99
Q

Quads tend to rupture at the ______.

100
Q

Hamstrings tend to rupture at the ____.

101
Q

Adductors rarely rupture, but adductor longus will rupture at the ______, while others rupture at the _____.

A

bottom, top

102
Q

What happens to any muscle that ruptures at the top?

A

they will fall

103
Q

What happens to any muscle that ruptures at the bottom?

A

they will roll

104
Q

How do we manage a grade 3 muscle strain?

A

surgically repaired

105
Q

How do we manage muscle strains?

A
  • RICE
  • Not​ ​a​ ​contusion
  • Can​ ​ultrasound
  • Current
  • Laser
  • Can​ ​heat​ ​before​ ​activity​ ​to​ ​warm​ ​it​ ​up
  • Stretch​ ​and​ ​ice​ ​after​ ​activity​ ​to​ ​calm​ ​down​ ​any​ ​spasm​ ​or​ ​inflammation
  • Can​ ​wrap​ ​to​ ​give​ ​it​ ​more​ ​support
106
Q

What is the special test for muscle strains?

A

resisted ROM exercises

KNSS 220 Athletic Therapy (14 decks)

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