Upper Leg and Hip Injuries Flashcards by Kathryn Fisher

What causes a collateral ligament sprain (LCL, MCL)?

Trauma

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What are the symptoms of a grade 1 collateral ligament sprain?

Tenderness over area
No swelling
Pain when ligament is stressed
1-4mm of joint opening

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What are the symptoms of a grade 2 collateral ligament sprain?

Significant tenderness over area
Swelling over area
Pain and laxity when joint stressed
5-10mm of joint opening

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What are the symptoms of a grade 3 collateral ligament sprain?

Complete tear of ligament
Pain can vary - sometimes less than grade 2
Instability
10-15mm joint opening

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How can you test for collateral ligament sprain?

30 degree flexion
Valgus and varus strain to test ligament
Apleys distraction

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How can collateral ligament sprains be treated?

RICE
hinged knee braces
Surgery if grade 3
Proprioceptive work
Concentric work on quads

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What are the causes of an anterior cruciate ligament sprain?

Lateral blow
Trauma forcing femur backwards
External rotation and valgus strain

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What are the causes of a posterior cruciate ligament sprain?

Hyperextension
Falling on tibial tuberosity
Trauma forcing tibia backwards

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What are the symptoms of a cruciate ligament sprain?

May hear ‘pop’, knee may give way
Sudden pain and swelling
Reduced range of motion

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How can cruciate ligament sprains be tested for?

Anterior draw test
Posterior draw test
Lachmans test

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How can cruciate ligament sprains be treated?

Brace
Surgery if grade 3
Extensive rehabilitation

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What are the causes of a meniscal tear?

Strong and sudden twisting
Deep knee bends
Lateral blow and MCL damage

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What are the symptoms of a meniscal tear?

Pain inside joint and along joint line
Locking, clicking, giving way
Inability to fully extend

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How can a meniscal tear be tested for?

McMurrays test

Apleys compression test

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How can a meniscal tear be treated?

Referral

Rehabilitation

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What is Osgood Schlatters Disease?

Inflammation of the periosteum at the attachment of the patella tendon

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What are the causes of Osgood Schlatters Disease?

Overuse/repeated trauma often in combination with a growth spurt

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What are the symptoms of Osgood Schlatters Disease?

Pain on palpation of tibial tuberosity
Pain with resisted knee extension
Tightness of quads
Red and hot skin

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What is the treatment for Osgood Schlatters Disease?

RICE
Infrapatellar strap
Stretching

What is the massage treatment for Osgood Schlatters Disease?

Massage techniques into quadriceps:

Effleurage, pétrissage, myofascial release, STR and NMT

What is Piriformis Syndrome?

A condition in which the piriformis muscle, located in the buttock region, spasms and causes buttock pain
It can also irritate the nearby sciatic nerve and cause pain, numbness and tingling along the back of the leg and potentially into the foot (similar to sciatic pain)

What are the causes of Piriformis Syndrome?

Lumbar spine pathology
Overuse
Gait

What is the treatment for Piriformis Syndrome?

Gentle stretching
Infra patellar strap
Foam rolling

What are the massage techniques for Piriformis Syndrome?

Cross fibre techniques onto gluteus maximus
NMT onto piriformis
STR onto piriformis

What is Patellofemoral Syndrome?

Degeneration of the posterior surface of the patella

What are the causes of Patellofemoral Syndrome?

``` Q angle > 18-20% Tight quads, ITB Disparity between lateral quads and medial quads Weak abductors Overuse, repetitive trauma ```

What are the symptoms of Patellofemoral Syndrome?

Anterior pain in knee joint and medial border of patella Pain going down stairs, sitting to standing, squatting Crepitus, creaking Sometimes swelling

What is the treatment for Patellofemoral Syndrome?

Correct underlying cause Strengthen vests medals and glut med Lessen tension into IT band

What are the massage techniques for Patellofemoral Syndrome?

Massage techniques into quads: Effleurage, pétrissage, deep frictions, myofascial release, STR and NMT Focus on areas of tension

What is Iliotibial Band Syndrome (Runners Knee)

Inflammation of the ITB as it moves over the lateral femoral condyle

What are the causes of ITB Syndrome?

``` Overuse Overpronation Tight lateral tissues Leg length discrepancy Poor biomechanics ```

What are the symptoms of ITB syndrome?

Pain in lateral knee Pain running downhill or climbing stairs Click when leg bends to 30 degrees Tenderness to palpate

How can ITB syndrome be tested for?

Ober test for ITB will establish if tension in lateral tissues

How can ITB syndrome be treated?

Address cause Foam rolling Self-stretching of hip abductors

What massage techniques can be used for ITB syndrome?

Massage on TFL and gluteus maximus: STR, NMT, myofascial release, MET stretching Longitudinal massage over ITB towards proximal end Mobilisation techniques on ITB

What is osteoarthritis of the knee?

Degeneration and wear and tear of the hyaline cartilage within the knee joint

What increases the risk of developing OA of the knee?

``` Heredity Gender Obesity Injury Joint overuse ```

What are the symptoms of OA of the knee?

``` Swelling Pain and stiffness, with pain at rest in advanced stages Crepitus Increased temperature Reduced mobility ```

What is the treatment for OA of the knee?

RICE Muscle strengthening Mobility exercises Behavioural change

What is trochanteric bursitis?

Inflammation of either the superficial or deep bursa of the greater trochanter

What are the causes of trochanteric bursitis?

Overpronation Running on cambered roads Trauma/blow to the area

What are the symptoms of trochanteric bursitis?

Pain on running Swelling and inflammation Pain on passive adduction Radiating at nights

What is the treatment for trochanteric bursitis?

Massage to surrounding muscles including TFL, glut max, med and min, and deep lateral rotators of hip

What are the causes of hamstring, quadricep and adductor strains?

Overstretching, overloading Unaccustomed activity Cramp Non-rehabilitated previous injury

What are the symptoms of hamstring, quadricep and adductor strain?

Sudden sharp pain Swelling, bleeding Pain on stretching and active resistance

What is the treatment for hamstring, quadricep and adductor strains?

RICE Passive mobility/stretching Strengthening of tissues

What massage can be used for hamstring, quadricep and adductor strains?

Effleurage, pétrissage, deep frictions, myofascial release, STR, and NMT