Documents

The knee complex: understanding the science behind both movement and dysfunction By Chris Gellert, PT, MMusc & Sportsphysio, MPT, CSCS, AMS

Categories
Published
of 11
All materials on our website are shared by users. If you have any questions about copyright issues, please report us to resolve them. We are always happy to assist you.
Related Documents
Share
Description
Introduction The foot is where movement begins, requiring mobility to perform simple functional movements. The knee however, requires stability with daily movements, but more importantly, dynamic sport movements such as soccer or football. In this article, we will review the anatomy of the knee, common injuries of the knee, functional assessments and training strategies to work with clients with previous injuries.
Transcript
  The knee complex: understanding the sciencebehind both movement and dysfunctionBy Chris Gellert, PT, MMusc  !portsphysio, MPT,C!C!, M! #ntroduction The foot is where movement begins, requiring mobility to perform simple functional movements. The knee however, requires stability with daily movements, but more importantly, dynamic sport movements such as soccer or football. In this article, we will review the anatomy of the knee, common injuries of the knee, functional assessments and training strategies to work with clients with previousinjuries. Figure 1. Dynamic sport of soccer Basic anatomy of the knee Let's look at the anatomy of the knee.. The joint is vulnerable when it comes to injury, because of the mechanical demands placed upon it and the reliance for soft tissue to support the knee.   There are  t$o primary joints within the knee, the tibiofemoral joint and thepatellofemoral joint. %nee &ointsa' Tibiofemoral (oint  Is a hinge joint that permits some rotation between the distalend of the femur and pro!imal end of tibia. The joint capsule surrounds the femoral condyles and tibial  plateaus and provides stability to the knee by the medial collateral ligament #$L% and the lateral collateral ligament L$L%. b' Patellofemoral (oint  Is formed by the patella knee bone% that glides in the trochlear groove of the femur. The height of the lateral femoral condyle helps prevent lateral sublu!ation, while soft tissue surrounds the joint to increase stability.   This is seen in &gure . )igure *' !tructures $ithin the knee (oint)igure +' Patellofemoral  (oint*' Primary structures $ithin the knee (oint: ligaments and mensici (everal ligaments described below provide stability at the knee joint. a' Collateral ligaments: The two primary supporting ligaments are the medial collateral ligament #$L%, which is along the inside of the knee. The #$L is a thinner and weaker ligament biomechanically, making it more susceptible to injury more often injured per the research. )hile the lateral collateral ligament L$L% is along the outside or lateral aspect of the knee providing lateral knee stability. b' nterior cruciate ligament C-.:  is the most commonly injured knee ligament  and 2  is taut during knee e!tension. It srcinates more pro!imally on the femoral side than the posterolateral *L% bundle. It inserts anteromedially front and to inner side% on the tibia.The +$L limits and controls forward translation of tibia on the femur and limits tibialrotation. c' Menisci: the menisci are &bro cartilaginous discs located on the articular surface of thetibia along the medial and lateral tibial plateaus. The outer portion of the meniscus lateral meniscus%is oval shaped % and thick. +ttaching at the anterior and posterior horns  via coronary ligaments.  /ascularity: The middle third and inner third of both menisci are relative avascular' The medial meniscus is more $-shaped, and thinner in structure . oth menisci receive nutrition through synovial di/usion and from blood supply to the horns of the menisci. )unction of the menisci  The menisci provide shock absorption, joint lubricationand stabili0ation. Common in(uries and causes There are several common injuries that a/ect the knee. The most common are patella femoral syndrome *1(%, osteoarthritis .+.% and anterior cruciate ligament +$L% injuries.In this ne!t section, we will review each condition providing a deeper understanding of each. a' Patellofemoral syndromePathophysiology0sign and symptoms: *1( is a condition where the patella does not translate biomechanically in the trochlear groove between the femoral condyles. 2ere the patella is positioned in either a tilt, glide or rotation accompanied by di/use, achiness in the front of the knee. Contributing )actors1vidence Based 2esearch.: (everal studies have shown that decreased 3exibility of 4uadriceps  and hip 3e!ors Lankhorst et al. 4564 7 #eira et al. 4566% 3  contribute to *1(. 8ecreased hip abductor strength  has been shown a signi&cant factor seen in multiple studies as contributing to *1( 9hayambashi, 2., et al. 4564, #eira et al, 4566%, olgla et al. 455:%,$ichanowski et al. 455;%, and <obinson et al. 455;%. ther factors include prolonged wearing of high heels, muscle imbalances quadriceps=hamstrings%. b' 5steoarthritis5 . of the kneePathophysiology0sign and symptoms:  + degenerative process of varied etiology, which includes mechanical changes  within the joint as seen in &gure >. 2isk )actors: ?!cessive weight born on hip joint, muscle imbalance, repetitive stressors. !ign and symptoms  *ain in the a.m. described as @achyA that decreases as the day progresses, pain with weight bearing or walking ,  di/iculty squatting, and lateral thigh discomfort.  )igure 6' 5steoarthritis of knee   c' nterior cruciate ligament in(uries In the last several years, there has been more news about the incidence of +$L injuries. The incidence rate is greatest between the ages of 6B and 6: years ' 1emale athletes are -C! more likely to sustain an +$L injury then male athletes. This results in at least 455,555 +$L reconstructions are performed each year in the Dnited (tates, with estimated direct costs of E billion in D.(. dollars% annually 1robell, <., et al 4565%. 4
Search
Tags
Related Search
We Need Your Support
Thank you for visiting our website and your interest in our free products and services. We are nonprofit website to share and download documents. To the running of this website, we need your help to support us.

Thanks to everyone for your continued support.

No, Thanks