Knee Injury Case Study

Damage to a knee ligament is graded according to degrees (from one to three). An injury that is a grade one will be painful, and it will impose some limits in regard to mobility. After an individual rests the knee for a certain time and performs exercises of strength, a full recovery is likely. A grade three rupture or tear will likely require some surgery before an individual may gain full use of the knee again.

An injury to the ACL is classified as a sprain. A sprain is a joint injury that causes a stretch or a tear in a ligament. Sprains are graded I, II, or III depending on how severe the injury is. A grade I sprain will have pain with minimal damage to the ligaments. A grade II sprain is going to have more ligament damage and mild looseness of the joint. Finally, in a grade III sprain, the ligament is completely torn and the joint is very loose or unstable. A grade III sprain, simply called an ACL tear, is most often a sports-related injury. Still, The ACL can be torn in other instances such as during rough play, vehicular collisions, falls, and work –related injuries. According to a study performed by Jonathan Cluett, M.D., about 80% of sports-related ACL tears are “non-contact” injuries. This means that the injury does not result from any contact with another athlete. A rupture to the ACL is the result of the ligament within the knee being overstretched. This is usually caused by a “plant-pivot” mechanism (a stop and twist motion) of the knee, or a blunt force to the front of the knee. Other factors include quick changes of motion, twisting or torquing, or landing from a jump. Hyperextension is most

Abby describes when athletes typically tear their ACL they are rolling around screaming, unable to walk off. This was not the case for her, however something was wrong so she went to an orthopedic doctor. Due to her stability the doctor did not order an MRI and assumed it was a strained PCL.

Common type of sprains would be in the ankle and in the wrist. The ankle is one of the most common injuries in professional and recreational sports and activities. Most ankle sprains happen when the foot abruptly turns inward or outward as an athlete runs, turns, falls, or lands after a jump. One or more of the lateral ligaments can be injured if this occurs. Wrists are often sprained after a fall in which the athlete lands on an outstretched hand.

Recovering from a serious knee injury and returning to pre-injury levels can be a difficult task to overcome, but it has been proven possible to do this. Improper injury protocols and the injuries themselves are two of the largest factors in professional athletes not having elongated and successful careers. ACL, MCL, PCL, LCL, and Patellar Tendonitis are the most common knee injuries in which athletes sustain. Sustaining a knee injury at the highest and most competitive levels of basketball can make the injury and recovery process much more difficult and stressful, however. Depending on the injury, it can take a very extended amount of time for the knee to return back to its normal functioning, especially since damaging one part of the knee does not come without other injuries. A permanent and career ending injury may be the result if the proper percussions are not taken throughout the recovery process.

Sport injuries have come to the forefront with the worldwide coverage of all sports. Of these injuries, the most common is knee injuries. A large portion of knee injuries are Medial Collateral Ligament (MCL) stains and tears.

These boots move the forces caused by a fall to the knee rather than the ankle or lower leg. The ACL injury usually occurs when the knee is forcefully twisted, or hyper-extended. Many patients recall hearing a loud pop when the ligament tears, and feel the knee give way. This injury has received a great deal of attention from orthopedic surgeons over the past 15 years and very successful operations to reconstruct the torn anterior cruciate ligament have been performed.

ACL tears. Immediately to this injury first aid, involving the PRICE theory is vital this should be in place for 72hours. This is protection, rest, ice, compression, and elevation. It is important its protected as the torn ligament does not want to receive any more damage, keeping this in a fixed position of no pain is the best surrounded by things soft like pillows when sleeping and crutches throughout the day. The ice will be very effective in reducing swelling and this is important as fluid and swelling around the torn ligament is not what you want, keeping it elevated will allow oxidised blood to reach it.

Grade 3 injuries result in almost complete tears or total ruptures of the ligament(s). There will be severe pain immediately and the ankle may feel very unstable and weak. Swelling usually develops immediately and bruising

Figure (14): Anteromedial view of the left knee, showing the injury grading scale established by the American Medical Association Standard Nomenclature of Athletic Injuries. Isolated grade-I injuries present with localized tenderness and no laxity. Isolated grade-II injuries present with a broader area of tenderness and partially torn medial collateral and posterior oblique fibers. Isolated grade-III injuries present with complete disruption, and there is laxity with an applied valgus stress. ( 70 )

stand, walk, run, squat, bounce, and turn. In the event that the knee is harmed, the knee may get

My diagnosis for the patients injury is medial tibial stress syndrome. I believe this due to the positive special test and the palpation’s. The compression test was positive with pain on the medial distal one third of the tibia. The fulcrum test was the most positive out of the two with the patient pulling back from pain. Also with the palpation's, he had point tenderness over the medial distal one third of the tibia (1985).

In many cases, the symptoms that the patient feels after the trauma has occurred can help the doctor make his or her diagnosis. Many times a doctor will ask the patient to recall what happened after the injury was sustained. Usually with an ACL injury, the patient will describe a so-called pop or snap that he or she heard during the impact. Pain, which is not terribly excruciating, will immediately follow, and if the individual tries to stand, he or she will be faced with an overwhelming feeling of instability, the leg will buckle under, and the individual will ultimately fall down onto the ground. Although the patient is experiencing pain, he or she cannot point out exactly where the injury has occurred. Garrick states, “some people say that their knee shifts in position – which it actually does” (118). Other symptoms that may arise are stiffness and swelling which may continue for a long

Exercises such as jogging and biking can be performed in order to maintain fitness and improve cardio. Once the ankle has healed, the athlete can return to cutting and twisting sports, in order to maintain their skills. Athletes should consult coaches or team physio’s before returning to play, to determine whether the injury is still present or not. If the injury has healed, the athlete should be pain free, able to fulfill their full range of motion, and the ankle should have returned to its previous strength. Skills tests, such as dribbling, as well as quick movements on the ankle can also determine the readiness of the athlete to return to play.

A twenty-one year old female, basketball player experienced an ankle sprain by accidentally stepping on another player’s foot. The player was going up to make a shot landed on the opponents foot when she came back down, which made her ankle invert. The head athletic trainer evaluated her then taped her ankle to provide support and keep the swelling to a minimum at that time, so the player could return to play. Immediately after the game, the player’s ankle was iced down to control the swelling and was receiving NSAID’s to help with the pain or discomfort she was feeling. The player was referred to the team physician for x-rays and MRI to help rule out fractures. Treatment was started to help relieving the swelling and pain.