++
LEARNING OBJECTIVES
Discuss common injuries that occur to the knee.
Demonstrate the application of taping, wrapping, bracing, and padding techniques when preventing, treating, and rehabilitating knee injuries.
Explain and demonstrate evidence-based practice for the implementation of taping, wrapping, bracing, and padding techniques for the knee within a clinical case.
+++
INJURIES AND CONDITIONS
++
Injury to the knee can occur from acute and chronic forces during contact and/or non-contact athletic and work activities. During athletic and work activities, extreme forces are placed on the knee. Because soft tissue structures act as the main stabilizers of the knee joint, injuries occur more frequently to ligaments, menisci, bursae, and tendons as a result of compression, friction, repetitive movements, and rotary and shearing forces. Common injuries to the knee include the following:
++
++
Contusions to the soft tissue and bone of the knee can be caused by compressive forces. Falling on the knee and being struck by a direct force may result in pain, swelling, and loss of range of motion. A direct blow, chronic compression from kneeling, and being pinched between the tibia, patella, and femur can cause an infrapatellar fat pad contusion (Fig. 6–1).
++
++
Knee sprains are caused by unidirectional, multidirectional, and/or rotary forces during contact or non-contact activities. Depending on the force, a sprain of the knee can result in damage to single or multiple ligamentous structures. A valgus force on the lateral aspect of the knee can result in a medial collateral ligament (MCL) sprain (Figs. 6–2 and 6–3). Adduction and internal rotation of the knee is a common mechanism of MCL injury.1 For example, a sprain can occur as a football offensive linemen pass blocks and another player is pushed or falls against the lateral aspect of the linemen’s right knee, causing a valgus force. The lateral collateral ligament (LCL) is injured by a varus force on the medial aspect of the knee, commonly with internal rotation of the tibia. Medial or lateral lower leg rotation on a planted foot, direct force causing hyperextension, and external tibia rotation with the knee in a valgus position can cause injury to the anterior cruciate ligament (ACL) (Fig. 6–4). ACL injuries typically occur with quick deceleration, cutting, twisting, and landing movements (Fig. 6–5). An ACL sprain can result as a lacrosse midfielder sprints down the field and suddenly stops, then pivots on the left foot and quickly turns to the right, causing external rotation of the left tibia and valgus stress at the knee (Fig. 6–6). The posterior cruciate ligament (PCL) can be ...