Key Points from DHMC Knee Injury Lecture

On November 9th there was an excellent three hour lecture that focused directly on prevention and treatment options for knee injuries. Members of the DHMC and Dartmouth-Hitchcook Keene’s Sports Medicine Department hosted and covered a variety of knee injury aspects in athletes of all age. These participants included Michael Sparks MD, Mark Silbey MD, Charles Carr MD, James Ames MD, Tate Erickson MS, ATC, Chad Howland PT, and Olympic Gold Medalist Hannah Kearney, who suffered from an ACL injury when she was 20 years old. Knee injuries are the one of the most common injuries to occur among sports, which generates the high importance of preventive knowledge and understanding of immediate and chronic treatment if an injury were to take place. Here are the highlights and key points from the lecture:

PART ONE

Topic One: Knee Anatomy




• The knee joint is constructed where the inferior head of femur meets the superior heads of the tibia and fibula. This large joint is filled with cartilage and synovial fluid, allowing the knee to seek a variety of ranges of motion. Ligaments play an important role in movement and support. There are four ligaments in the knee: the lateral collateral ligament (LCL), medial collateral ligament (MCL), posterior cruciate ligament (PCL), and anterior cruciate ligament (ACL). The meniscus, articular cartilage, and synovial fluid (fluid that surrounds the interior and exterior joint) acts as a cushion for the joint, which aids in smooth knee movements.


Topic Two: Facts


• Skiing/Snowboarding has a high knee injury rate.
• Not getting an ACL injury fixed can later lead to arthritis.
• Females are at higher risk of knee injuries.
o Women have a greater Q angle position than men (Photo 1 & 2).


Photo 1 Photo 2

o Women naturally have weaker gluts, hamstrings, and abdominals creating an improper
tort load on the lower extremities (Photo 1 & 2).
o Knee injury prevention should start around 7th to 8th grade.


Topic Three: Most common sports related knee injuries and causes

Injuries:
• Anterior Cruciate Ligament (ACL) Tear
• Posterior Cruciate Ligament (PCL) Tear
• Medial Collateral Ligament (MCL) Tear
• Lateral Collateral Ligament (LCL) Tear
• Meniscus Tear
• Patellar Dislocation

Top Causes:

• Improper cutting, pivoting, landing from a jump or direct blow to the knee.



Topic Four: When to see the doctor


Immediately after an injury occurs, there may be visible signs and symptoms. See the doctor immediately if the injured individual has:

1. A gross deformity. The picture below is a great example of a visible
kneecap dislocation.


Photo 3

2. Loss of sensation. Areas of the injured extremity may be followed by a loss
of sensation, or numbness.
3. Joint effusion; swelling. If the knee is immediately swollen, or swollen within a
few hours to even a day or two, it is indicating there is some sort of issue taking place.
4. Intense pain.
5. Inability to bear weight. Unable to walk and/or bear standing weight.

Signs or symptoms that may indicate a fainter immediate doctor visit demand:

1. Able to bear weight: no limping.
2. Zero to moderate swelling
3. Slightly poor to full range of motion.
4. Good disposition. The individual is talking fairly calm, not acting in a painful,
anxious manor.
5. Can walk normally.


Online Resource:
www.STOPsportsinjuries.org

To follow: PART TWO

The next installment will include proper knee injury prevention techniques, including evidence based exercises to help keep your knees safe.