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Intro AT

by: McKenzie Jordan
McKenzie Jordan

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About this Document

Knee Hip thigh patella
Intro to Athletic Training
Mark Boatright
Class Notes
25 ?




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This 6 page Class Notes was uploaded by McKenzie Jordan on Monday October 10, 2016. The Class Notes belongs to 1600 at Appalachian State University taught by Mark Boatright in Fall 2016. Since its upload, it has received 2 views. For similar materials see Intro to Athletic Training in Athletic Training at Appalachian State University.


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Date Created: 10/10/16
Introduction to Athletic Training 1600 ­ 104 Mark Boatright 10/6/16 (McKenzie Jordan) Hip Pointer ­ contusion/bruise to iliac crest ● Very common to male and female sports  ● Rapid swelling and discoloration ● Very painful ● Caused by direct blow ● Treatment: RICE, NSAIDS, padding Quadricep Contusion  ● Mx: direct blow to front of quad mass ○ Very painful ○ Massive swelling and discoloration ○ Loss of ROM, mostly flexion ○ May or may not be able to bear weight ○ Heterotopic bone = bone spur (bone development in muscle tissue) ○ Treatment: ice with stretch Quadricep Strain ● Over stretch or tear of muscle ● Usually occurs during eccentric contraction ● Can be graded 1,2,3 ● Treatment: RICE, stretch, strength Bone Injuries 1) Pelvic Fracture: excessive force applied directly to pelvic girdle, not common (car wreck, fall) 2) Avulsion Fracture: forceful muscle contraction pulling bone away from muscle attachment (rest) 3) Femoral Stress fracture: repetitive stress, pounding of femur a) Femur bends with impact stretching one side, compressing other side b) Treatment: prolong rest, with return to play protocol c) Females at risk Hip Dislocation ● MEDICAL EMERGENCY ­ Circumflex artery and vein ● Usually occurs posteriorly  ● Mx ­ hip flexion with adduction and axial load ● Gross deformity with pain in butt ● Neurological and vascular compromise Femur Fracture ● Takes excessive force to fracture femur ● Extremely painful ● MEDICAL EMERGENCY Introduction to Athletic Training 1600 ­ 104 Mark Boatright 10/6/16 (McKenzie Jordan) ● Have traction splint: fits into gluteal fold, length of leg to ankle, buckle ● Mx: torsion or shear force across bone ● Immediate loss of function ● Shortening of leg ● Bone ends can compromise neurovascular structures ● Bone ends can act as scissors Snapping Hip Syndrome ● IT band snaps over greater trochanter with hip flexion ● Trochanteric bursa ● Usually happens in very thin individuals Ischial Bursitis “pain in the butt” ● Caused by movement of buttocks in seated position ● Sitting long periods of time ● Donut seat (inflatable) Special Test ● Thomas Test ­ tight hip flexor or tight iliopsoas ● Hip Scouring ­ cartilage tear or labral tear in hip ● Trendelenburg Test ­ weak gluteus minimus  Introduction to Athletic Training 1600 ­ 104 Mark Boatright 10/27/16 (McKenzie Jordan) Patella Dislocations ­ superficial ● Mx ­ flexion and rotation ● Dislocates laterally ● Deformity  ● Reduce with knee extension and medial pressure Knee Joint Dislocation (acute) ● Traumatic  ● MEDICAL EMERGENCY  ● Check dermatomes ● Check distole pulses ● Sx ­ psychogenic shock ● Splint as it lies ­ Vascular and neural compromises ­ No dermatome sensation Fractures Ex. condylar fracture ­ 3 screws through condylar  Ex. Patella fracture Introduction to Athletic Training 1600 ­ 104 Mark Boatright 10/4/16 (McKenzie Jordan) ­ Biomechanical dysfunction of kneecap ­ Weak VMO ­ General knee pain Osteochondral Dissecans Lesions (OCD) ● History  ○ Onset ­ acute (mx ­ shear, rotational, compression) ○ Chronic (mx ­ repetitive micro trauma), secondary  ○ Pn ­ diffuse within knee joint ○ Sx ­ locking or catching, instability, giving way, decrease with rest ● FAMILY HISTORY, PRIOR INJURY  ● Inspection ­ joint effusion, quadricep atrophy, especially VMO ● Palpation ­ sweep test (distole to proximal), ballotable patella (grab thigh and shin, move to  knee) ● Function ­ NWB: normal ROM, WB: decrease ROM ● Special Test ­ Wilson test (sit, extend knee, externally rotate, drop knee = pain) ● Imaging ­ x rays, MRI Iliotibial Band Friction Syndrome (IT Band) ● History  ○ Onset: chronic ○ Pn ­ lateral femoral condyle, increase running downhill, terminal ends ○ Mx ­ repetitive knee flexion and extension ● Inspection: genu varum, leg length issues ● Palpation: lateral femoral condyle 2 cm above joint line ● Function: ROM with normal limits, pain at 30° flexion and extension, weak abduction (lateral  femoral condyle) ● Special Test: Nobles and Ober's Test = lay on side, check IT Band ○ Unable to control hip motion with single leg squat ○ Pain with descending stairs, walking downhill = eccentric contraction ● Imaging: CT Scan, MRI (PTF) Patellofemoral Pain ­ Biomechanical dysfunction of kneecap, Weak VMO, General knee  pain ● History: chronic with gradual onset ○ Pn: patellofemoral area and PTF ○ Sx: clicking or giving way of knee ○ Mx: unknown (theorized) ● Predisposing: increased Q angle, patella baja, patella alta, lateral femoral condyle ● Function: ROM, knee extension inscrease sx., quadriceps weakness (VMO), end range of  flexion compresses patella Introduction to Athletic Training 1600 ­ 104 Mark Boatright 10/4/16 (McKenzie Jordan) ● Special Test: ober test, navicular drop ○ Increase pain with sitting, ascending and descending stairs, squatting  ● Imaging: x­ rays AP, lateral, sunrise views Patella Tendonitis ● Pressure off knee cap ● Need to strengthen kneecap (knee extension) Patella Tendinopathy ­ kind of like achilles tendonitis ● History ○ Onset ­ chronic ○ Pn ­ tibial tuberosity, midsubstance, inferior patella pole ○ Mx ­ repetitive resistance knee flexion (jumping), surface, shoes, tracking issues ● Inspection: swelling around patella tendon ● Palpation: thickening and crepitus of tendon ● Function: pain at end ranges, increase pain with eccentric loading ● Imaging: x rays, MRI, ultrasound ○ Ultrasound can determine necrosis of tendon Synovial Plica ­ everybody has one, good until inflammed ● History  ○ Onset ­ chronic ○ Pn ­ anterior portion of knee, clicking, popping, locking ○ Sx ­ worse in morning, increase as days go on ○ Mx­ friction caused by the plica rubbing accross the femoral condyle ● Inspection: swelling on joint effusion ● Palpation: thicken band of tissue that is point tender to touch medial anterior portion of joint line ● Function: AROM (clicking or catching), PROM (catching or locking) ● Special Test: medial synovial plica test (extend knee, externally rotate with toe up = pain  increase), stutter test (extend knee, slowly bring down, will stutter last 30° of flexion) ● Imaging: MRI ● MIMIC ­ chondromalacia meniscal test (clicking or grinding of crepitus knee cap) Popliteus Tendinopathy ­ unlocks screw home ● History  ○ Onset: chronic ○ Pn: popliteal fossa and length of tendon posterior to LCL ○ Mx ­ overuse (biomechanical changes in the knee) ● Predisposing: running downhill, posterior knee instability ● Inspection: swelling along the lateral joint line Introduction to Athletic Training 1600 ­ 104 Mark Boatright 10/4/16 (McKenzie Jordan) ● Palpation: figure four position (pain and crepitus) ● Function: ROM within normal limits, pain with unlocking screw home (last 30° of flexion) ● Imaging: MRI ● ITB syndrome and popliteus tendon syndrome ­ Popliteal Fossa = back of knee


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