patellofemoral injuries taelar shelton, ms, atc, at/l
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PatellofemorPatellofemoral Injuriesal Injuries
Taelar Shelton, MS, ATC, Taelar Shelton, MS, ATC, AT/LAT/L
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Patellar FracturePatellar Fracture
MOI: direct or indirect MOI: direct or indirect trauma, severe pull of the trauma, severe pull of the patellar tendon when the patellar tendon when the knee is semi-flexed or a knee is semi-flexed or a fall on the knee fall on the knee
S&S: hemorrhage, joint S&S: hemorrhage, joint effusion, swelling, capsular effusion, swelling, capsular tearing, separation of tearing, separation of bone fragmnetsbone fragmnets
Rx: x-ray conformation, ice Rx: x-ray conformation, ice with compression, splint with compression, splint and crutches for walking, and crutches for walking, referral to doctor, usually referral to doctor, usually immobilized for 2-3 immobilized for 2-3 monthsmonths
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Subluxation/Dislocation Subluxation/Dislocation of the Patellaof the Patella
MOI- plant and twistMOI- plant and twist S&S, obvious deformity, S&S, obvious deformity,
usually lateral usually lateral dislocation, VMO dislocation, VMO weakness, decrease in weakness, decrease in function, swelling, P! function, swelling, P! and decreased ROM and decreased ROM
Rx- reduction by a Rx- reduction by a physician, immobilize, physician, immobilize, crutches, RICE, work on crutches, RICE, work on quad strengthening, quad strengthening, patellar tracking patellar tracking
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Chondromalacia Chondromalacia
MOI- abnormal patellar MOI- abnormal patellar tracking, tibial rotation, tracking, tibial rotation, pronated foot, pronated foot, anteverted hip, anteverted hip, genuvalgum, gradual genuvalgum, gradual degenerationdegeneration
S&S- gradual S&S- gradual degeneration of degeneration of cartilage, p! with cartilage, p! with activities, swellingactivities, swelling
Rx- take care of the Rx- take care of the mechanism, rest prn, mechanism, rest prn, surgical interventionsurgical intervention
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Larsen-Johansson Larsen-Johansson Disease Disease
MOI- at inferior pole of MOI- at inferior pole of the patella, repetitive the patella, repetitive strain of the patellar strain of the patellar tendontendon
S&S- swelling, P! and S&S- swelling, P! and x-rayx-ray
Rx- ice, rest, wait to Rx- ice, rest, wait to stress the knee until stress the knee until the growth plates are the growth plates are closed, isometrics closed, isometrics
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Osgood-Schlatter Osgood-Schlatter Disease Disease
MOI- excessive strain MOI- excessive strain of the patellar tendon of the patellar tendon
S&S- enlarged tibial S&S- enlarged tibial tuberosity tuberosity
Rx- rest, ice after Rx- rest, ice after activities, strengthen activities, strengthen quads and hamstrings quads and hamstrings
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Patellar Tendon Patellar Tendon Rupture Rupture
MOI- sudden powerful MOI- sudden powerful quad contraction, quad contraction, usually previous Hxusually previous Hx
S&S- obvious S&S- obvious deformity, swelling, P! deformity, swelling, P! and patella alta and patella alta
Rx- surgical repair Rx- surgical repair
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Patellar TendonitisPatellar Tendonitis
MOI- jumping or kicking MOI- jumping or kicking that is repeated that is repeated frequently that leads to frequently that leads to degeneration degeneration
S&S- P! after activity S&S- P! after activity progresses to during and progresses to during and after then gets worse after then gets worse after activity after activity
Rx- avoid the mechanism, Rx- avoid the mechanism, use heating modalities use heating modalities prior to activity, ice after, prior to activity, ice after, transverse friction transverse friction massage, rest prnmassage, rest prn
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IT Band Friction IT Band Friction SyndromeSyndrome
MOI- repetitive running MOI- repetitive running or biking, usually have or biking, usually have malalignment problems malalignment problems
S&S- p! on distal S&S- p! on distal insertion, +Ober’s test insertion, +Ober’s test
Rx- PRT, fix the Rx- PRT, fix the malalignment, take the malalignment, take the mechanism awaymechanism away
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Collapsing KneeCollapsing Knee
MOI- week quads, MOI- week quads, chronic instability of chronic instability of the MCL, ACL or the MCL, ACL or posterior capsule; torn posterior capsule; torn meniscus; loose bodies; meniscus; loose bodies; subluxating patellasubluxating patella
S&S- knee feels like it S&S- knee feels like it will collapse or give will collapse or give wayway
Rx- quad Rx- quad strengthening, fix the strengthening, fix the mechanism of injurymechanism of injury