- 15-30, F
- Overuse/overload of joint
- (-) loaded knee extension (stairs, squats, kneeling)
- PERIPATELLAR knee pain
Test:
Squatting
Patellar compression
Resisted knee extension
Clarkes (Grind test)
Management
Load management > strengthen (quads, gluts)
- 15-30, M (uni or bi)
- Overuse
- Anterior knee pain below patella
- Warm up effect
- PROM end range knee flexion = pain
- (-) patellar grind
- Management?
Patellar Tendonitis “Jumpers Knee”
Tets:
Point tenderness below patella (best)
Single leg stance/squat
- Stretch > strengthen (closed chain eccentric)
- 15 - 50 (any active athlete)
- Lateral knee pain (progressive, sharp, diffuse)
- Snapping/popping often associated
- +/- RADIATE INTO LATERAL THIGH (GREATER TROCH)
- (-) DOWNHILL running, DOWN stairs
- Management?
ITB tendinopathy “runners knee”
Tests:
Nobel Compression, Ober
Management:
Load management > decrease downhill run > strengthen (knee and hip)
- 20-40, M (3:1)
- RF: obesity, overuse, athletes
- +/- clicking, swelling (delayed), bakers cyst (chronic)
- A/PROM +/- pain, clicking/locking
- Aggravation: deep knee flexion (squatting, kneeling)
- Management?
Meniscal Tear
Test:
JOINT LINE TENDERNESS
Apley compression
Mcmurray’s
Thessaly
Management
Progressive weight bearing > surgery
- Any age
- MIO: excessive stress or physical damage
- RF: physical activity, obesity, chronic overuse
- pain is dull, achy, worse with movement
- LOCAL SWELLING
Bursitis
Test: aggravated w/ AROM of its “coordinating” mm
Management:
Popliteal bursitis
- 15-30, rare occurence
Lateral knee tenderness worse with full extension - Feeling of instability
- A/PROM pain with full extension
- DDX: Common Peroneal Nerve pathology
- Management/Imaging?
LCL
Test: Varus stress Test (strain vs rupture?)
Management: Ottawa rules > PRICE > PFROM > Closed Chain > Open chain > Wobble board
- 15-35, swimmers
- MOI: Valgus force
- Associated with medial meniscal tears
- +/- swelling
- Management/Imaging?
MCL
Test:
- Valgus Stress Test (0 and 30)
- Direct palpation
Xray if suspect fracture (Ottawa rules)
PRICE > PFROM > closed chain > open chain > wobble board
Mild-mod - 3 months, severe - 6-9 months
- Mc young, M (3:1)
- Cycle of worse, better, worse
- MOI: knee flexion + rotation
- Locking, swelling
- A+PROM - end range with mechanical blocking
- Management/imaging?
Test: Apley, Thessaly (disco), McMurray
MRI (GS) > PRICE > PFROM (prevent atrophy) > Strengthen (low impact - bike, swim)
- FEMALE (6:1), 15-30
- MOI: rapid deceleration + sharp change in direction,
SINGLE LEG - Deep pain, Pop, IMMEDIATE EFFUSION
- Associated with other knee injuries
- A/PROM - limited in extension
- Management/imaging?
Test: Anterior Drawer, Lachmans
- Ottawa rules > MRI (GS) > PRICE > Core + PFROM >
Closed chain > Open chain > low impact exercise > WB
- 15-35, M, RARE
- Deep pain, HEMARTHROSIS
- MOI: Flexed knee (fall, dashboard) or hyperextension
- INSTABILITY
- Associated with other injuries
- Management/Imaging?
PCL
Test: Posterior Sag Sign, Posterior Drawer
- MRI (GS) > PRICE > PFROM > Close chain > Open chain > low impact strengthening + core > WB
- 10-15 (active pre-teens), Boys (5:1)
- Insidious onset after intense activity
- Focal tenderness, pain, swelling,
- (-) RROM - Extension
- Management/imaging
Osgood Schlatter’s
aka “avulsion of TT”
Test: Ant test challenging the quadriceps tendon
Management:
Xray > stop athletics for 2 weeks > stretch quad + hams > PFROM > increase activity accordingly
- Rare injury, Professional runner/athlete
- MOI: direct varus force or while knee is ER or
HYPEREXTENSION - Acute pain in posterior/lateral knee joint
- Crepitus,
- PAINFUL RROM 15-30 degrees
Popliteal tendonitis
Tests:
Tenderness at LE, swelling, redness
