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The Knee
History or subjective
Question | Answer | Tensile Forces | Tensile Forces | Compressive Forces | Compressive Force |
---|---|---|---|---|---|
Questions on onset will give us what 2 pieces of information? What are we thing about maybe injured given this information? | 1. Is it acute: ligamentous vs. muscle injury (sprain vs. strain), bony injury, meniscus 2. Is it chronic: inflammation conditions, patellofemoral problems | Valgus | Medial structure: MCL, medial joint capsule, pes anserine muscle group, medial meniscus | Valgus | Lateral meniscus |
What do questions on location of pain tell us? | Tear directly to ligaments normally result in pain directly corresponding to area of trauma | Varus | Lateral structure: LCL, lateral joint capsule, IT band, bicep femoris | Varus | Medial meniscus |
How is ACL pain described? | As deep, often the knee feels weird or just not right | Anterior Tibial Displacement | ACL, IT band, LCL, MCL, medial & lateral joint capsule | Anterior Tibial Displacement | Posterior portion of the medial & lateral meniscus |
Where is meniscus pain usually felt? | Often at joint line & referred backward toward back of knee | Posterior Tibial Displacement | PCL, politeus, medial & lateral joint capsules | Posterior Tibial Displacement | Anterior portion of the medial & lateral meniscus |
What else do we want to know about the injury? (1) | 1. Was the foot fixed at time of injury? Foot fixation means the tibia is set and the femur is moving independent (ligamentous injury) | Internal Tibial Rotation | Anterolateral joint capsule, posteromedial joint capsule, posterolateral joint capsule, ACL, LCL | Internal Tibial Rotation | Anterior horn of the lateral meniscus, posterior horn of the medial meniscus |
What else do we want to know about the injury? (2) | 2. Associated sounds or sensation? ligaments tend to pop or snap when injured (look for bruises) | External Tibial Rotation | Posterolateral joint capsule, MCL, PCL, LCL, ACL | External Tibial Rotation | Anterior horn of the medial meniscus, posterior horn of the lateral meniscus |
What else do we want to know about the injury? (3) | 3. Prior history: Have they had a knee injury before? How does this compare? | Hyper-extension | ACL, posterior joint capsule, PCL | Hyper-extension | Anterior portion of the medial and lateral meniscus |
Hyper-flexion | ACL, PCL | Hyper-flexion | Posterior portion of the medial and lateral meniscus |