Lecture 23 Outline of Last Lecture I. Walking and Running Issues II. Lower Leg Compartments III. Muscles Outline of Current Lecture I. Hip Pain II. Snapping on Side of Hip III. Contusions IV. Dislocations V. Injuries VI. Strain or Muscle Tear VII. Lower Leg Injuries VIII. Ankle Injuries IX. Foot Injuries X. Knee Injuries Current Lecture A. Hip Pain 1. Trochanteric bursitis a. excessive training b. poor running form c. tight fitting equipment HPER 205 1st Edition These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best !used as a supplement to your own notes, not as a substitute. !2. Abductor muscle strain B. Snapping on Side of Hip 1. Occurs during bending or hip rotation 2. Tensor fascia lata moves over greater trochanter a. irritation b. common in dancers C. Contusions 1. Hip pointer: blow to hip 2. Mild hematoma 3. Articular cartilage damage 4. Myositis ossificans (thigh bruises) a. front of thigh b. deep pooling of blood c. affects knee motion d. ossification of area D. Dislocations 1. Very rare due to hip stability 2. Factors a. auto accidents 3. Anterior inferior dislocation a. 10-20% of hip dislocation b. force abduction c. abduction, flexion and ext. rotation E. Injuries 1. Fractures of the femoral neck a. > 250,000b. women 3x more likely to get fracture 2. Osteoporosis a. high energy forces - falls, car accidents, side impacts 3. Osteoarthritis a. wear and tear of articular cartilage b. more on medial side c. obesity factor d. > 20 million of americans F. Strain or Muscle Tear 1. Most common in hamstring and quadriceps 2. Pain over the area 3. Mild tear-pain when muscle is stretched 4. Mild strain usually around the belly of the muscle 5. More serious when strains occur in tendon 6. Quads: tear near top of patella 7. Hamstrings: high near ischial tuberosity or low just above knee G. Lower Leg Injuries 1. Four muscle compartments a. anterior, lateral, sup and deep posterior 2. Compartment syndrome a. fluid accumulation as a result of acute or chronic exertion b. can affect vascular and neural function c. ischemia d. fascia adaptations e. fasciotomy3. Tibial stress syndrome: inflammatory reaction of the deep fascia 4. Mechanism a. chronic overload b. can lead to periostitis c. common in runners d. multifactor 5. Stress reaction: bone with evidence of remodeling but without actual fracture 6. Stress fracture a. 50% occur on tibia b. runners: middle and distal third c. jumpers: proximal fractures d. daners: midshaft 7. High energy fracture a. car accidents: direct impact b. skiing: torsional and boot fractures c. baseball bats H. Ankle Injuries 1. Achilles tendon: largest and stronger a. forces = 10x BW 2. Injuries a. multifactorial etiology - training, malalignments, trauma, footwear 3. Tendon rupture a. degeneration b. men 30-40 yearsc. blood type O 4. Mechanism a. sudden dorsiflexion b. rapid change in direction c. excess tension on taut tendon d. taut tendon struck by object 5. Ankle sprains: most common a. irregular talus and stability b. involve ankle and subtalar joint c. 85% inversion sprain d. eversion (pronation) sprain is less common 6. Fractures malleolus, deltoid ligament, tibia and fibula seperation I. Foot Injuries 1. Plantar fasciitis: inflammation of the plantar fascia involving microtears of partial rupture of the fascia a. lack of flexibility b. lack of ankle strength c. overtraining d. poor mechanics e. leg length discrepancies f. over pronation 2. Lisfranc (dancers) a. low energy: tripping or bumping b. high: falls, crashes c. axial loading foot in extreme plantar flexion or dorsiflexion d. violent twisting3. Turf toe a. damage to capsule and ligaments of 1st MP joint 4. Stress fractures a. metatarsal neck in runners 5. Morton’s neuroma 6. Nerve impingement J. Knee Injuries 1. Ligament sprains and severity a. MCL, LCL, ACL, PCL 2. Meniscus tears a. difficult to heal-poor blood supply b. mechanism - sharp cuts or twists - quick and forceful motion of the knee 3. PCL tears a. stops lower leg from moving backward b. direct blows 4. Baker’s Cyst a. closed sac of fluid b. associated w/ other knee problems - torn cartilage or arthritis 5. Chondromalacia a. patellar tracking b. more common in women c. affected by Q angle 6. Jumper’s kneea. patella tendinitis b. overuse injury 7. Osgood Schlatter’s a. tenderness and swelling around insertion of patellar