KNEE & THIGH
CHAPTER 7
Objectives:
UNDERSTAND:
1.
Anatomy of the knee & thigh
2.
Principles of rehabilitation to the knee & knee
3.
Preventive/supportive techniques and devices
IDENTIFY:
1.
Assessment tests for injuries to the knee and thigh
RECOGNIZE:
1.
Steps in the evaluation format
2.
Common injuries to the knee and thigh
Anatomy

The Knee
 Largest
joint in the body, but structurally very weak.
 Unstable bony structure: the femur (longest & strongest
bone in the body) sits on top of the smaller tibia (main
weight bearing bone of lower leg).
Anatomy




Femur -longest and strongest
Tibia -main weight bearing bone of lower leg
Fibula -non-weight bearing bone of lower leg
Patella -(knee cap) encased in powerful patellar
tendon
Ligaments

Medial Collateral (MCL)
-secure femur to tibia
- connects to the medial meniscus
-Reduce Valgus & varus movement (abduction & adduction of tibia
and femur)

Lateral Collateral (LCL)-(not as strong)
-does not attach to the lateral meniscus
-Reduce Valgus & varus movement (abduction & adduction of tibia
and femur)


Anterior Cruciate (ACL)-form “X” control anterior & posterior movement of
femur on the tibia.
Posterior Cruciate (PCL)
Other structures
Cartilage: (rest on top of tibia, form a cushion for the femur to rest on, and
shock-absorption, joint stability, smooth gliding & rotating of the femur and
tibia)
 Medial Meniscus (cartilage)
 Lateral Meniscus (cartilage)




Bursa -closed, fluid-filled sacs, cushion against friction over bone, or where
tendon moves over a bone.
Synovial membrane -large sac that lines the inside of the knee joint, helps:
tendons, ligaments, and bones.
Fat pads -soft tissue: weight bearing and absorbing impact
Muscles

Quadriceps: Anterior, extend (straighten) lower leg,
form patellar tendon (attaches on front of tibia)
1. Rectus femoris
2. vastus medialis-patellar tracking
3. vastus lateralis
4. vastus medialis
Muscles

Hamstrings: posterior, flexes the knee, controls the
rotary movements of the tibia.
1. Semitendinosus
2. semimembranosus
3. biceps femoris
Muscles & Tendons








Vastus Medialis: extension of knee
Vastus Lateralis: extension of knee
Vastus Intermedius: extension of knee
Rectus Femoris: extension of knee, flexion of hip
Gracilis: adduction of hip and flexion of knee
Sartorius: flexion & rotation of hip & knee
Semitendinosus: knee flexion & medial rotation
Semimebranosus: Knee flexion & medial rotation
Muscles & Tendons




Popliteus: flexion of knee & medial rotation
Biceps Femoris: flexion of knee & lateral rotation
Gastrocnemius: knee flexion
Plantaris: knee flexion
Assessment Tests

Test for knee ligament stability:
- abduction or valgus stress: medial joint
stability
-adduction or varus stress: lateral joint
stability
-anterior drawer: acl
-posterior drawer: pcl
-Lachman’s: acl
Common Injuries
Ligament sprains: 1st, 2nd, 3rd degrees.
-Contusion: direct blow to knee joint
-Torsion: feet are fixed and body/injured joint
is twisted (most often menisci)
-Shearing: force delivered to opposite side
of joint
 Patellar Tendinitis: Inflammation above/below
patella. (pain after exercise, swelling) Ice & rest

Common Injuries



Chondromalacis Patellae: irritation and softening of
the cartilage on the posterior aspect of the patella,
causing unusual tracking of the patella as it moves.
(causes: muscle weakness, imbalance, females: wider
pelvic)
Osgood-Schlatter: Adolescents due to rapid growth
during growth spurts, swelling below one/both knees.
(causes: inflammation of the tibial tubercle, where the
patellar tendon attaches) Rest & maybe cast
Muscular strains: PRICES