Football Related Knee Injuries

The knee is a complex joint that is vulnerable to a variety of injuries. The knee is made up of the femur (the thigh bone), the tibia (the shin bone), and the patella (the knee cap). The femur rotates on the upper end of the tibia and the patella fits on the end of the femur.

There are also many large ligaments that connect the bones of the knee and help control knee motion. The meniscus is a wedge of cartilage that serves as a cushion between the femur and tibia and also absorbs shock. Many football athletes experience injuries to these knee structures.

Ligament Injuries

Football players frequently injure one or more of the knee ligaments. These ligaments include the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), and the lateral collateral ligament (LCL).

  • ACL Injury – When an athlete changes direction rapidly, lands wrong from a jump, or simply slows down when running, the ACL could tear. With this injury, knee swelling immediately occurs and walking is painful. The knee may have loss of range of motion and tenderness with an ACL injury. Treatment for this type of injury depends on the degree of tear to the ligament, whether or not there are other associated injuries, and how much physical demand the patient puts on their knee. Sometimes, the orthopedic specialist needs to operate to repair a complete tear of the ACL. Recovery is measured in months, rather than weeks for this type of injury.
  • MCL Injury – The MCL is generally injured from a direct blow to the outside portion of the knee. The ligament is torn or stretched when the foot is planted firmly on the ground and a sideways force hits the knee. An injured MCL causes pain, difficulty walking, and tenderness. Therapy involves the use of a knee immobilizer, rest, ice applications, compression with a support bandage, and frequent knee elevation. Surgery is only necessary for severe tears of the MCL.
  • PCL Injury – The PCL is injured when a football player receives a blow to the front aspect of the knee or makes a simple misstep on the turf. Most PCL tears and injuries will heal with conservative treatment. An injured PCL leads to pain with walking, instability, and swelling of the knee. Surgery may be necessary with complete tearing and extensive damage to the PCL.
    LCL Injury – The LCL is the least likely ligament to be injured during football activities. When severe force is applied to the inside of the knee, a LCL injury could occur. Symptoms include pain, swelling, weakness, tenderness, and discomfort to the outside of the knee. Treatment involves the RICE method, anti-inflammatory medications, and immobilization. Surgery to reattach the ligament to the bone is sometimes required.

Cartilage Injuries
Torn Cartilage – Most of the time, the meniscus is the cartilage that is torn during a football game. This rubbery, tough structure serves as a shock absorber during athletic activities. The meniscus tears with cutting, decelerating, pivoting, twisting, or from being tackled. Most torn meniscus injuries cause gradual pain and swelling, worse with climbing steps or uphill.

Not all meniscus tears require surgery, but frequently the damage can only be repaired through an operation.

Fractures
The patella can break if the football player falls directly onto it or receives a direct blow in that area. If the bone is fragmented, surgery will be required for repair. If the bone is in appropriate position, the orthopedic specialist may prescribe an immobilizer and rest for the injury.

The head of the fibula on the outside area of the knee joint is easily fractured from direct blows or as part of an injury to the lower leg. If the bone is not out of alignment, immobilization and conventional therapy will treat the injury.

Sometimes, however, the fibula fracture is complex and requires surgical repair. With jumping types of injuries, the tibia bone can be damaged. If the fracture occurs in the tibial plateau, surgery is often necessary.

Bursa Inflammation
Bursa inflammation is also called ‘housemaid’s knee’ or prepatellar bursitis and is the result of repetitive kneeling or crawling on the knees. The space between the kneecap and skin is called the bursa and it becomes irritated and fills with fluid. Bursa inflammation is a common type of knee injury of football players. Treatment includes using anti-inflammatory medications and rest. Occasionally the bursa needs to be drained for resolution of the problem.

Patellar Injuries
The patella can dislocate if it receives a direct blow. The blow can force this bone toward the outside area of the knee. Most dislocations of the patella easily return to normal alignment by simply straightening out the knee. However, some patella dislocations are serious and require surgery.

Also, patella-femoral syndrome is inflammation to the underside of the patella. This condition causes localized pain, which is worse with running and walking down stairs.

Treatment involves strengthening exercises, the use of ice therapy, and anti-inflammatory medications. Severe cases of this disorder require arthroscopic surgery to remove the damaged cartilage and realign parts of the quadriceps muscle.

Muscle and Tendon Strain
Most strains of the knee are treated with rest, ice therapy, elevation, and compression. Crutches help with walking, and the doctor may order an anti-inflammatory medication. These injuries are often the result of hyper-extension involving the hamstring muscles or hyperflexion causing the quadriceps to be injured.

If the patellar or quadriceps tendon is ruptured, there is inability to extend the knee. Surgery is necessary to repair this type of injury.

Common Football Injuries

Football is a rough sport, regardless of the protective equipment worn. Injuries go with the territory when it comes to this sport. Because the players are big, the game is fast, and the nature is physical, football injuries are quite common. In the United States alone, there are an estimated 1.2 million football injuries each year, and around 50 percent of these injuries occur during training. … read more

Ankle Fractures

Ankle Fractures Causes, Symptoms, and Treatment

Ankle injuries are among the most common of the bone injuries. An ankle fracture is also known as a broken ankle. These types of fractures occur when one or more of the ankle joint bones separate into pieces. It is typical for the ankle ligaments to be damaged with an ankle injury. The types of ankle fractures and injury we cover include lateral malleolus fracture, medial malleolus fracture, posterior malleolus fracture, bimalleolar fracture, and trimalleolar fracture.

Ankle Anatomy

The ankle consists of three bones that come together: the tibia (shin bone), the fibula (small lower leg bone), and the talus (a foot bone). The medial malleolus is the inner portion of the tibia. The posterior malleolus is the back portion of the tibia. The lateral malleolus is the end of the fibula. The syndesmosis is the joint between the fibula and tibia, which connects together with ligaments.

Cause of Broken Ankles

Broken ankles occur in all age groups. They come about when there is twisting or rotating of the ankle during a fall or impact of a car accident. Many refer to this type of injury as a “rolled” ankle.

Symptoms of a Broken Ankle

A severe ankle sprain feels the same as a broken ankle. Common complaints include immediate, severe pain, bruising, tenderness to the touch, swelling, inability to bear weight, and a deformity of the ankle. For severe ankle fractures, the bone may protrude through the skin.

Diagnosis

Because it is difficult to tell a sprain from a fracture, our orthopedic specialists recommend an evaluation by x-ray. Depending upon the type of fracture the surgeon finds, he may order a “stress x-ray” for further evaluation. In some cases, the surgeon orders a computed tomography (CAT scan) or magnetic resonance imaging (MRI) for further evaluation.

Lateral Malleolus Fracture Treatment

A lateral malleolus fracture is a fracture of the fibula bone. Since there are different levels at which the fibula can be injured, the treatment depends on the severity.

Nonsurgical Treatment – When lateral malleolus fractures are not out of place, the surgeon will treat these without surgery. The surgeon places you in a short leg cast or other device for protection. Depending on the injury, you will not be able to put weight on the affected leg for 4 to 6 weeks, meaning you will have to use crutches.

Surgical Treatment – For lateral malleolus fractures that are out of place, the orthopedic specialist will perform surgery on the injury. To make the ankle stable, he uses a plate and screws or screws and a rod. These attach to the bone fragments to realign the fibula so it can heal properly.

Medial Malleolus Fracture Treatment

A medial malleolus fracture can also involve injury to the fibula, the posterior malleolus, and the ankle ligaments. Just like the lateral types, the orthopedic specialist treats medial malleolus fractures according to their severity.

Nonsurgical Treatment – If the fracture is in alignment, it can be treated without surgery. The doctor put you in a removable brace or short leg cast to be worn for 4 to 6 weeks. The doctor recommends crutches also for a period of time.

Surgical Treatment – The surgeon will perform a procedure if the medial malleolus fracture is unstable and out of alignment. If the injury includes impaction of the ankle joint (damage to the cartilage surfaces), the surgeon will sometimes apply bone graft to repair it and decrease later risk of arthritis development. Many different techniques are used for this type of surgery.

Posterior Malleolus Fracture Treatment

A posterior malleolus fracture is a break in the back of the shinbone near the ankle joint. These types of fractures often include ligament damage. Many times with a posterior malleolus fracture, a lateral malleolus injury occurs.

Nonsurgical Treatment – Like other ankle fractures, fractures that are in alignment can often be treated conservatively without surgery. The orthopedic specialist will place you in a short leg cast or other device and recommend crutches for 4 to 6 weeks.

Surgical Treatment – Surgery is necessary when the bones are not in proper position, and the break is serious. The surgeon can use screws and plates along the back area of the shinbone to hold the bones in place while they heal.

Bimalleolar Fracture Treatment

“Bi” simply means two. When fractures are bimalleolar, this means that two or more parts of the malleoli of the ankle are involved. These injuries typically involve the lateral malleolus and the media malleolus. Bimalleolar fractures are not stable, as they are also often associated with ligament damage. Many times, there is a break of the fibula along with other structure damage.

Nonsurgical Treatment – Bimalleolar fractures require surgery. However, if you have significant health problems, the surgeon will not operate and recommend conservative treatment. The doctor uses a splint or short leg cast to stabilize and protect the injury. Also, you will not be able to bear weight on the ankle for 4 to 6 weeks.

Surgical Treatment – Because of the complexity of these types of fractures, the orthopedic specialist may combine surgical techniques in order to repair the various structures. Often times, a plate and screws are used to align bone fragments. Also, it may be necessary for the surgeon to use bone graft in bimalleolar fractures.

Trimalleolar Fracture Treatment

“Tri” means three. Trimalleolar injuries involve all three malleoli of the ankle. These types of fractures are unstable injuries and dislocation is common.

Nonsurgical Treatment – Unless you are in considerable poor health, the orthopedic specialist will recommend surgery for trimalleolar fractures. However, if you cannot undergo surgery, the surgeon will place your lower leg in a cast or removable device for stabilization and place you on crutches.

Surgical Treatment – These types of fractures are complex and require a combination of surgical efforts for repair. The surgeon will often use plates and screws, bone grafting, and other techniques during the procedure. Because dislocation is common, the doctor will have to properly align the bone and ligaments.

Knee Dislocations

Knee Dislocations | Treatment of Knee Dislocation Knee dislocations are uncommon orthopedic injuries and occur when the bones that form the knee are out of place. A knee dislocation involves damage to multiple ligaments, resulting in severe instability. Knee dislocations also often occur with injuries to the meniscus and the nerves and vessels that surround the knee. A knee dislocation occurs when the femur (thigh bone) and tibia (shin bone) lose contact with each other. In some injuries, the knee cap (patella) also is disrupted. Most knee dislocations are the result of high-energy traumatic injury, such as a motor vehicle accident or severe fall or impact. … read more

Care and Treatment of Clavicle (Collarbone) Injury

Clavicle Fracture

The collarbone is also called the clavicle. A fracture to this bone is a common injury that occurs in people of all ages. Most breaks to the clavicle occur in the middle portion. The clavicle is located between the ribcage and the shoulder blade. This structure connects the arm to the trunk of the body and lies above several important blood vessels and nerves. These vital body components do not usually become injured with a clavicle fracture.

What causes clavicle fractures?

The collarbone gets broken when there is a direct blow to the shoulder. This can occur during a fall onto the shoulder or during a motor vehicle accident. A fall onto an outstretched arm can also lead to a fracture of the clavicle. Many infants are born with a fracture to the collarbone – an injury that occurs during a traumatic birth.

What are the symptoms of a clavicle fracture?

If you sustain a clavicle fracture, it will most likely be very painful and hard to move your arm. Other symptoms include:

  • Shoulder sagging downward and forward
  • A deformity or “bump” over the area of the break
  • Inability to lift the arm without pain
  • Bruising, swelling, or tenderness over the clavicle
  • A grinding sensation when the arm is raised up

How is a clavicle fracture treated?

With some breaks, the ends of the bone have not shifted out of place and line up correctly. These types of fractures do not require surgery, and the orthopedic specialist can treat them with conservative measures.

These include the use of an arm support or sling (worn to keep the arm in proper position while the bone heals), mild pain medication, and physical therapy. Therapy is done to increase muscle strength in your shoulder and to prevent stiffness and weakness of the muscles.

The orthopedic specialist will recommend surgery if the bones are displaced (out of place) and do not line up correctly. During the procedure, the bone fragments are situated into their normal alignment and held that way with special screws and plates that are attached to the outer surface of the bone.

These structures are not removed until after the bone has healed. Some surgeons use pins to hold the fracture in proper position once the bone ends are put back in alignment.

AC Separation

The acromioclavicular joint (also called the AC joint) is the area where the clavicle meets the highest point of the shoulder blade. An injury to this structure that is common is an AC separation, where a force causes the ligaments that attach to the underside of the clavicle to tear.

What causes an AC separation?

The most common reason for a person to suffer an AC separation is a fall directly onto the shoulder. The force causes the ligaments to be injured and the collarbone separates from the wingbone (shoulder blade). This type of injury will cause the wingbone to move downward with the weight of the arm, creating a bulge above the shoulder.

How is an AC separation treated?

If the shoulder is not seriously deformed, and the AC separation is mild, the orthopedic specialist will recommend nonsurgical treatment modalities. These include the use of a sling, cold packs, and pain medications. Most people will return to full activity once the injury has healed without permanent, significant deformity.

If the pain of AC separation persists with conservative treatment, or the tears to the ligaments are severe, the orthopedic specialist will recommend surgery. This is done to trim back the end of the clavicle so that it will not rub against the shoulder blade. This procedure can be done long after the injury has occurred, too.