Sports Injury Bulletin
My third article in SIB.has been published in the February issue 2009. The article discusses injury trends in amateur football and explains a simple protocol on returning players back to playing after injury. This would benefit your club. Previous articles have been on 'Peripheral Injuries and Core Stability', and ' Pitch side Medical Care in Amateur Clubs'
THE FUNCTIONAL KNEE
This is an exert from an article I wrote on the Functional Knee. It will give you an idea on my approach to assessing athletic injuries.
Injuries to the knee are seen throughout virtually all sports and across all ages. Have you wondered why the knee is one of the most common reasons for visiting an Orthopaedic Surgeon ? Moreover have you ever wondered how rehabilitation and training programs could better alleviate the stresses placed on the knee ? This practical example best illustrates a situation when dysfunction at the hip is the underlying cause of patella femoral pain. I have always maintained that patella femoral pain (knee cap pain) is a problem with femur tracking than a ‘train’ problem (knee cap). Patellofemoral joint function could be characterised as the femur rotating underneath the patella, not the other way round. Interventions aimed at controlling hip and ankle motions should be considered when treating persons with patellofemoral (knee cap) joint pain.
A forty year old triathlete with excessive femoral internal rotation during the loading phase of gait presents with lateral knee pain while running. His knee pain can be explained by the inability of the hip external rotators, adductors, and hamstring muscles to decelerate the excessive femoral motion. The track (femur) crashing toward midline too rapidly, in effect, causes the train (patella) to derail laterally (gets pulled over to outside of knee). The symptoms are present at the knee, but lower extremity chain reaction biomechanics, one can easily understand how the cause is at the hip.
This example illustrates three core principles, 1) Joints of the body move in three planes of motion. 2) Movement is driven by ground reaction forces and gravity. Lastly 3) Movement at one joint will create chain reaction responces at other joints throughout the body. A thorough understanding of the chain reaction biomechanics of all three joints will assist in implementing rehabilitation and training programs that ensure that the knee, all though caught in the middle, has two powerfull friends to support it, the hip and the foot.
Please note: If you would like reprints of any of these please contact me and I will send it to you.
Posted on 07 Aug 2008