Lower Extremity Injury (copy)

What is patellofemoral pain syndrome (PFPS)?

Anterior knee pain around or behind the patella.

Who commonly develops PFPS?

Runners, cyclists, hikers, and people who sit for prolonged periods.

What are the main causes of PFPS?

Overuse, biomechanical abnormalities, and muscular dysfunction.

What foot abnormalities can contribute to PFPS?

Pes planus (flat feet) and pes cavus (high arches).

How does pes planus contribute to PFPS?

Medial ankle rolling causes internal tibial/femoral rotation and increased knee valgus.

How does pes cavus contribute to PFPS?

Reduced shock absorption increases stress on the patellofemoral joint.

What is the normal Q-angle in males and females?

Males: 13°; females: 18°. -> Increase angle causes lateral tracking of patella

What is the J sign in PFPS?

Abnormal lateral movement of the patella during knee extension.

Why does knee flexion aggravate PFPS?

It increases reactive forces and pressure at the patellofemoral joint.

What activities typically aggravate PFPS?

Squatting, stairs, hills, and prolonged sitting.

What are typical examination findings in PFPS?

Patellar tenderness, excessive mobility, pain with compression or resisted extension, and quadriceps atrophy.

How is PFPS treated?

Exercise therapy, strengthening, stretching, taping, orthotics, footwear modification, and pain management.

What is Osgood-Schlatter disease?

Traction-related inflammation of the tibial tuberosity apophysis in growing adolescents (12-16 y/o)

What are the characteristic symptoms of Osgood-Schlatter disease?

Gradual activity-related pain, swelling, and enlargement of the tibial tuberosity.

Which sports are commonly associated with Osgood-Schlatter disease?

Soccer, gymnastics, basketball, and distance running.

How is Osgood-Schlatter disease treated?

Activity modification, quadriceps/hamstring strengthening and stretching, ice, and education.

What is patellar tendinitis (jumper's knee)?

Overuse injury involving inflammation, tearing, or degeneration of the patellar tendon.

What causes patellar tendinitis?

Repetitive overloading of the knee extensor mechanism, especially explosive jumping.

What are typical findings in patellar tendinitis?

Patellar tendon pain, localized swelling, and ecchymosis.

What exercise is particularly useful for patellar tendinitis rehabilitation?

Progressive closed-chain quadriceps strengthening, including eccentric single-leg squats.

What is the primary function of the iliotibial (IT) band?

Lateral hip and knee stabilization; resists hip adduction and knee internal rotation.

What causes iliotibial band friction syndrome?

Repetitive knee flexion, commonly during running.

Where is tenderness found in IT band friction syndrome?

Lateral femoral epicondyle or Gerdy's tubercle.

How is IT band friction syndrome treated?

Rest, NSAIDs, appropriate footwear, ITB stretching, and hip/thigh strengthening.

What is the primary function of the ACL?

Prevents anterior tibial translation and rotational instability relative to the femur.

Which sports are commonly associated with ACL tears?

Basketball, football, soccer, volleyball, gymnastics, and skiing.

What mechanisms commonly cause non-contact ACL injuries?

Pivoting maneuvers and landing from jumps.

What are characteristic symptoms of an acute ACL tear?

A popping sensation, severe pain, swelling, and difficulty walking.

What are characteristic symptoms of chronic ACL deficiency?

Recurrent knee instability, giving way, swelling, and limited ROM.

When is ACL reconstruction commonly recommended?

For patients wishing to continue high-level cutting or jumping sports.

What complications can occur with untreated ACL deficiency?

Subsequent meniscal injuries and osteoarthritis.

What is the primary function of the MCL?

Primary static medial stabilizer of the knee.

What mechanism commonly causes MCL injury?

Valgus stress (abduction injury).

Which sports commonly cause MCL injuries?

Football and skiing.

What are typical symptoms of MCL injury?

Medial knee pain, swelling, tenderness, instability, and giving way into valgus.

How are MCL injuries managed according to severity?

Grade 1: symptomatic treatment; Grade 2: immobilization for 1–2 weeks; Grade 3: immobilization for 4 weeks.

What is the primary function of the menisci?

Distribute load, reduce force per unit area, and protect articular cartilage.

What are typical symptoms of meniscal injury?

Joint-line pain, catching, locking, popping, effusion, and limited ROM.

What movements commonly aggravate meniscal injuries?

Twisting and pivoting.

What is Apley's test used to assess?

Meniscal and ligamentous injuries.

In Apley's test, what does pain during compression suggest?

Meniscal injury.

In Apley's test, what does pain during distraction suggest?

Ligamentous injury.

What is the unhappy triad?

Combined injury of the ACL, MCL, and medial (or lateral) meniscus.

Which sports are commonly associated with the unhappy triad?

Soccer, basketball, rugby, and skiing.

What is medial tibial stress syndrome (MTSS)?

An overuse injury involving the fascia of the medial soleus at the posteromedial tibia.

Where is pain typically located in MTSS?

Approximately 4 cm above the medial malleolus.

How is MTSS initially managed?

Rest, ice, non-weight-bearing activity for 1–2 weeks, and NSAIDs.

What are common risk factors for Achilles tendinitis?

Repetitive overuse, increased activity, improper footwear, cavus feet, tight hamstrings, and training errors.

What are characteristic symptoms of Achilles tendinitis?

Pain, swelling, and tenderness just above the tendon insertion.

What does a sudden popping sensation during Achilles injury suggest?

Achilles tendon rupture.

How is Achilles tendinitis managed?

Avoid running/jumping, exercise therapy, appropriate footwear, orthotics when indicated, and pain management.

What is plantar fasciitis?

An overuse injury caused by repetitive stretching of the plantar fascia at its calcaneal origin.

Where does plantar fasciitis typically cause pain?

Plantar heel at the medial calcaneal tuberosity.

What is the characteristic pain pattern of plantar fasciitis?

Sharp heel pain, especially during the first steps after waking or after prolonged standing.

What are risk factors for plantar fasciitis?

Flat feet, high arches, excessive pronation, and inadequate footwear.

How is plantar fasciitis treated?

Rest, PRICE, stretching, strengthening, taping/splinting, and correction of excessive pronation.