The knee is made up of four components:

The knee is a complicated joint. It moves like a door hinge, allowing a person to bend and straighten their legs so they can sit, squat, jump, and run.

bones

cartilage

ligaments

tendons

The femur, commonly known as the thighbone, is at the top of the knee joint. The shinbone, or tibia, makes up the bottom of the knee joint. The patella or kneecap covers the meeting point between the femur and tibia.

The cartilage is the tissue that cushions the bones of the knee joint, helping ligaments slide easily over the bones and protecting the bones from impact.

There are four ligaments in the knee that act similarly to ropes, holding the bones together and stabilizing them. Tendons connect the muscles that support the knee joint to bones in the upper and lower leg.

There are many different types of knee injuries. Below are 10 of the most common injuries of the knee.

1. Fractures

Any of the bones in or around the knee can be fractured. The most commonly broken bone in the joint is the patella or kneecap.

High impact trauma, such as a fall or car accident, causes most knee fractures. People with underlying osteoporosis may fracture their knees just by stepping the wrong way or tripping.

2. Anterior cruciate ligament injuries

ACL injuries can range from grade 1 to 3 in severity.

The anterior cruciate ligament (ACL) runs diagonally down the front of the knee, providing critical stability to the joint. Injuries to the ACL can be serious and require surgery.

ACL injuries are graded on a scale from one to three. A grade 1 sprain is a mild injury to the ACL, while a grade 3 refers to a complete tear.

Athletes who participate in contact sports such as football or soccer often injure their ACLs. However, contact sports are not the only cause of this injury.

Improperly landing from a jump or quickly changing the direction of motion can lead to a tear in the ACL.

3. Dislocation

Dislocating the knee happens when the bones of the knee are out of their proper placement and alignment.

In a knee dislocation, one or more of the bones may slip out of place. Structural abnormalities or traumas, including car accidents, falls, and contact sports, can cause a knee dislocation.

4. Meniscal tears

When people refer to torn cartilage in the knee, they are probably talking about a meniscal tear.

The menisci are two rubbery wedges of cartilage between the thighbone and shinbone. These pieces of cartilage can tear suddenly during sporting activities. They may also tear slowly due to aging.

When the meniscus tears due to the natural aging process, it is referred to as a degenerative meniscus tear.

With a sudden meniscus tear, a pop may be heard or felt in the knee. After the initial injury, pain, swelling, and tightness may increase over the next few days.

5. Bursitis

Bursae are small fluid-filled sacs that cushion the knee joints and allow the tendons and ligaments to slide easily over the joint.

These sacs can swell and become inflamed with overuse or repeated pressure from kneeling. This is known as bursitis.

Most cases of bursitis are not serious and can be treated by self-care. However, some instances may require antibiotic treatment or aspiration, which is a procedure that uses a needle to withdraw excess fluid.

6. Tendonitis

Tendonitis can affect physically active people.

Tendonitis or inflammation in the knee is known as patellar tendinitis. This is an injury to the tendon that connects the kneecap to the shinbone.

The patellar tendon works with the front of the thigh to extend the knee so a person can run, jump, and perform other physical activities.

Often referred to as jumper’s knee, tendonitis is common among athletes who frequently jump. However, any physically active person can be at risk of developing tendonitis.

7. Tendon tears

Tendons are soft tissues that connect the muscles to the bones. In the knee, a common tendon to be injured is the patellar.

It is not uncommon for an athlete or middle-aged person involved in physical activities to tear or overstretch the tendons. Direct impact from a fall or hit may also cause a tear in the tendon.

8. Collateral ligament injuries

Collateral ligaments connect the thighbone to the shinbone. Injury to these ligaments is a common problem for athletes, particularly those involved in contact sports.

Collateral ligament tears often occur due to a direct impact or collision with another person or object.

9. Iliotibial band syndrome

Iliotibial band syndrome is common among long-distance runners. It is caused when the iliotibial band, which is located on the outside of the knee, rubs against the outside of the knee joint.

Typically, the pain starts off as a minor irritation. It can gradually build to the point where a runner must stop running for a period to let the iliotibial band heal.

10. Posterior cruciate ligament injuries

The posterior cruciate ligament is located at the back of the knee. It is one of the many ligaments that connect the thighbone to the shinbone. This ligament keeps the shinbone from moving too far backward.

An injury to the posterior cruciate requires powerful force while the knee is in a bent position. This level of force typically happens when someone falls hard onto a bent knee or is in an accident that impacts the knee while it is bent.

When to see a doctor

If knee pain becomes chronic, is severe, or lasts for more than a week, a person should consult a doctor. It is important to see a doctor if there is a reduced range of motion in the joint or if bending the knee becomes difficult.

In cases of blunt force or trauma, a doctor should be seen immediately after an injury has occurred.

Treatment options

Physical therapy is one type of knee treatment.

Treatment will vary based on the cause of the knee pain and the specifics of the injury. In cases of strain or overuse injuries, rest and ice will typically allow the knee to heal over time.

Treatment may also involve managing pain and inflammation with medication. In most cases, a person will need to rest for a period of time.

Tears or other trauma-induced injuries may require bracing, popping the knee back into place, or surgery. In the case of surgery, a person will likely not be able to use the knee after the procedure and may need either crutches or a wheelchair while recovering.

In some cases, physical therapy may be needed to help a person regain movement and strength in their knee and leg.

Prevention

Preventing knee injuries is not always possible, but a person can take precautions to reduce the risk. For instance, people who run or play sports should wear the appropriate shoes and protective gear.

In cases of iliotibial band syndrome and overuse injuries, a person may want to consider reducing the number of miles they run.

Certain exercises also help strengthen the smaller leg muscles, which may help prevent injury. Finally, stretching before and after exercise can help prevent injury to the knees.

Proper nutrition, especially for athletes, is also important. Protein, calcium, and vitamin D are essential for maintaining healthy bones, muscles, and ligaments.

https://www.medicalnewstoday.com/articles/319324#when-to-see-a-doctor

The first section is to work with the training cadre and includes:

1- Selection of athletes (selection): healthy and physically qualified players are selected to play games and exclude athletes who are injured or still in the process of being treated. and in coordination with the team's training cadre. Medical surveillance: this means regular and periodic examination of athletes - phylogenetic and physical registration of training marks - and, more importantly, investigation of symptoms or phenomena of over-exercise that may appear in an athlete.

2- Doctor's Athletic / In order to be able to diagnose any non-mathematical injury that may be harmful to an athlete and distinguish it from an injury to an athlete, his knowledge of all medical specialties (albeit non-extensive). Let's not forget that an athlete is, above all, an ordinary human being at risk of any organic, physiological or viral disease.

3- Feed the athlete/ Interest in fully nourishing an athlete from a period of preparation in training camp and during games and tournaments. We all know that good food is the right and best way to get to good fitness, and that integrated and scientific food leads us away from taking steroids or banned substances taken by some athletes and without knowledge of their side effects. By proper scientific feeding, more energy can be given to an athlete while helping to store the necessary air energy for an athlete during the first seconds of exercise.

4- Psychological training for an athlete: An athlete is trained not to get ego in the event of good results during competitions. He's trained not to have psychological frustration in the event of loss. The fact that it affects the quality of its next results can lead to isolation and lack of follow-up exercises.

5- assist the instructor / One of the duties of a specialist in sports medicine is to assist the instructor in determining the level of the athlete and to direct the exercise accordingly. and according to the fitness of each member of his or her sports team. In collegiate sports, the same exercise is not to be followed for all team members. Rather, the team is divided into groups with almost the same level of fitness and thus trying to reach the same fitness as the entire team. This is determined by the physical assessment form.

of Course, Not

The sports rehabilitation specialist must have knowledge of sports sciences such as sports training, physiology and biomechanics, and on the other hand, he must have extensive knowledge of anatomy as well as knowledge of exercise in order to be able to describe a suitable rehabilitation program for sports injuries or types of body deviation.

The sports rehabilitation specialist must design, implement and supervise the rehabilitation program, it is not only important to design a successful rehabilitation program, you also have to make sure that this program is well implemented because performing the wrong exercise may cause negative results on the case

The rehabilitation specialist does not have to examine the patient clinically. We are operating after the doctor diagnoses the infection

Because of your extensive experience in this area, you may have good information on diagnosing an infection. But you are not authorised to be examined clinically, or to prescribe medication, we have to define our role and respect our specialisation. Any mistake will cost you a lot.

So, who are the specialists in sports rehabilitation and job training

Graduates of physical education colleges and departments , who have master's degrees and higher in the field of sports injury rehabilitation

Physical therapy graduates who have extensive knowledge of exercise

Various other health and medical specialties. Those who have extensive knowledge of exercise

Objectives of rehabilitation, for example:

- To restore the victim to a normal state.

- Enhance daily motor skills, flexibility and mobility.

- Muscle strengthening.

- Long-term pain relief.

- Improving body imperfections.

- Healthy lifestyle.

Is physical therapy sports rehabilitation and job training?

They complement each other, but they do not have the same meaning,

From a personal point of view, sports rehabilitation and job training work to prepare rehabilitation programs aimed at increasing muscle and ligament strength, whose effect appears mostly after 6-8 weeks, and can continue to perform them even after this period individually to maintain the result.

Whereas, physical therapy devices or massages work mainly to relieve pain, or remove the tumor and are often assigned specific sessions.

And there is the term rehabilitation sports, which means practicing some sports that have a good effect on the general health of the body, for example athletics, swimming, cycling. Often many people exercise it on a daily basis, which increases the general strength of the body.

Pedro Olabarri – Sports and Remedial Massage Therapist

The different techniques used in Sports Massage are as follows:

· Compression (dry technique): This technique allows the therapist to identify spots of tension, tender muscles, adhesions or scar tissue. It also helps to warm up, flash and relax the tissue and addresses other tissue receptors. It also deactivates or relaxes tense muscles when using deeper strokes.

· Effleurage: It consists of long and smooth strokes along the fibres of the muscle. It allows the therapist to palpate any irregularities of the tissue as well as to establish the first contact with the client’s skin. It also warms and flushes the tissue.

· Petrissage: A technique consisting on lifting, kneading and picking up the tissue. This helps to separate tissue and stimulates circulation and tissue fluid. It can also help to relax the muscle.

· Friction: The therapist applies pressure on the target muscle using thumbs, elbow or knuckles in different directions such as transverse, longitudinal or circular. The movements are slow so the depth is controlled depending on the severity of the injury or the quality of the tissue.

· Tapotement: Great technique to stimulate or relax the tissue. It does also enhance muscle tone, stimulates skin and muscle contraction, breaks up fluid congestion in lungs and stimulates sensory receptors.

· Vibration: It consists of grabbing the tissue and shaking it with controlled but firm movements. This is a dry technique and like the others it has some physiological effects such as relaxation or stimulation of the tissue, increase of blood circulation and muscle hypertonicity decrease.

· Muscle Energy Technique (MET): is a combination of techniques which allow to stretch and strengthen muscles as well as to break down adhesions.

· Soft Tissue Release is a form of stretching used mainly to elongate muscle tissue but can also help to release tensed muscles and relieve chronic tissue congestion, improve elasticity of the muscle, break up scar tissue and/or disengage adhesions.

· Trigger Points Treatment: This technique is applied with strong manual pressure and is aimed to eliminate muscle knots known as trigger points which may refer pain both in the local area or/and to other areas of the body.

· Positional release: Technique that involves moving the tightened muscle and joint into a position in which the client’s pain is reduced.

· Myofascial release: technique used to stretch and loosen the fascia which is the dense tough tissue that surrounds the muscles and bones of the body.

·

https://pedroolabarri.com

Osteopathic medicine brings a unique philosophy to traditional patient care. Understanding that the body is more than just a sum of its parts, osteopathic physicians (DOs) assist the patient’s innate capacity to heal by addressing the interrelationship of the body’s nerves, muscles, bones and organs. the American Academy of Osteopathy retains the older nomenclature to remain connected to its history and to connect with clinicians around the world who practice osteopathic manipulation.

For any medical condition, osteopathic physicians understand that each individual expresses health and disease differently and that the absence of disease does not imply the presence of health. Therefore, osteopathic physicians are trained to recognize changes in body structure that alter function which may contribute to “dis-ease.”, DOs are trained in osteopathic manipulative treatment (OMT). OMT is the therapeutic application of manual techniques by an osteopathic physician to address the changes in body structure to improve physiologic function.

The Osteopathic Principles

*The body is a unit

*Structure and function are interrelated

*The body has intrinsic healing properties

*When the normal adaptability is disrupted the body capacity for self maintenance decrease and my disease overcome

Osteopathic physicians shares many of the same goals as traditional medicine, but places greater emphasis on the relationship between organs and musculoskeletal system, Osteopaths focusing on how skeleton, joints, muscles, nerves, circulation, connective tissue and organ’s function as a holistic unit, treating the whole individual rather than just symptoms, strongly believe in the healing power of the body and do their best to facilitate that strength.

What Does a Chiropractor Do?

The scope of practice of chiropractic in Ontario is defined in the Chiropractic Act, 1991, as follows:

The practice of chiropractic is the assessment of conditions related to the spine, nervous system and joints and the diagnosis, prevention and treatment, primarily by adjustment, of,

(a) dysfunctions or disorders arising from the structures or functions of the spine and the effects of those dysfunctions or disorders on the nervous system; and

(b) dysfunctions or disorders arising from the structures or functions of the joints.

Chiropractors practise within the scope of practice to examine, diagnose and provide care to patients with a variety of health concerns related to the spine and joints and the effect on the nervous system, such as low back, shoulder and knee pain, sports injuries, and overall wellness care. Chiropractors focus on patient-centred care, use manual therapies, and often work in collaboration with other regulated health professionals.

What Can You Expect From a Chiropractor?

Patients can expect from their chiropractor:

· An initial consultation to review your complaint, case history, ask questions and review relevant paperwork and available reports;

· An explanation of the fee structure and business practices of the chiropractor;

· An explanation and consent to a physical examination and appropriate diagnostic tests;

· A chiropractic examination, which may include orthopedic, neurological, muscle function, joint function and radiographic testing;

· A report of findings, which will include a diagnosis or clinical impression with a complete explanation by the chiropractor of what has been found;

· A referral to another regulated health professional, if the chiropractor feels a health condition of the patient is outside the chiropractic scope of practice;

· Recommendations for care, which may include a course of chiropractic adjustment or manipulation and/or adjunctive therapies, such as muscle therapy, electrotherapy, lifestyle advice and recommendation of assistive devices;

· Informed consent to care;

· A course of care with appropriate re-examinations; and

· Adherence to CCO regulations, standards of practice, policies and guidelines and maintenance of appropriate privacy and confidentiality throughout the doctor/patient relationship.

Where Can You Find a Chiropractor?

Chiropractors can be found practising in a wide variety of health care settings, such as in solo practice, multi-chiropractor offices, multi-disciplinary settings, family health teams and hospitals. Many chiropractors are also involved in education, research, government, advocacy and regulation.

Scope of Practice and Authorized Acts

The scope of practice and authorized acts for Ontario chiropractors are set out in the Chiropractic Act, 1991.

Scope of Practice

The practice of chiropractic is the assessment of conditions related to the spine, nervous system and joints and the diagnosis, prevention and treatment, primarily by adjustment of:

· dysfunctions or disorders arising from the structures or functions of the spine and the effects of those dysfunctions or disorders on the nervous system; and

· dysfunctions or disorders arising from the structures or functions of the joints.

Authorised Acts

In the course of engaging in the practice of chiropractic, a member is authorised, subject to the terms, conditions and limitations imposed on his or her certificate of registration, to perform the following:

· Communicating a diagnosis identifying, as the cause of a person’s symptoms,

· a disorder arising from the structures or functions of the spine and their effects on the nervous system, or

· a disorder arising from the structures or functions of the joints of the extremities.

· Moving the joints of the spine beyond a person’s usual physiological range of motion using a fast, low amplitude thrust.

· Putting a finger beyond the anal verge for the purpose of manipulating the tailbone

Reference:

www.cco.on.ca

* The function of this ligament is to prevent the femur bone and tibia bone from sliding forward or backward .

The injury occurs:

1) 80-85% without interference .

2) 10% with the opponent's interference in the trunk. 3) 7% during jumping and landing.

Causes and mechanism of injury :

• 1) The leg is moving away from the axis of the body.

• 2) The rotation of femur bone from 10 degrees to 20 degrees inward.

• 3) The rotation of tibia bone outward and the foot points forward or outward.

• 4) Flexion in the knee joint.

• Degrees of injury in the cruciate ligament:

• 1) Sprain:Itis a stretching of the ligament, with intact muscle fibers and requires rehabilitation from 4 to 6 weeks .

• 2) Partial tear : damage occurs to the muscle fiber, the displacement is up to 3 mm, and a rehabilitation period of up to 3-4 months is required.

• 3) Complete tear: damage occurs to the entire ligament and the displacement is more than 5 mm.

• Ligament reconstruction is performed surgically and requires a rehabilitation period of at least 6 months.

• Important recommendations to prevent and reduce injury:

• *Predictive tests to find out the prediction of injury. *Orthopaedic tests.

*Structural tests.

*Muscle balance tests.