Injury Mechanisms

Most sports medicine professionals must deduce the cause of injuries from the history presented by patients or clients. Occasionally athletic trainers may be at a practice or competition where they witness an injury. Knowledge of the biomechanical causes of certain injuries can assist an ath letic trainer in these situations, in that diagnosis of the particular tissues injured is facilitated. Imagine you are an athletic trainer walking behind the basket during a basketball game. You look onto the court and see one of your athletes getting injured as she makes a rebound (see Figure 12.1). What kind of injury do you think occurred? What about the movement gave you the clues that certain tissues would be at risk of overload?

The athlete depicted in Figure 12.1 likely sprained several knee ligaments. Landing from a jump is a high-load event for the lower extremity, where muscle activity must be built up prior to landing. It is likely the awkward landing position, insufficient pre-impact muscle activity, and twisting (internal tibial rotation) contributed to the injury. It is also likely that the anterior (ACL) and posterior (PCL) cruciate ligaments were sprained. The valgus deformation of the lower leg would also suggest potential insult to the tibial (medial) collateral ligament. Female athletes are more likely to experience a non-contact ACL injury than males (Malone, Hardaker, Gar-rett, Feagin, & Bassett, 1993), and the majority of ACL injuries are non-contact injuries (Griffin et al., 2000). There are good recent reviews of knee ligament injury mechanisms (Bojsen-Moller & Magnusson, 2000; Whiting & Zernicke, 1998).

You rush to the athlete with these injuries in mind. Unfortunately, any of these sprains are quite painful. Care must be taken to comfort the athlete, treat pain

Figure 12.1. A basketball player injuring her knee during a rebound.

and inflammation, and prevent motion that would stress the injured ligaments. Joint tests and diagnostic imaging will eventually be used to diagnosis the exact injury. What biomechanical issue or principle do you think was most influential in this injury?

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