An acute knee injury commonly seen in adolescent female football players is an anterior cruciate ligament (ACL) tear, which often occurs due to hyperflexion and internal rotation of the knee. A Lachman test is used to diagnose an ACL injury by attempting to displace the tibia forward while stabilizing the femur. A prevention program including a 15-minute neuromuscular warm-up performed twice weekly was shown to reduce the rate of ACL injuries by 64% in the study. Knee injuries are generally treated initially with RICE (rest, ice, compression, elevation) and physical therapy, with surgery such as ACL reconstruction or knee arthroscopy sometimes required.

1. Acute knee injuries in adolescent
female football players

2. MOST COMMON INJURIES
 Anterior Cruciate Ligament Injuries
The ACL is injured during recovery from falling
backwards (in expert skiers) or hyperflexion and
internal rotation of the knee (in lowerlevel skiers).

3. LACHMAN TEST
 The test is performed with the patient in a supine position and the injured knee flexed to 30 degrees. The
physician stabilizes the distal femur with one hand, grasps the proximal tibia in the other hand, and then
attempts to sublux the tibia anteriorly. Lack of a clear end point indicates a positive Lachman test.

4.  Collateral Ligament Injuries
The medial collateral ligamentis a medial stabilizer
of the knee and is most commonly injured by a
blow to the lateral aspect of the knee or by the
patient planting the foot and then colliding with
another athlete.
Injury of the lateral collateral ligament is less
common but more disabling. It occurs via
hyperextension with varus stress or from a
direct blow or rotation.

5.  Knee Dislocation
This often occurs as a result of a high-speed motor A knee dislocation occurs when the bones that form the
vehicle accident. Knee dislocations are classified knee are out of place. A knee dislocation, more
according to the direction that the tibia is displaced specifically, is when the bones of the leg (the tibia and
in relation to the femur. Of knee dislocations, 50%- fibula) are moved in relation to the bone in the thigh
60% are anterior, but popliteal artery injury is most (femur). The bones of the knee are held together by
commonly associated with posterior dislocations strong bands of tissue called ligaments. Each ligament
is responsible for stabilizing the knee in a certain
position. For a knee dislocation to occur, these
ligaments must tear.

6. PREVENTION
 15 minute neuromuscular warm-up programme (targeting: core stability, balance, and proper
knee alignment) to be carried out twice a week throughout the season.

7. Exercises
 one legged knee squat
 pelvic lift
 two legged knee squat
 the bench(step over knee)
 the lunge
 and jump/landing technique

8. INTERVENTION INFORMATION
 The exercises were preceded by 5 minutes of low intensity running and took about
15 minutes to complete after familiarisation. The intervention clubs were instructed
to do the exercises during the warm-up at two training sessions a week throughout
the whole season. All players started on the first level of difficulty and proceeded to
the next level when exercises were performed with good control as assessed by the
coach.
Example of described exercise

9. RESULTS OF PREVENTION
 Seven players (0.28%) in the intervention group, and 14 (0.67%) in the control group had an
anterior cruciate ligament injury. By Cox regression analysis according to intention to treat, a
64% reduction in the rate of anterior cruciate ligament injury was seen in the intervention group
(rate ratio 0.36, 95% confidence interval 0.15 to 0.85). The absolute rate difference was −0.07
(95% confidence interval −0.13 to 0.001) per 1000 playing hours in favour of the intervention
group. No significant rate reductions were seen for secondary outcomes.
 A 15 minute neuromuscular warm-up programme reduced the overall rate of anterior cruciate
ligament injury by 64% in adolescent female football players Players who carried out the
programme at least once a week (compliers) additionally had lower rates of severe knee injury
(>4 weeks’ absence) and any acute knee injury Neuromuscular training should be part of the
warm-up programme for young female football players

10. TREATMENT
 Almost all knee injuries will need more than one visit to the doctor. If no operation is indicated,
then RICE (rest, ice, compression, and elevation) with some strengthening exercises and
perhaps physical therapy will be needed. Sometimes the decision for surgery is delayed to see
if the RICE and physical therapy will be effective. Each injury is unique, and treatment decisions
depend on what the expectation for function will be. As an example, a torn ACL (anterior
cruciate ligament) would usually require surgery in a young athlete or a construction worker, but
the ACL may be allowed to heal with physical therapy in an 80-year-old who is not very mobile.

12. KNEE ARTHROSCOPY
 is a minimally invasive surgical procedure in which an examination and sometimes treatment of
damage of the interior of a joint is performed using an arthroscope, a type of endoscope that is
inserted into the joint through a small incision.
Today knee arthroscopy is commonly performed for
reconstruction of the anterior cruciate ligament.
Arthroscopy can also be performed just for diagnosing
and checking of the knee; however, the latter use has
been mainly replaced by magnetic resonance imaging.
During an average knee arthroscopy, a small fiberoptic
camera (the arthroscope) is inserted into the joint
through a small incision, about 4 mm (1/8 inch) long. A
special fluid is used to visualize the joint parts. More
incisions might be performed in order to check other
parts of the knee. Then other miniature instruments are
used and the surgery is performed.

13. EXERCISE GUIDE AFTER KNEE ARTHROSCOPY
 Before You Start
Recommendation: approximately 20 to 30 minutes of exercises two or three times a day.
As you increase the intensity of your exercise program, you may experience temporary set backs.
If your knee swells or hurts after a particular exercise activity, you should lessen or stop the activity
until you feel better.
You should Rest, Ice, Compress (with an elastic bandage), and Elevate your knee
(R.I.C.E.).
Initial Exercise: Hamstring Contraction

14.  Intermediate Exercise: Terminal Knee Extension, Supine
Advanced Exercise: Step-ups, Forward

15. THANKS FOR ATTENTION