Unraveling the Mystery of Knee Pain #4: Medial and Lateral Coronary Ligament Sprains
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1 Unraveling the Mystery of Knee Pain #4: Medial and Lateral Coronary Ligament Sprains 1 Instructor: Ben Benjamin, Ph.D. 2 1
2 Instructor: Ben Benjamin, Ph.D. 3 Webinar Goals Explore the assessment and treatment of one of the most ubiquitous injuries to the knee, coronary ligament sprains. 4 2
3 Time: 60 minutes Schedule: Logistics Presentation minutes Questions minutes Ongoing questions: Use Question box. If I don t get to your question, ask me on my Dr Ben Benjamin Facebook page after the webinar. Get a pen and paper please 5 Pretest 1. The function of the medial coronary ligament is to limit lateral rotation. True or False? 2. The coronary ligaments attach the femur to the tibia. True or False? 3. Both coronary ligaments are attached to the medial meniscus. True or False? 4. Medial rotation of the lower leg tests the lateral coronary ligament. True or False? 5. Valgus stress test sometimes creates a false positive for the medial coronary ligament. True or False? 6. The coronary ligaments help cushion the femur on the tibia. True or False? 6 3
4 Anatomy 7 Coronary Ligaments Also known as meniscotibial ligaments Connect inferior edges of menisci to joint capsule Medial coronary ligament limits lateral rotation Lateral coronary ligament limits medial rotation 8 4
5 Locating Coronary Ligaments Medial Coronary Lateral Coronary 9 Assessment 10 5
6 Passive Lateral Rotation 11 Passive Medial Rotation 12 6
7 Passive Flexion 13 Passive Extension 14 7
8 Heat Test 15 False Positives When you get a positive pain result but not for the structure you are testing. 16 8
9 False Positives Lateral Pain when testing the medial collateral ligament crushes the lateral coronary ligament 17 False Positives Medial Pain when testing the lateral collateral ligament crushes the medial coronary ligament 18 9
10 Theory 19 Medial Coronary Ligament Positive Tests MI: Passive Lateral Rotation is painful (this is a major indicator) AUX: Passive Flexion of the Knee is painful and often limited AUX: Passive Extension of the Knee is painful and often limited Heat Test: The injured knee is often hot or at least warmer then the good knee 20 10
11 Lateral Coronary Ligament Positive Tests Swelling Test 21 Lateral Coronary Ligament Lateral coronary ligament is not attached to Lateral Collateral Ligament Lateral coronary injuries often mistaken for IT band strain, lateral hamstring injury, meniscus tear At times feels like the knee will collapse 22 11
12 Lateral Coronary Ligament Lateral coronary ligament is not attached to Lateral Collateral Ligament Lateral coronary injuries often mistaken for IT band strain, lateral hamstring injury, meniscus tear At times feels like the knee will collapse 23 Lateral Coronary Ligament Positive Tests MI: Passive Medial Rotation is painful (this is a major indicator) AUX: Passive Flexion of the Knee is painful and often limited AUX: Passive Extension of the Knee is painful and often limited Heat Test: The injured knee is often hot or at least warmer then the good knee Swelling Test: The knee is often swollen
13 How it Happens Dancing Soccer Basketball Football Running Poor knee alignment 25 How it Happens Dancing Soccer Basketball Football Running Poor knee alignment 26 13
14 Treatment 27 Friction Therapy Medial Coronary Lateral Coronary 28 14
15 Myofascial Therapy 29 Massage Therapy 30 15
16 Exercise Therapy Medial Coronary Ligament Stretch 31 Exercise Therapy Lateral Coronary Ligament Stretch 32 16
17 Exercise Therapy 33 Questions Facebook.com/DrBenBenjamin 34 17
18 Post-test 1. The function of the medial coronary ligament is to limit lateral rotation. True or False? 2. The coronary ligaments attach the femur to the tibia. True or False? 3. Both coronary ligaments are attached to the medial meniscus. True or False? 4. Medial rotation of the lower leg tests the lateral coronary ligament. True or False? 5. Valgus stress test sometimes creates a false positive for the medial coronary ligament. True or False? 6. The coronary ligaments help cushion the femur on the tibia. True or False? 35 18
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