Knee Injures in football

Abstract

Zglob koljena najveći je i najsloženiji zglob u ljudskom tijelu, a povezuje bedrenu kost (femur), goljeničnu kost (tibia) i iver (patelu). Stabilnost koljena osiguravaju ligamenti, menisci i mišići. U koljenu su mogući pokreti poput savijanja, ispružanja te blago rotacijski pokreti. Koljenski zglob je izuzetno složen i omogućuje veliku pokretljivost te podnosi velika biomehanička opterećenja, zbog čega spada u tzv. "zglobove u opterećenju". Zbog svoje kompleksne strukture, koljeno je sposobno prilagoditi se različitim aktivnostima poput hodanja, trčanja i penjanja, što uključuje važne pokrete poput fleksije, ekstenzije i rotacije potkoljenice. Mehaničke sile djeluju na koljeno čak i u mirovanju, dok se tijekom hodanja, a osobito pri hodanju po stepenicama, tibiofemoralni zglob opterećuje silom koja može biti i četiri puta veća od tjelesne težine. Patella u patelofemoralnom zglobu ima ključnu ulogu u ekstenziji koljena i raspodjeli naprezanja unutar zgloba. Zbog složene strukture zgloba i nekongruentnosti zglobnih površina, stabilnost koljena osiguravaju statički i dinamički stabilizatori, koji uključuju ligamente, meniske i mišićnu aktivnost. Nogomet je dinamičan sport koji uključuje učestale promjene smjera, nagla zaustavljanja, ubrzanja, skokove i kontakte s drugim igračima. Ovakvi zahtjevni pokreti i visoka opterećenja čine koljeno jednim od najugroženijih zglobova, osobito ako mišićna stabilnost nije adekvatna ili ako postoji prethodna ozljeda. U nogometu postoje brojne ozljede ne samo koljena nego i drugih dijelova tijela. Najčešće ozljede koje se javljaju su ozljede prednjeg ukriženog ligamenta, česte su kod naglih promjena pravca ili doskoka, a zahtijevaju dugotrajnu rehabilitaciju i često kirurški zahvat zatim ozljede meniska, nastaju pri uvrtanju koljena pod opterećenjem i mogu uzrokovati bol, oteklinu i zakočenost zgloba i ozljede kolateralnih ligamenata koje nastaju prilikom naglih bočnih pokreta, krivih doskoka. Rehabilitacija koljena uključuje postupnu obnovu pokretljivosti, snage i stabilnosti zgloba nakon ozljede ili operacije. Program rehabilitacije prilagođava se vrsti ozljede i fazama oporavka, a može uključivati fizikalnu terapiju, vježbe snage i ravnoteže te postepeni povratak sportskim aktivnostima.The knee joint is the largest and most complex joint in the human body, connecting the femur, tibia and patella. The stability of the knee is ensured by ligaments, menisci and muscles. In the knee, movements such as bending, stretching and slightly rotational movements are possible. The knee joint is extremely complex and provides great mobility and withstands high biomechanical loads, which is why it belongs to the so-called "joints under load". Due to its complex structure, the knee is capable of adapting to various activities such as walking, running and climbing, which includes important movements such as flexion, extension and rotation of the lower leg. Mechanical forces act on the knee even at rest, while during walking, and especially when walking up stairs, the tibiofemoral joint is loaded with a force that can be four times the body weight. The patella in the patellofemoral joint plays a key role in the extension of the knee and the distribution of stress within the joint. Due to the complex structure of the joint and the incongruence of the articular surfaces, the stability of the knee is ensured by static and dynamic stabilizers, which include ligaments, menisci and muscle activity. Football is a dynamic sport that involves frequent changes of direction, sudden stops, accelerations, jumps and contact with other players. Such demanding movements and high loads make the knee one of the most vulnerable joints, especially if muscle stability is not adequate or if there is a previous injury. In football, there are numerous injuries not only to the knee but also to other parts of the body. The most common injuries that occur are anterior cruciate ligament injury - they are common in sudden changes of direction or landing, and require long-term rehabilitation and often surgery, meniscus injuries - occur when twisting the knee under load and can cause pain, swelling and stiffness of the joint and injuries to the collateral ligaments - sudden lateral movements, wrong landings. Knee rehabilitation involves the gradual restoration of the joint's mobility, strength, and stability after injury or surgery. The first goal is to reduce pain and swelling, and then focuses on strengthening the muscles around the knee, improving flexibility, and restoring functionality. The rehabilitation program is adapted to the type of injury and the stages of recovery, and may include physical therapy, strength and balance exercises, and a gradual return to sports activities