Knee Internal Derangement in a 19-Year-Old Collegiate Football Player: A Case Study

Football is comprised of intense, high-velocity movements that result in relatively high injury rates at all levels of athletics. Knowledge of how to adequately prevent, evaluate, treat, and rehabilitate sports related injuries is imperative for medical professionals, especially athletic trainers. Specifically, knee internal derangement is a common set of pathologies in football athletes; the structures involved mainly include ligamentous and cartilaginous structures. In our case, a 19-year-old collegiate football player experienced a Grade-III PCL sprain, Grade-I MCL sprain, tear of the posterior horn of the medial meniscus, and a lateral tibial plateau fracture with accompanying traumatic synovitis, all in response to a hyperextension mechanism. Internal knee derangement is commonly associated with a hyperextension mechanism; however, the specific combination of structures involved in this case is quite unique, allowing for in depth discussion on the intricacies of knee anatomy and biomechanics as discussed in peer reviewed research. Further, our case’s specific combination of pathologies complicates the injury evaluation, treatment, and rehabilitation phases of care. This case highlights the role of athletic trainers in diagnosis and how to adequately prioritize care for an athlete suffering from multiple concurrent pathologies; each varying in their severity, ability to heal through natural processes, and timeline for return to play. Through applying the principles and take home points of this case, medical professionals may further prevent, evaluate, treat, and rehabilitate sports related injuries

Corticospinal Activity During A Single-Leg Stance In People With Chronic Ankle Instability

Purpose: The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability (CAI), lateral ankle sprain copers, and healthy controls. Methods: Twenty-three participants with CAI, 23 lateral ankle sprain copers, and 24 healthy control participants volunteered. Active motor threshold (AMT), normalized motor-evoked potential (MEP), and cortical silent period (CSP) were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task. Results: Participants with CAI had significantly longer CSP at 100% of AMT and lower normalized MEP at 120% of AMT compared to lateral ankle sprain copers (CSP100%: p = 0.003, MEP120%: p = 0.044) and controls (CSP 100%: p = 0.041, MEP120%: p = 0.006). Conclusion: This investigation demonstrated altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with CAI. Further research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI

Corticospinal Activity during a Single-Leg Stance in People with Chronic Ankle Instability

PURPOSE: The aim of the study was to determine whether corticospinal excitability and inhibition of the tibialis anterior during single-leg standing differs among individuals with chronic ankle instability (CAI), lateral ankle sprain copers, and healthy controls. METHODS: Twenty-three participants with CAI, 23 lateral ankle sprain copers, and 24 healthy control participants volunteered. Active motor threshold (AMT), normalized motor-evoked potential (MEP), and cortical silent period (CSP) were evaluated by transcranial magnetic stimulation while participants performed a single-leg standing task. RESULTS: Participants with CAI had significantly longer CSP at 100% of AMT and lower normalized MEP at 120% of AMT compared to lateral ankle sprain copers (CSP100%: p = 0.003; MEP120%: p = 0.044) and controls (CSP100%: p = 0.041; MEP120%: p = 0.006). CONCLUSION: This investigation demonstrated altered corticospinal excitability and inhibition of the tibialis anterior during single-leg standing in participants with CAI. Further research is needed to examine the effects of corticospinal maladaptations to motor control of the tibial anterior on postural control performance in those with CAI