Lenoir-Rhyne University
Athletic Training Education Program
Scenario Outline: Jonathon Inscore
Jonathon Inscore is a 15-year-old defensive back that is playing on your varsity football team. On October 15th, he was involved in a pile-up at practice when he sustained a 2nd degree MCL sprain of the right knee. The physical exam revealed edema, erythema, and pain at the medial aspect of the right knee. Pain is greatest in the distal 1/3 of the MCL down to the insertion.
Pain on palpation of MCL greatest at distal 1/3 (Pain is described as sharp, 8/10 pain)
AROM is limited due to pain and edema
Valgus at 25deg. = (+) with moderate laxity and pain, spongy endpoint
Valgus at 0deg. = (-) for laxity, with pain
Ligamentous tests for the LCL, ACL, and PCL are negative
Meniscal tests are negative.
The physical exam also reveals a 5mm laxity with Lachman’s and Anterior Drawer for the Left Knee that you were unaware of.
1) What are the possible explanations for the laxity found in the left knee?
2) How could you have known about the left knee prior to this incidence?
3) From a physiological perspective, why is the athlete experiencing or displaying the current signs/symptoms in the right knee?
4) Explain the possible mechanisms of injury for the right knee. Which mechanism of injury would you suspect occurred in this case and why?
5) Thoroughly explain your on-field action plan for this athlete.
6) Thoroughly explain your off-field action plan for this athlete.
7) 2 weeks post-injury the athlete has less pain at the MCL but continues to have medial pain, erythema, and edema. He notes that the pain is greatest with TDWB and an active quad contraction.
a. Why would the athlete show little signs of recovery? What else could be happening?
b. What is your action plan at this time?