Barkov Injury - KNEE ON KNEE

Alex Barkov of the Florida Panthers was injured in the game against the Anaheim Ducks.

Welcome back, Dr. Wilson here, this channel was created for the understanding of the mechanisms of sports injuries.

We'll look at the replay here. So, we see Barkov who is number 16 for the Panthers here, is skating through the neutral zone and moves to his right to go around the Ducks defenseman. When he skates to his right, his left knee makes contact with the left knee of the defenseman. We can see it even better on this angle. So when this happens, I want you to look closely at the positioning of their legs and see if you can determine which player has more leverage or stability going into the impact. Here, we see Barkov's left hip in a fairly straight up and down position which we can accurately define as let's say a neutral position. If we compare that to the defenseman's left hip, his hip is forward in a position of flexion. Also, take a look at Barkov's left knee. His knee is also fairly straight. But again, compare that to the defenseman's knee. His knee is bent in again a position of flexion. So with Barkov's hip and knee both in a straight vertical position and is about to slam into the defenseman's leg who's hip and knee are both flexed, it is pretty easy to predict who has more stability, rigidity and who is more likely to get hurt. Then we follow through a bit through the play we can see Barkov's knee hyperextending a bit past its normal comfortable range of motion. There are certain structures in your knee that are in place to prevent movement like this from occurring in your knee. Mainly, your posterior cruciate ligament. And an injury to this structure is a concern for Barkov. Your PCL is designed to prevent or hold back your knee from an over extension type of movement.

When we look at the anatomy model of a knee we can see the thigh bone and femur at the top and your shin bone and tibia below your knee joint. Deep inside your knee joint we have two ligaments that work together to help stabilize your knee. These are your anterior cruciate and posterior cruciate ligaments. Here is your ACL, it is a little rope that connects from the top of your shin bone to the bottom of your thigh bone. Its job is to hold your knee joint in place and to prevent forward movement of your shin bone or tibia relative to your thigh. Its partner here is the PCL which is located next to it and its job is to prevent backward movement of your shin bone relative to your thigh, just like a hyperextension type movement. Orthopedically we would use what is called a posterior drawer test to investigate whether there is any excess movement or laxity of the PCL and if there is, it will also produce what we call a Posterior Sag where the shin bone or tibia will visibly move backwards or posteriorly relative to the thigh or knee joint.

Now if we go back to the replay again, we can see the impact of their legs together will cause that hyperextension type of movement in Barkov's knee which will stress those ligament's inside of his knee that we just talked about. This movement can also be harmful to the meniscus as well. Certainly bruising or a hematoma with some subsequent swelling is a given for Barkov to have to go through here, but the real danger is just how much strain was placed onto his PCL or ACL and that will dictate how long Barkov is out of action. Now currently he is listed as only day-to-day with a lower body injury which is encouraging. You can form what opinion you want to in regards to what was the intent of the defenseman, whether he wanted to initiate that knee on knee contact or not. Personally I don't think there was intent on the play, but regardless, he is responsible for the control of his legs and how he contacts other players. Clearly he was in the wrong, it's just a matter as to what degree. Please let me know what you think in the comments below. Do you think there was intent or not and who bares responsibility here. Take care.