Restricted Knee Movement and Knee Pain Walking

Restricted Knee Movement and Knee Pain Walking
An elderly lady (83 yr old) contacted me 3 weeks ago looking to make an appointment, she told me she found me @ www.romphysicaltherapy.ie when she googled Physical Therapy Lucan, she is 83 yr old, cool super granny.

Her Chiropractor had suggested she get some physical therapy on the back of her knee due to posterior knee pain and restriction. She had been attending her chiropractor for a number of years having manipulations carried out every 3-4 weeks, it has gotten to the stage were she would only get a couple of days relief following the manipulations on her spine, pelvis and occasionally on her knee.

On her first appointment she reported intermittent knee pain at the back of the knee at 5/10, pain walking, going down the stairs and moving from sitting to standing position, she has been going up and down the stairs sideways, one step at a time for a number of years.

Her knee is restricted to 160 degrees of extension and 90 degrees of flexion, with a hard end feel, this range may never improve due to OA. She also had hypertonic gastroc, quad and her popliteaus muscle was tender on palpation.

The 1st appointment involved the assessment and some simple soft tissue work (STW) to calf, hamstring, quads and popliteaus, hip & knee mobs. Home exercise was simple repeated knee extension exercise.

2nd appointment she reported the knee has felt loser, less pain walking 3/10 and relief lasted a few days, on examination gastro was still hypertonic and pain on palpation, popliteaus muscle had released significantly. Home exercises involved more hip strengthening exercise: Single Leg Raises, Clam, Abduction and Quad Sets. She was due to have an app with her chiropractor before her next appointment.

3rd appointment she reported very little pain in the back of the knee, she was now walking up and down the stairs correctly with slight pain, she never thought she would be able to do it. At her chiropractor visit the chiropractor said the lumber spine and sacro illiac joint was no longer misaligned and she did not carry out a manipulation on this region for the first time in years.

I have added some simple step up/down exercises to assist with her single leg strength, to facilitate her going up and down the stairs. The client commented she should have started exercises a long time ago but felt they would make her worse…..years of manipulations with little improvement and lessening relief, 3 weeks of simple isolated strengthening exercises and she is now climbing stairs and walking pain free….go figure!!!

She is due back in 10 days so hopefully she is flying up and down the stairs. Forgot to mention that she also has a stair lift at home which she refuses to use!!!


Range of Motion Physical Therapy Gift Vouchers

Range of Motion Physical Therapy Gift Vouchers

Treat someone special to a Christmas Gift Voucher from Range of Motion Physical Theapy
A great Christmas present idea for someone in your life that does a lot of training or enjoys a good deep tissue or sports massage.

Gift Vouchers now available for Christmas and special occasions, contact me should you wish to place an order!!

 


Plantar Fasciitis:

At Range of Motion Physical Therapy Lucan, we see a lot of clients with plantar fasciitis, below is an article to give you an overview and some good exercises to help prevent and treat plantar fasciitis.

The plantar fascia is a ligament (attaches bone to bone) that supports the arch of the foot. Plantar fasciitis is a degenerative condition of the fascia which is probably caused by repetitive microtrauma and occurs at its proximal attachment. Plantar fasciitis affects mainly middle aged or older people and those who walk a lot and/or have an increased body weight are more at risk.
Reduced range of ankle dorsiflexion, calf- and hamstring tightness are associated with plantar fasciitis.
Differential diagnosis: Achilles tendinopathy, subtalar arthritis, S1 nerve root impingement, fat pad contusion, calcaneal bone bruise or stress fracture.

Symptoms:
- Pain and tenderness of the bottom (sole) of the foot.
- Pain weight-bearing on the involved foot, especially the first steps after awakening from sleep.
- Pain is burning, often sharp, and can be severe.
- The symptoms may come on gradually or appear following an athletic activity.

Treatment options:
- Foot Strenghtening Exercises
- Footwear modifications to reduce pronation and thereby unload the plantar fascia.
- Stretching techniques (night splints)
- Extracorporeal shock wave
- Cortisone injections
- Surgery
- Weight loss

Some interesting Foot Arch Strengthening Exercises to try!!!

Arch Strengthening Exercise:

If you are experiencing any of the symptoms above contact us for an assessment and treatment on how to resolve this issue.

British Medical Journal 345 (2012) e6603. All rights reserved to BMJ Publishing Group Ltd.