Hi My name is Dwijen K Pandya. I am a physio from India, i have recently completed my studies and i am currently practising physiotherapy in the field of cardio respiratory physiotherapy. However, I have a query about a patient with a knee problem.
My Patient suffered a knee injury while trying to walk quickly at home. She sort of twisted her leg while trying to walk quickly, since then she developed a sort of limping gait pattern, where the main problem was that she couldnt extend the knee fully.
Last december she met an ortho surgeon (this was 1 yr after the injury) and the MRI Scan investigations revealed meniscal injuries and low grade cruciate ligament injuries in the left knee. She underwent a surgery (on 24/12/2008) after which the pain was gone completely and swelling sustained after the injury was reduced comparatively. At present, the major problem still remains the same, that being of not being able to extend the knee fully, and a limping gait. Hamstrings and quadriceps both have a power of 3+ to 4. However, with a lot of efforts from my side, there are improvements in both the gait and the knee extension problem but the issue is not resolved fully.
Any body with any helpful suggestions to this problem are welcome, kindly help me out.
Any specific suggestions about MFR Techniques to release the muscle contractures are wel come Thanks in advance
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I would check to make sure it is the hamstrings and not the plantarflexors. Lay the pt prone and see if the knee goes straight. If not I would take a closer look at gastroc etc length (ie dorsiflexion ROM). If the pt has been walking with a flexed knee for basically a year as you stated, there are going to be posterior joint capsule contractures. Check the capsule for tightness comparable to the other side. Add joint mobs if it is tight. Contractures of that time period also need several hours of low-load prolonged stretches. I will try and find the article but it was along the lines of 2-3 hours slowly building up of course to obtain changes that stay.