Knee Oa
Patient Scenario:
SH:Keen gardener, cuts locals grass as a job, currently not doing it due to pain in left knee and aims to get back to this activity. Walking distance reduced significantly.
Problem: Anterior Knee Pain Degenerative changes OA Struggling to fully weight bear Walking with stick for stability Left leg muscle bulk significantly reduced.
History: Previous meniscus tear whilst twisting around with post. Previous knee arthroscopy Pain hasn't improved
Objective Ax: MCL, LCL, ACL, PCL all intact. Patella compression positive test for anterior knee pain, patella femoral syndrome. Measured AROM. Left knee reduced ROM
Findings: Reduced quadricep and hamstring strength in left leg compared to right.
Initial Exercises: Isometric quadriceps Hamstring curls Calf raises. Weight bearing side to side. (balance and proprioception)
2nd Review: Improved ROM Increased strength from grade 2.5 to 3.5 Wall squats – for functional aspect related to gardening Step ups – for functional aspect hamstring curls.
Plan for next session: Check ROM Check strength Work on step ups Add proprioception exercises in.
Advice: to carry out exercises 2-3 times a day
For swelling aspects- Cryotherapy applied: 20 mins on and protected round with a towel to prevent burns on skin. Evidence attached on reliability of benefits of ice therapy.
Knee extensions: Evidence shows that knee extension exercises alone compared to knee extension combined with medial and lateral rotation of the knee activates VMO.
VMO is an active and dynamic stabiliser of the patella. In healthy, pain free individuals the fibres of VMO are active throughout the range of movement. In patients with Patello-Femoral Knee Pain (Chondromalacia Patella) the fibres contract in phases, inconsistently and fatigue easily.
The specific role of VMO is to stabilise the patella within the patella
SH:Keen gardener, cuts locals grass as a job, currently not doing it due to pain in left knee and aims to get back to this activity. Walking distance reduced significantly.
Problem: Anterior Knee Pain Degenerative changes OA Struggling to fully weight bear Walking with stick for stability Left leg muscle bulk significantly reduced.
History: Previous meniscus tear whilst twisting around with post. Previous knee arthroscopy Pain hasn't improved
Objective Ax: MCL, LCL, ACL, PCL all intact. Patella compression positive test for anterior knee pain, patella femoral syndrome. Measured AROM. Left knee reduced ROM
Findings: Reduced quadricep and hamstring strength in left leg compared to right.
Initial Exercises: Isometric quadriceps Hamstring curls Calf raises. Weight bearing side to side. (balance and proprioception)
2nd Review: Improved ROM Increased strength from grade 2.5 to 3.5 Wall squats – for functional aspect related to gardening Step ups – for functional aspect hamstring curls.
Plan for next session: Check ROM Check strength Work on step ups Add proprioception exercises in.
Advice: to carry out exercises 2-3 times a day
For swelling aspects- Cryotherapy applied: 20 mins on and protected round with a towel to prevent burns on skin. Evidence attached on reliability of benefits of ice therapy.
Knee extensions: Evidence shows that knee extension exercises alone compared to knee extension combined with medial and lateral rotation of the knee activates VMO.
VMO is an active and dynamic stabiliser of the patella. In healthy, pain free individuals the fibres of VMO are active throughout the range of movement. In patients with Patello-Femoral Knee Pain (Chondromalacia Patella) the fibres contract in phases, inconsistently and fatigue easily.
The specific role of VMO is to stabilise the patella within the patella