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Physiotherapy Treatment For Knees

Posted by admin on December 18th, 2008 filed in Treatment


The Physiotherapy Treatment Of Injured Knees

Knee injuries are very common in accidents and sporting incidents and can cause chronic pain, loss of joint stability and difficulty with daily activities. Physiotherapy starts with a subjective examination, enquiring about how the injury occurred, what forces were involved in the event, how quickly the knee swelling appeared, whether there was knee instability or difficulty putting full weight on the knee.
The amount of pain a patient suffers indicates the severity of the injury involved and the particular location of the pain can point to which anatomical structures have been injured. As the knee will be very difficult to walk on in the presence of a fracture these injuries are rarely missed in diagnosis. During the examination the physiotherapist will test the knee structures to look for the cause of the injury.
The Knee Examination
The physiotherapist will look at the knee and check for effusion by observation or doing the patellar tap test. The knee can swell greatly and be very tight, needing aspiration by a needle. How well the knee can move when not weight bearing is assessed by the physio. Knee extension is the movement of straightening the knee out and flexion is bending the knee. The knee does have a certain degree of rotation but that is rarely checked in the initial period.
The reaction to examination testing indicates how the treatment plan should proceed. The pain level, ease of joint movement and reaction to tests are included in this assessment. The patient moves the joint actively with the physiotherapist adding passive movement to test the joint further. The power of the main antigravity muscles, the hamstrings and quadriceps, are tested by manually resisting the knee movements or asking the patient to perform weight bearing movements.
Manual testing of the knee ligaments by the physiotherapist tells him or her about these important stability structures. The physio levers the knee inwards and outwards to test the medial ligament and the lateral ligament (the collateral ligaments) and pulls the shin bone back and forward to test the anterior cruciate ligament and the posterior cruciate ligament. Manual palpation around the joint and adjacent structures can help indicate which structure has been injured.
Physiotherapy treatment plan
Cryotherapy, or cold treatment, is an initial treatment for an acute painful knee and is used to reduce the swelling and pain. If pain is reduced then movement can occur more readily, allowing rehabilitation to progress to the next stage. A compression sleeve useful to compress the effusion as swelling inhibits the function of knee muscles. Of the knee is unstable on weight bearing a brace can be used to stabilise and protect it, with crutches or a stick necessary if the patient cannot weight bear well or achieve a reasonable gait.
Once the swelling and pain are under control the physio will work on the range of motion and move onto the strength of the major muscles. The quadriceps is the most important knee muscle, allowing normal gait and stability in the knee, and so this is the first and main target of muscle strengthening physiotherapy. Weight bearing exercises are started once the knee has settled and progressed to gradually more dynamic exercises.
A normal knee joint involved in activity sends a stream of impulses up to the brain, informing us of the joint position at all times, the degree of muscle activity and movement. This is known as joint position sense (JPS) or , which is lost to some degree after injury and restoring it to a normal level is vital if the knee is to successfully return to activity. The physio starts with balancing on one leg and progresses to standing on a wobble board and finally works on active, dynamic exercises in preparation for sport.

By: Jonathan Blood-Smyth..

Article Directory: http://www.articledashboard.com

Jonathan Blood Smyth is a Superintendent Physiotherapist at an NHS hospital in the South-West of the UK. He specialises in orthopaedic conditions and looking after joint replacements as well as managing chronic pain. Visit the website hepublishes if you are looking for Physiotherapists in Kensington.

 

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3 Responses to “Physiotherapy Treatment For Knees”

  1. johnny Says:

    zHex8h Thanks for good post

  2. Enlargement Says:

    I am amazed with it. It is a good thing for my research. Thanks

  3. abiola blair Says:

    this imformation is very useful to me but wish to have the treatment plan in sequence to how to go ahead example use the ice for how long period

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