Knee pain with restricted mobility A forty five year old woman presented with persistent left knee pain following
a knee replacement operation complicated by a staph infection. The infection has eaten away at the tissue surrounding the
knee and had caused a large scar to form over the kneecap. She complained of persistent pain and limited motion for the three
months since the surgery despite being treated with physical therapy. I observed a great deal of swelling on the inside of her knee and a lesser degree on the outside. Flexion of her
knee caused the skin to become tight over the knee and the tissue covering the patella was immobile. When laying down, her left leg was longer than her right. Her left ankle turned in and was tender to the touch on
the outside heel.
Her left buttocks was tender as were several spots in her low and mid back along with her neck. I concluded that: - The
limited mobility and persistent pain in her knee were a result of scar formation, tissue adhesion and persistent swelling
rather than due to muscle tightness or weakness in the leg.
- The persistent swelling in her
leg was due to a lymphatic drainage problem.
- The difference in leg lengths along with trigger
points along the leg and spine indicated a biomechanical dysfunction that most likely was the original cause of knee degeneration
and also was contributing to the lack of progress after correction.
Treatment consisted
of : - Manual flexion/extension traction with heat to lengthen shortened spinal muscles.
- Intersegmental traction to improve joint mobility in the spine.
- Manual manipulation
to the spine and lower leg to remove fixations and increase circulation, proprioception and comfort.Aggressive vibratory
massage to the scar and restrictions surrounding the left knee.
- Application of Kinesio Tape
to the left knee with varying techniques to either encourage lymphatic drainage or to aid in muscle function.
- Patient was seen three times a week for four weeks.. then two times a week for six weeks and as of this writing prefers
to be seen two times a week.
Result: - A dramatic reduction
in joint restriction was observed following the first treatment and continued throughout the duration of treatment.
- Lower leg swelling is persistent and contingent upon the patients activity prior to treatment. Swelling is confined
to her ankle and medial knee but is greatly reduced in both areas.
- Patients pain has decreased
to occasional from constant.
- Patellar restriction and scar formation have both been greatly
reduced. During the initial stages of treatment improvements were observed at the top area of the scar in regard to flexibility
and coloring. As treatment progressed, the scar started to widen and become absorbed by the surrounding area.
- After the 5th week it was observed that while the tissue towards the top and bottom of the scar were improving in
mobility, the central area was slower to respond and on several visits has reverted back to its tendency to adhere to the
patella. Alterations were made in the application of the Kinesio tape which resulted in a slow yet constant improvement in
this area.
- By week 11 the whole scar has become mobile. althoug in different degrees. and lifted
from the patella.
- Patient began squatting exercises and reported increased mobility, decreased
pain and was very happy with her progress and the treatment.
Call Today for an appointment! 484-480-6820
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