Knee - Manual Therapy Flashcards
General Soft Tissue Techniques
- Noninvasive techniques include = ?
- Invasive techniques include = ?
Manual Therapy - Knee
General Soft Tissue Techniques:
- Noninvasive :
- Effleurage and Petrissage
- Bend & stretch
- Ischemic compression
- Myofascial release holds
- Scar massage
- Instrument-assisted soft tissue mobilization
- Invasive :
- Dry Needling (Deep/Superficial)
Quads, Hamstrings, ITB, Gastroc, Adductors
- Quads, Hamstrings, ITB, Gastroc, Adductors
Cross-Friction Massage
- This technique is used for patients experiencing ?.
- Cross-friction force is applied in ? direction.
- How long sould this technique be performed ?
Manual Therapy - Knee
Cross-Friction Massage:
- Indication:
- This technique is used for patients experiencing tendinopathy.
- Goal:
- Improve Recollagenation
- Discourage Neural Ingrowth
- Decrease Pain
- Overview:
- The patient is positioned in supine or sitting.
- Cross-friction force is applied in a one-directional motion across the tendon.
- Force should be mildly irritable but very tolerable for the patient.
- Perform this technique ~2 min. at one intensity and increase intensity for another 2 minutes if there was local pain reduction in the area.
Patellofemoral Mobilization
- These techniques are used for patients experiencing ?.
- Mobilization is performed for ? ( how long )
Manual Therapy - Knee
- Indication:
- These techniques are used for patients experiencing patellofemoral restriction.
- Goal:
- Improve capsular mobility.
- Improve Range of Motion.
- Overview:
(I) The patient is positioned in supine with a towel under their knee.
(II) Mobilization force is applied similarly to that of joint play to the patella:
- Superior = Promotes Extension
- Inferior = Promotes Flexion
- Medial Glide = Improves Patellar Tracking
- Medial Tilt = Improves Patellar Tracking
(III) Perform this mobilization for 4 x 30-45 seconds, or until capsular change
(IV) Finish the technique with neuro-muscular re-education.
- Agonist → Antagonist → Agonist
Patellofemoral Mobilization
Mobilization force is applied similarly to that of joint play to the patella:
- Superior mobilization promotes = ?
- Inferior mobilization promotes = ?
- Medial Glide improves = ?
- Medial Tilt improves = ?
Manual Therapy - Knee
(I) Mobilization force is applied similarly to that of joint play to the patella:
- Superior = Promotes Extension
- Inferior = Promotes Flexion
- Medial Glide = Improves Patellar Tracking
- Medial Tilt = Improves Patellar Tracking
Tibiofemoral Extension Mobilization
- This technique is used for patients experiencing ?.
- Mobilization force is applied in a ? direction.
- Mobilization is performed for ? ( how long ).
Manual Therapy - Knee
Tibiofemoral Extension Mobilization
- Indication:
- This technique is used for patients experiencing tibiofemoral restriction in extension.
- Goal:
- Improve capsular mobility.
- Improve Range of Motion.
- Overview:
- The patient is positioned in supine.
- Stabilization is provided by a towel or your hand on the proximal posterior tibia.
- Mobilization force is applied in a posterior direction to the distal femur.
- Perform this mobilization for 4 x 30-45 seconds, or until capsular change
Finish the technique with neuro-muscular re-education
- Agonist → Antagonist → Agonist
Tibiofemoral Flexion Mobilization
- This technique is used for patients experiencing ?.
- Mobilization force is applied in a ? direction.
- Mobilization is performed for ? (how long ).
Manual Therapy - Knee
Tibiofemoral Flexion Mobilization:
- Indication:
- This technique is used for patients experiencing tibiofemoral restriction in flexion.
- Goal:
- Improve capsular mobility.
- Improve Range of Motion.
- Overview:
- The patient is positioned in supine with their knee flexed.
- Stabilization is optional and may be provided to the femur or distal tibia.
- Mobilization force is applied in a posterior direction to the proximal tibia.
- Perform this mobilization for 4 x 30-45 seconds, or until capsular change
Finish the technique with neuro-muscular re-education
- Agonist → Antagonist → Agonist
Tibiofibular Posterior Mobilization
- This technique is used for patients experiencing ?.
- Mobilization force is applied in an ? or ? directions.
- Mobilization is performed for ? (how long ).
Manual Therapy - Knee
Tibiofibular Posterior Mobilization:
- Indication:
This technique is used for patients experiencing
- tibiofemoral restriction in extension ,
- reduced tibial external rotation ,
- peroneal nerve irritation .
- Goal:
- Improve Knee Extension.
- Improve Tibial External Rotation.
- Reduce Peroneal Nerve Irritation
- Overview:
- The patient is positioned in supine with a towel under their knee.
- Mobilization force is applied in an anterior direction to the proximal tibia with your inside hand.
- Mobilization force is applied in a posterior-medial direction to the proximal fibula with your outside hand.
- Perform this mobilization for 4 x 30-45 seconds, or until capsular change
Finish the technique with neuro-muscular re-education
- Agonist → Antagonist → Agonist
Tibiofibular Anterior Mobilization
- This technique is used for patients experiencing ?.
- Mobilization force is applied in an ? direction.
- Mobilization is performed for ? (how long ).
Manual Therapy - Knee
Tibiofibular Anterior Mobilization:
- Indication:
- This technique is used for patients experiencing tibiofemoral restriction in flexion, reduced tibial internal rotation, prior ankle inversion sprain, or peroneal nerve irritation.
- Goal:
- Improve Knee Flexion and/or Tibial Internal Rotation
- Improve Mobility s/p Inversion Trauma
- Reduce Peroneal Nerve Irritation
- Overview:
- The patient is positioned in quadruped.
- Stabilization force brings the foot and ankle into dorsiflexion.
- Mobilization force is applied in an anterior-lateral direction to the proximal fibula.
- Perform this mobilization for 4 x 30-45 seconds, or until capsular change
Finish the technique with neuro-muscular re-education
- Agonist → Antagonist → Agonist
Tibiofibular Anterior Mobilization
- Goals = ?
Manual Therapy - Knee
Tibiofibular Anterior Mobilization:
- Goal:
- Improve Knee Flexion / Tibial Internal Rotation
- Improve Mobility s/p Inversion Trauma
- Reduce Peroneal Nerve Irritation
Tibiofibular Posterior Mobilization
- Goals = ?
Manual Therapy - Knee
Tibiofibular Posterior Mobilization:
- Goal:
- Improve Knee Extension.
- Improve Tibial External Rotation.
- Reduce Peroneal Nerve Irritation
Meniscotibial Flexion Mobilization
- Goals = ?
Manual Therapy - Knee
Meniscotibial Flexion Mobilization
- This technique is used for patients experiencing ?.
- Mobilization force is applied in an ? direction.
- Oscillation force into ?.
- Mobilization is performed for ? (how long ).
Manual Therapy - Knee
Meniscotibial Flexion Mobilization:
- Indication:
- This technique is used for patients experiencing tibiofemoral restriction in flexion .
- Goal:
- Improve capsular mobility
- Improve Range of Motion
- Overview:
- The patient is positioned in supine with their knee flexed and tibia in internal rotation.
- Mobilization force is applied in an anterior direction to the proximal tibia with both hands
- The lateral hand pulls more than the medial hand, thereby encouraging internal rotation.
- Oscillation force into Tibial Internal Rotation is added to the mobilization.
- Perform this mobilization for 4 x 30-45 seconds, or until capsular change
Finish the technique with neuro-muscular re-education
- Agonist → Antagonist → Agonist
Meniscofemoral Flexion Mobilization
- This technique is used for patients experiencing ?.
- Mobilization force is applied in an ? direction.
- Oscillation force into ?.
- Mobilization is performed for ? (how long ).
Manual Therapy - Knee
Meniscofemoral Flexion Mobilization:
- Indication:
- This technique is used for patients experiencing tibiofemoral restriction in flexion .
- Goal:
- Improve capsular mobility.
- Improve Range of Motion.
- Overview:
- The patient is positioned in supine with their knee flexed and tibia in internal rotation.
- Stabilization is optional and may be provided to the femur or distal tibia.
- Mobilization force is applied in a posterior-inferior direction to the proximal tibia at 45° .
- Oscillation force into Tibial Internal Rotation is added to the mobilization.
- Perform this mobilization for 4 x 30-45 seconds, or until capsular change
Finish the technique with neuro-muscular re-education
- Agonist → Antagonist → Agonist
Meniscofemoral Flexion Mobilization
- Goals = ?
Manual Therapy - Knee
Tibiofemoral Flexion Mobilization
- Goals = ?
Manual Therapy - Knee
Neuromuscular Re-education in Terminal Extension
- This technique is used for patients experiencing ?
- What mobilization forces are applied ?.
- Perform this mobilization for ? min.
Manual Therapy - Knee
Neuromuscular Re-education in Terminal Extension:
- Indication:
- This technique is used for patients experiencing tibiofemoral restriction in extension.
- Goal:
- Improve Terminal Extension.
- Improve Neuromuscular Control.
- Overview:
- The patient is positioned in a stride stance with the involved leg forward.
- The patient should hold on for balance.
- Ask the patient to step forward with the uninvolved leg as you provide your mobilization force.
- Posterior mobilization force is applied to the medial distal femur with the outside hand with Internal Rotation overpressure at end range. (Top Hand)
- Anterior mobilization force is applied to the medial proximal tibia with External Rotation overpressure at end range. (Bottom Hand)
- Perform this mobilization for ~2 minutes.
Neuromuscular Re-education in Terminal Extension
- Goals = ?
Manual Therapy - Knee
Neuromuscular Re-education in Terminal Extension:
- Goal:
- Improve Terminal Extension.
- Improve Neuromuscular Control.
