Knee rehabilitation Flashcards
What are some common knee injuries?
- Ligament sprain/rupture (ACL/MCL)
- Ligament reconstruction (ACL)
- Patellar subluxation/dislocation
- ITBFS
- Muscle strains (hamstrings)
- Tendinitis
- Meniscal tear
- Superior tib/fib sprain
- Osteoarthritis
- Patellofemoral syndrome
What are some acute phase objectives?
- Decreased pain
- Decreased swelling
- Prevent secondary complication
What are some secondary complications during the acute phase?
- Contractures
- Instability (ligaments, PFJ)
- Impingement (meniscal)
- Friction (ITBFS)
What are some way sot relieve pain during the acute phase?
- Ice
- TENS
- Medications
What are some ways to relieve swelling during the acute phase?
- Pressure
- Ice
- Elevation
- Medication
What are some ways to support the knee during the acute phase?
- Zimmer splint
- Hinge brace
- PF support
What are some ways to deal with infection during the acute phase?
- Clean suture sites
- Monitor
- Medication
What are some important things to note about suture healing?
- Usually made along the lines of dermal stress
- Early AROM can place excessive stress on the suture line
- Can cause post rehab irritation
What are some sub scute phase objectives?
- Decrease residual swelling
- Increase range of motion
- Muscle re-education
- Ligament healing
- Suture healing
- Whole body maintenance
- Psychological intervention
What are some treatment methods for suture healing?
- Transverse frictions
- Ultrasound
- LASER
- Vitamin E
What muscles should be the focus for re-education?
- Hip flexion: iliopsoas. rectus femoris
- Extension: gluteus maximus, iliotibial band
- Hip abduction: gluteus medius/minimus, tensor fascia lata
- Adduction: gracillis
- Calf planar flexion: gastrocnemius
What is important to strengthen for flexion?
The hamstrings; dynamic stabilizers against anterior tibial translation and rotation
What are some ways to strengthen the knee in a closed kinetic position?
- Stool walking exercise
- Backward cycling
What are some ways to strengthen the knee in an open kinetic position?
Hamstring curls (tubing, isotonic)
What muscles do you want to strengthen for internal rotation?
Semitendinosus and semimembranosus
What muscle do you want to strengthen for external rotation?
Biceps femoris
What is strengthening the quadriceps important for and what are some cautions?
- Important for patellofemoral stabilization
- Caution against anterior tibial traction
- Caution against PF compression
What are some closed kinetic chain strength exercises for the knee?
- Leg press
- Wall squats, tubing squats
- Peterson step-ups, terminal extensions
- Drop squat
What are some open kinetic chain strength exercises for the knee?
- Water exercises
- Tubing leg extensions
- Machines
What are some considerations for high velocity strength?
- 180-360 degrees/second
- Minimal tibio/femoral shearing
- Minimal patellofemoral compression
- Used for power/endurance training
What are some considerations for low velocity strength?
- 60 degrees/second
- Increased tibiofemoral shearing
- Increased patellofemoral compression
- Patellar tendon stress
- Used for strength training
When it comes to endurance what are some different knee positions for some sports?
- Swimming: 15-20 degrees
- Stepper: 45 degrees
- Cycling/stairs: 90 degrees
- Rowing: 120 degrees
What are some guidelines for proprioception of the knee?
- Begin early with basic exercises: mirroring, weight shifts
- Start with fully extended knee
What are some considerations for return to sport?
- Proprioception
- Agility
- Power
- Plyometrics
- Psychological readiness
- Skill development
- Full ROM
- Good joint stability
- Practice before games
- Begin with minimal stress
- Progressively increase the level of activity
