LE Diagnostic Packet - MPD of Knee Flashcards
what are the muscle power deficits of the knee
patellar tendinopathy
hamstring strain
outcome measures associated with MPD of knee
PSFS
KOOS - PF subsection
LEFS
Functional Assessment for Acute HS strain
diagnosing factors of HS strain
sudden onset of posterior thigh pain during activity
pain w/resisted hamstring contraction and active stretch
muscle tenderness w/palpation
loss of function
diagnostic criteria of patellar tendinopathy
typically a diagnosis of exclusion
– presence of retro-patellar or peri-patellar pain and it being reproduced during loading of PFJ in a flexed position
four main classifications of PFPS include
overuse/overload
movement coordination deficit
muscle power deficit
mobility deficit
ROM finding associated with muscle power deficit in the knee
abnormal hamstring muscle length via active knee extension (HS Strain)
end range flexion is most limited/painful in PFPS
muscle performance finding associated with MPD in the knee
decreased muscle performance
- HS / Glutes (HS)
- Gluteal Muscles (PFPS)
muscle length finding associated with MPD in the knee
decreased in HS
general muscle length issues found in PFPS
palpation finding associated with MPD in the knee
pinpoint tenderness of muscle belly/tendinous insertion of HS
pinpoint tenderness of retro/peri-patellar regions in PFPS
joint mobility/neurological finding associated with MPD in the knee
n/a
explain injury prevention for HS strain
include nordic hamstring exercises as part of a prevention program
- add components of warm-up, stretching, stability training, strengthening and other functional movements
after HS injury explain what is needed to improve return to play time
eccentric training
stretching
strengthening
stabilization
progressive running programs
what should clinicians do to reduce reinjury of hamstring
progressive agility and trunk stabilization
– on top of comprehensive impairment-based treatment program
explain exercise therapy for those with PFPS
hip/knee targeted exercises to reduce pain and improve patient reported outcomes
– hip targeted may be biased earlier in rehab
what muscles should hip-targeted exercise therapy target
posterolateral hip musculature
what exercises should be included in knee-targeted exercise therapy
resisted squats (FWB) or knee extension (NWB)
explain patellar taping for PFPS
in combination with exercise therapy for pain reduction
- enhances outcomes of exercise therapy in short term (4 weeks)
explain patellar bracing for those with PFPS
do not prescribe any bracing
explain foot orthoses for those with PFPS
prefabricated foot orthoses should be prescribed for those with greater than normal pronation to reduce pain
– short term (6 weeks)
explain biofeedback intervention for those with PFPS
clinicians should not use EMG based biofeedback on quads
clinicians should not use visual biofeedback on LE during hip/knee targeted exercises
how would gait retraining help those with PFPS
adopting forefoot strike pattern (for those with rearfoot strike)
increasing running cadence
reduce peak hip adduction while running
is blood flow restriction suggested for those with PFPS
no, F level evidence
explain the efficacy of dry needling for those with PFPS
“clinicians should not use dry needling for treatment of patients with PFPS”
explain the efficacy of manual therapy for those with PFPS
clinicians should not use manual therapy in isolation for those with PFP
