Ongoing Knee Pain

[nicola]

Hi,

Seeking help and advice on next step of rehabilitation for this pt.

Pt: Male Rugby Player

Over the last 4 months knee pain has gradually worsened. Pain comes on due to playing rugby and running.

Gets pain on medial knee after running for 5 minutes, the pain gradually worsens causing reduced speed. The Pt presents with medial knee joint line pain, pain on medial patella tendon (this comes and goes), reduced knee extension, pain on EoR knee flexion, locking, clicking, giving way and pain on full flexion on McMurrys Test. Patella glides normal and strength = contralateral limb, no pain on squatting, lunges, single leg stance. Biomechanics and alignment is good. All other tests negative.

Therefore medial meniscus damaged and patella tendonitis was queried.

The pt has had a MRI scan 3 weeks ago which was described as ' shows medial mensicus damage but this could be a blip' and the consultant wished to wait 6 weeks before further investigation.

During these 3 weeks the pt has been carrying out conservation rehabilitation program - 5 mins cross trainer (any longer causes onset of the pain), bilateral squats, lunges, single leg stance 30 secs, leg press, swiss ball exercises, wobble cushion exercises and just introduced step up and step downs.

The locking, clicking and giving way has reduced significantly and the pt is pain free until 5 minutes on the cross trainer and has not run any significant distance or speed since.

I would be interested in any help or opinion of what is going on and how to continue management of this pt.

Thanks for your help

[Heidi]

It definately sounds like a meniscus tear. Was there an accident when it occured?

You sound like you are doing everything I would do, comntinue with this and increase reps and weight accordingly.

The only other thing I could suggest would be do you do much in the way of flexibility work? and do your exercises focus on VMO activation?