rehabilitation after knee artroscopy..

[sebastian]

Hi everyone, I'm new on this forum, studying sport massage...

I need some advice. Have a friend, she is one of my case studies.
Around 12weeks ago she had knee artroscopy, had removed medial synovial plica and WAPR adhesions.

On palpation, found:
sweeling, oedema, widespread tenderness, painful to touch patella and quadriceps tendons, pain in the inside of the knee. Weak and tender to touch muscles of the upper and lower leg, trigger points within the muscles.

Done:
Scoop test for sweeling -positive
glide test for pain under the patella -positive
straight leg test

on the above tests found:
pain when performing knee extension, painful to touch front of the knee, under and around the side of the joint, very weak and tender muscles of the left upper and lower leg.

Treaatment:
1. applied ice on the knee (10-15 min)
2. Sports massage for the front of the thigh, used electric percussor
3. lover leg and feet massage
4. knee massage: applied small circular frictions around the side of the knee joint, applied gentle cross friction tothe patella tendon
5. applied audiosonic up to 10 min (patient found that very painfull at the beginning)
6. back of the tight massage and calf muscle

Recommended some stretches ans strenghtens for hamstrings and tights

Could you give me some tips for the next session, how often should I treat her?
Could you recommend me some stretches, strenghtens and joint mobilization exercises?
Anything else what I can do?

regards
Seb

[Heidi]

Hi

What you do on your next session will depend on the reaction to the last session and the progress she has made. If there is no deifference I would do the same again. If there is an improvement I would do the same but perhaps using more pressure and look at the exercises you gave and progress them if necessary.

In terms of exercises, obviously I don't know what you have already given her and what she is capable of.

I would normally start a case like this with knee extension in a sitting position, with a rolled up towel (or similar) under the knee. They have to push the knee down into the towel and concentrate on VMO contraction.

If this is all ok and VMO is firing properyly I would progress to standing mini squats or leg press with a small range. Gradually increase the weight and depth before adding lunges into the program.

Stretch all leg muscles at least twice a day and possibly MET stretches (contract relax) when you see her.

Everything should be pain free. If it hurts, stop. Aching is fine though.

Initially you should be seeing her 1-2 times a week. When an exercise plan is the main treatment you can start to decrease this.

Hope this helps!

[sebastian]

Thanks Heidi, really appreciatte

I'll be in touch...

Regards
Sebastian