Stiff knees can pose significant challenges in physiotherapy practice. Despite my extensive experience, traditional education often lacks a clear strategy for addressing this issue. Over the past three decades, I have developed and refined a safe and effective approach to managing stiff knees.
When I mention a stiff knee, I'm not just referring to patients who feel stiff due to conditions like osteoarthritis or rare syndromes. I'm talking about patients with severely restricted knee motion, such as -20 degrees extension to 60 degrees flexion or similar. These cases are common.
In managing stiff knees, the initial focus should be on restoring knee extension before addressing flexion. Achieving full extension early on is crucial for improving walking ability. While aiming for textbook normal ranges of motion is ideal, practical limitations mean that's not always true.
It's essential to conduct a thorough assessment including history, range of motion, strength, and gait analysis. This helps categorize patients into overuse, traumatic, or systemic injury groups, influencing treatment approaches.
The treatment approach I advocate involves four key elements: Education, Exercises, Manual Therapy, and sometimes Splinting. Education focuses on setting realistic goals and emphasizing pain-free exercises that patients can continue at home. Exercises are tailored to restore both extension and flexion, progressing from seated exercises to dynamic movements like standing lunges and butt kicks.
Manual therapy, despite my preference for active treatments, has a role in easing knee stiffness. Techniques like long leg traction and manually assisted quad sets can aid in restoring motion without causing discomfort. Splinting remains controversial but can be considered for specific cases where other methods have not yielded sufficient improvement.
Treatment must be adapted based on the underlying cause of knee stiffness. Overuse injuries may require more focus on pain management initially, while traumatic injuries often benefit from aggressive range of motion recovery. Systemic conditions like osteoarthritis require a balanced approach, emphasizing safety and daily activity rather than achieving textbook ranges of motion.
00:00 How I Deal With Stiff Knees After 30 Years Of Physio: Safe And Effective
01:30 Knee Extension First For Better Walking Then Flexion But Both Pain Free
02:41 Leave Manipulation Under Anesthesia (MUA) To Doctors; We Physios Handle Stiff Knee Recoveries Afterwards
03:14 Measure Patients 'Cold' For True Range Of Motion; Honesty Is Key In Assessments
04:24 Education Is Key: Focus On One Goal, Pain-free Exercises, And Realistic Expectations
05:14 Home Exercises Are Crucial : Start With Knee Extension Then Flexion For Optimal Recovery
06:21 Utilize Effective Manual Therapy Techniques To Restore Knee Extension And Flexion Painlessly
08:30 Consider Splinting Options Cautiously For Improving Knee Motion, Despite Mixed Results
09:28 Tailor Treatment To Patient Needs: Manage Pain, Promote Motion Recovery, Ensure Daily Activity Safety
11:04 Level Up Your Treatment: Adapt Approaches Daily, Build Rapport, And Embrace The Entire Patient
13:48 Possible Massage For Stiff Knee If Hard Unyielding Indurated Otherwise Don't Bother
LINKS =
Physio Simplified:3 Diagnoses & 3 Treatments ( Core Principles: 3 diagnoses and 3 treatments ) • Physio Simplified:3 Diagnoses & 3 Treatmen...
Active physiotherapy treatments are more effective than passive(Core Principles : Active preferred) • Active physiotherapy treatments are more e...
Basics of building rapport ( Building Relationships: Patient rapport ) • Basics of building rapport ( Building Rela...
FROM INJURY TO RECOVERY THROUGH EXERCISE: Simple functional exercise progressions for physiotherapists to restore lifting, standing,
walking by Francis Olivier https://www.amazon.com/dp/B0CFZFJDRF
WHAT THEY DON'T TEACH YOU ABOUT DOCUMENTATION IN PHYSIOTHERAPY SCHOOL : A short how-to manual for successful daily note templates by
Francis Olivier https://www.amazon.com/dp/B0BNZKG7TQ
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