In this blog we will discuss about various knee mobilisation techniques which are used for complete knee rehabilitation. These techniques not only relieves pain but also helps in regaining good range of motion. A systematic review has shown that early mobilization after a knee arthroplasty can reduce the length of hospital stay to about 1.8 days without any increase in adverse results.Joint mobilization, as a clinical commonly used intervention, can alleviate the chronic pain of knee OA patients by reducing the excitability of reflection.
It is Chronic progressive, degenerative, painful disease of knee joint present with chronic pain, loss of joint ROM, bony crepitus, joint deformities in later stage like “genu valgum”.
EPIDEMIOLOGY AND CAUSES
Most common form of joint arthritis.
15% population is affected.
Strongly age related OA knee occurs with 70% population in age group 60 and above.
Leading cause of long term movement disability
11.6 millions cases expected to be in US till 2020.
Repetitive Stress Fracture
Joint Imbalance or mal-alignment
Genetics like FRZB, LRP5 gene etc
CLINICAL FEATURES AND PATHOPHYSIOLOGY
swelling in the joint area
pain worsen up in the morning
pain increases after activity
buckling of the knee
inability to straighten up your knee
grinding or snapping noises when perform movements ( bony crepitus )
weakness in the knee joint
Damage at more weight bearing joint like knee joint
PHYSICAL EXAMINATION AND DIAGNOSIS
Physical examination includes
Check joint alignment
Access quadriceps strength
Evaluation of tenderness point and pain
Access Joint ROM
Palpation for bony swelling
Access Bony Crepitus
Radiographically we find
X-rays show up cartilage loss is revealed by a narrowing of the joint space. An X-ray may also show bone spurs around a joint. Presence of subchondral cyst, bony erosion, inflammed synovium.
A study found that a combination of manual physical therapy and supervised exercise has functional benefits for patients with knee osteoarthritis.
Physical therapy can help to reduce the pain, swelling, and stiffness of knee osteoarthritis, and it can help improve knee joint motion. It can also make it easier for you to walk, bend, kneel, squat, and sit. The two main types of physical therapy — passive and active treatments. It can help make your knee OA more manageable.
Common Passive Treatments for Knee Osteoarthritis
Cold therapy: It reduces circulation and can help decrease swelling.
Heat therapy: Heat therapy increases blood flow to decrease stiffness in the knee joints and muscles surrounding the knee.
Hydrotherapy: This treatment uses water to decrease your symptoms. There are several advantages of hydrotherapy, you can do gentle exercises in the water and warm water help facilitate motion as well as help you provide pain relief.
Common Active Treatments for Knee Osteoarthritis
Strengthening exercises: Your physical therapist will show you certain exercises that you can do at home to strengthen your muscles. Working out muscles in the leg can help make your knee joints stronger. Strengthening these muscles alone can help decrease the pain of knee OA.
Flexibility exercises: Flexibility exercises are very important. Regular sessions can help increase range of motion, make your knees more flexible, and restore normal knee joint function.
Both strengthening and flexibility exercises are important because they assist in taking strain off the knee.
Knee joint is Complex joint Structure involving many ligaments, tendon, fat pad and other soft tissue structures along with patella bone in the front Injury at any level can lead to pain, disability and restricted range of motion.
To diagnose the exact cause
Following are the physical examination applied to confirm diagnosis of knee injuries.