Rehab of Knee Disorders

8/11/2019 Rehab of Knee Disorders

1/18


2/18

Fast walking Water aerobicsSwimming (crawl stroke, flutter kick)Cross-country ski glide machine

Walking on soft-platform treadmillTrampoline


3/18

Squatting Kneeling

Twisting and pivoting Repetitive bending (such as stair climbing) Jogging

Jazzercize Racquetball Tennis


4/18

Basketball Swimming (frog or whip kick)

Bicycling Stair-step machine Stationary bicycle Rowing machine Leg extension weight machine Power yoga


5/18

Preoperative therapy concentrates on reducing the painand swelling and attempting full ROM.

Decreasing joint effusion is key to all these goals.It is done through compression, elevation, cryotherapy(application of cold), and electrical stimulation.

If all else fails, the knee may be aspirated by syringe.Inhibiting joint effusion is vital if they are to restoreROM and inhibit atrophy of the quadriceps muscle.


6/18

A six-week rehabilitation program before surgeryallows them to build good quadriceps and hamstringstrength.If the knee responds well, surgery may not be needed.Even if surgery is necessary, your postoperativerehabilitation program will be easier with well-tonedmuscles, and your likelihood of full recovery will begreatly improved.


7/18

During the first week after surgery,Rehabilitation is mostly passive.The leg may be placed in a continuous passive motion

(CPM) machine for many hours a day to gentlyincrease its range of motion.CPM assists patellar mobility and reduces scarring ofthe patella.

Regular icing and elevation are used to reduceswelling.The goal is full extension (or 10 degrees short of that)and 70 degrees of flexion by the end of the first week.


8/18


9/18


10/18


11/18

Nonimpact reciprocal or elliptical trainers can be usedto strengthen your muscles and maintain your aerobiccapacity. You can use the leg press and balance board and dohamstring strengthening exercises.


12/18

At four to six weeks ,Start using a cross-country ski machine, such as theNordic Track.

At about eight weeks,Focus on the proprioception and coordination bystepping forward, stepping backward, and balancingon a slide board. Add stair climbing on the StairMaster, both forwardand backward.


13/18

By the third to fourth month,Begin running figure eights. Although the patients are not allowed to participate in vigorous sports for at least six and preferably ninemonths, they can mimic the movements of the sportthey love.If its tennis, for example, begin to move forward toback and side to side, with stops and starts.


14/18

After four months Attempt pliometrics (jumping and explosive types oftraining). A functional brace is generally recommended forsports activity for at least the first year after surgery.Be warned that a knee without pain is not anindication that the ACL is completely recovered. ACLs are not totally healed (the graft isnt fully

mature) until about nine months after surgery.Many ACLs are reinjured because patients resumesports activities too soon.


15/18

MCL and LCL injuries come in three grades: Grades oneand two are partial tears of varying degrees, while gradethree is a complete tear.

Unless accompanied by other ligament tears, MCL and LCLinjuries are generally treated without surgery.Lower-grade injuries are milder than higher-grade onesand require less rehabilitation.The protocol is similar to that for ACL injury (preoperativeand postoperative), but the time required for healing isshorter usually only four to six weeks because you donot need to wait for a tendon graft to mature.


16/18


17/18

Depending on its severity, a meniscal injury may ormay not require surgery. When the tear is minor, after the pain and othersymptoms abate, prescribe a course of exercises.If no surgery is needed, once the swelling hassubsided, move rapidly into resistance exercises.If surgery is called for, one of two procedures will be

done: suturing of the meniscal tear or, in extremeinjuries, full or partial removal of the meniscus.


18/18

One goal of rehabilitation is to protect weight loadingof the knee, especially loading in flexion, until at leastsix to eight weeks postoperatively.CKC exercises are started early, with flexion limited to70 to 80 degrees.OKC exercises are avoided until at least six monthsafter a meniscal repair.

Starting to move as early as possible after surgery iscritical.

Rehab of Knee Disorders

Documents

Transcript of Rehab of Knee Disorders