Having specialised in the rehabilitation of lower limb injuries, and particulary knee injuries, for many years now, I have observed 5 key objectives to achieve quickly to optimise knee function. This is irrespective of whether the rehab is post- injury, or post-operative. With these 5 goals in place, the knee will quicly function more normally.
1. Reduce swelling.
After an injury to structures inside the knee, it will swell- an effusion. This is known to cause reflex muscle inhibition, which can cause the quadriceps muscle to switch off, and the knee to feel as though it may give way. Minise the effusion to optimise quads activity.
2. Restore full Active Extension.
The ability to actively fully straighten the knee is critical. This is the ability for you to switch on and tense your front thigh muscle (Quadriceps) by choice. If this is not possible, you cannot actively keep yourself upright on your feet- the knee will give way.
3. Restore full Passive Extension.
This is the ability of an external force, i.e not you or your quadriceps muscle, to straighten your knee: e.g. ability for it to sag straight under the weight of gravity, or for someone (usually a Physio, when testing the knee), to pull it into a fully straight position. If this is not possible, it may indicate something inside the knee is mechanically blocking it. This must be dealt with quickly, as a block to extension left untreated can leave the knee stiff in the long-term, and will disable your ability to actively straighten your knee, and may again lead to giving-way or buckling of the knee.
4. Mobilise the Patella.
The patella (kneecap) is free to be moved within a specific range when the knee is relaxed. Often, usually after surgery, this ability for the kneecap to be freely moved is limited, and can have a consequential negative impact on the ability to develop quadriceps strength, and cause kneecap pain. This can be restored by manual therapy during Physio sessions.
5. Normalise Gait.
The walking (gait) cycle is often significantly affected by pain/stiffness after injury or surgery. The adaptations to the walking pattern, if left unaddressed, can have significant negative effects on knee health: loss of movement, stiffness, muscle shortening and quadriceps inhibition. Normalising the gait cycle as quickly as possible is critical to knee health!
If you, or anyone you know are affected by these problems, please don’t hesitate to get in touch. Our expertise will get you on the path to healthy knees in no time!!