Thoughts from the journey… Excerpts from a day in the life of Sherry McLaughlin

26Mar/102

A knee that won’t bend

Ever seen a knee that has a hard time bending after a total knee replacement?

Next time before you stretch them, ask them if they feel the pain in the front or the back of the knee. More times than not, the limitation isn't due to scar tissue formation...and more times than not the pain sensation is in the back of the knee instead of the front.

If this applies to you, there is a real solution that doesn't require a manipulation. This is often due to a posteriorly displaced fibular head and is fixable with a simple technique.

What causes this displacement? Our best intelligent guesses are:
- a lack of subtalar joint eversion (stiff ankle)
- a tight lateral hamstring
- walking toed-out usually due to tight calf muscles

It takes about 120 degrees of flexion to walk up and down stairs normally, put your pants on standing up, get your socks on easily or ride a bike!

If you have this problem, I'd love to hear from you and help you fix it.

After all, spring is here. It's time to pull out the bicycle and enjoy it a little...and it doesn't hurt to have pants on while you do it. 🙂

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  1. Hi Sherry, I descoverd this also and after performing MET for fibular head correction I follow with an exercise where the pt. is hooklying with the involved LE on a SB and a theraband handle around the foot and the other handle held in the contralateral hand. I hang onto the middle of the theraband to apply resistance.Next, the pt. performs flexion with the contralateal UE to activate the core, followed by hip flexion, knee flexion and dorsi flexion rolling the SB superior. Return the LE first to the starting position followed by the contralateral UE and then repeat. I usually have them perform 2 x 10, and by the next tx sx signifantly reduce or are eliminated in the posterior region. Let me know what you think.
    Thanks, Kara Ettema

  2. That is an awesome suggestion, Kara. Thanks for the tip. I am going to give it a shot and will let you know. But it seems to make sense that the pull with contralateral arm may be inducing a slight internal rotation of the tibia (hence lengthening the lateral hamstring in the transverse plane) while assisted flexion is being performed. Nice work!


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