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RECUPERAREA POST-
TRAUMATICA A GENUNCHIULUI
- Flexia genunchiului :
- ROM normal intre 130-1400
– ADL necesita flexie de 115°
– Poate creste pana la 160° in ‘squatting’
REHAB GOALS Control inflammation Promote mobile scar Inc strength and
Promote early healing Inc pain free motion endurance
Prevent immob effects Begin strengthening Progress to full
function
REHAB Pain management Pain management Stretch progressions
GUIDELINES ROM ROM / Stretching Dynamic PREs
Isometrics Light PREs Proprioception
Early proprioception Endurance, Power,
and Skilled Activities
Rehabilitation Techniques
• Phase I:
– Control pain, swelling and assist tissue
healing
• P.R.I.C.E.
– For some knee injuries may require immobilizer or
rehabilitation brace
• Modalities
– Maintain core and cardiorespiratory function
Rehabilitation Techniques
• Open Chain
– SLR
– Steamboats
– Short arc quads
– Knee extensions (avoid last 30 deg)
– Hamstring curls
Strengthening
• Closed Chain
– Terminal knee extension
– Squat progression (wall, mini, full)
– Lunges / Split squats
– Step-ups/Step-downs
– Hamstring stool scoots
– Eccentric HS in kneeling (difficult can be painful)
– Calf raises
Strengthening
• Do not forget the Hip
• Prior emphasis on quad/VMO activation and
deficits missed weakness and imbalance of hip
ER, ABD and EXT
Proprioception
• SLS
– Eyes open / closed
• Foam
• BOSU Ball
• Rebounder
• BAPS Board
• Body Blade
• Clock Drills
• Perturbations
Endurance
• Bike
• Treadmill
– Walk, Jog, Run
• Elliptical
• Stair stepper
• Pool
– Swim, Jog, Aerobics
Power
• Advanced weight lifting
– Leg press
– Hamstring curl
– Squats
– Lunges
– Dead lifts
– Calf raises
Skilled Activity
• Figure 8s
• Kariokas
• Single leg hop
• Lateral shuffles
• Ladder drills
• Form drills
• Box jumps/plyometrics
Full Activity
• Walk to run progression
• Return to sport drills
• Return to full practice
• Return to competition
Summary
• Effective interventions:
– Eccentric exercise
– General quad strengthening
– Hip, trunk, ankle strengthening: emphasize form
– Plyometrics
• Consider:
– Taping during exercise if reduces pain
– Foot orthoses if rearfoot varus
– SI joint manipulation if fits hypothesized criteria