Knee problems & physiotherapy (kunjal shah)

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Knee problems & physiotherapy (kunjal shah)

  1. 1. KNEE OSTEOARTHRITIS AND PHYSICAL THERAPY BASED SOLUTIONS DR. KUNJAL SHAH GADA M.P.TH (SPORTS)
  2. 2. OBJECTIVES • What is osteoarthritis of knee and how it affects us. • Explain physical therapy approach towards knee problem • Teach preventive strategies • Details of physical therapy treatment options available.
  3. 3. INTRODUCTION • Osteoarthritis (OA) is the most common disease affecting weight bearing joints. It gradually leads to a disability restricting the individual from various daily functional activities. • It is currently a very big concern and slow growing disability causing disease in our society which requires awarness and preventive management. • This condition does not follow the same course in everybody and there are certain things that you can do to help yourself and prevent problems in the future.
  4. 4. OA KNEES • TIBIOFEMORAL JOINT • PATELLO FEMORAL JOINT • LINKAGES
  5. 5. THE KNEE JOINT ANATOMY
  6. 6. THE PATELLOFEMORAL JOINT
  7. 7. EFFECTS OF OSTEOARTHRITIS ON THE KNEE JOINT
  8. 8. EFFECTS OF OA KNEE The cartilage becomes thin and worn away especially where more weight is borne
  9. 9. EFFECTS OF OA KNEE • The joint space becomes narrower allowing less space between the bones for movement.
  10. 10. • Increased stress/load on the ligaments and muscles and the capsule may lead to inflammation (swelling). The capsule may become thickened.
  11. 11. EFFECTS OF OA KNEE • New bone forms at the edge of the joint which can be quite rough (osteophytes).
  12. 12. EFFECTS OF OA KNEE • Cartilage may fragment to give loose pieces causing symptoms of locking or giving way of the knee.
  13. 13. EFFECTS OF OA KNEE • The inflammation and swelling may cause pain. • Decreased mobility due to pain/ aching and fear of making the knee worse may lead to muscles wasting and weakening, therefore causing more stress and decreased protection to the knee joint. • The knee becomes stiff as it is moved less through its available range of movement.
  14. 14. Grades of OA KNEE
  15. 15. OTHER CONDITIONS ASSOCIATED WITH OA KNEES • PATELLOFEMORAL PAIN SYNDROME • SCIATICA • FLAT FOOT/ PRONATED FOOT • TRAUMATIC ARTHRITIS • MENISCAL/ ACL/PCL LIGAMENT TEAR. • OBESITY • FAULTY POSTURE.
  16. 16. PHYSIOTHERAPY ASSESMENT IN OSTEOARTHRITIS OF KNEE
  17. 17. PHYSIOTHERAPY ASSESMENT o Chief Complains (Functional Problems) o Tightness / Weakness o Hip Musculature Tone / Strength o Foot posture o Gait Problems o Proprioception o Daily functional activity restriction. BIO MECHAN ICS
  18. 18. CHIEF COMPLAINS Area of Pain Pain Scale What Activities Cause/ relieve Pain Problem since how many Days / Months / Years Daily Routine (Job / Housework) Clicking / Locking of Joint Swelling / Temperature
  19. 19. BIOMECHANICS-(TIGHTNESS/ WEAKNESS) • When muscles around knee & thigh are tight they are not able to contract to their full capacity, as a result over a period of time the become weak as well…hence the term tight / weak muscles • Such problems in turn results in deformities and other complications like knock knees, bow legs, abnormal gait
  20. 20. BIOMECHANICS (HIP MUSCULATURE / TONE)
  21. 21. (BIOMECHANICS)FOO T POSTURE
  22. 22. BIOMECHANICS (ABNORMAL GAIT)
  23. 23. PROPRIOCEPTION
  24. 24. DAILY FUNCTIONAL ACTIVITIES • Squatting • Climbing up. • Descending stairs • Getting in and out of the car • Walking or standing for log time • Sitting cross legged. • Early morning stiffness.
  25. 25. POSSIBLE TREATMENTS • Physiotherapy rehabilitation • Aids • Medication • Surgery
  26. 26. Physical Therapy Treatment Options • Preventive Strategies • Joint Mobilizations • Taping • Knee Braces & Stick • Foot Posture Corrections & Footwear Change • Gait Rehabilitation • Accupuncture / Soft Tissue Release • Ergonomic Analysis & Correction • Basic Rehabilitation (4 Weeks) • Advanced Rehabilitation (8 Weeks)
  27. 27. PREVENTIVE STRATEGIES • Any kind of physical activity (Climbing Stairs / Walking / Jogging / Cycling / Yoga / Gym / Swimming / Sport) • Use good footwear with arch support • Avoid roaming around bear foot in house • Every time you want to pick something from ground, try and squat in a right manner • Whenever a tiring day in office / house…. stretch your body before going to bed • Use a stool / small table to alternate weight shift if u have to stand for long hours • Consult a physical therapist whenever minor / major problems
  28. 28. JOINT MOBILIZATIONS • Improve Joint Mobility • Improve Blood Flow In The Joint
  29. 29. TAPING • Helps in Improving Alignment • Used in Pain Relief • Reduces Swelling • Prevents Excessive Movement
  30. 30. Knee Braces & Stick
  31. 31. Foot Posture Correction
  32. 32. GAIT REHABILITATION
  33. 33. Accupuncture / Soft Tissue Release
  34. 34. Ergonomic Analysis
  35. 35. BASIC REHABILITATION PROGRAMME FOR 1 MONTH /FIVE TIMES A WEEK/ TWICE A DAY
  36. 36. FIRST WEEK • NON WEIGHT BEARING EXERCISES • STRETCHING • JOINT MOBILIZATIONS • FOOT POSTURE CORRECTION • WEIGHT CONTROL MEASURES • ORTHOTIC AID/ TAPING • ACCUPUNCTURE/ SOFT TISSUE RELEASE
  37. 37. 2ND WEEK • STRENGTHENING EXERCISES • STRETCHING • ACCUPUNCTURE/ SOFT TISSUE RELEASE • CARDIO (SWIMMING/ CYCLING) • FOOTWEAR ASSESMENT AND MODIFICATION
  38. 38. 3RD & 4TH WEEK • STRENGTHENING AND WEIGHT BEARING EXERCISES • FUNCTIONAL REHABILIATATION • ACCUPUNCTURE/ SOFT TISSUE RELEASE. • CARDIO EXERCISES • POSTURE ASSESMENT AND CORRECTION
  39. 39. ADVANCED REHABILITATION (2 MONTHS/ 3 DAYS A WEEK) • STRENGTHENING WITH WEIGHTS • BALANCE TRAINING • GAIT REHABILITATION • CARDIO (SWIMMING/ CYCLING) • REGULAR STRETCHING • FULL BODY MASSAGE (ONCE A WEEK) • ACCUPUNCTURE/ SOFT TISSUE RELEASE
  40. 40. Any Questions ?

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