injuries poisoning
Knee Pain
Treatment of Knee Pain
Quadriceps-strengthening exercises Sometimes stabilizing pads, supports, or braces Nonsteroidal anti-inflammatory drugs (NSAIDs) Treatment is tailored to the specific cause of the pain. Treatment of chondromalacia includes quadriceps-strengthening exercises with balanced strengthening exercises for the hamstrings, use of arch supports if excessive pronation is a possible contributor, and use of NSAIDs. For patellar subluxation, use of patella-stabilizing pads or braces may be necessary, especially in sports that require rapid, agile movements in various planes (eg, basketball, tennis). If there is excessive pronation of the foot, and all other possible causes of knee pain have been excluded, use of an orthotic insert is sometimes useful. Stress fractures require rest and cessation of weight-bearing activity. Intra-articular pathology often requires surgery. 1. Lie on back with uninvolved knee bent so foot is on the floor/table. 2. Contract quadriceps muscle on the involved side then raise straight leg to thigh level of uninvolved leg. 3. Return to starting position slowly to control the lowering phase. 4. Perform 3 sets of 10 repetitions, 1 time a day. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Sit with involved leg extended. 2. Contract quadriceps muscle on the front of the leg to push back of knee down to the floor/table. 3. Hold exercise for 10 seconds. 4. Perform 1 set of 10 repetitions, every hour. 5. Special Instructions a. Do not hold your breath during the exercise. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Once the inflammatory phase has subsided and the patient is able to perform knee flexion without pain: 2. Lie on stomach. 3. Begin with knee straight. 4. Bend knee through available range that is pain free. 5. Slowly return to starting position. 6. Perform 3 sets of 10 repetitions, 1 time a day. 7. Special Instructions a. Start with least resistance, adding weight as tolerated. Band resistance can also be used. b. Focus on eccentric lowering phase with a count of 4 to lower and extend knee to starting position and a count of 2 for knee flexion. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Lie on stomach, keep knee straight on involved side. 2. Perform abdominal contraction. 3. Lift involved leg up off the floor/table. 4. Return to starting position. 5. Perform 3 sets of 10 repetitions, 1 time a day. 6. Special Instructions a. Keep the knee straight and abdominals contracted through the repetition. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Lie on stomach. 2. Bend involved knee and loop towel or band around the ankle. 3. Gently pull towel or band to stretch muscle on front of thigh pulling ankle toward buttocks. 4. Hold exercise for 30 seconds. 5. Perform 1 set of 4 repetitions, 3 times a day. 6. Repeat on the other leg. 7. Special Instructions a. For added stretch, place a towel roll just above the knee to place the hip in slight extension. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Stand about a foot away from the wall with the involved leg closest to the wall. 2. Place the uninvolved leg in front of the involved leg. 3. Keep the involved knee straight. 4. Lean trunk away from the wall so the hip on the involved side goes toward the wall. 5. Be sure not to lean forward at the waist. 6. Hold exercise for 30 seconds. 7. Perform 1 set of 4 repetitions, 3 times a day. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Lie on back, hold behind the involved knee to pull it gently toward the chest. 2. Gently extend the knee to straighten the leg. 3. Hold exercise for 30 seconds. 4. Perform 1 set of 4 repetitions, 3 times a day. 5. Repeat on the other leg. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Lie on involved side. 2. Keep shoulders and hips in line with ankles slightly behind the body with the knees bent approximately 90°. 3. Keep feet together while lifting left knee up toward the ceiling. 4. Lower and repeat. 5. Repeat exercise lying on the uninvolved side. 6. Perform 3 sets of 10 repetitions, 3 times a day. 7. Special Instructions a. For added resistance, place a band around the knees, start with the least resistance. Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 1. Stand with feet about hip width apart. 2. Toes should point forward to stay aligned with the knees. 3. Keeping core tight, move buttocks backward, similar to beginning to sit in a chair, and squat down until the thighs are almost parallel with the floor. 4. Return to start position and repeat. 5. Perform 3 sets of 10 repetitions, 1 time every other day. 6. Special Instructions a. Keep weight on outside of foot and heels. b. Start with a partial squat and increase as you become familiar with the movement. c. Add weight only as tolerated. Start with 1 to 2 pounds (0.5 to 1 kg [ie, a soup can]). Courtesy of Tomah Memorial Hospital, Department of Physical Therapy, Tomah, WI; Elizabeth C.K. Bender, MSPT, ATC, CSCS; and Whitney Gnewikow, DPT, ATC. 