Simpson Brad G, Simon Corey B
Life's Work Physical Therapy, Portland, OR, USA.
Department of Physical Therapy, College of Health and Human Professions, University of Florida, Gainesville, FL, USA.
J Man Manip Ther. 2014 May;22(2):100-7. doi: 10.1179/2042618613Y.0000000042.
A 40-year old female presented to physical therapy with a one-year history of insidious right anteromedial and anterolateral knee pain. Additionally, the patient had a history of multiple lateral ankle sprains bilaterally, the last sprain occurring on the right ankle 1 year prior to the onset of knee pain. The patient was evaluated and given a physical therapy diagnosis of patellofemoral pain syndrome (PFPS), with associated talocrural and tibiofemoral joint hypomobility limiting ankle dorsiflexion and knee extension, respectively. Treatment included a high-velocity low amplitude thrust manipulation to the talocrural joint, which helped restore normal ankle dorsiflexion range of motion. The patient also received tibiofemoral joint non-thrust manual therapy to regain normal knee extension mobility prior to implementing further functional progression exercises to her home program (HEP). This case report highlights the importance of a detailed evaluation of knee and ankle joint mobility in patients presenting with anterior knee pain. Further, manual physical therapy to the lower extremity was found to be successful in restoring normal movement patterns and pain-free function in a patient with chronic anterior knee pain.
一名40岁女性因右膝前内侧和前外侧隐匿性疼痛1年前来接受物理治疗。此外，该患者双侧有多次外侧踝关节扭伤史，最后一次扭伤发生在右踝，在膝关节疼痛发作前1年。对该患者进行了评估，并给出了物理治疗诊断为髌股疼痛综合征（PFPS），伴有距小腿关节和胫股关节活动度降低，分别限制了踝关节背屈和膝关节伸展。治疗包括对距小腿关节进行高速低幅推按手法，这有助于恢复正常的踝关节背屈活动范围。在为患者实施进一步的家庭康复计划（HEP）中的功能进阶训练之前，患者还接受了胫股关节非推按式手法治疗，以恢复正常的膝关节伸展活动度。本病例报告强调了对出现前膝痛的患者进行膝关节和踝关节活动度详细评估的重要性。此外，发现对下肢进行手法物理治疗成功地恢复了一名慢性前膝痛患者的正常运动模式和无痛功能。
