Knee Interventions

After what surges is quad NMES most commonly used?

• S/P ACLR

• S/P TKA

What movement does an anterior tibiofemoral joint mob improve?

Knee extension

When is the only time you really shouldn’t do an anterior tibiofemoral joint mob?

Post ACLR

What movement will a posterior tibiofemoral joint mob improve?

Knee flexion

When doing MWM AP for knee flexion or extension, how many reps and sets should ya do?

6-10 reps, 3-5 sets

What patellar mob will help improve knee extension?

Superior mob

What patellar mob will help improve knee flexion?

Inferior mob

If a pt has some hypertonicity and hypotonicity, which should you treat first?

Hypertonicity

What is the origin of the articularis genu?

Anterior surface of the femur distal to the vastus intermedius

What is the insertion of the articularis genu?

Synovial membrane of the knee joint

What is the function of the articularis genu?

Pull the synovial membrane around the knee superior during knee extension and it stabilizes the knee joint

Have distal or proximal exercise programs shown a consistent reduction in pain and improvement in function when treating PFPS?

Proximal exercise programs (proximal stability = distal mobility)

What are some interventions you should do if a pt has patellar tendinopathy?

• Patellar tendon unloading strap

• Isometrics with high resistance

• Hip strengthening

• Load management

• Ice massage

• Heavy/slow quad loading

What kind of exercises (including sets, reps, and intensity) should be done in stage 1 of patella tendinopathy recovery?

• 5× 45 sec holds 2-3x/day at 70% max voluntary contraction

  • Isometric knee extension between 30-60°

  • Spanish squat at 70-90°

• Isometrics

What kind of exercises (including sets, reps, and intensity) should be done in stage 2 of patella tendinopathy recovery?

• 3-4 sets at 15RM progressing to 6RM every other day between 10-60° knee flexion progression to 90°

  • Leg spress

  • Split quart

• Isotonic exercises

What kind of exercises (including sets, reps, and intensity) should be done in stage 3 of patella tendinopathy recovery?

• Progressing volume first and then intensity to eventually replicate the demands of a sport

What is the treatment for Osgood-schlatter’s disease?

• Rest

• Bracing

• Graded activity

• Flexibility training

• No eccentrics until clear signs of healing and NO symptom aggravation

How long can Osgood-Schlatter’s disease take to heal?

8+ wks

Controlling what hip movement can be helpful for IT band syndrome in the short term?

Hip adduction

When working with a pt who is recovering from a PCL injury, how long do you have to avoid hyperextension and hamstring strengthening?

12 wks

Order the following exercises from least amount of load on the PCL to greatest: wall squat with feet far from wall, one-legged squat, wall squat with feet close to wall

One-legged squat → wall squat with feet far from wall → wall squat with feet close to wall

Order the following lunges from least to highest load on the PCL: forward lunge with long step forward, side lunges, forward lunge with short step forward

Forward lunge with short step forward → forward lunge with long step forward → side lunge

What knee ligament when torn, is often not surgically fixed?

MCL

What is the goal of a SLR?

Controlled knee extension through hip ROM

What is the goal of TKE exercise?

• Increase quad activation

• Reinforce end range knee extension

What are the top 5 best glute max exercises?

1. Front plank with hip extension

2. Gluteal squeeze

3. Side plank abd, DL up

4. Side plank abd, DL down

5. Single limb squat

What are the top 5 glute medius exercises?

1. Side plank abd, DL down

2. Side plank abd, DL up

3. Single limb squat

4. Clamshell (hip clam) 4

5. Front plank with hip ext

How do you cue a pt to use the hip strategy for a step down?

• Stick butt back

• Lean forward through hips

How do you cue a pt to use the knee strategy for a step down?

• Chest up

• Go straight down

Which strategy for step downs is more functional, hip or knee strategy?

Knee

What strategy for step downs has more PFJ and TF compression? Hip or knee strategy?

Knee strategy

How long can it take our fascia to heal?

3-7 wks

How long can it take a muscle to heal with the following levels of injury: DOMS, grade 1, grade 2, grade 3

• DOMS: 0-3 days

• Grade 1: 0 days - 4 wks

• Grade 2: 3-12 wks

• Grade 3: 5 wks - 6 months

How long can it take a tendon to heal at the following stages of injury: acute, subacute, chronic, rupture

• Acute: 3-7 wks

• Subacute: 2-6 months

• Chronic: 3 months-1+ years

• Rupture: 3 months-1+ years

How long can it take a ligament to heal at the following levels of injury: grade 1, grade 2, grade 3, intra-articular damage

• Grade 1: 3 days-4wks

• Grade 2: 2 wks-6 months

• Grade 3: 5 wks-12 months

• Intra-articular: probably ain’t healing

On average, how long does it take a bone to health from a fracture?

5 wks to 3 months