There are many
comorbidities associated with any knee surgery. This challenges the job
of the physiotherapist working with the patient. One of the complications is-
quadriceps atrophy leading to extension lag or quadriceps lag. Even if the
physio gains the range of motion (ROM) in the patient, the problem of gait
disturbance still persists. This is annoying both for the patient and the
physio. We've been using many modalities of the therapy to deal with it. Many
of them are age old techniques. I have witnessed my colleagues trying with
rigorous strengthening programme which are equally tiring for the patient and
the physio as well.
I very strongly feel that we lack in the insight. We disregard the basics of what we've learned in the graduate levels. We should utilise what is still remaining in the muscle and enhance its strength by exploiting itself. We all are aware of the concept of eccentric, concentric and isometric contractions. But not many remember that during isometric contractions the ability of the muscle to generate force enhances by about 10 degrees on either side. e.g.: if a muscle is asked to perform resisted isomeric contraction at 30 degree of any range, its ability to contract in enhanced from 20-40 degrees. Thus using this simple principle we can eliminate the quadriceps extension lag very efficiently.
This technique of resisted isometric training warrants recovery of full strength and attainment of full active knee ROM within a period of 2-3 weeks. Let alone the use of other modalities viz: EMS, kinesio taping, PNF technique, etc.
I hope this would help to be an eye-opener for betterment of patient care by all the physiotherapists.
I very strongly feel that we lack in the insight. We disregard the basics of what we've learned in the graduate levels. We should utilise what is still remaining in the muscle and enhance its strength by exploiting itself. We all are aware of the concept of eccentric, concentric and isometric contractions. But not many remember that during isometric contractions the ability of the muscle to generate force enhances by about 10 degrees on either side. e.g.: if a muscle is asked to perform resisted isomeric contraction at 30 degree of any range, its ability to contract in enhanced from 20-40 degrees. Thus using this simple principle we can eliminate the quadriceps extension lag very efficiently.
This technique of resisted isometric training warrants recovery of full strength and attainment of full active knee ROM within a period of 2-3 weeks. Let alone the use of other modalities viz: EMS, kinesio taping, PNF technique, etc.
I hope this would help to be an eye-opener for betterment of patient care by all the physiotherapists.
