Frozen Knee

 

Case History: Frozen Knee x 18 years
In 1995, Ms. B injured her left knee while she was inline skating at Memorial Park and tripped and fell secondary to colliding with another skater. There was immediate swelling and bruising of the knee noted. It wasn't until four months later that medical care was sought; first from her family doctor, and then from an orthopedist who aspirated the knee joint. Over the years treatment included two orthroscopic surgeries, manipulation under general anesthesia, casting, and physical therapy treatments; none of which resulted in dramatic reduction in discomfort or improvement of mobility.

In addition to a constant dull aching in the knee itself, Ms. B continued to have pain and swelling following even small amounts of activity, such as walking on a treadmill or across uneven ground. Orthopedic plan (as she described it) was to avoid any activities that induce pain or result in swelling (such as walking, running, treadmill exercises, etc.), keep her weight down (currently 116 pounds), and at a later date, should symptoms persist or worsen, perform a knee replacement surgery.

The reason she sought FAAST treatment at this time was because for the last week and a half she had a new complaint which was a pulling/burning pain on the lateral and medial anterior thigh. She attributes this new problem to her attempting to run on the sidelines at Semi-pro football games carrying camera equipment.

Physical Exam: October 14, 2003
Left knee demonstrates healed puncture wounds from previous procedures. There is no redness, swelling, or deformity noted. Ligaments are intact. Ms. B walks with a slight limp. A slight instability of the knee is noted when she attempts to sit, i.e., buckles slightly during this movement. Knee to chest motion is normal.

Heel to Buttock Motion:
Right: normal ( i.e., fast, fluid movement in which she easily is able to grab her right heel with her right hand and effortlessly pull it to her right buttock without pain).

Left: abnormal: makes three attempts before her left hand is able to grab her left heel. There is resistance while pulling the foot toward the buttock due to tightness and pain in the thigh and knee, and more than two fists of deficit is noted (i.e., left heel can not be pulled closer than within 10 inches of the left buttock).

Impression: Frozen Knee

Plan: Continuum technique of popliteal fossa
Triggerband technique of anterior thigh
Folding technique of knee capsule

Result: At completion of first visit Ms. B demonstrated no knee instability and heel to buttock motion showed only one fist of deficit. In addition, she walked without a limp. At the completion of her 7th treatment she was able to perform the following activities without pain or subsequent swelling: walk on uneven ground, jump on a trampoline, swim, and run 100 yards carrying TV camera equipment at a football game (she's a part time sports television camera person). At completion of her 9th office visit (November 19, 2003) she had zero pain, zero swelling, no physical limitations and could touch her left heel to her left buttock.

     

FAAST Sports Rehab * Dr. David Morrissey , DC, BS, ATC
* 4950 Bissonnet St., Suite 130 Bellaire, TX 77401 * (832) 372-1999
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