Patient Case: 20 years of chronic knee pain

Condition: Right posterior chronic knee pain (pain behind the knee) with squatting or sitting on the ground cross legged to play with his kids.

Total treatments to resolution: 5

Restrictions: Unable to squat down to play with his kids, unable to sit cross legged on the floor, unable to get up from squat without limping.

Bruce had knee pain bothering him since 1998. He had x-rays and MRI’s that came back normal. So far, the only solution that had been implemented was to stop doing the things that hurt, such as squatting. Everyone who has had small children knows that if you want to lead the ‘clean up’ game, the ability to get near the floor is a must. If every time you squat down you have knee pain and limp afterwards, you’ll soon stop using your knees and bend at the hips and low back, which is exactly what Bruce had started to do and it had started giving him back pain.

Using a high-speed camera to capture his walking pattern it was determined that he was unable to extend his knee fully due to the popliteus muscle which is directly in the back of the knee.

Treatment: This patient required just 5 treatments to reach full recovery of this 20-year chronic knee pain.

Treatment #1: With any muscular restriction, it is necessary to improve the available range of that muscle. We focused on manual trigger point therapy to the popliteus. Once range was gained we proceeded to stretch the popliteus and mobilize the leg into extension. After full range of motion was achieved we initiated an exercise program specifically targeted at working into the last few degrees of extension.

Treatment #2 (one week later): After 1 treatment knee pain was significantly reduced. He could squat for longer and then stand and walk without limping. Treatment #2 repeated treatment #1.

Treatment #3 (one week later): After two treatments Bruce was elated. He had been able to go to Disney land and sit cross-legged on the floor with his kids for a show. Afterwards he had gotten up without pain or limping! He had also been able to squat to the floor with his kids to help them with their chores. With his knee pain 85-90% gone it was decided that he had the tools necessary to keep progressing on his own.

Two more treatments were performed at extended intervals. Bruce did not have any return of symptoms and is currently living life today.

blog image: https://kaizenseattle.com/physical-therapy-services/hip-pain-knee-pain-relief/