by Monica Lita
My client is a soccer athlete one month into rehabilitation following ACL reconstruction surgery after an unfortunate injury while playing.
Due to the swollen knee, lack of patellar degrees of freedom, and increased tone of surrounding muscles (quadriceps group, lower leg posterior compartment, and pain referral lateral lower leg), our initial rehabilitation approach includes:
- Scar tissue myofascial release, both extra and intra layers
- Patellar fat pad release
- Manual force inputs to the patella (knee cap) in different directions
- Manual force inputs around medial and lateral coronary ligaments and other tendinous structures attached to the femur, tibia, and fibula
- CARs (Controlled Articular Rotations)
- Capsular CARs
- Isometric contractions and ENGs-Eccentric Neural Grooving in various knee flexion positions combined with tibial medial or lateral rotation, all performed in both prone and supine positions (not shown). The intent is to down-regulate the tone of the muscles by influencing the length-tension relationship of the musculotendinous units involved in different knee joint positions.
To understand human movement dynamics, it's essential to consider that joint position influences force transmission. Muscles do not work independently but have interdependent relationships in terms of force conduction, both within and between muscle compartments. There are various pathways at the intramuscular, intermuscular, and extramuscular levels, where different connective tissue structures blend and act as a continuum Bioflow to help transmit force contractions.
Accurate client feedback is necessary to work within ranges just below the pain threshold. By doing so, we influence the knee's intrinsic and extrinsic articular innervation to decrease overall pain.