07-25-2006, 04:58 AM
PFS Mx
Physical Therapy:
The basic exercise principles for management of PFS are restoring muscle balance within the quadriceps group, improving range of motion, and restricting the offending physical activity. Quadriceps strengthening traditionally is performed while the knee is flexed 0-30°. Usually, the lateral forces of the vastus lateralis need to be countered better by the vastus medialis. This goal is accomplished best by strengthening all of the quadriceps.
Stretching of the quadriceps should be of long duration (20-30 seconds) and with low force. This technique allows for overcoming neural and connective tissue barriers to lengthening. Exercises to stretch the iliotibial band, hip, hamstring, and calf also are important for patients with PFS.
Patellar taping techniques are used in patients with PFS to reduce the friction on the patella. Proper footwear also is important for individuals with PFS.
Soft knee braces may also be of benefit to patients with PFS.
Occupational Therapy:
Medical Issues/Complications:
Most symptoms of PFS resolve with simple measures. As with many exercise routines, patients often fail to adhere to the exercise prescription, resulting in apparent refractory treatment results when the therapeutic approach has not been given a fair trial.
Surgical Intervention:
Surgical intervention usually is in the form of arthroscopic evaluation followed by release of the lateral attachments of the patella.
Surgical procedures performed for patellofemoral arthritis include lateral facetectomy and patellar resurfacing.
Other Treatment (injection, manipulation, etc.): Knee pain secondary to defined degenerative changes may be relieved by injecting the joint with steroid or synthetic hyaluronic acid. Such management of PFS is rare.
BURSITIS
Is of two types, Aseptic which is usually treated with NSAIDS
Septic, which is NSAIDS and Abx.
Physical Therapy:
The basic exercise principles for management of PFS are restoring muscle balance within the quadriceps group, improving range of motion, and restricting the offending physical activity. Quadriceps strengthening traditionally is performed while the knee is flexed 0-30°. Usually, the lateral forces of the vastus lateralis need to be countered better by the vastus medialis. This goal is accomplished best by strengthening all of the quadriceps.
Stretching of the quadriceps should be of long duration (20-30 seconds) and with low force. This technique allows for overcoming neural and connective tissue barriers to lengthening. Exercises to stretch the iliotibial band, hip, hamstring, and calf also are important for patients with PFS.
Patellar taping techniques are used in patients with PFS to reduce the friction on the patella. Proper footwear also is important for individuals with PFS.
Soft knee braces may also be of benefit to patients with PFS.
Occupational Therapy:
Medical Issues/Complications:
Most symptoms of PFS resolve with simple measures. As with many exercise routines, patients often fail to adhere to the exercise prescription, resulting in apparent refractory treatment results when the therapeutic approach has not been given a fair trial.
Surgical Intervention:
Surgical intervention usually is in the form of arthroscopic evaluation followed by release of the lateral attachments of the patella.
Surgical procedures performed for patellofemoral arthritis include lateral facetectomy and patellar resurfacing.
Other Treatment (injection, manipulation, etc.): Knee pain secondary to defined degenerative changes may be relieved by injecting the joint with steroid or synthetic hyaluronic acid. Such management of PFS is rare.
BURSITIS
Is of two types, Aseptic which is usually treated with NSAIDS
Septic, which is NSAIDS and Abx.