Case Study
40-Year-Old Man presented with Left Knee Stretched Ligaments

A 40 year-old man presented with left knee pain.  At the age of 16 he sustained an unusual basketball injury.  He was hit from the side of the leg as he was making a jump-shot and the kneecap moved.  There were no tears, all ligaments and muscles were stretched.  The knee was returned to position and held in place with a cast.  However, the knee was prone to repeated injury and pain.  The pain had increased to the point where it was almost constant. There was stiffness and a tendency to become "locked".

He had previously had some physical therapy sessions that he had quit due to pain and lack of improvement. He had also had some chiropractic treatments that were minimally effective.  Patient is opposed to taking pain medications of any kind.

He was referred to us by his wife, who had been seeing us for shoulder pain.  On his first visit we did an evaluation and began treatment. Patient was reluctant to have anyone touch his knee.  He had marked tightness in the hamstrings and quads.  He stood in a genu recurvatum posture (locks his knees out).  He had significant anterior tilt of the pelvis with poor lumbar range of motion.  He also had marked tightness throughout spine and neck.  By locking his knees out, he changed the vector of force throughout his knee, which exacerbated his pain.  He had poor patella tracking. 

We worked on balancing his pelvis, releasing the lumbar spine, releasing the quads and hamstrings and mobilizing the knee and kneecap.  The scar adhesions had locked the kneecap down so it would not move. That coupled with the lack of range of motion in his body started to wear out the ligaments.  We began to stretch and release the scar adhesions and tissue.

We gave him quad exercises for stretching and strengthening to do at home.  He was also given exercises to stretch his back and reposition the pelvis under him.  He was told to do these one to two times daily to help with muscle memory, take the strain off to reduce his pain and recommended he come back on a regular basis.

Patient did not do the exercises we had prescribed.  He canceled repeated appointments.

The patient reported after the first treatment that his pain had significantly improved and there was greater range of motion.

At the second treatment, we continued working on these things and made some more recommendations. The patient did not follow the recommendations or do any of the exercises, but again experienced improvement in range of motion and a decrease in pain and flare-ups in the knee.

The patient continued to miss treatments and come in on an irregular basis.

At future sessions, in balancing the body, he reported a decrease in pain from carpal tunnel and an improvement in his golf swing and the distance that he could drive the ball.  He also reported that weather was having less of a detrimental effect on the knee and he was no longer experiencing severe stiffness or pain with changes in the weather.

This website last updated on 31 July 2010

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