Diagnosis & Presentation:
Patient arrived at clinic with a several years history of knee pain that was aggravated by a skiing injury. His pain increased with walking down stairs, working around the house and sleeping on his side. The evaluation focused on the patient's overpronation (pronation occurs as the foot rolls inwards and the arch of the foot flattens, 'flat feet') with walking, tight knee & thigh muscles (especially hamstrings and lateral quads with iliotibial band adhesions), poor squatting ability, poor balance and positive meniscus test.
Sessions included: knee mobilization, Graston Technique® soft-tissue release, a home and gym exercise program to restore muscle balance and the use of arch supports to control pronation and decrease torque on the meniscus. Despite the chronic history and significant impairment to ADLs (activities of daily living), treatment resolved all patient complaints and clinical findings in 8 sessions of physical therapy.
Goals were met with notable functional improvement and significantly improved muscle strength. The patient returned to all usual activities, including walking 2.5 miles of hills, doing carpentry work, as well as improved balance, better gait quality, and undisturbed sleep.