Functional problems associated with the knee—Part one: Sources of biomechancial overload

Abstract

Rehabilitation of patients with knee problems should progress from sparing to stabilizing to functional integrated training (FIT) approaches. A few of the most common clinical presentations seen in practice include patello-femoral tracking disorders, iliotibial band syndrome, post-operative functional limitations after anterior cruciate ligament rupture, partially torn medial meniscus, knee osteoarthritis, and post-operative functional limitations after knee arthroplasty. Sparing strategies include avoidance of valgus overload due to medial collapse of the knee secondary to subtalar hyperpronation or lack of frontal plane stability of the hip (Trendelenberg sign). Stabilizing strategies include training appropriate motor control of patello-femoral tracking ensuring vastus medialis oblique (VMO) activation. FIT includes upright single leg stance, stepping, squats and lunges.