TRAINING LADDER FOR CHILDREN AND ADOLESCENTS: FOR LUXATION OF THE KNEE CAP (LUXATIO PATELLAE)
STEP 4
Unlimited: Cycling. Swimming. Running and spurting with sudden directional change.
(5 min)
Lie on your back. Draw the injured leg up towards your head so that the muscles in the back of the thigh become increasingly stretched. Perform the exercise with outstretched as well as bent knee. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be performed standing with the injured leg outstretched on a chair while the upper body is bent slightly forwards.
Stand with support from the back of a chair or the wall. Using your hand, bend the knee and draw the foot up and your knee slightly backwards so that the muscles in the front of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done lying down. If you lie on your stomach you can draw the foot up by using a towel.
Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.
Lie on your back with one leg outstretched and the other bent with the foot on the other side of the outstretched leg. Draw the knee up towards the opposite shoulder so that the buttocks become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Lie on your back with one leg over the other, and hold behind the lower leg’s knee. Draw the leg up towards your head so that the buttock on the upper leg becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Sit with bent knees and the soles of your feet together. Place your hands on your knees and slowly press the knees apart so that the groin becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
(5 min)
Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.
(10 min)
Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.
Sit on a chair with elastic attached to the ankle. Raise the leg and slowly stretch and bend the knee.
Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.
Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.
Lie on your back with a ball or firm round cushion under the injured leg. Lift your backside up from the floor and stretch the healthy leg. Hold the position for a few seconds.
Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated.
The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.
TRAINING LADDER FOR CHILDREN AND ADOLESCENTS: FOR LUXATION OF THE KNEE CAP (LUXATIO PATELLAE)
STEP 3
Unlimited: Cycling. Swimming. Running with increasing speed and cautious directional change.
(5 min)
Lig på ryggen. Træk træningsbenet op mod hovedet, så der kommer tiltagende udspænding af baglåret. Udfør øvelsen både med strakt og bøjet knæ. Hold udspændingen i 20 sekunder. Slap af i 20 sekunder. Øvelsen kan også udføres stående med træningsbenet strakt på et stol, mens forkroppen bøjes let fremover.
Stå med støtte. Bøj i knæet og tag om foden med hånden. Træk foden op og knæet lidt bagud, så der kommer tiltagende udspænding af forlåret. Hold udspændingen i 20 sekunder. Slap af i 20 sekunder. Øvelsen kan også udføres liggende. Hvis du ligger på maven, kan du trække foden op ved hjælp af et håndklæde.
Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.
Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
(5 min)
Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.
(10 min)
Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.
Sit on a chair with elastic attached to the ankle. Raise the leg and slowly stretch and bend the knee.
Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.
Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.
Lie on your back with a ball or firm round cushion under both feet. Raise your backside up from the floor and hold your feet on the ball. Hold the position for a few seconds.
Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated.
The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.
TRAINING LADDER FOR CHILDREN AND ADOLESCENTS: FOR LUXATION OF THE KNEE CAP (LUXATIO PATELLAE)
STEP 2
Unlimited: Cycling. Swimming. Light jogging.
(5 min)
Lig på ryggen. Træk træningsbenet op mod hovedet, så der kommer tiltagende udspænding af baglåret. Udfør øvelsen både med strakt og bøjet knæ. Hold udspændingen i 20 sekunder. Slap af i 20 sekunder. Øvelsen kan også udføres stående med træningsbenet strakt på et stol, mens forkroppen bøjes let fremover.
Stå med støtte. Bøj i knæet og tag om foden med hånden. Træk foden op og knæet lidt bagud, så der kommer tiltagende udspænding af forlåret. Hold udspændingen i 20 sekunder. Slap af i 20 sekunder. Øvelsen kan også udføres liggende. Hvis du ligger på maven, kan du trække foden op ved hjælp af et håndklæde.
Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.
Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
(5 min)
Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.
(5 min)
Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.
Sit on a chair with elastic attached to the ankle. Raise the leg and slowly stretch and bend the knee.
Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.
Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.
Lie on your back and bend the injured leg. Lift the healthy leg, and then raise your backside with the weight on the injured leg to be trained. Hold the position a few seconds and lower your backside again. Moving the injured leg further away from the body will increase the load.
Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated.
The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.
TRAINING LADDER FOR CHILDREN AND ADOLESCENTS: FOR LUXATION OF THE KNEE CAP (LUXATIO PATELLAE)
STEP 1
Unlimited: Cycling with raised saddle. Swimming (crawl).
(5 min)
Lig på ryggen. Træk træningsbenet op mod hovedet, så der kommer tiltagende udspænding af baglåret. Udfør øvelsen både med strakt og bøjet knæ. Hold udspændingen i 20 sekunder. Slap af i 20 sekunder. Øvelsen kan også udføres stående med træningsbenet strakt på et stol, mens forkroppen bøjes let fremover.
Stå med støtte. Bøj i knæet og tag om foden med hånden. Træk foden op og knæet lidt bagud, så der kommer tiltagende udspænding af forlåret. Hold udspændingen i 20 sekunder. Slap af i 20 sekunder. Øvelsen kan også udføres liggende. Hvis du ligger på maven, kan du trække foden op ved hjælp af et håndklæde.
Lie on your side on a table. Bend one leg up under your body and let the other hang over the edge of the table so that the muscles in the outer side of the thigh become increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating. The exercise can also be done standing by placing the outstretched injured leg behind the good leg at the same time as bending over the injured leg.
Stand with one leg outstretched and the other slightly bent. Thrust your weight to the side over the bent leg so that the inner side of the opposite thigh becomes increasingly stretched. Hold the position for 20 seconds and relax for 20 seconds before repeating.
(5 min)
Seesaw. Balance on two legs, possibly using a hand as support against the wall, balancing subsequently on one leg without support. Look straight ahead and keep knees bent.
(5 min)
Sit on a chair with elastic around the ankle, facing the elastic. Lift the leg and slowly bend and stretch the knee.
Sit on a chair with elastic attached to the ankle. Raise the leg and slowly stretch and bend the knee.
Stand on the healthy leg with the elastic around the inside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.
Stand on the healthy leg with the elastic around the outside of the injured leg. Move the injured leg from side to side in a slow smooth movement. Moving the position of the elastic lower down the leg can increase the load.
Stretching is carried out in the following way: stretch the muscle group for 3-5 seconds. Relax for 3-5 seconds. The muscle group should subsequently be stretched for 20 seconds. The muscle is allowed to be tender, but must not hurt. Relax for 20 seconds, after which the procedure can be repeated.
The time consumed for stretching, coordination and strength training can be altered depending on the training opportunities available and individual requirements.
Objective: To control the movement of the kneecap so that it glides up and down in a direct line. The tape should immediately provide less pain, and is a good indicator of whether the patient will gain any benefit of a kneecap stabilising bandage.
Application: The knee should be held slightly bent when applying the tape. One anchor is applied above the knee and one below (A & B), and should be open to the rear. A strip is applied (C) over the kneecap’s lower outer half, so that half the tape is over the kneecap. The tape is in line with the edge of the kneecap, and in this way has a sloping course, lifting and pushing the kneecap slightly inwards. The second strip (D) is applied over the kneecap’s upper outer half, so that half the tape is over the kneecap and runs slanting downwards over the first strip. Finish with further strips on top of the anchors A & B.
Femoropatellar pain syndrome. Conservative treatment and results 7-10 years following Maquet operation.
Munzinger U, Dubs L, Buchmann R. Orthopade 1985 Sep;14(4):247-60.
Owing to the largely unsatisfactory results achieved to date following surgery for chondromalacia patellae, and owing to our greater knowledge of the functional relationships within the knee joint, the range of aetiological factors in femoropatellar pain needs to be expanded. Functional variants in the muscular and ligamentous system must be considered as well as anatomical variants. On the basis of symptomatology and the results of clinical examination, two extreme forms can be distinguished, depending on ligamentous laxity and muscular stabilisation capacity. Physiotherapy must be determined by these. There remain few cases in which surgery is indicated.
Casscells SW. J Pediatr Orthop 1982;2(5):560-4 One hundred and sixty-three patients who underwent arthroscopic studies of the knee have been reviewed in an attempt to better understand the clinical condition present in chondromalacia of the patella. All patients included in the study were found to have either painful knees, patellar chondromalacia, or both, but no other intraarticular pathology. The difference between true chondromalacia of the patella (which may or may not be symptomatic) and other types of pain in the patello-femoral area is emphasized. Although various types of conservative and operative treatment have been described, the symptoms have frequently been found to resolve spontaneously, especially in young patients.
The initial (I and II) and advanced (III and IV) stages of juvenile patellar chondromalacia. Its diagnosis by magnetic resonance using a 1.5-T magnet with FLASH sequences.
Macarini L, Rizzo A, Martino F, Zaccheo N, Angelelli G, Rotondo A. Radiol Med (Torino) 1998 Jun;95(6):557-62 PURPOSE: Juvenile patellar chondromalacia is a common orthopedic disorder which can mimic other conditions; early diagnosis is mandatory to prevent its evolution into osteoarthrosis. In the early stages of patellar chondromalacia (I and II), the lesions originate in the deep cartilage layer and the joint surface is not affected. Arthroscopy can demonstrate joint surface changes only and give indirect information about deeper lesions. We investigated the yield of 2D FLASH MRI with 30 degrees flip angle and a dedicated coil in the diagnosis of patellar chondromalacia, especially in its early stages. MATERIAL AND METHODS: Eighteen patients (mean age: 21 years) with clinically suspected patellar chondromalacia were examined with MRI; 13 of them were also submitted to arthroscopy. A 1.5 T unit with a transmit-and-receive extremity coil was used. We acquired T1 SE sequences (TR/TE: 500-700/15/20) and 2D T2* FLASH sequence (TR/TE/FA: 500-800/18/30 degrees). The field of view was 160-180 mm and the matrix 192 x 256, with 2-3 NEX. The images were obtained on the axial plane. The lesions were classified in 4 stages according to Shahriaree classification. RESULTS: Agreement between MR and arthroscopic findings was good in both early and advanced lesions in 12/13 cases. Early lesions appeared as hyperintense focal thickening of the hyaline cartilage (stage I) or as small cystic lesions within the cartilage and no articular surface involvement (stage II). The medial patellar facet was the most frequent site. Advanced lesions appeared as articular surface ulcerations, thinning and cartilage hypointensity (stage III); stage IV lesions presented as complete erosions of the hyaline cartilage and hypointense underlying bone. CONCLUSIONS: 2D FLASH MRI with 30 degrees flip angle can show the differences in water content in the cartilage and thus permit to detect early chondromalacia lesions in the deep cartilage.
Witonski D. Chir Narzadow Ruchu Ortop Pol 1998;63(4):379-85. Anterior knee pain is a frequent musculoskeletal complaint affecting adolescent population with incidence of 36% in 14 years old schoolchildren. Until late sixties anterior knee pain used to be associated with chondromalacia. This review discusses etiology and treatment of anterior knee pain. Various etiologic theories exist ranging from trauma and patellar maltracking to retinacular nerves injury. None of these theories has been generally accepted and etiology of patellofemoral pain remains unclear.
