In her youth Karolyne was a keen figure skater but had recurrent issues with her left patella which would dislocate without warning – not ideal in the leg on which she should have been landing jumps…
It was noted by her surgeon that her patella and subsequent patella grooves were both on the small side. Duncan, Noehren & Lattermann (2012) noted that 85% of patients with patella instability have trochlea dysplasia. Her surgeon was confident that he could correct the problem but unfortunately what he chose to do was permanently dislocate her patella.
Essentially, Karolyne was unable to skate competitively again but from then on she focussed on keeping herself mobile with regular exercise (Pilates and Yoga). However, just over two years ago, to add insult to injury, she tore her meniscus in the same knee and was unable to stand or walk for more than 20 mins even after she had recovered enough to dispense with crutches and then a walking stick. She had continued to maintain a healthy weight and exercised regularly to try and stabilise her knee as best as she could but it was always in her thoughts: she couldn’t plan anything without considering how far it would be to walk or stand. Her knee had taken over her life!
As many of the clinic’s patients are, Karolyne was a referral from a previous client. I was told that she was very sceptical and not very optimistic much could be done to help her as she had essentially been suffering with this for most of her life. From the moment I saw Karolyne’s knee, one of the major issues was very apparent, her surgical scar. The scar, ran down the lateral (outside) of the thigh and underneath her patella. It was very prominent and avascular, basically there had been very little blood vessel growth and very little mobilising work performed during rehabilitation.
This had left Karolyne with an altered feedback pattern in her brain when it came to her knee. Her skin around her knee could not slide as it’s designed to do and as a result reduced her range of motion and strength. It also affected her sensation around the joint.
The first thing we looked at was just how much movement there was in the knee joint and just how strong it was compared to her other leg. Then we got down to the nitty gritty of that scar. As soon as I put my finger on the deepest part of the scar, Karolyne became very uncomfortable but not through pain. It was very difficult for her to explain what she was feeling other than she was very apprehensive and did not like it.
After some very gentle de-sensitizing work, I began to start to apply a bit more pressure that Karolyne was still comfortable with. This began to stress the scar tissue and promoted blood flow in and around the area. The more we mobilised the scar the more comfortable she became.
After the first 20 mins of scar work we got Karolyne back to her feet where she began to cry, not thorough pain but because she had never felt her knee feel so free of restriction. I’m glad to report that today Karolyne has gone from strength to strength. From not being able to stand for more than 10 mins to now being able to walk for several hours pain free!! This is testament to her continued work with her exercises and scar mobilising work.
Karolyne’s knee Pre (left) and Post (Right) scar mobilisation work.
Recent Comments