The video is in Italian with the possibility of selecting English subtitles

Integrated knee treatment incorporates several approaches to achieve the results of manual therapy, instruments, and therapeutic exercise, creating therapeutic synergy.

Early tecar therapy units, equipped only with plate and electrode, didn’t allow for integrating other techniques and adapt to the geometry of each area of the body. But today, Fisiowarm 7.0 and its 28 accessories makes it super easy. In this article, we’ll see how we can treat knee pain with an integrated approach.

Many conditions cause knee pain. Many of these are due to bones (e.g. patellar fracture), tendons (e.g. patellar tendonitis), intra-articular problems (e.g. meniscopathy), cruciate ligament injuries, or extracapsular problems (e.g. collateral ligament injuries). 

In this Facebook Live, we’ll focus on patellofemoral pain syndrome.

Patellofemoral pain syndrome

What is it?

Patellofemoral pain syndrome (PFPS) is one of the most common musculoskeletal disorders. It mainly affects young athletes (age: 18 to 35 years), especially women. Overuse is a contributing factor that increases pain and patellofemoral compressive forces. Usually, PFPS is not a consequence of trauma or an intra-articular injury.

Symptoms

Patellofemoral pain syndrome symptoms include anterior knee pain or non-specific peripatellar pain during everyday activities, such as:

  • going up the stairs
  • squatting
  • sitting for a long time

What are the causes?

Common causes can be divided into two groups:

  • Local factors: related to the patella
  • General factors: related to bone and joint alignment in the lower limbs

Local factors

These factors affect patellar motility and stability. They include:

  • An abnormally shaped trochlear groove. A flatter trochlear groove reduces medial stability of the knee during movement
  • Medial patellofemoral ligament (also known as medial retinaculum) injury 
  • Excessive tension in the iliotibial band or lateral retinaculum

General factors

General factors include excessive knee valgus on loading. This condition may increase the Q-angle and the stress on the patellofemoral joint, especially on the lateral compartment.

This dysfunction is linked to various factors, some of which are not directly related to the knee joint. For example, they can be related to the hip or the foot due to regional interdependence and motor control of the pelvic and lower limb muscles.

Below are two factors that can affect knee valgus and can be noticed when performing single-leg squats:

1) increased hip adduction on loading, often due to stiff adductors or weak hip abductors. Weak hip abductors also cause the knee to be excessively outward angled, which is also considered responsible for valgus joint loading.

2) subtalar joint overpronation. This biomechanical problem can increase knee valgus because it leads to upward biomechanical reactions.

tecarterapia ginocchio

What accessory should be used for this target tissue?

When tecar therapy units had only a plate and an electrode, it was almost impossible to concentrate energy delivery in the patellofemoral joint. But now, Fisiowarm 7.0 makes it easy, thanks to the Neutro Dinamico® accessory. 

Fisiowarm allows for an integrated approach, incorporating manual techniques and exercises into the treatment.

neutrodinamico

What is Neutro Dinamico®?

It’s a system that involves using an electrode (neutral) and a dynamic plate, which thus serves as a second moveable electrode. For the patellofemoral joint, we’ll choose a dynamic plate of the same size as the electrode to ensure the same energy concentration on both surfaces. 

neutro dinamico ginocchio

 If we position the two electrodes on the patellar tendon and the distal quadricep near the patella, we can concentrate the energy flow in the specific area and even integrate joint mobilisation and active exercises into the treatment.

One of the most common exercises for conditions like this is the single-leg squat, often performed with a band or a balance board. This exercise is essential for knee function assessment and recovery.

propriocezione tavoletta

IASTM in integrated knee treatment

Fisiowarm 7.0 also allows the integration of IASTM to treat excessive tension in the iliotibial band or adductors using myofascial techniques. 

It does so, using an instrument – Fascial Full – as a resistive electrode. 

This way, physiotherapists can integrate mechanical stimulation into the treatment.

In this case, the plate is positioned under the thigh.

Andrea Pettirossi
Physiotherapist, Expert in Orthopaedic Manual Therapy. Specialised in Chiropractic Techniques.

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