An 83 year-old man had been experiencing knee pain (left more than right) due to osteoarthritis. He was referred to physiotherapy by an orthopaedic surgeon to increase knee strength and stability in order to avoid having a total knee replacement. Xrays had shown that the knee was bone-on-bone but had good articulation. The major complaint of the patient was decreased walking distance and pain when walking. On examination, there was a lot of crepitus with knee movement and decreased strength of the muscles around the left knee.
Treatment consisted of manual therapy and exercises 3x/week. The exercise prescription began with exercises to isolated muscles, such as the quadriceps and adductors, and progressed to more functional exercises in standing, such as squats and balancing in various positions. The manual therapy focused on releasing tight muscles, treating bone bruises, reducing inflammation, increasing circulation, and increasing space within the joint. The technique that is used is called Evolutionary Process, which works with lines of tension in the body to increase mobility and relieve pain. Part of this work involves stimulating quanta, which is particles of light that exist in joints. By engaging this energy manually, joint space increases, which can be beneficial in resolving chronic joint problems.
After 4 weeks of treatment, walking distance had increased with less reported pain, and strength had increased to full strength. A follow up appointment with the surgeon is coming up, so it is not known yet if the knee replacement will still be recommended. Treatment is ongoing 3x/week with a focus on improving the gait pattern and continuing to increase space in the joint.
Joanna Miller, Physiotherapist
