Sounds like she has start-up pain, Which is frequently caused by ambulation without an assistive device too
early, so you get inflammation continuing in the bone as it trys to heal. I would put her back to crutches or a
cane for 2 weeks, initially, and wean her again, as long as the pain goes away. Keep going with the stretches,
and a progressive walking program, in a pool if this is what she needs to be painfree with initial ambulation.
Tracey.
--------
>From: [log in to unmask]
>To: [log in to unmask]
>Subject: RE: Knee Replacement
>Date: February 01, 1999
>
>I would like any input to the following case
>
>-middle-aged woman with partial knee replacement
>-8 weeks post surgery This is the first time I have seen her but she was seen
>initially for the usually post-op exercise program and discharged as ROM and
>strength were good.
>-ROM flexion and extension full as compared to the other side
>-tightness ITB on surgical side
>-tightness of the lateral aspect of the patella on the non-surgical side,
>tight plantar fascia Right & Left
>-Strength - Quads 4+ otherwise grade 5/5 no Quads lag
>
>Main complaint- Stiffness/pain on initial weight bearing after resting more
>than 3 - 5 minutes .
>
>Initial Treatment - given ITB stretches and 1/4 knee bends
>Future Ideas - McConnell type taping, more intensive exercise program
>
>My question: Once she has walked about 10 steps the gait pattern is quite good
>but this initial stiffness does not seem to be going away. Does anyone have
>any ideas?
>
>Thanks for any input
>
>J. Armstrong
%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%
|