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D/C current is pro-inflammatory? I don't buy that. ----- Original Message ----- From: John Willenbruch To: [log in to unmask] Sent: Thursday, March 03, 2005 4:55 AM Subject: Re: Lateral knee pain! Dr. White Why do you use iontophoresis for pain relief in anterior knee pain (AKA latertally tracking patellar, runners knee) does not involve an inflammatory process why would you choose a pro-inflamatory modality with an anti-inflamatory drug? At present we don't use iontophoresis at our hospital Thanks for any help with this, John >If the patella is tracking laterally I have had success with taping the >patella to track properly. This also stretches the lateral retinaculum. >Iontophoresis with a steroid should give symptomatic relief. I would also >r/o a lateral meniscus tear. > > > >******************************************************* > >Dr. Douglas M. White > > > > > >Confidential: > >This email, including attachments, may contain information that is >privileged, confidential, and/or exempt from disclosure under applicable law >(including, but not limited to, protected health information). It is not >intended for transmission to, or receipt by, any unauthorized persons. If >the reader of this message is not the intended recipient you are hereby >notified that any dissemination, distribution or copying of this >communication is strictly prohibited. If you believe this email was sent to >you in error, do not read it. Reply to the sender informing them of the >error and then destroy all copies and attachments of the message from your >system. Thank you. > > _____ > >From: - for physiotherapists in education and practice >[mailto:[log in to unmask]] On Behalf Of John Willenbruch >Sent: Wednesday, March 02, 2005 4:02 AM >To: [log in to unmask] >Subject: Re: [PHYSIO] Lateral knee pain! > > > >Nabil, > >Have you looked at the way the patellar tracks in the trochlear groove? >What will commonly be seen is that the affected knees patellar will track >laterally when compared to the non affected patellar. > >This can be associated with Clarkes sign being positive and weakness when a >straight leg raise is performed in external rotation of the hip. >Theoretically this would indicate a weakness in VMO, a tightness in ITB or >both. If modified Obers test is positive start ITB stretches/mobilisation, >if not straight leg raise in external rotation can be used to increase VMO >strength. > >Hopefully someone will come up with some evidence to back this up, I >remember a US study looking at this but can't remember a reference. > >Cheers, > >John > > >From: nabil keshavjee <[log in to unmask]> > > >Reply-To: - for physiotherapists in education and practice ><[log in to unmask]> > > >To: [log in to unmask] > > >Subject: Lateral knee pain! > > >Date: Tue, 1 Mar 2005 20:54:04 -0500 > > > > > >Hi All! > > >A case I hope you can all help me with in regards to > > >treatment, and possible other diagnosi. > > >Female, 40s, came in with lateral knee pain. Pain has > > >been getting worse, and started about 5 months back. > > >Started during her runs, and gradually she had to > > >reduce her runs distance wise. She is now at a point > > >where walking even aggravates the pain. Pain is very > > >irritable. Aggravated with stairs, running, rising. > > >No real easers, other than rest. Although she feels > > >she is unable to find a comfortable spot for her knee, > > >and needs to move it. > > >No locking or giving way. > > >Repeated lumbar movements (flexion/extension), do not > > >provoke pain. Any knee movement does. > > >Valgus/Varus Stress Tests were negative. ACL/PCL > > >drawer were negative. At this point was very sore, so > > >meniscal tests were painful, but no locking or > > >increase in pain. > > >On palpation, very tender only ITB insertion, and > > >along band. > > >I would assume this ITB, but am stuck due to the > > >irritablity. I have used only pain relief > > >modlalities, with limited results. Have thought of > > >possible orthotics (destress ITB) but her feet look to > > >be doing pretty good. > > >Any helpful hints would be greatly appreciated. > > > > > >Nabil K. > > > > > >______________________________________________________________________ > > >Post your free ad now! http://personals.yahoo.ca >