Knee flexion contracture is a painful and particularly debilitating condition. However, rehabilitation solutions exist to help patients suffering from this condition. knee pathologyBut do you really know what a knee flexion contracture is, what its origins and symptoms are? That's what we propose to discover together in the rest of this article.
What is a knee flexion contracture?
Knee flexion contracture is characterized by an inability to fully extend the knee joint. It usually occurs following significant trauma or knee surgery.
It should be noted that certain more mechanical aspects, such as fluid effusion within the joint following a sprain, one leg longer than the other or the modification of posture due to a splint can sometimes be involved in the development of a flexion contracture.
What are the symptoms of a knee flexion contracture?
Knee flexion contracture is characterized by the discomfort it causes the patient, particularly during walking. The patient may then complain of muscle tightness, especially in the calf and hamstring muscles.
However, to diagnose a knee flexion contracture, it is essential for the patient to consult their primary care physician. A physical examination, comparing the condition with the other knee, will then be performed by the healthcare professional. The physician will subsequently be able to refer the patient to a rheumatologist or orthopedic surgeon if necessary.
Knee flexion contracture and motor inhibition
In the context of a knee flexion contracture, motor inhibitions (more commonly known asArthrogenic Muscle Inhibitions (AMI)) are characterized by a reflex mechanism of overuse of the hamstring muscles, as well as quadriceps paralysis [1]. The cause of this disorder is very often central in origin and this inhibition can persist over time, potentially leading to irreversible stiffness, thus requiring surgical intervention for the patient.
The importance of rehabilitation in the context of a knee flexion contracture
The management of knee flexion contracture always relies on functional rehabilitation, implemented with a physiotherapist. It must be based on first addressing the loosening of the hamstrings, then activating the quadriceps.
Flexion is very often an antalgic posture that can be reduced through rehabilitation. Furthermore, it is important to rule out mechanical complications, such as a bucket-handle tear, which would require surgical intervention, before beginning this rehabilitation phase.
How to prevent recurrence of a knee flexion contracture?
To prevent the risk of recurrence of a knee flexion contracture, particular vigilance is necessary, especially during the post-operative period or following a knee injury. In these situations, the joint can be particularly painful. However, it is essential to avoid leaving the knee at rest in a semi-flexed position and elevated by a cushion, for example. Similarly, it is crucial to ensure that a brace, if necessary, is correctly positioned and does not allow the knee to remain in a semi-flexed position when in use.
The Allyane method in the context of managing knee flexion contracture
The Allyane method of neuromotor reprogramming appears to be a promising approach for treating knee flexion contracture. It includes multisensory work on motor control, combining motor imagery with proprioceptive identification of the movement. All this mental work is carried out while listening to specific low-frequency sounds delivered by a patented medical device. The patient is thus placed at the heart of the treatment, as they are asked to become aware of the correct movement on the unaffected side and transfer it to the injured limb.
The practitioner and patient begin by working on releasing the hamstrings, following a specific protocol inspired by the methods of Schultz and Jacobson. This involves maximal muscle contraction throughout the body, leading to equally maximal relaxation, before targeting the specific area to be treated, in this case, the hamstrings.
Once this hamstring relaxation command is acquired, the next step is to reactivate the key muscle for knee stability, namely the vastus medialis, by identifying the correct natural neuro-sensory-motor information on the unaffected side and mirroring it to the affected limb. The patient thus leaves with clear and precise motor patterns that will need to be practiced subsequently both at home, through mental imagery exercises, and with the physiotherapist, using specific exercises.
In conclusion, knee flexion contracture is a complication that can appear as early as the initial stage of joint trauma and often persists despite rehabilitation and return to sport. It represents a significant obstacle to the patient's progress, which is why it is essential to treat it and prevent its occurrence. The Allyane neuromotor reprogramming method complements other rehabilitation techniques already in place. It adds a more central dimension by placing greater emphasis on the importance of muscle activation itself. The clinical assessment and patient history therefore require a thorough analysis to detect these motor inhibitions and treat them as early as possible to ensure successful rehabilitation.
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