A Case of Regional Interdependence

This is a post right medial meniscus repair patient of mine. His brief history is he tore his right medial meniscus in Jan 2016 and had his repair in May 2016. I first saw him early November . His physical examination showed:

Right knee swelling +

Limited right hip IR

Limited right knee flexion to 100 deg with pain

Rt knee extension strength of 4/5

ODS: DP

My programme for him involved primarily balance, coordination, proprioception and strength training for the lower limbs.

I knew he had issues with his squats but I did not know that it affected his right lumbar and/or right hip as well. Maybe this is a case of regional interdependence? If you watch the clip, you can actually see my patient side flexing to the right on his lumbar, shifting his pelvis to the right and has limited hip flexion. This can mean that he is not putting equal weight through the right side of his body. So what?

So, I gave him some simple movement exercises to load the right lumbar vertebral/facet joints in order to "correct" his asymmetry. The movements were: REIL and SGIS, 3x10 and the changes are shown in the after clip.

Take home message:

Did I cause any changes to his body structures or did I simply just encourage more joint loading? My bias goes to the latter~

#Hip #Reflection #Lumbar #Opinions