Knee Extension Issues After Injury: Causes and Treatments - Orthopedics

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The knee may not fully extend?


Hello, doctor.
I previously had swelling in my knee due to a car accident, but the swelling has now subsided and I can walk without pain.
No matter how I touch my knee, it doesn't hurt, but I cannot fully extend it (the injury is on my left leg, compared to my right leg).
What could be the problem? How should I treat it?

DK, 20~29 year old female. Ask Date: 2010/03/09

Dr. Zhou Lizhi reply Orthopedics


Dear readers: Injuries to the knee from car accidents can include not only fractures but also other types of damage.
For instance, the anterior and posterior cruciate ligaments, as well as the medial and lateral menisci, can be affected.
Additionally, fibrosis of the soft tissues due to swelling may lead to residual limitations in knee joint function after an injury.
If these symptoms do not improve or persistently trouble you, it is advisable for patients to undergo arthroscopic examination to confirm the diagnosis.

Reply Date: 2010/03/09

More Info


Knee extension issues following an injury, such as those sustained in a car accident, can be quite common and may arise from several underlying causes. In your case, it seems that while the swelling has subsided and you are able to walk without pain, you are experiencing difficulty fully extending your knee. This can be attributed to a few potential factors, which I will outline below, along with suggested treatments.


Possible Causes of Knee Extension Issues
1. Soft Tissue Injury: After an injury, the muscles, tendons, and ligaments around the knee may become tight or scarred, limiting your range of motion. This is particularly common if there was significant trauma to the knee joint.

2. Joint Stiffness: Following an injury, the knee joint can become stiff due to disuse or inflammation. This stiffness can prevent full extension, even if there is no pain.

3. Meniscus or Cartilage Damage: If there was any damage to the meniscus or cartilage during the injury, it could lead to mechanical blockages in the knee joint, preventing full extension.

4. Patellar Tracking Issues: If the patella (kneecap) is not tracking properly due to muscle imbalances or structural changes, it can affect your ability to extend the knee fully.

5. Post-Surgical Changes: If you underwent surgery, scar tissue formation around the joint can also contribute to limited range of motion.


Treatment Options
1. Physical Therapy: Engaging in a structured physical therapy program is one of the most effective ways to regain knee extension. A physical therapist can provide targeted exercises to improve flexibility, strengthen the muscles around the knee, and enhance overall function. Stretching exercises focusing on the quadriceps, hamstrings, and calf muscles are particularly beneficial.

2. Manual Therapy: Techniques such as joint mobilization and soft tissue manipulation performed by a skilled therapist can help improve joint mobility and reduce stiffness.

3. Strengthening Exercises: Strengthening the muscles around the knee, particularly the quadriceps, can help support the joint and improve extension. Exercises like straight leg raises, wall slides, and step-ups can be beneficial.

4. Use of Orthotics or Braces: In some cases, a knee brace may help stabilize the joint and provide support during the healing process. However, it’s essential to consult with your healthcare provider to determine if this is appropriate for your situation.

5. Heat and Cold Therapy: Applying heat before exercises can help relax the muscles, while cold therapy can reduce any inflammation post-exercise. This combination can facilitate better movement and comfort.

6. Gradual Return to Activities: As you regain strength and flexibility, gradually returning to activities that require knee extension, such as walking, cycling, or swimming, can help improve function without overloading the joint.

7. Consultation with an Orthopedic Specialist: If your knee extension does not improve with conservative measures, it may be necessary to consult an orthopedic specialist. They can evaluate for any underlying issues such as meniscal tears or other structural problems that may require further intervention.


Conclusion
Knee extension issues following an injury can be frustrating, but with the right approach, significant improvements can be made. It’s crucial to be patient and consistent with your rehabilitation efforts. If you have not already, consider seeking a referral to a physical therapist who specializes in knee rehabilitation. They can provide you with a tailored program to address your specific limitations and help you regain full function of your knee. If symptoms persist or worsen, further evaluation by an orthopedic specialist may be warranted to rule out any serious underlying conditions.

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