A Multimodal Physiotherapy Treatment for Patient with Anterior Knee Pain Using Manual Therapy and Targeted Exercise -A Case Report

Abstract

Background: The most frequent musculoskeletal complaint is anterior knee pain. These complaints are often the result of muscle imbalance, joint malalignment and alterations in biomechanics, particularly of the lower limb. Symptoms of anterior knee pain can be efficiently managed, and overall function enhancement can occur, through the application of a movement system-based approach that targets deficits in neuromuscular control, joint mobility and/or the kinetic chain.

Materials and methods: A 45year-old female referred to the clinic with left anterior knee pain of six months duration that worsened with prolonged sitting, crouching, and climbing stairs. The patient's Knee Outcome Survey-Activities of Daily Living (KOOS-ADL) was 73% and before treatment her Numeric Pain Rating Scale (NPRS) was 6/10. The clinical exam demonstrated weakness in the VMO, tight hamstrings, tight iliotibial band, restriction of patellar mobility, excess external tibial torsion, and flat foot.

Results: Post-intervention assessments revealed a reduction in NPRS from 6/10 to 2/10 and an improvement in KOOS-ADL score from 73% to around 89%. Improved patellar mobility and muscle flexibility.  Strengthened hip and knee stabilizers.  Reduced dynamic valgus and aberrant movement patterns.

Conclusion: patient with knee pain, a movement system-based physiotherapy strategy that combined manual therapy, corrective exercises, and patient education successfully decreased pain and enhanced function. These results underline the significance of treating both local and global biomechanical variables and support the adoption of tailored impairment-based therapies