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Thread: Permanent knee contracture?

  1. #1

    Permanent knee contracture?

    Is there anyway besides surgery, to stretch shortened tendons in the backs of the knees?

    I'm a C7/8 quad with a 35 degree contracture in both of my knees for 10 years. Exercise and ultrasound didn't help.

  2. #2

    casting?

    I found this site while researching, I wonder if this technique can be applied to SCI induced atrophy?

    http://www.congo-pages.org/ipvrc/muscle.htm

  3. #3

    knee contracture

    Seneca - I am assuming that you were in the described program in a rehab setting whose personnel were familiar with SCI. Were you evaluated by a physiatrist (doctor of Physical Medicine) whose background/expertise is in SCI?

    I have looked at the link listed and would suggest that such an approach should be discussed with a physiatrist who does have SCI experience. The use of casting in SCI can be a source of further problems due to the risk of pressure points and skin breakdown under the cast.

    The development of contractures unfortunately is a preventable complication. It is so very important that one's daily routine include range of motion of the joints of the paralyzed limbs and stretching of those muscles. CRF

  4. #4
    I received therapy in 1978. When I was sent home, I don't think anyone told my mother to make sure my legs spent a couple of hours straightened instead of in the bent position they were always in while sleeping on my side and sitting in my wc. By the time I was 9/10, my knees had significant contracture and no one's recommended anything worthwhile, outside of surgery, since.

  5. #5

    knee contractures

    Seneca - I am sure your Mother probably was not given this kind of instruction. I think so little was known and/or identified at that point in time re: management of the spinal cord injured person. The development of the Clinical Practice Guidelines has only occurred in the recent years. Have you been evaluated for the contractures by a doctor with expertise in SCI? If not, I would encourage you to do so. I will do some more searching re: this issue. CRF

  6. #6

    knee contractures

    Seneca - With some discussion with another member of the SCI-Nurse team, we offer this additional information. Surgery for the SCI patient with contractures is at best a risky choice as there may be bony involvement as well as tendon involvement with a contracture that has existed for a long time. One may not necessarily regain range of motion (ROM) with surgery but rather end up with the leg in a fixed extended position. As with any surgery, but particularly a risk in this kind of surgery, is the concern about infection and hematoma formation.

    A word of caution to all with SCI should include education about the importance of daily ROM, proper positioning, standing (where possible) and periods of time daily during which one lies in a prone (face down) position. This latter activity will stretch the tendons and muscles of the lower extremeties. CRF

  7. #7
    Senior Member Jeremy's Avatar
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    Seneca: Here's some site for range of motion exercises

    http://www.rohcg.on.ca/mobile/rom/index.html

    http://calder.med.miami.edu/pointis/range.html

    "If the wind could blow my troubles away,
    I'd stand in front of a hurricane."

  8. #8

    ROM sites

    Jeremy - Thanks for posting these sites; both are most helpful. CRF

  9. #9

    Seneca

    I started getting the same thing too and found it helpful to do leg stretches while sitting in a hottub. I push down on my knees with an even pressure (no bouncing) and slowly the legs go into the extended position. I found that in doing this everyday for about a month, my legs now go into a straight out position fairly easily. Things were getting so bad for a while that I could not even get on my long leg braces, now its no problem.

    "Life is about how you
    respond to not only the
    challenges you're dealt but
    the challenges you seek...If
    you have no goals, no
    mountains to climb, your
    soul dies".~Liz Fordred

  10. #10
    Thank you everyone for your responses.

    ROM is good for preventing contracture but it's ineffective for reversing contracture. All my other joints are fairly lithe and limber.

    SCI-Nurse, since surgery is so risky, are you saying that at this point, there's really nothing that can be done.

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