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Knee Mobilization

Knee Mobilization is a physical therapy technique used to improve motion in the knee joint. It can help increase range of motion, reduce pain and improve the effectiveness of other treatments. During the procedure, the therapist uses manual manipulation to move the knee joint in specific directions and hold it in particular positions in order to improve mobility and reduce stiffness.

Transcript

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This is Brent coming at you
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live from Rick Ritchie's Independent
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Training Spot, the new home of the Brookbush Institute. Very excited to continue
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with our self-administered mobilization techniques. In this video we're going
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to start breaking down at knee mobilization. So we going to look past some of
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the muscular dysfunction we talked about in the past. I know we've already talked
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about VMO activation, and how the biceps femoris affects knee motion, and the
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gluteus medius and how important that is to femoral control. But at some point we
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still have to address our arthrokinematic dysfunction. The dysfunction at
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the knee generally speaking, is the tibia can't move from posterior to anterior as
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we move into terminal extension. So what we're going to do, is we're going to use
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one of these monster bands, take that VMO activation exercise we used in a
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previous video, and we're going to turn it into a mobilization, and then i'm
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going to show you guys a fancy little trick at the end, to start focusing on
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lateral compartment mobilization. I'm going to have my friend Jordan come out,
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trainer here at the Independent Training Spot. He's going to take this band and put
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it around the back of his calf. Now in the VMO activation video, I had you guys
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put it around the femur, so that we can increase load during knee extension. This
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one I'm not so concerned with load. As much as I'm concerned with creating that
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posterior to anterior force, that posterior to anterior glide on the tibia
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as I have him squeeze his quad. Now you can see we have a little step set up here,
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that's just to keep this leg soft, keep his knee bent, so that he doesn't rest in
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terminal knee extension on his other side. Make sure the rest of this kinetic
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chain checkpoints are in line here, so he's nice and standing up tall, he's
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going to go soft knee, and then he's just going to squeeze his quad. Now Jordan
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doesn't have knee dysfunction, and this looks probably pretty easy for him, but
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you guys will find that those individuals who are missing that last
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five or ten degrees of terminal extension, this exercise is extremely
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challenging. In fact you may find that they can't even get to the
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terminal knee extension he has, and rather than this larger motion, that
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maybe we could call a grade three mobilization. Sometimes what you end up
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with is somebody who's stuck about here, and then what you're going to do is, this
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will still pull posterior to anterior, and we'll just work on a quad
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contraction for a couple seconds. Good and then relax, right so this is kind of
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equivalent to those grade fours we learned in school. We're going to get to
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end range, just work on some muscle contraction, and getting these little
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oscillations at the end range. How's that feel, doing great, Alright, now a little
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trick if we're going to get really really technical with our arthrokinematic
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dysfunction, it's not just that the tibia can't move posterior to
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anterior, but in fact that the lateral compartment gets stuck posterior, that
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creates some of that knee turn out we see in that overhead squat assessment.
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Right so as somebody gets down their knee can't shift into position, and it goes
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further and further into tibial external rotation. All Jordan has to do to focus
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more on the lateral compartment, is he's going to move this way, we're going to
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turn the band a little bit here,
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alright.
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You guys could look at this as a progression two, we could start with the straight arm
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mobilization, and then move to this. So now I have this band creating two
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vectors right, posterior to anterior, as well as lateral to medial, and providing
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he can get his glute to contract and maintain his femur parallel, so he's not
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adducting right, give me a good squeeze, that'll force a little tibial internal
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rotation, and the posterior to anterior force will force motion in that lateral
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compartment. So now we've taken a knee mobilization from posterior to anterior,
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to lateral posterior to anterior. Same thing here guys, think about all those
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different principles we learned in our mobilization classes right. Like if we're
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going to go to just up to pain free, or up through pain free range of motion. We
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don't want to go into pain, so you could use this with somebody with a painful
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knee, just adjust your range of motion accordingly. If you're going to do grades
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three, you can work through larger ranges of motion. You could do just end range
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oscillations. I would start with 15 to 20 repetitions and see how somebody feels,
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and of course you could use two oscillations per second for 30 seconds,
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as we often do in our manual techniques. How you feeling Jordan? Great, alright go
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ahead and step out, make sure with all of these techniques you're doing them for a
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good reason, and you are reassessing. So let's see your squat, and as I reassess
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Jordan here, I hope you guys enjoy this video and get a lot from these
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techniques.