The problem

Tom, a 49 year old company director and keen sportsman, sustained an hyperextension injury to his knee while skiing. This resulted in a fracture to his lateral tibia condyle requiring internal fixation and knee extension brace.

On return home from his holiday Tom attended for physiotherapy. Assessment revealed an effused and thickened knee joint, marked wasting of his thigh muscles and restricted joint mobility.

At this stage Tom was walking with elbow crutches and only able to take 10% of his weight on his injured leg.


The treatment

Tom attended for treatment over a three month period. Initially treatment included manual therapy techniques aimed at reducing the effusion, improving joint mobility and facilitating muscle strengthening. Tom was also given specific exercises to continue at home between treatment sessions.

At 6 weeks post injury a check x-ray revealed the fracture was healing with good bony union and he was advised that he could remove his brace for exercise sessions. This was 2 weeks earlier than originally predicted and allowed his treatment to include more dynamic exercises.

Treatment now focused on exercises to overcome apprehension of full knee extension and ensure return of proprioception and balance. At 8 weeks post injury Tom was able to return to the gym and advice was given for incorporating gym activities into his rehabilitation programme.


The results

Tom returned for a final review five months following the original injury. Assessment showed some minor biomechanical changes and Tom was advised how to adjust his exercises to correct this.

Tom reported he was able to undertake his pre injury gym sessions and was cycling up to 20 miles. He had also progressed his training for a long distance charity bike ride due to take place the following month.

Overall the indications were that Tom would be fit to return to skiing the following season which was his ultimate goal.