32 year old male with CRPS in his left knee after an arthroscopic meniscus tear injury.
1. The patient was asked to lift his left foot to the second step, while flexing his knee. He moves slowly during the entire exercise to preserve control over his movement and avoid pain. He tries to avoid flexing his knee and uses excessive ankle dorsi flexion (DF), hip flexion (FLX) and sways his pelvis posterior to make room for his straight leg.
2. In order to prevent the patient’s pelvis sway, the PT supports him from behind. Now when the patient removes his foot from the stair, he drags it to avoid knee FLX, but also slightly bends his knee.
3. The PT continues to support the patient’s pelvis to prevent its sway. The patient bends his knee slightly more than the last time, but still uses excessive DF, hip FLX, and starts bending his back left to lift his left pelvis side higher.
4. The patient continues to flex his knee slightly more, and now uses only DF as compensation. He puts only half of his foot on the stair and the PT corrects him.
When the patient steps down he again shifts his pelvis posteriorly, drags his foot, and sidebands his back to avoid knee FLX.
5. To try and get a better knee FLX the patient was asked to lift his left foot to the third stair. He again uses DF, hip FLX, side bend, and foot dragging to avoid knee FLX.
6. The PT asks the patient to shift his weight over his left leg. The patient complains about the pain, but manages to FLX his knee a bit more. Again, he moves very slowly to manage his pain and fear.
Video guide 27