I may use this particular repeated movement test as part of my orthopedic evaluation for knee complaints. If this specific movement positively impacts symptoms and signs, this may then become the treatment (making the diagnosis knee joint derangement).

There are many different movements a knee joint derangement could need. The key is to use repeated movement testing to isolate the specific one that resolves a patient’s symptoms & restores normal pain-free motion, strength, and function. This is called the joint’s directional preference.

Clinicians often pin knee symptoms on a tendon or muscle (like patella tendinopathy or quad weakness). They also often use diagnoses like patellofemoral pain syndrome or ITB syndrome for knee complaints, pathophysiologies I argue don’t exist. Thirdly, they’ll blame structures like the meniscus or cartilage.

I find most knee complaints in fact come from a mechanical joint derangement in the knee joint itself or in a relevant spinal joint. To figure out the root cause diagnosis, in addition to any orthopedic special tests (OSTs), I use McKenzie's repeated movement testing. By using repeated movement testing (in the knee, spine, and/or hip), I almost always find that moving the affected joint in the right direction restores the knee to normal.

Knee extension is commonly the direction joint derangements in the knee need for treatment, but it could be in standing, sitting, or supine and the amount of weight through the limb is variable. It could also be a form of flexion or a sagittal movement with tibial rotation. There are many movements of the knee one could test and therefore many that could be beneficial. The specific verbal history and the patient's baselines inform which test to use.

Robin McKenzie's books "Treat Your Own Knee" and "Treat Your Own Back" are useful for a lot of people who are willing to self-assess and self-treat.

Dr. Laura Mannering DPT, OCS, Dip MDT
Doctor of Physical Therapy
Board-certified in Orthopedic Physical Therapy
Diploma in MDT (Mechanical Diagnosis and Therapy)

For more information about my practice:
www.drlauramannering.com

Clinic located in Dupont Circle in downtown Washington, DC.

#orthopedics #knee #kneepain #dpt #physicaltherapy