The Pivot Disc

The Pivot Disc

Due to leg weakness (Knee/Hip), it may be very difficult for a
trainer, therapist or caregiver to safely transfer their client/patient from one surface to another. Their client may be able to bear weight on their legs, but may not be able to advance either foot in order to take steps. This makes transferring from the bed to a chair or vice versa very difficult. The Pivot Disc is a great tool that can be used in this situation to minimize the risk of injuring your client or yourself during functional transfers.

Pivot Disc

Place client's feet on outer edge of disc with enough room between the feet for your foot

Upon standing your client, use your foot that is on the disc to control the rotation of the disc, transferring your client from one surface to another

Average price of a Pivot Disc is $50-60

The VMO

Located at the inside portion of your knee

The VMO and The Knee

The Vastus Medialis (VMO) Muscle is one of four of the the QUADriceps Muscles.  The VMO is the "tear drop" shaped portion which provides a medial pull on the patella upon knee extension (tightening the thigh muscles).  Upon injury, surgery, or any type of inflammation/edema to the knee joint, the VMO "shuts down." It does not take a great deal of inflammation for this to occur.  Looking at the pictures below, one can see the size difference between the VMO and the Vastus Lateralis (VL).  Without the VMO pulling the knee cap medially, the VL's overbearing lateral pull may lead to other knee joint problems such as Patello-Femoral Pain Syndrome.  To "turn on" the VMO, many techniques and exercises are available.  Neuromuscular Electric Stimulation (NMES) may be applied to the VMO and Rectus Femoris to assist muscle contraction.  Tapping the VMO while performing quad exercises may also help.  Check out www.kbfitnessonline.com for specific exercises that will help correct this problem  

The VMO is also referred to as the "Tear Drop" shaped muscle

Vastus Lateralis is a much larger muscle than the VMO

Here's is picture of the VMO and VL with Quad Contraction

Knee Mechanics: Down and In

Knee Mechanics: Down & In

Watching your client's jumping mechanics can tell you a great deal and potentially help you prevent or recover from knee injury.

Down and In Video

This athlete presents with a "down and in" motion of both lower extremities upon jump and landing.
 
What does this tell you?
1. Your client may have overly pronated ankles or flat feet possibly due to tight gastrocnemius, soleus or subtalar joint
2.  Your client may have a tight Ilio-tibial band or Tensor Fascia Latae musculature
3.  Your client may have weak gluteus medius

How do you work with this client?
1.  Stretch the gastrocnemius and soleus
2.  Stretch the ITB/TFL and use a foam roller for deep massage
3.  Strengthen the posterior Glute Medius with clamshell or prone figure four exercises
4.  Practice the intended motion with proper technique...Work the movement pattern and the muscle timing will follow

Join www.kbfitnessonline.com for follow along rehab exercises and workouts for common knee problems

ACL Rehabilitation

ACL  Rehabilitation

This is a common traumatic ACL tear in sports. Here, a medial directed force is applied to the knee.

ACL Injury

Below is a quick overview of ACL Repair surgery

Surgical ACL Repair

I was contacted recently by a woman who was injured and scheduled to have her ACL repaired. She was receiving Physical Therapy from a local clinic and was paying close to $130 for each visit! She asked me if KBFITNESSONLINE.COM could help, as she was referred to the site by her therapists. I explained that this site was designed as a guide from day one post-surgery, explaining what exercises you should do and when to do them following the surgery. I told her that there is even a follow along workout for each time frame following the surgery so that you can perform the exercises with a Physical Therapist's cues. The video exercises included in each of the kbfitnessonline.com protocols are the most common exercises used in most rehabilitation protocols for each diagnosis. But I advised that she request her doctor to inform her of any particular precautions following her surgery, as each patient is slightly different, and some surgeries may have more complications than others. www.kbfitnessonline.com also offers a community forum for rehab professionals and the clients themselves to discuss their progress. KB Fitness staff is accessible to answer any questions during your rehabilitation.

Please check out our site:

www.kbfitnessonline.com

Become a KBFitnessOnline.com Member

Here is a short video explaining what information KBFitnessonline.com members will have access to.  Knee conditions include Total Knee Replacement, Patella-Femoral Pain Syndrome, Quadriceps Strain, Hamstring Strain, Shin Splints, Arthroscopic Surgery, ACL Repair, Medial Collateral Ligament Sprain, and topics such as walking with crutches, stair climbing, lifting techniques, pain management, exercise progressions, manual techniques, etc.. You will receive explanatory videos as well as follow along treatment sessions based on rehabilitation protocols.

KBFitnessonline Membership Offer

Check out www.kbfitnessonline.com to become a member today!

Meniscus Arthroscopic Surgery

Many of my patients have undergone arthoscopic surgery for a meniscus tear.  Upon initiating Physical Therapy, they are usually confused as to what the surgery entailed, and do not really know what or where the meniscus actually is.  This video is a good basic explanation of the knee anatomy and surgical procedure. 

Arthroscopy for Meniscus Tear

Become a member of www.kbfitnessonline.com for access to the step-by-step exercise rehabilitation protocol and follow along treatment sessions following your arthroscopic meniscectomy.  You will also gain access to the full knee exercise video library, which will assist in your progression to a Post-Rehab Fitness Program. 

Considerations When Placing Your Client/Patient on a Stationary Bike

Seat Height:
You may initially use a high seat position to allow full pedal revolution. However, this position may not be the most beneficial for clients with ACL injuries/reconstructions or those suffering from Iliotibial Band Syndrome. A low seat position is not advised for those with Patello-Femoral Pain Syndrome (PFPS).
Recumbent Bike or Upright:
There is minimal to no difference in the required Knee ROM to pedal either type. However, there is less load on the ACL using the recumbent bike, so it is advised for ACL patients/clients.
Direction of pedaling:?
Retro or backward pedaling may be used for meniscus conditions and Tibio-Femoral osteoarthritis, but is not advised for ACL or PFPS conditions. Retro-pedaling creates increased stress on the patella-femoral joint due to the increase activity of the quadriceps relative to the hamstrings. Also, when the knee is fully extended in retro-pedaling, the ACL is most vulnerable.
Summary:
For patients/clients with ACL conditions, use a recumbent bike, avoid a high seat position and retro-pedaling.
For patients/clients with Patella-Femoral Pain Syndrome (PFPS), avoid a low seat position as well as retro-pedaling.

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