Since the body works in kinetic chains, observe the mobility (or lack of) of the ankle and hips. Do the ankles dorsiflex beyond 90 degrees? do they evert (tilt outward-facing at the bottom of the foot) or invert (opposite of evert) at or near end-ROM for plantarflexion or dorsiflexion? What about the hips? Are the hip flexors chronically shortened and overtight (if this subject is American, then the answer is a resounding yes 99.99% of the time), and are the glute /hip complexes able to effectively rotate the femur inward and outward at all points of hip flexion/extension? Check all these points to observe what issues the kinetic chain is placing on the knee. An example is the lack of femur rotation outward near the bottom of a squat (almost end-ROM for most ppl) causing varus stress on the knee and possible overtension of the MCL.
Band Traction
Band traction for the knee is iffy business. If the ligamentous tissue is damaged this could result in serious pain and/or injury. Even meniscal damage can cause some pain due to the vacuum suction-like effect when pulling apart the joint space. With that said, however, feel free to give it a try. If it helps, use it. If not, avoid it.
Knee Traction #1
Wrap the knee before traction and distraction |
Knee traction on swiss ball |
Alternate view of traction on knee |
Knee Traction #2
This alternate setup is more aggressive and should be approached mildly at first to evaluate the appropriateness for the individual and their particular issues.
Tension on the ankle and above the knee |
Additional tension by looping around the elbow and pulling upward |
Band Distraction
Band distraction is very similar to traction, except the tension is less than with traction, and this is dynamic traction through a ROM essentially, where traction by itself is simply static. Move the joint around through a ROM, and use additional help moving the body/joint complex against resistance if needed. An example is Knee Traction #2, the band looped above the knee joint, that setup can be used if you arent strong enough (ie your hip flexors) to move the knee through a decent ROM against the band.
Extended in distraction |
Partial flexion in distraction |
Knee Rehab
Knee rehab is a snake oil business at best unless you can identify what/where weaknessess are coming from.
Foam rolling and SMR should be your friend and you should identify which tissues are sensitive to the SMR and correct this sensitivity (usually due to a trigger point).
This video shows the Terminal Knee Extension (TKE) which is the basis for most knee rehab.
This video is part one of several (I think 8) and Buddy Morris is VERY knowledgeable about fixing knee issues, being a former NFL head/strength coach. He gives a good progression/regression for TKE's somewhere in one of the parts of this interview: ie watch all of them.
If this video has information you need be sure to seek out the other parts to this interview.
This video below has several good ideas for knee rehab, however, I would personally use them as a method of evaluating for problems, not necessarily the method of correcting them.
Lastly, for more information on traction/distraction, check out this:
http://www.t-nation.com/readArticle.do?id=1105903
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