Classification of Knee Inversion
Knee retroflexion, also known as knee hyperextension and knee dystocia, is a condition in which the knee joint is angled backwards. According to the causes, they can be classified as
1, anterior knee paralysis or low muscle strength: due to quadriceps paralysis or low muscle strength, N rope muscle strength is weakened, the knee joint can not be stabilized in the straight position, forced to walk in the posterior extension position when carrying weight;
2.Posterior knee paralysis or low muscle strength type: N cord muscle and calf triceps are paralyzed or low muscle strength, posterior knee including joint capsule, ligament and other relaxation, causing knee hyperextension;
3. Bone changes in the knee joint itself, resulting in abnormal knee joint position. The first two are caused by the loss of proprioception in the knee joint due to poor control. Depending on the degree of knee retroflexion, there are mild (below 10°), moderate (10-30°) and severe (above 30°). It can be divided into functional knee retroflexion and organic knee retroflexion based on the presence or absence of damage to joint structures. It is a more severe deformity and its treatment is relatively slow and time-consuming.
(The causes of knee retroflexion should be analyzed, and there are several causes such as quadriceps weakness, quadriceps spasm, gastrocnemius spasm, etc.)
1, Severe imbalance between extensor muscle strength and flexor muscle strength, i.e. flexor muscle strength is too small.
2, excessive tension of the knee extensor muscle.
3, weakness of the knee extensor muscle.
4.Triceps tension is too high/that is, the foot drops down and passively cannot cross the neutral position.
5, May be related to hip control.
6, Weak quadriceps muscle strength is also a cause of knee hyperextension.
7, Weakness of one knee joint leads to compensatory knee hyperextension on the opposite side.
8, Flexor spasm or contracture leads to knee hyperextension.
9, Knee hyperextension is used to compensate during knee collapse gait.
10, Spasm of the supporting phase knee extensor muscle.
11, The line of gravity falls in front of the center of the knee during trunk forward flexion, prompting posterior extension of the knee to maintain balance.
12, Compensatory knee hyperextension due to Achilles tendon contracture.
Achilles tendon pulling training: the child is in supine position or long sitting position, parents hold the ankle of the child with one hand, the palm of the other hand is placed under the heel of the child, then hold the heel, let the child’s foot against the forearm, and pull upward along the horizontal direction. Note that the palm of the ankle should be fixed in a good position, so that the whole foot is not pulled up; at the same time, note that the force we use is mainly to pull the Achilles tendon, not to press the palm of the foot, otherwise it will easily lead to the destruction of the arch of the child’s foot.
Each pull can last for 1 to 3 minutes, and the number of pulls depends on the degree of plantar flexor contracture in the child.
②Help the child with both hands or let him hold the bed rails or table or other objects and slowly squat down. You can also let the child stand triangular plate, each pulling time can last 1-3 minutes.
③Improve the muscle strength of the anterior thigh group: the child in a long sitting position, do knee extension training, such as putting a towel roll under his knee joint, so that the knee joint from the bed or a certain distance from the ground. Then, have the child press the knee joint downward, hook the toe, and tense the thigh for 6 to 10 seconds, then relax. This can also be done in a seated position. Have the child sit on the edge of a chair or bed, hold the edge of the chair or bed with both hands, kick the foot straight for 6 to lO seconds, and then put it down. You can also have the child bend the knee and hip first, and we apply the block at the ankle of the calf, and then order him to straighten the leg to improve the muscle strength of the anterior thigh group. Or use the quadriceps trainer for training.
④ Training to improve the thigh and posterior group muscle strength: The child is placed in a prone position, and the parent holds the thigh with one hand and the ankle with the other hand to help the child do the knee flexion and extension. When the child is able to perform this movement on his or her own, the parent can use both hands to hold the child’s hips to prevent them from buckling during forceful knee flexion. Likewise, parents can use their hands or other heavy objects such as sandbags tied to the ankle as resistance for this exercise.
(5) Improve plantar dorsiflexor strength training: This training is especially important for children who have hyperextended knees due to plantar flexor contractures or high tone. Let the child is in a long sitting position, and then hook the toes upward, or use a rubber band or make a rubber band, put it on both feet, step down with one foot and hook upward with the other foot.
In addition to the above-mentioned training methods, in order to increase the fun *, parents can also use colorful cloth sewn several sandbags of varying weights, so that the child try to pick up with the toes of both feet and put them not far from the basin, which can also achieve the purpose of training.
(6) Knee joint control training: Parents face the child, let the child put his hands on the parents’ shoulders, and parents put their hands on the outer side of the child’s knee joints to help the child control the knee joint activities. Then put the child in an upright position, slowly squat down and then slowly stand up. Note that the knee should be in a normal position when the child is upright and should not be overextended. The magnitude of the squat should be determined by the child’s ability to control the knee joint. Generally, it should be from small to large amplitude, from double leg to single leg.