15 year old male went to get out of bed just before Christmas last year and found he couldn't bend his knee without serious pain. Fast fwd to his first appt with me in Sept, still on a cane after seeing every specialist imaginable. MRI showed nothing at hip, leg, or knee except one spot at knee they felt was arthritis or something, but not anything that would cause him distress in bending the knee. He had been through extensive PT where he took vicodin to help with the pain and left soaking wet from sweat from the therapy. Many family members and school teachers/friends have come to the conclusion he is making it up as they can't find anything wrong.
First session, he can't bend the knee at all without cringing. Quads are very tight, but gracilis isn't too bound. The binding is medial to lateral. Pain starts about 3 inches above knee dead center and then angles laterally. I did MFR leg pull and for knee cap as well. Worked semi-deep at quads going by pain tolerance and worked glutes/hip pretty deep. Not too bound there. Iliopsoas is fine as well. Have worked on him once a week since end of August. Went to Walt in NY for MFR and he showed me some quad work to try on him. After 2 sessions of those stretches plus continued deep tissue work, he can bend his leg for the fist time 90 degrees (thanks Walt!) but he can't hold it there but for a short period of time. He describes his pain as deep inside his knee and then Medial to lateral quad. He also describes feeling as if his knee is going to pop when he bends it.
My question finally (sorry for the length) is it possible they missed something in the MRI back then? But his knee is not loose and isn't unstable? I am trying to decide if we have gone as far as we can in what I'm doing and if I should send him back to PT or what? I also have him walking without his cane 3 times a day but he can only walk twice down the hall without loosing strength. His goal is to be well by his b-day so he can drive his car.
First session, he can't bend the knee at all without cringing. Quads are very tight, but gracilis isn't too bound. The binding is medial to lateral. Pain starts about 3 inches above knee dead center and then angles laterally. I did MFR leg pull and for knee cap as well. Worked semi-deep at quads going by pain tolerance and worked glutes/hip pretty deep. Not too bound there. Iliopsoas is fine as well. Have worked on him once a week since end of August. Went to Walt in NY for MFR and he showed me some quad work to try on him. After 2 sessions of those stretches plus continued deep tissue work, he can bend his leg for the fist time 90 degrees (thanks Walt!) but he can't hold it there but for a short period of time. He describes his pain as deep inside his knee and then Medial to lateral quad. He also describes feeling as if his knee is going to pop when he bends it.
My question finally (sorry for the length) is it possible they missed something in the MRI back then? But his knee is not loose and isn't unstable? I am trying to decide if we have gone as far as we can in what I'm doing and if I should send him back to PT or what? I also have him walking without his cane 3 times a day but he can only walk twice down the hall without loosing strength. His goal is to be well by his b-day so he can drive his car.