Phoenix Osteopractic Physical Therapy

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Interesting shoulder mobility exercises.

📃Management of chronic knee pain caused by postsurgical or posttraumatic neuroma of the infrapatellar branch of the saphenous nerve

📌 Key Takeaways

-Injury to the infrapatellar branch of the saphenous nerve (IBSN) is a relatively common complication after knee surgery, which can interfere with patient satisfaction and functional outcome.

-Symptomatic IBSN injury has been reported in 55–100% of patients following Total Knee Arthroplasty (TKA) , in 37–86% following ACL reconstruction, and in up to 28% following surgical meniscectomy.

-Injury to the IBSN may also result in neuroma formation due to Wallerian degeneration and subsequent axonal growth, leading to severe and debilitating pain.

-Following surgery, 80.0% reported improvement in leg pain, 68.0% reported clinically meaningful improvement, and 68.0% reported improvement in health-related quality of life.

-Overall, 72.0% reported they were satisfied with the surgical outcome.

-Lack of postoperative improvement was significantly associated with older age, female gender, multiple prior knee surgeries, and prior resection of IBSN neuroma.

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🩺 Clinical Implications

-Neuroma of the IBSN should be suspected in patients who develop neuropathic medial knee pain following orthopedic surgery or trauma.

-IBSN neuroma as a cause of debilitating chronic knee pain is likely under-recognized, particularly in community hospitals and other institutions without a dedicated peripheral nerve surgery unit.

-In properly diagnosed and selected patients, surgical neurolysis and resection of painful IBSN neuroma provide clinically meaningful pain improvement in a majority of patients as well as improvement in health-related quality of life.

-Future research should verify risk factors for poor postsurgical outcome and optimize selection criteria for surgical intervention.

👉Link to article in the comments 👇

📌Whay about physiotherapy?(out of the article)

🏥 Role of Physical Therapy in IBSN Neuroma Management

🔹 Before Surgery (Conservative Phase)

-Pain modulation:

Desensitization techniques (gentle massage, tapping, graded exposure to textures).

-TENS or other neuromodulation methods for neuropathic pain relief.

-Edema and scar management:

Soft tissue mobilization, scar massage, silicone pads if surgical scar sensitivity is present.

-Activity modification:

Avoiding positions or activities that overstretch or compress the nerve.

-Functional maintenance:

Gentle quadriceps strengthening, ROM exercises, avoiding aggravation of neuropathic symptoms.

🔹 After Surgery (Post-Neuroma Resection / Neurolysis)

-Wound care & protection: Early phase focus on healing, avoiding excessive stretch on the medial knee.

-Gradual desensitization: Continued sensory re-education to reduce hypersensitivity.

-Strength & mobility: Restore knee ROM, quadriceps and hip strength, and gait training.

-Neuropathic pain management: TENS, graded motor imagery, mirror therapy if central sensitization develops.

-Functional rehab: Progression to ADL training, balance work, and gradual return to activity.

⚠️ Key Considerations for PT

👉If neuroma pain is severe and refractory → physiotherapy alone is usually insufficient, and surgery may be required.

👉PT is most beneficial for symptom modulation, function maintenance, and postoperative rehabilitation.

👉Collaboration with pain specialists and orthopedic/nerve surgeons is crucial for comprehensive management.

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This is the base program that I use to help many many guys overcome their months and years of shoulder injury neglect. But I also customize several other exercises to address the specific needs of each patient. Hit me up with a DM if you want to learn more! Or reach out to me on my website or page.

My garage gym warm-up just got a major upgrade with @crossoversymmetry ✨ I know warming up is important, but I never know what to do. 🫣 Crossover Symmetry comes with a guide and videos to show me exactly how to warm up my shoulders & scapular muscles! If you’re like me, & you know you should warmup but never do, this is your sign to be intentional and proactive with your shoulder health! 💪🏼

This can affect knee extension, producing pain but also resulting in muscular weakness. Want to know how advanced, cutting edge treatments such as electro-dry needling and extracorporeal shockwave therapy can be effectively used to resolve this problem…?

🦵 The fat pad in the knee, also known as Hoffa's fat pad, is a small, soft mass of fatty tissue located just below the patella and behind the patellar tendon. It plays a crucial role as a shock absorber, cushioning and protecting knee joint structures during movement. ⚠️ In knee arthrofibrosis, the infrapatellar fat pad can become inflamed, scarred, or compressed, leading to pain and limited mobility. ✅ Watch the full lecture 'Management of Knee Arthrofibrosis' by Sebastiano Nutarelli on Trust Me-Ed to learn more about arthrofibrosis! 🔗 https://www.trustme-ed.com/lectures/management-of-knee-arthrofibrosis-2

🦶 Achilles tendon rupture can occur suddenly and is often associated with certain risk factors that increase the likelihood of this injury.

📝 Key risk factors include:

Age 👵👴,
S*x ♂️♀️
Training program 🏋️‍♂️🏃‍♀️
Type of sport 🏀⚽
Prolonged use of corticosteroids 💊
Certain antibiotics 💉
Genetic factors 🧬.

✅ You can learn all about achilles tendon ruptures by watching our new lecture 'Achilles Tendon Rupture' by Dr Mathijs van Ark on Trust Me-Ed!

🔗 https://www.trustme-ed.com/lectures/achilles-tendon-rupture