Each treatment session began with ASTYM provided by the certified physical therapist to both anterior lower extremities with the patient seated in order to break up fibrotic tissue and regenerate new healthy tissue. Each treatment session for the first four weeks ended with the patient lying supine with Normatec compression boots on both lower extremities at level three for 15 minutes to decrease edema. For the first two weeks manual therapy included medial to lateral glides of bilateral tibias with PROM knee flexion x six reps each with the patient supine. Bilateral patellas were mobilized superiorly and inferiorly using a grade IV mobilization x six reps each every treatment session. Manual stretching with the patient in supine was performed next with PROM knee flexion to both lower extremities x 6 reps. During the third week of treatment, the manual therapy progressed to grade III bilateral posterior tibia glides and bilateral PROM knee flexion in prone x 6 reps each. Also during the third week of treatment, high speed vibration therapy using Rapid Release Technology was introduced to the patient and applied to both medial and lateral knees moving one inch/per second in all directions for approximately four minutes to decrease scar tissue. At the next treatment session, the vibration therapy was performed with the Vibracussor tool for four minutes at level eight in all directions to both IT bands and lateral knees to decrease myofascial restrictions. These mobilizations along with vibration therapy continued for the rest of the time the student therapist worked with the patient.
Each week PROM bilateral knee flexion was measured after manual therapy. During the second week of treatment, PROM bilateral knee flexion was measured in supine after manual therapy and the left knee had increased to 109 degrees with the right knee at 114 degrees of knee flexion. PROM knee flexion was again measured during the third week of therapy and the patient had 112 degrees on the left and 113 degrees on the right. On the fourth week PROM knee flexion measured at 114 degrees on the left and 115 degrees on the right. Some days the patient stated that he hadn’t been very active and that his knees felt stiff. This could be the reason why he did not show progression in both knees at each week of measurement. After the fourth week, measurements were taken again during the re-evaluation of the patient.
At the first treatment session, the patient started out on the recumbent bike at level one for five minutes rocking both legs back and forth on the pedals in order to stretch both legs. The patient also strengthened the bilateral lower extremities in supine on the shuttle doing leg press at level five for three minutes x two sets. Heel raises were also performed on the shuttle at level four with two sets of 15. After the shuttle, the patient stretched both calves standing on the wedge at level four for 30 seconds x five sets. The shuttle leg...