MCL second degree tear - JP Fitness Forums

loladog2 · 09-30-2007, 02:45 PM

My client felt pain severe knee pain when we were marching in place during a dynamic warm-up. She sat down awhile and said she felt fine so we continued the workout but took out all leg work and focused on a upper body band workout. We've been working out a month, she is 272 pounds after losing 6 pounds since starting workouts. She had been sedentary for years and has osteoarthritis in her knees. The doctor recommendation was no step or stairs before said injury. She went to the clinic the next day and was diagnosed with a MCL second degree tear. He felt it was caused from the lateral band walks from the previous workout.(2 days before). He said she should rest it for a few days. Everything I am reading on line indicates a much longer rest period with rehab with a Physical therapist. Should I proceed training her with isometric quad. strengthening or just work upper body?

UConnJulie · 10-01-2007, 02:14 PM

A second degree tear from lateral band walks? With no onset of pain for 48+ hours? Poppycock!

How old is she?

Does she have a significant valgus deformity of the knees (ie is she really knock-kneed)?

Does she currently have pain with walking, marching, etc?

What does her current lower body program look like?

loladog2 · 10-01-2007, 03:00 PM

Hi,
She is 36 years old. She does have pain in her legs while exercising.
Osteoarthritis and inflammation. She has been fine with the marching for the last month but we have taken out the low wide marching due to pain.

There has not been much of a lower body program. Supine knee extensions and quad setting to strengthen the quads. Hamstring curls prone with me resisting her curl. Some standing hip extensions. side extensions, front extensions and hamstring curls with a cuff band easiest resistance. We have tried shallow ball squats a few times but have taken them out due to pain issues. I have done the lateral banded walks only twice with her 20 reps each direction. She has really increased her walking with my encouragement.

We finished out her workout that evening with upper body only and she said she would ice it and take anti-inflammatories. The next day she had signed up for her first 5K to walk and not being able to complete it went to the clinic where he diagnosed the MCL second degree tear. She said she is staying off it and hopes we can get back to working out this week...I don't want to make anything worse. Everything I've read in the last 2 days tells me she needs to be in rehab.

Thanks for your input.

loladog2 · 10-01-2007, 03:02 PM

Sorry missed one of your questions...she is not knock-kneed if anything they tend to move outward.

UConnJulie · 10-01-2007, 04:46 PM

I question the competence of the physician who diagnosed her, but that is beside the point. If she is having such pain that is preventing you from effectively working with her, then she probably does need to be in rehab as there are other things that a good therapist will do to diagnose the cause of her pain and reduce it to allow her to exercise.

Do you have access to a pool? One thing that is great for persons with lower body issues (ie pain, inflammation, arthritis, etc) and obesity is exercising in the water. Get her waist deep or so and do all the functional/closed-chain things that you have been doing.

FWIW, I would avoid things like knee extensions and ham curls ... you are better off doing closed-chain exercises with someone with pain/inflammation/arthritis (age and weight are non-factors).

loladog2 · 10-11-2007, 09:55 AM

Julie,
I have taken all you said and applied it. We are back training and progressing very nicely and slowly. In addition to your advisement I have also consulted with others and have been buried in knee rehab books.
Thanks again,
Pamela

UConnJulie · 10-11-2007, 01:02 PM

No problem, glad that it helped!

Feel free to email me or PM me if you need more advice ...