Role of ankle position in static stretching for hamstrings to improve flexibility in post-operative knee stiffness-a case report

Abstract

A 30 years old male patient presented with complaint of difficulty in bending right knee since 2months and pain around right knee joint following an operation for supracondylar fracture of right femur.On objective examination, swelling over right knee; on postural analysis, there was right pelvic drop; gait was antalgic with limping on left side.On palpation,muscle spasm and tendernesswere present over quadriceps, hamstrings.Tightness of hamstring, piriformiswere prominent.The ROM and strengthwas reduced-for-knee.According to the subjective, objective examination and radiological investigations of right knee, the case was diagnosed as post-operativeright knee stiffness. A treatment session of 14days was given along with hamstring stretching with ankle plantar flexed for 7days.The therapeutic interventions taken weremanual therapy-MET with mulligan technique for knee joint, patellar mobilization, continuous passive movement(CPM), exercise therapy and stretching of hamstring.In cases of post-op knee stiffness,primary concern is always for improving joint range of motion  and reducing pain but the tightness of hamstringplays a major role in knee joint mobility during locomotion and also the altered biomechanics.So the stretching of hamstrings with ankle plantar-flexedand working on the biomechanics should be taken into consideration in any type of post-operativecases of lower extremity.