I have a client who has had a patella injury and surgery. After surgery, she complained of tingling in her right foot, and a ligament was removed to help with the problem. The operation was a disaster, and she now has no dorsi flexion of the foot. Also, the tendon in the longitudinal arch is tight, and the foot is slightly dropped. She now walks with a walking frame, and she is overweight. Can you recommend some training and flexibility exercises for her?
Thanks for your question! This is not an easy situation; however, we will attempt to help you with your thought process as there is no such thing as specific “canned” exercises for individual anomalies. Please take the following recommendations and “tweak” them to fit your client’s needs.
- Find out what the physical therapist and/or doctor has recommended.
- Assess what tasks must be performed day to day. This can be done by simply asking questions about her daily activities.
- Assess her ability to perform the tasks from a movement perspective. For example, sitting to get into a chair is a squat, picking up an object at knee height is a lunge with a reach to knee height, walking up and down stairs even if assisted is a stepping exercise, etc.
- Once you find your client’s threshold, design similar movements that eventually expand her movement vocabulary (threshold of function). For example, the squat exercise may be assisted for now because she’s successful, but eventually she will build the strength to perform without assistance.
Always THINK WITH THE END IN MIND! The goal is to enhance your client’s ability to move more efficiently (thus reduce discomfort). The only way to accomplish this is to test what tasks must be performed. Once understood, create movements (exercises) that are similar but successful. Build on her current level of success, and slowly start to progress from that point. A big mistake is often made when an exercise program is so far removed from the intended task and therefore little carry over is seen, which equals poor results. Good luck!