Knee osteoarthritis (OA) presents significant challenges for both patients and clinicians. A primary goal in managing OA is improving knee flexion without exacerbating joint pain. This post explores an effective technique to enhance knee flexion while minimizing discomfort.
The Challenge of Knee Flexion in OA
Patients with knee OA often struggle with limited range of motion due to joint pain and stiffness. Traditional methods of forcing the knee into flexion can compress the joint, leading to increased pain and potential damage. However, research supports the use of gentle, targeted exercises to improve knee flexion and overall function in OA patients[1].
The Towel Technique: A Research-Backed Approach
The towel technique you describe aligns with evidence-based practices for improving knee flexion in OA patients. Studies have shown that exercises focusing on improving range of motion, when performed regularly, can lead to significant improvements in knee function and pain reduction[1][2].
Step-by-Step Guide
Preparation: Have the patient lie prone (on their stomach). This position helps reduce joint compression.
Placement: Position a rolled-up towel underneath the knee.
Flexion: Gently guide the knee into flexion while maintaining the towel's position. This creates a small gap in the joint, reducing compression and allowing for a greater range of motion.
Communication: Maintain open dialogue with the patient to ensure minimal pain and address any concerns, such as patellofemoral pain.
Benefits of the Towel Technique
Reduced Joint Compression: The towel acts as a wedge, creating space in the joint and minimizing compression.
Increased Flexion: This method allows for deeper knee flexion and a more effective quadriceps stretch.
Patient Comfort: By minimizing pain, patients are more likely to engage in and adhere to their rehabilitation program.
Home Exercise Program
To ensure continued progress, patients can perform a modified version of this exercise at home:
Sitting Position: Have the patient sit comfortably.
Towel Placement: Place the towel under the knee.
Heel Slide: Instruct the patient to perform heel slides, bending the knee while the towel maintains the joint gap.
Research indicates that home-based exercise programs can be highly effective in improving knee function and reducing pain in OA patients[3].
Supporting Research
A systematic review and meta-analysis published in 2023 found moderate-quality evidence supporting the effectiveness of stretching exercises in improving knee flexion range of motion (ROM) and reducing pain in OA patients[2]. The study reported:
Improved total knee ROM by a mean difference of 9.3° compared to controls
Enhanced knee flexion ROM by 10.8°
Reduced pain with a standardized mean difference of 1.9
These findings underscore the importance of incorporating targeted stretching exercises, such as the towel technique, into OA management plans.
Conclusion
Incorporating the towel technique into rehabilitation programs can significantly improve knee flexion in patients with OA. This gentle, effective, and patient-friendly method aligns with current research and can enhance overall treatment outcomes. By focusing on improving range of motion through targeted exercises, clinicians can help OA patients achieve better knee function and reduced pain levels.
If you want to see a visual demonstration and learn how to execute these techniques, you can watch Donis Gil in the video.
Citations:
[1] https://e3rehab.com/knee-flexion/
[2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10606959/
[3] https://www.micahadamsonmd.com/knee-strengthening-exercises-for-osteoarthritis-orthopedic-hip-knee-replacement-denver-westminster-co/
[4] https://www.webmd.com/osteoarthritis/ss/slideshow-knee-exercises
[5] https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/exercises/exercises-for-osteoarthritis-of-the-knee/
[6] https://www.physio-pedia.com/Manual_Therapy:_Knee
[7] https://www.youtube.com/watch?v=Vuv7CUMZFYc