Meralgia

March 21, 2017 | By | Reply READ MORE...

23 years old Rishabh Punjabi (name changed), came to PhysioRehab with complaints of:

Bilateral knee pain for the last 2-3 months

  • Intensity 8/10
  • Pain would get aggravated upon getting up after sitting for long, climbing stairs, performing squats and lunges, high impact activities like playing football or jumping

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Bilateral hip pain for the last 3 months associated with reduced sensation on touch

  • Intensity of pain 7/10
  • Pain was sharp and shooting in nature while sprinting, cycling, jumping
  • He was wearing compression tights while playing football to avoid pain and numbness

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LIFESTYLE

  • A sports conditioning student and very fitness conscious.
  • Gym 7 days/week which included heavy weight lifting.
  • Football 3 days/week.

MEDICAL HISTORY

  • Rishabh weighed 130 kgs 3 years back and lost 50 kgs over the period of 3 years.
  • Underwent bariatric surgery to tighten skin around the belly in June 2016.
  • The suture line runs around the entire waist line.

EVALUATION

On observation:

  • Tall, well-built guy, standing with trunk slightly bent forward
  • Mildly squinting patella

On palpation:

  • Tenderness under the patella and in buttock area
  • Tingling on side of buttocks and thighs on tapping

On examination:

  • Severe restriction on bending forward and backwards from the back
  • Hip flexors and iliotibial band tight on both sides
  • Weakness in gluteus (buttock) and quadriceps muscle strength
  • Squat painful
  • Walks with a limp due to knee pain

PLAN OF CARE

  • Pain management with ultrasound and taping of the knee to reduce inflammation.
  • To improve flexibility: stretching of tight muscles like hamstrings, iliotibial band and hip flexors.

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  • Core training: gradual core muscle training to strengthen abdominal muscles

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  • Strengthening of lower limb muscles:

Gluteus muscle
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Quadriceps muscle
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  • Balance and proprioception

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  • We started the rehab in October 2016 and focused on correcting the muscle imbalances as the main approach and gradually progressed to agility training.
  • Patient was pain-free in both knees and hip and with significant reduction in numbness within 6 weeks.
  • Patient has resumed playing football without compression tights and can manage without reproduction of any symptoms.
  • Has resumed all gym activities.

PATIENT SPEAKS

“The hip pain I had was gone in weeks and my knees haven’t ever felt better. Not only have I gotten better physically, but also gained knowledge about my own body that I previously wasn’t aware of. I have thoroughly enjoyed my sessions at PhysioRehab.”

PHYSIO SPEAKS

“Inadequate treatment post-surgery leads to muscle imbalances due to weakness of few structures and tightness of other. This imbalance over a prolonged period of times along with high-loading led to subsequent inflammation of patellar tendon of the knee causing knee pain. It is thus important to not only treat the symptom but address the root cause of the problem.”

Category: Case Studies

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