Thursday, May 14, 2009

knee contractures Multiple Sclerosis

Knee contractures are more than a Multiple Sclerosis symptom; they affect Patti’s opportunity to participate in life.

In the wheelchair era of Multiple Sclerosis changes occur in the surrounding muscle, tendons and ligaments of the knees which make the legs stiffer to bend and straighten. Knee contractures impair transferring because legs essentially tuck up under a person rather than extending.

From a caregiver’s perspective the safer and easier transfer of Patti from her wheelchair to bed, scooter, non-accessible seating, or whatever by simply helping her to stand and pivot equals outings and involvement.

When dead lifting her is necessitated because of knee contractures not only are both of us are at risk but her world shrinks.

Patti can be a genuine b*tch (“and proud of it” in her own words) about physical therapy.

A saint of a new therapist persists with Patti and changed the modalities of therapy:

  1. Ultrasound is used to deep heat muscles and tendons.
  2. Legs are manually manipulated and stretched.
  3. SoftPro Static Gel Knee Orthosis are applied and supported with an ottoman like cushion while Patti is still in her wheel chair.
  4. A nap wearing the soft pro braces closes out the routine.

In my opinion the results have been phenomenal, seemingly setting the clock back several years when it comes to transferring.

While PT cannot last forever, the nap with ortho braces is to be written into the nursing plan. ANY nap that is written into a care plan is a plus with Multiple Sclerosis care.

Additionally occupational therapy will next evaluate Patti for modifications to her wheelchair and/or a new wheelchair to focus on improving leg extension and posture.

A plus to the care facility era is that medical care surrounds you from aides for attended activities of daily living to nursing staff to doctors visiting you to ‘down the hall’ therapy.

Please always remember that the pluses are in large part driven by YOU. You must insure that a specific Multiple Sclerosis oriented care plan is in effect. Most important of all YOU, FAMILY, AND FRIENDS must remain involved and supporting.

previous related entries:
10/21/08 Multiple Sclerosis knee contractures
08/12/08 memory loss and knee contracture

Caregivingly Yours, Patrick Leer
web site:
Patrick Ponders ...


  1. I just wanted to stop by and say that I can see how hard life can be for you. I myself have MS and I don't necessarily recognize what it must be like for my husband or my family. If you don't mind I will continue to follow along.

  2. it is good, Patrick, that you are still involved and supportive in Patti's PT/OT even after all these years; that is to be commended!



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