© 2014 Michael Gamache
Background and Purpose: Medial Plica Syndrome (MPS) is characterized by pain on the anteriomedial aspect of the knee. The pain results from irritation caused by repetitive use or direct impact. Closed-chain exercises and hamstring stretching have shown to decrease compressive forces on the anterior aspect of the knee. This case report will look at using these exercises in the conservative management of MPS. Case Description: The patient is a 13-year-old female who sustained a direct blow to the anteriomedial aspect of her left knee. After a diagnosis of Chondromalacia Patella, she was treated with non-specific exercises. Pain continued and no progress was made. After persistent pain, an MRI revealed an inflamed medial plica (MP). The patient was referred to physical therapy with the hopes of using conservative treatment to avoid arthroscopic surgery to remove the MP. Outcomes: After an episode of care that consisted of closed-chain exercises, hamstring stretching and functional rehabilitation, the patient showed improved strength and range of motion. Her impairment level, based on the Lower Extremity Functional Scale, showed a substantial improvement. She returned to playing with her friends and siblings, participating in soccer and was unrestricted in activities of daily living. Discussion: The results of this case report suggest that closed-chain exercises and hamstring stretching may be beneficial in the management of MPS. The patient was able to avoid surgery and return to her prior level of function, even though she was discharged in the midst of another secondary medical issue.
Gamache, Michael, "Closed-Chain Quadriceps Strengthening And Hamstring Stretching In The Conservative Treatment Of Medial Plica Syndrome: A Case Report" (2014). Case Report Papers. 9.