Integrating healing dynamics is a holistic approach and is a synthesis of several anatomically directed healing techniques. Here the techniques used include:
Barral’s global joint manipulation
Usually after the knee joint begins to degenerate from wear and tear and osteoarthritis slowly sets in, you have a patient walk into your office, unable to straighten out his/her knee. Several reasons contribute to this…here we will discuss one of the more commonly occurring types of tears in the medial meniscus. The meniscii have a front or anterior horn and a back or posterior horn. This tear causes the anterior horn of the meniscus to spread forward and be displaced from its regular moorings. This can be felt like a small bump in the space between the tibia and femur, medially on the inside of the knee joint.
The Upper End of the Tibia, displaying its Upper Surface
Treatment would include the following steps, as in the teachings of Jean-Pierre Barral: The patient lies on his/her back. You place the foot of the patient’s affected side on your shoulder for Steps (1) and (2). In Steps (3) and (4) the patient’s leg is treated lying straight on the table.
(1) Gently grip the upper border of the tibia with both hands and follow the motion of the knee as it rotates. It does so, first inward then outward.
(2) Next, continue to grip the upper border of the tibia. This time, make firm yet gentle contact both the sides of the knee cap, with both your thumbs, along the knee joint line. Gently but very firmly (without causing pain), nudge the protruding anterior horn back into its original space, using a series of knee bends/straightenings. This usually completely straightens the knee.
(3) The knee cap is usually displaced laterally, in these cases. Lift the knee cap upward and pull/push it gently toward the inside of the knee.
(4) Now open up the back of the knee. Stretching the muscles (in this case the semi-membranosus tendon) from medial to lateral side does the trick. Gently grip the back of the knee with both hands, while holding the knee cap in place with both thumbs and stretch outward , each hand away from the other.
(5) This is a good time to tape the knee with KinesioTape, pulling the knee cap lateral to medial to maintain the tracking achieved earlier.
(6) Exercising the knee with gentle knee presses down into the table, is best done now. I advice my patients to do these “24/7”.
(7) Finally I do a release of the lower back and spine using craniosacral techniques to afford complete relief.
(8) The patient is then shown a series of home exercises to maintain the range achieved and to strengthen both knees, in order to reduce the strain pattern developing in the normal leg.