Physiotherapy

Here are clear, effective strategies and exercises to manage knee stiffness in Cerebral Palsy (CP) children, commonly caused by spasticity, muscle tightness, limited joint mobility, or poor motor control. ⸻ ⭐ Knee Stiffness in CP Children – Causes Knee stiffness usually results from: • Spasticity in quadriceps or hamstring muscles • Muscle tightness (especially hamstrings, gastrocnemius) • Poor weight-bearing or standing tolerance • Reduced joint movement due to immobility • Contractures developing over time • Abnormal gait patterns (crouched gait, toe-walking) ⸻ ⭐ Effective Exercises for Knee Stiffness in CP Children 1. Hamstring Stretch (Most Important) • Child lies on back • Lift leg slowly • Hold behind thigh • Gently straighten knee • Hold 20–30 sec × 3–5 reps Key: Do slowly, avoid jerks. ⸻ 2. Heel Cord -Calf Stretch • Tight calves increase knee stiffness • Child stands facing wall • Keep back leg straight, heel down • Lean forward • Hold 20 sec × 3 reps ⸻ 3. Quadriceps Stretch (Front Thigh) • Child lies on tummy • Bend knee and bring heel toward buttocks • Hold 15–20 sec × 3 reps (If spasticity is high, do very slowly.) ⸻ 4. Passive Knee Bending–Straightening • Child lying or sitting • Hold thigh and lower leg • Slowly bend (flex) & straighten (extend) • 10–15 repetitions Goal: Improve joint mobility. ⸻ 5. Cycling Movements • Tricycle -Static cycle -Assisted cycling • Excellent for reducing stiffness and improving knee ROM • Do 5–10 minutes daily ⸻ 6. Weight-Bearing Activities Improves knee extension control: • Standing frame • Supported standing • Wall standing with heels touching wall • Knee extension standing with visual cues Goal: Promote proper alignment & reduce stiffness. ⸻ 7. Sit-to-Stand Practice • From chair, help child stand with knees aligned • Encourage controlled movement • 5–10 reps Good for strengthening quads & improving knee mobility. ⸻ 8. Heel–Toe Walking (if possible) • Encourages proper gait • Reduces spasticity in calves • Improves knee alignment ⸻ 9. Ball Squeezing Exercises For adductor spasticity: • Child sits with knees bent • Place soft ball between knees • Gently squeeze • 10 reps × 2 sets ⸻ 10. Play-Based Activities To make therapy engaging: • Kicking soft ball (small kicks) • Step over small hurdles • Squatting to pick toys • Climbing soft steps ⸻ ⭐ Management Tips for Parents & Therapists • Doing daily stretching is crucial • Avoid sudden or forced knee extension • Warm compress before stretching can help • Combine stretches with functional movement • Maintain proper seating: hips at 90°, knees at 90° • Monitor for any knee pain or swelling • Consult physiotherapist for orthotics if needed • Botox or serial casting may be recommended for severe cases ⸻