The “SQUEEZE” for the knee (for both acute and long standing knee symptoms
Brian Mulligan: “The origin of this technique must be told and before doing so I would again remind the reader of that famous quote attributed to Louis Pasteur .. “In the field of discovery chance only favours the prepared mind”.
Some years ago we were treating a grubby, 25 year old male, with a knee joint “derangement”. He twisted it playing football resulting in a loss of at least 25 degrees of extension and 35 degrees of flexion. Some hours after his injury the knee became swollen and he had a noticeable bulge over the antero-medial joint margin. An appointment has been made for him to see an orthopaedic surgeon and pending this visit he was referred to us for therapy.”
“Our management included the usual manual techniques one may try to restore knee movement, ultrasound and, of course, quadriceps and hamstring exercises. The therapy was useless and resulted in the patient understandably complaining, after five visits, that he would be wasting his time by attending further. We readily agreed with him and asked him to maintain an exercise program at home until assessed by the surgeon. As a final gesture, I decided to again check his knee. I used the McMurray test and applied a very firm pressure over the anterior horn with the medial border of my thumb where the prominent bulge was located. To my amazement, while squeezing firmly over the joint margin, I was able to flex the knee fully without pain, and even more amazingly, I was then able to extend it fully from the flexed position. It must be added that I did not release my firm thumb pressure over the anterior horn. The patient was understandably delighted. “I’m cured!” he exclaimed. “Of course!” was my nonchalant reply. It was then pointed out to this fellow that only a temporary resolution to his problem had been brought about, and he could expect further trouble if he twisted his knee again. He demanded, after this “miracle”, a return appointment two days later, which was agreed to. He was fine and required neither further therapy nor surgery.
Referring again to my quotation above (“In the field of discovery chance only favours the prepared mind”) may I say, that I most certainly had a prepared mind. From that time the “Squeeze” technique has been an important and rewarding part of my therapy for knees that have lost movement after injury, and the pain with his movement is very, very localised over the joint margin near the anterior horn medially or laterally.
The “Squeeze” can be applied in lying or standing, but for extension is only done in lying. “
Source: Manual Therapy, NAGS, SNAGS, MWMS etc. by Brian R Mulligan, 7th edition.
Watch technique: K.11.