Download Full Text (528 KB)


The purpose of this case report is to utilize mobilization with movement (MWM) to restore knee flexion in a patient with delayed quadriceps tendon repair.

Publication Date

Spring 2018


St. Augustine, FL


Musculoskeletal Manipulations, Range of Motion - Articular, Knee Joint, Quadriceps Muscle, Tendon Injuries, Physical Therapy Modalities, Rehabilitation


Physical Therapy


Presented at the Spring 2018 Research Day on the St. Augustine, FL, campus of the University of St. Augustine for Health Sciences

References (

1.Clayton RAE, Court-Brown CM. The epidemiology of musculoskeletal tendinous and ligamentous injuries. Injury. 2008;39(12):1338-1344. doi:10.1016/j.injury.2008.06.021. 2. Maffulli N, Del Buono A, Spiezia F, Longo UG, Denaro V. Light microscopic histology of quadriceps tendon ruptures. Int Orthop. 2012;36(11):2367-2371. doi:10.1007/s00264-012-1637-z. 3. Omar M, Haas P, Ettinger M, Krettek C, Petri M. Simultaneous Bilateral Quadriceps Tendon Rupture following Long-Term Low-Dose Nasal Corticosteroid Application. Case Rep Orthop. 2013;2013:1-5. doi:10.1155/2013/657845. 4. Serino J, Mohamadi A, Orman S, et al. Comparison of adverse events and postoperative mobilization following knee extensor mechanism rupture repair: A systematic review and network meta-analysis. Injury. 2017;48(12):2793-2799. doi:10.1016/j.injury.2017.10.013. 5. Perfitt JS, Petrie MJ, Blundell CM, Davies MB. Acute quadriceps tendon rupture: a pragmatic approach to diagnostic imaging. Eur J Orthop Surg Traumatol. 2014;24(7):1237-1241. doi:10.1007/s00590-013-1307-x. 6. Langenhan R, Baumann M, Ricart P, et al. Postoperative functional rehabilitation after repair of quadriceps tendon ruptures: A comparison of two different protocols. Knee Surgery, Sport Traumatol Arthrosc. 2012;20(11):2275-2278. doi:10.1007/s00167-012-1887-8. 7. Bring D, Reno C, Renstrom P, Salo P, Hart D, Ackermann P. Prolonged immobilization compromises up-regulation of repair genes after tendon rupture in a rat model. Scand J Med Sci Sport. 2010;20(3):411-417. doi:10.1111/j.1600-0838.2009.00954.x. 8. Mulligan BR. Manual therapy: "NAGS", "SNAGS", "MWMS" etc. Wellington, N.Z.: Plane View Services Ltd.; 2010. 9. Boudissa M, Roudet A, Rubens-Duval B, Chaussard C, Saragaglia D. Acute quadriceps tendon ruptures: A series of 50 knees with an average follow-up of more than 6 years. Orthopaedics & Traumatology: Surgery & Research. 2014;100(2):217-220. 10. Rao R V., Balthillaya G, Prabhu A, Kamath A. Immediate effects of Maitland mobilization versus Mulligan Mobilization with Movement in Osteoarthritis knee- A Randomized Crossover trial. J Bodyw Mov Ther. 2017. 11. Binkley JM, Stratford PW, Lott S a, Riddle DL. The Lower Extremity Functional Scale (LEFS): Scale development, measurement properties, and clinical application. Phys Ther. 1999;79(4):371-383. doi:10.1097/00005650-198903001-00007. 12. Cynthia C. Norkin PT E, D. Joyce White PT DS. Measurement of Joint Motion A Guide to Goniometry, 4th Ed.; 2009. doi:10.2310/6640.2004.00031. 13. Florence P K, Patricia G P, Rodgers M, William R. Muscles: Testing and Function, with Posture and Pain. Vol 53.; 2013. doi:10.1017/CBO9781107415324.004. 14. Lang JT, Kassan TO, Devaney LL, Colon-Semenza C, Joseph MF. Test-Retest Reliability and Minimal Detectable Change for the 10-Meter Walk Test in Older Adults With Parkinsonʼs disease. J Geriatr Phys Ther. 2015:1. doi:10.1519/JPT.0000000000000068. 15. Association APT. Guide to Physical Therapist Practice. Guid to Phys Ther Pract 30. 2014:1-39. doi:10.2522/ptguide3.0_978-1-931369-85-5. 16. Yuksel E, Kalkan S, Cekmece S, Unver B, Karatosun V. Assessing Minimal Detectable Changes and Test-Retest Reliability of the Timed Up and Go Test and the 2-Minute Walk Test in Patients With Total Knee Arthroplasty. J Arthroplasty. 2017;32(426):430. doi:10.1016/j.arth.2016.07.031.

Ease into It. Effects of Mobilization with Movement Utilizing Patients Body Weight



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.