Crouching/Excess Knee Flexion
Patients with weakness in the muscle groups that control the knee position will often crouch when muscle strength is insufficient to maintain an upright posture and stand tall. For patients with chronic high tone contractures of hamstrings, the knees are pulled into a flexed position, resulting in a crouched posture.
• Excessive knee flexion during weight-bearing
• Can vary from mild and inconsistent to very pronounced and constant
• Caused by weakness or high tone:
- When strength and/or control of the plantarflexors and quadriceps are inadequate, patient cannot support or maintain a normal upright stance posture
- High tone contractures of the hamstrings can constrict stance to crouched posture - associated strong plantarflexion may result in “rocker-bottom” foot
• May also have pronated or supinated foot
Brace Selection for Crouching/Excess Knee Flexion
Within each level of involvement, there are recommended brace solutions.
- Occasional and slight knee flexion
- Can correct easily when prompted
- Often associated with fatique
- Slight impact on daily function
- Frequent to constant knee flexion
- Can correct some when prompted
- Always present with fatique
- Some limits on daily function
- Constant and marked knee flexion
- Little or no voluntary control
- Significant impact on ambulation
