PRADEEP — the pillow, the jerk, the walks and the stand
Five stages in order, and the first of them is the placing of a pillow
Five stages, given in order — and the first of them is the placing of a pillow, which tells you how much of this treatment is decided before a foot touches anybody.
Key teaching
The variant some therapists use in place of stages 3 and 4 {{x3}}
In place of numbers 3 and 4 above, some therapists do it this way → placing the soles on both sides of the knee, they move the two feet alternately in opposite directions — that is, the left foot travels from the knee towards the hip while at the same time the right foot travels from below the knee towards the heel.
Three rounds like that. After that, do number 5 above.
This is not a shortcut and not a correction. It is a second way of covering the same territory, in which the two halves happen together rather than one after the other. Both are given; neither is marked as preferred. What the variant does not replace is stage 5, which follows in either version. Learn both, give one, and write on the card which one you gave.
Patient's position
Lying; the knee being treated kept bent inward; the pillow at an angle — corner slightly outside the knee, long side under the thigh, part of its width under the lower leg. Left knee first, then the right Supine Left Right
The therapist
Between the patient's legs, looking at the knee, body weight taken on the hands on the chairs
The five stages, in short
1 the pillow · 2 the stance · 3 heels either side of the knee, one downward jerk, then from near the upper border walk knee → hip pressing inward, 3 rounds · 4 from just below the knee walk down to the heel pressing downward and inward, 3 rounds · 5 the soft middle of the sole exactly in the middle of the knee bone, whole weight, standing up straight. Then the whole process on the other knee × 3
Variant
In place of 3 and 4 — the soles on both sides of the knee, the two feet moved alternately in opposite directions: left foot knee → hip while the right foot travels from below the knee → heel. Three rounds; then number 5
What it is for
Part of the knee sequence, following Giriraj and calf muscle ghisai
Stage 1 is a treatment, not bedding. The pillow goes under the knee at an angle, its corner slightly outside the knee, its long side under the thigh, part of its width under the lower leg — three separate placements in one sentence. What it achieves is that thigh and lower leg are both carried and the knee rests in a little bend with nothing hanging, which is the position of greatest room inside the joint and least pressure across it. A knee held dead straight passes every downward force through the joint line. Set the pillow wrongly and you have changed what stage 5 lands on. And "kept bent inward" turns the limb so the inner side of the knee comes up toward you — the aspect the figure shows and the aspect your feet will meet.
"Stand between their legs, looking at the knee" — not beside the patient, as almost everywhere else. The walks run away from you and back towards you along the limb, and only from between the legs can one therapist reach them all.
The jerk comes first and is given once. Both feet on either side of the knee — not on it — and pressure downward through the heels with a jerk. One impulse, then the walking begins. A jerk is the one load a therapist cannot take back once begun, which is why it is given at the start, on a knee already softened by four treatments.
The two walks are mirror images with different pressure directions: upward from near the upper border of the knee, pressing the muscles inward, small close steps, three rounds; downward from just below the knee to the heel, pressing downward and inward, three rounds. Inward going up; downward and inward coming down. Both start beside the joint, not on it. The rule The Low Back states three separate times — by no mistake should the foot fall on the knee joint — governs every travelling step here. (Figure 23.3)
Pradeep — the pillow, the jerk, the walks and the stand. The five stages in order: the pillow set at an angle under the knee, the plan view of the four walks with their three stations each way and the inward press at each, and the jerk and the final full-weight stand set out with the patients for whom both are simply not given.
And stage 5 is not a step of the walk. It is a separate, named, final action, described in full. The soft middle part of the sole — the softest tool a therapist has — placed exactly in the middle of the knee bone, and then the whole weight put on it, standing up straight. It is placed, not walked onto; it is the mid-sole, not the heel; it lands on a knee bent inward on an angled pillow with thigh and lower leg both carried; and it comes after everything above. Every one of those clauses is part of the instruction. Give stage 5 as it is written, with the pillow as it is written, and give it last.
Read next
Face Down Face Down — the jerk, and why a load you cannot take back is given first
The Child, the Elder and the Frail The Child, the Elder and the Frail — bones that break easily, and what is withheld rather than reduced
When the Hand Must Stop When the Hand Must Stop — the replaced joint nobody thinks to mention
JJ GROIN and JJ BACK — for the pain that is left over
Inner side of the knee → Groin; outer side → Back. Two words decide
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