{"id":3515,"date":"2025-09-05T15:27:28","date_gmt":"2025-09-05T18:27:28","guid":{"rendered":"https:\/\/rpgl.org\/blog\/?p=3515"},"modified":"2025-10-27T18:21:18","modified_gmt":"2025-10-27T21:21:18","slug":"deficit-de-control-en-la-alineacion-de-la-rodilla","status":"publish","type":"post","link":"https:\/\/rpgl.org\/blog\/deficit-de-control-en-la-alineacion-de-la-rodilla\/","title":{"rendered":"D\u00e9ficit de control en la alineaci\u00f3n de la rodilla"},"content":{"rendered":"\n<div class=\"wp-block-uagb-container uagb-block-3328596a alignfull uagb-is-root-container\"><div class=\"uagb-container-inner-blocks-wrap\">\n<h2 class=\"wp-block-heading has-text-align-left has-medium-font-size\" style=\"margin-top:0;margin-right:0;margin-bottom:0;margin-left:0\">Un motivo frecuente de consulta<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>El dolor de rodilla es un motivo frecuente de consulta en j\u00f3venes f\u00edsicamente activos, siendo multifactorial en su origen. Entre los factores m\u00e1s relevantes, el d\u00e9ficit de control neuromuscular y la incapacidad para mantener la alineaci\u00f3n din\u00e1mica de la articulaci\u00f3n se han identificado como elementos clave en la g\u00e9nesis y perpetuaci\u00f3n del dolor anterior y lateral de rodilla (Willy &amp; Davis, 2019; Noehren et al., 2012). <\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>El presente trabajo analiza el caso cl\u00ednico de Luc\u00eda, una mujer de 26 a\u00f1os con dolor persistente en la rodilla derecha, en el marco de un modelo de an\u00e1lisis que contempla las nociones de insuficiencia real e insuficiencia relativa para interpretar los cambios en la funci\u00f3n postural y el movimiento corporal (Korell, s.f.).<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-uagb-image uagb-block-92bcd4b5 wp-block-uagb-image--layout-overlay wp-block-uagb-image--effect-static wp-block-uagb-image--align-none\"><figure class=\"wp-block-uagb-image__figure\"><img data-recalc-dims=\"1\" decoding=\"async\" srcset=\"https:\/\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/Sin-titulo.jpg ,https:\/\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/Sin-titulo.jpg 780w, https:\/\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/Sin-titulo.jpg 360w\" sizes=\"auto, (max-width: 480px) 150px\" src=\"https:\/\/i0.wp.com\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/Sin-titulo.jpg?resize=825%2C857&#038;ssl=1\" alt=\"d\u00e9ficit de control\" class=\"uag-image-3532\" width=\"825\" height=\"857\" title=\"dolor de rodilla\" loading=\"lazy\" role=\"img\"\/><div class=\"wp-block-uagb-image--layout-overlay__color-wrapper\"><\/div><div class=\"wp-block-uagb-image--layout-overlay__inner center-center\"><\/div><\/figure><\/div>\n\n\n\n<footer class=\"wp-block-uagb-container uagb-block-d34b7a22 alignfull uagb-is-root-container\"><div class=\"uagb-container-inner-blocks-wrap\">\n<h2 class=\"wp-block-heading has-text-align-left has-medium-font-size\" style=\"margin-top:var(--wp--preset--spacing--40);margin-bottom:var(--wp--preset--spacing--40)\">Presentaci\u00f3n del caso<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br><strong>Paciente:<\/strong> Luc\u00eda, 26 a\u00f1os.<br><strong>Motivo de consulta: <\/strong>dolor constante en la cara externa y anterior de la rodilla derecha.<br><strong>Historia:<\/strong> refiere que el dolor se inicia y exacerba durante la ejecuci\u00f3n de estocadas en el gimnasio. La molestia se mantiene durante el resto del d\u00eda tras el entrenamiento.<br>Evaluaci\u00f3n cl\u00ednica: Se aplica una prueba de reequilibraci\u00f3n, guiando el movimiento para mantener la alineaci\u00f3n mientras se realiza el movimiento. Bajo esta condici\u00f3n el dolor disminuye, aunque la paciente refiere tensi\u00f3n en la cara medial del muslo. Se observa una p\u00e9rdida de control en la alineaci\u00f3n de la rodilla respecto a pies y cadera, con una desviaci\u00f3n hacia la l\u00ednea media (valgo din\u00e1mico). El presente trabajo analiza el caso cl\u00ednico de Luc\u00eda, una mujer de 26 a\u00f1os con  dolor persistente en la rodilla derecha, en el marco de un modelo de an\u00e1lisis que contempla las nociones de insuficiencia real e insuficiencia relativa para interpretar los cambios en la funci\u00f3n postural y el movimiento corporal (Korell, s.f.).<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-align-center has-medium-font-size\">An\u00e1lisis cl\u00ednico desde el modelo de insuficiencia real y relativa<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>El modelo da la posibilidad de analizar e interpretar la p\u00e9rdida de control postural y del movimiento en base a dos perspectivas que aporta informaci\u00f3n para luego elaborar y aplicar el adecuado enfoque terap\u00e9utico:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Insuficiencia real: p\u00e9rdida de la capacidad por hipoton\u00eda, atrofia o inhibici\u00f3n neurol\u00f3gica<br>de la musculatura agonista. Requiere un abordaje centrado en la reeducaci\u00f3n neuromotriz y<br>fortalecimiento (Korell, s.f.).<\/li>\n\n\n\n<li>Insuficiencia relativa: incapacidad funcional debida a rigidez, retracci\u00f3n o incremento de<br>tono en la musculatura antagonista. El abordaje requiere flexibilizaci\u00f3n, disminuci\u00f3n de<br>tono y posterior reeducaci\u00f3n neuromotriz (Korell, s.f.).<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>En el caso de Luc\u00eda, el dolor disminuye al corregir la alineaci\u00f3n mediante la prueba de reequilibraci\u00f3n, pero aparece tensi\u00f3n en la cara medial del muslo y resistencia a la alineaci\u00f3n. Esto sugiere la presencia de una insuficiencia relativa, donde la musculatura aductora\/medial incrementa su tono y limita el control efectivo de los estabilizadores<br>laterales (como gl\u00fateo medio). <\/p>\n\n\n\n<h2 class=\"wp-block-heading alignwide has-text-align-left has-medium-font-size\">Evidencia cient\u00edfica<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>La literatura respalda que el valgo din\u00e1mico de rodilla se asocia con sobrecarga patelofemoral y lateral de la rodilla (Hollman et al., 2009; Powers, 2010). Estudios con an\u00e1lisis cinem\u00e1tico muestran que la incapacidad para controlar la abducci\u00f3n y rotaci\u00f3n interna de la cadera predicen la presencia de dolor anterior de rodilla (Noehren et al.,<br>2012).<br>Adem\u00e1s, programas de intervenci\u00f3n enfocados en mejorar el control neuromuscular de cadera y rodilla han demostrado eficacia en reducir s\u00edntomas y mejorar la alineaci\u00f3n din\u00e1mica (Ferber et al., 2015; Baldon et al., 2014).<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-text-align-left has-medium-font-size\">Discusi\u00f3n<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\">El d\u00e9ficit de control observado en Luc\u00eda se interpreta como un desequilibrio funcional entre musculatura agonista y antagonista, enmarc\u00e1ndose en la perspectiva de insuficiencia relativa. La prueba de reequilibraci\u00f3n act\u00faa como confirmaci\u00f3n cl\u00ednica de este modelo, ya que la correcci\u00f3n manual permite disminuir el dolor y revelar la falta de flexibilidad del componente aductor traduci\u00e9ndose en tensi\u00f3n a nivel cognitivo del paciente (Korell, s.f.).<br><\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><strong>Desde el punto de vista terap\u00e9utico, la evidencia sugiere que un programa de intervenci\u00f3n<br>deber\u00eda incluir:<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Flexibilizaci\u00f3n y liberaci\u00f3n miofascial de aductores y estructuras mediales.<\/li>\n\n\n\n<li>Fortalecimiento neuromuscular de gl\u00fateo medio y mayor, orientado al control en tareas<br>funcionales como estocadas y saltos.<\/li>\n\n\n\n<li>Reeducaci\u00f3n del patr\u00f3n motor, integrando feedback visual o t\u00e1ctil para consolidar la<br>alineaci\u00f3n din\u00e1mica (Willy &amp; Davis, 2019).<\/li>\n<\/ol>\n\n\n\n<h2 class=\"wp-block-heading has-medium-font-size\">Conclusiones<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>El caso de Luc\u00eda ilustra c\u00f3mo el d\u00e9ficit de control en la alineaci\u00f3n de la rodilla puede generar dolor persistente en j\u00f3venes activos. El modelo de insuficiencia real y relativa resulta un marco cl\u00ednico v\u00e1lido para diferenciar las causas subyacentes y orientar el tratamiento. La<br>evidencia cient\u00edfica apoya la intervenci\u00f3n combinada de flexibilizaci\u00f3n, fortalecimiento y reeducaci\u00f3n neuromotora como estrategia eficaz para restaurar la funci\u00f3n y disminuir el dolor.<\/p>\n\n\n\n<h2 class=\"wp-block-heading has-medium-font-size\">Referencias<\/h2>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>Baldon, R. de M., Serrao, F. V., Scattone Silva, R., &amp; Piva, S. R. (2014). Effects of functional stabilization training on lower limb biomechanics in women. Medicine &amp; Science in Sports &amp; Exercise, 46(12), 2381\u20132391. https:\/\/doi.org\/10.1249\/MSS.0000000000000365<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>Ferber, R., Bolgla, L., Earl-Boehm, J., Emery, C., &amp; Hamstra-Wright, K. (2015). Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: a multicenter randomized clinical trial. Journal of Athletic Training, 50(4), 366\u2013377. https:\/\/doi.org\/10.4085\/1062-6050-49.3.70 <\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>Hollman, J. H., Ginos, B. E., Kozuchowski, J., Vaughn, A. S., Krause, D. A., &amp; Youdas, J. W. (2009). Relationships between knee valgus, hip-muscle strength, and hip-muscle recruitment during a single-limb step-down. Journal of Sport Rehabilitation, 18(1), 104\u2013https:\/\/doi.org\/10.1123\/jsr.18.1.104<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br>Noehren, B., Hamill, J., &amp; Davis, I. (2012). Prospective evidence for a hip etiology in patellofemoral pain. Medicine &amp; Science in Sports &amp; Exercise, 45(6), 1120\u20131124. https:\/\/doi.org\/10.1249\/MSS.0b013e31828249d2<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br><\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\">Powers, C. M. (2010). The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. Journal of Orthopaedic &amp; Sports Physical Therapy, 40(2), 42\u201351. https:\/\/doi.org\/10.2519\/jospt.2010.3337<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br><\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\">Willy, R. W., &amp; Davis, I. S. (2019). The effect of a hip-strengthening program on mechanics during running and during a single-leg squat. Journal of Orthopaedic &amp; Sports Physical Therapy, 49(9), 654\u2013662. https:\/\/doi.org\/10.2519\/jospt.2019.8825<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><br><\/p>\n\n\n\n<p class=\"has-text-align-left wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\">Korell, M. E. (s.f.). Modelo de an\u00e1lisis para interpretar cambios en la funci\u00f3n postural y movimiento corporal. Documento in\u00e9dito.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\" style=\"margin-top:0;margin-right:var(--wp--preset--spacing--70);margin-bottom:0;margin-left:var(--wp--preset--spacing--70)\"><\/p>\n\n\n\n<div style=\"height:100px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n\n\n<div class=\"wp-block-buttons is-content-justification-right is-layout-flex wp-container-core-buttons-is-layout-b507c051 wp-block-buttons-is-layout-flex\">\n<div class=\"wp-block-button\"><a class=\"wp-block-button__link wp-element-button\" href=\"https:\/\/rpgl.org\/\">Conocer m\u00e1s&#8230;<\/a><\/div>\n<\/div>\n<\/div><\/footer>\n","protected":false},"excerpt":{"rendered":"<p>El dolor de rodilla es un motivo frecuente de consulta en j\u00f3venes f\u00edsicamente activos. En este art\u00edculo abordamos uno de los factores m\u00e1s relevantes.<\/p>\n","protected":false},"author":1,"featured_media":3517,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_uag_custom_page_level_css":"","site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"disabled","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"set","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[46],"tags":[],"class_list":["post-3515","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-inicio"],"jetpack_featured_media_url":"https:\/\/i0.wp.com\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/una-imagen-para-mostrar-esto-d-ficit-de-control-en.png?fit=1024%2C1024&ssl=1","uagb_featured_image_src":{"full":["https:\/\/i0.wp.com\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/una-imagen-para-mostrar-esto-d-ficit-de-control-en.png?fit=1024%2C1024&ssl=1",1024,1024,false],"thumbnail":["https:\/\/i0.wp.com\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/una-imagen-para-mostrar-esto-d-ficit-de-control-en.png?resize=150%2C150&ssl=1",150,150,true],"medium":["https:\/\/i0.wp.com\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/una-imagen-para-mostrar-esto-d-ficit-de-control-en.png?fit=300%2C300&ssl=1",300,300,true],"medium_large":["https:\/\/i0.wp.com\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/una-imagen-para-mostrar-esto-d-ficit-de-control-en.png?fit=768%2C768&ssl=1",768,768,true],"large":["https:\/\/i0.wp.com\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/una-imagen-para-mostrar-esto-d-ficit-de-control-en.png?fit=1024%2C1024&ssl=1",1024,1024,true],"1536x1536":["https:\/\/i0.wp.com\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/una-imagen-para-mostrar-esto-d-ficit-de-control-en.png?fit=1024%2C1024&ssl=1",1024,1024,true],"2048x2048":["https:\/\/i0.wp.com\/rpgl.org\/blog\/wp-content\/uploads\/2025\/09\/una-imagen-para-mostrar-esto-d-ficit-de-control-en.png?fit=1024%2C1024&ssl=1",1024,1024,true]},"uagb_author_info":{"display_name":"Mario Korell Lic. Kinesi\u00f3logo Fisiatra","author_link":"https:\/\/rpgl.org\/blog\/author\/mario\/"},"uagb_comment_info":1,"uagb_excerpt":"El dolor de rodilla es un motivo frecuente de consulta en j\u00f3venes f\u00edsicamente activos. En este art\u00edculo abordamos uno de los factores m\u00e1s relevantes.","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/posts\/3515","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/comments?post=3515"}],"version-history":[{"count":27,"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/posts\/3515\/revisions"}],"predecessor-version":[{"id":3717,"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/posts\/3515\/revisions\/3717"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/media\/3517"}],"wp:attachment":[{"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/media?parent=3515"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/categories?post=3515"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/rpgl.org\/blog\/wp-json\/wp\/v2\/tags?post=3515"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}