Dx: Right knee pain
S:
Patient is a 15 y.o. African American female that is active in sports, playing basketball and track. She is
currently running the 100 and 200 meter sprints and has been complaining of right knee
...
Dx: Right knee pain
S:
Patient is a 15 y.o. African American female that is active in sports, playing basketball and track. She is
currently running the 100 and 200 meter sprints and has been complaining of right knee pain. She rates her pain
during these activities as a 4/10. She reports that her knee has been a problem in the past but always has been
minor. This episode has lasted approximately 3 weeks. Her knee bothers her when she goes up and down stairs
and runs, but is relatively pain free unless she sits for prolonged periods of time (>30 minutes). Then the knee
is achy as she goes from sit → stand. The patient is anxious to get back to sports.
O:
Observation: Patient stands with slight genu valgum and ankle pronation on the right. Gait is normal at this
time.
Palpation: There is slight tenderness upon palpation over the patellar tendon and tibial tuberosity on the right.
Patellar Mobility: Decrease in medial glide on right as compared to the left patella.
Knee Range of Motion and Muscle Flexibility Right Left
Knee flexion with hip flexed 140 145
Knee flexion with hip extended (rectus femoris) 130 140
Knee extension in supine 0 0
Knee extension in sitting (hamstring) -10 5
Knee flexion excursion (unilateral squat) 45 with c/o pain 70
patellofemoral area
Strength: Quads 4+/5 with c/o pain 5/5
Hamstrings 5/5 5/5
Special Tests: McMurrays (-), Apley’s Compression (-), Lachman’s (-), Pivot Shift (–)
Balance: Single leg stance with eyes closed 30 sec 30 sec
A: Problem List:
1. Right knee pain with activity and palpation
2. Postural deficits
3. Patellar mobility restrictions
4. Decreased right knee strength and range of motion
5. Limitations with sport activities
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A CLAUSE IHUMAN CASE STUDY
Short Term Goals: Time Frame: 1 week
1. Decrease right knee pain to <2/10 with stair negotiation and short distance running.
2. Patient to be fit for appropriate orthotics to correct right ankle pronation and trial during running
activities.
3. Patient to exhibit a 10 degree increase in hamstring length as well as a 20 degree increase in knee
flexion excursion to promote flexibility necessary for pain free functional mobility and sport activities.
Long Term Goals: Time Frame: 2-3 weeks
1. Right knee pain to be negligible with stair negotiation, running sprints and sit → stand after prolonged
sitting.
2. All right knee AROM to be within normal range without pain to promote safe return to running
activities.
3. Increase right quad strength to 5/5 without pain to promote right knee stability with functional and sport
activities.
4. Patient to be independent with a home exercise program aimed to maintain right knee strength, stability,
and ROM.
P: Physical therapy for modalities to reduce pain, assessment for proper foot orthotics, postural education,
manual therapy for patellar mobilization, instruction in an exercise program to increase right knee range of
motion, strength, and stability, and fully return to running activities.
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