Abstract
A 23-year-old female patient with chronic bilateral anterior knee pain was seen for 8 sessions over a 10-week period at an outpatient physical therapy clinic. Treatment was provided by a student physical therapist under the supervision of a licensed physical therapist.
The initial encounter included examination procedures including, observation of lower extremity posture and kinematics, the Numeric Pain Rating Scale, muscle length testing, handheld dynamometry, manual muscle testing, palpation of specific structures, joint mobility testing of the patellofemoral joint, Focus on Therapeutic Outcomes, Anterior Knee Pain Scale, Patient Specific Functional Scale, and Fear Avoidance Beliefs Questionnaire. A plan of care was established to address pain, impaired lower extremity posture and kinematics, decreased strength and muscle length, and fear avoidance beliefs that limited the patient’s ability to squat, ascend/descend stairs, stand or sit for prolonged periods of time, kneel, and use a stationary bike. Limitations in activities further restricted her participation in work-related tasks and lower extremity exercises at the gym. Main goals for the patient were to improve and better manage symptoms, improve lower extremity strength, and return to performing exercises at the gym. Main interventions used were McConnel taping, pain neuroscience education, early hip strengthening, progressive loading and strengthening of quadriceps, lower extremity stretching, and task specific training. At the end of the care plan, the patient was found to have improved strength and flexibility, kinematics with step down and squat, overall function, and was able to return to gym exercise 2-3x per week.