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F, 36, (L) Knee Pain (Science (Evidence Based Practive (PFPS Management…

- - - - Symptom relief: taping to provide temporary relief to get through pt's grand final game, as an adjunct
      - Rehab Exercise: strengthen both hip and knee to provide the most optimal outcome in improving pt's function and movement
      - Load management provide relative rest and remove the aggravating load to provide tissue the best chance to heal during rehab process. Reintroduce load progressively as tissue adapts and its tolerance gradually increases
      - Education regarding condition, possible contributing factors to allow better understanding to maximise pt's involvement in rehab process for a better outcome
    - - Multifactorial presentation that requires addressing all factors to facilitate healing and return to sports/function
        
        Hip strength + control
        
        Knee strength + control
        
        ?Movement pattern/ netball technique
      - Appropriate load management to prevent exacerbation/ overloading
  - - - ❌rule out ligamentous injury. nil traumatic incidents and no feeling instability
      - Thought ?overloaded tendon
        
        Objective wall squat 30 sec// did not relieve symptoms
        
        Thoughts unlikely patellar tendinopathy ❌
      - ❌rule out muscular strain, as it does not fit MOI
      - PFPS
        
        Objective reduced (L) hip ext, ER, ADD strength on HHD compared to (R)
        
        Thoughts ?weakness of (L) hip musculature causes compensation at the knee with increased load placed through jt
        
        Treatment (L) clamshall to promotes activation of hip ER// relief some pain in stair descend
        
        Treatment (L) staggered stance hip thruster 3x12 w/ 30kg on Jones // reduced running pain, increased hip ext HHD
        
        Objective running Ax showed reduced (R) stride length to compensate for (L) to reduce loading on (L) side
        
        Thought weakness of (L) eccentric quadricep control in stance phase to absorb load
        
        Treatment (L) seated cable knee extension w/ focus on eccentric 3x5// delayed onset of running pain on treadmil
        
        Objective stairs Ax: pt reported pain in knee at descend, felt in posterior knee
        
        Thought ?involvement of popliteus in knee flexion and unlocking knee
        
        Treatment STR on popliteus // nil pain in stair descend
  - - - Pain reduced with active stability/control provided by muscle contraction
      - Contribution from proximal joint such as hip extensor weakness
      - No major traumatic incident
      - Contributed by a range of factors
- - - - Outcomes required to achieve: symptom relief, increase confidence to play, LL strengthening, pain management strategies for the game e.g. taping
    - - Outcomes required to achieve: symptom relief, strengthen knee extensor, build tissue tolerance, Ax netball techniques, increase tissue shock absorption capacity, ongoing LL strengthening
  - - - Conversation regarding her kid and occupation may assist in building rapport and trust with pt
    - - Constant reassurance and building pt's self confidence would be beneficial for treatment outcome
    - - Use appropriate language of pt's level of knowledge during any education