Visit 3
One week later, the patient returned to therapy with a selfdiscovery.
She reported while driving over the weekend she began
to experience increased knee pain. She noted the internally rotated
position of her thigh with her knee pointing medially. Correction
of the poor alignment by externally rotating her femur and placing
her leg in slight abduction immediately decreased her knee pain.
Her pain experienced while descending stairs had improved to 2
out of 10. Re-evaluation of the step-up and step-down activities
on the 15-cm box revealed deviations on less than 30% of the attempts, and no increase in pain. The patient was able to
verbalize when poor mechanics occurred insuring she had a firm
understanding of the desired movement pattern. It was noted that
the patient was able to verbalize deviations of medial collapse
100% of the time they occurred.
Strength measures via manual muscle testing remained
unchanged from the initial visit. Instructions for a home exercise
program to address impairments of decreased abdominal, gluteal
and hip lateral rotators strength were provided. She was instructed
to perform the home exercise program (Appendix B) three times a
day. The patient was encouraged to maintain diligence with
correction of medial collapse during functional activities.