Visit 4
Three weeks after her initial visit, the patient reported marked
improvements with only rare occurrence of knee pain over the past
week. Descending stairs produced intermittent pain rated a 1 out of
10. Manual muscle performance testing was unchanged from the
initial visit. While strength had not changed, improvements in
movement patterns were demonstrated along with a reported
decrease in pain. Functional movements previously assessed were
again performed and recorded. Video analysis of double leg squats,
step-up on a 15-cm box and step-downs on a 15-cm box, confirmed
a vertical line from the midline of the patella fell lateral to the
second toe during all movements (Figures 7–9). The patient was
discharged from outpatient physical therapy as she demonstrated
normal lower extremity alignment with all functional activities, a
decreased complaint of pain and independence with a home
exercise program to address strength deficits.