- Subjective Report:
- September 2016, Steel city orthopedics diagnosed patellofemoral pain
- Went to David Physical Therapy for 8 weeks which provided some relief but symptoms never completely subsided
- Mother reports she experienced a significant growth spurt las t August
- She feels the pain has gotten progressively worse over the past 2 months
- Aggravating activities include figure skating, jumping during ballet
- Reports she attempts to work around the pain during sport related activities with significant collapse of the knee medially
- Dr. Vayas believes there may be some cartilage damage from faulty patellar tracking that may improve if the mechanics are corrected
- Symptoms surround the patella on the left
- H/o Sever’s disease 3 years ago
- Left ankle sprain 2 years ago
- Objective findings
- Increased left quad and hamstring resting muscle tone
- mild to moderate pronation slightly increased on the left
- elevation of L iliac crest
- Shifted upper body posture to the R during flexion and extension of low back
- Decreased L sidebend compared to the R
- Significant tenderness along lateral quad/ITB on the left
- Limitation in L hip external rotation and combined external rotation with flexion and adduction
- Thomas test position with lateral drift of left thigh and apprx 90deg quad flex
- Mild limitation in L ankle dorsiflexion and inversion
- Limited patella mobility left compred to the R
- Dynamic single leg balance with moderate valgus collapse of bilateral knees more so on the L
