KP: Ballet Dancer/ Figure Skater Patellofemoral Pain: Initial Evaluation/Day 1

  • 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