Date: 01/03/2021
Hours: 1
Total hours: 40
This session was an online consultation which took place during lockdown due to the recent covid-19 restrictions.
Client is a 20-year-old student who had complaints of right knee pain after suffering an injury to the right foot after another player stepping on their foot with a stud when playing football. At the time of foot injury, the client had pain, swelling and bruising with the 1st MTP joint feeling out of place, however this pain was resolved and was then able to return to football. The client now has a lump at the base of the 1st MTP.
The knee pain is described as following a line, with the Pt can pinpoint to Rectus femoris (mid-portion to insertion) which came on following a run 10/7. After resting the injury for a week and a half there is still pain on movement. The client used to frequently run 2-3 times a week however has rested for the last 10/7 due to the pain. AF running up hill. The client describes the complaint as a recurring injury, which they experienced 2-3 times. The client believes his foot injury may have predisposed him to his current injury, due to concerns he is overcompensating. He is particularly interested in learning how he can prevent future injuries.
Upon assessment, the client experienced pain which they described as a dull ache in hip flexion (L and R), Knee flexion (R) and felt a “niggle” in the right leg during the figure 4 stretch. When assessing functional movements, the client felt pain in the right leg during 1 leg squat, Lunge, squat, tightness in right knee extension with a towel. They experienced no pain in adductor squeeze test however felt some pain when the knees were bent and at 90 degrees.
The clinical impression of this injury was a rectus femoris grade 1 tear. The treatment for this injury was exercise prescription to help increase strength and stretching to help increase ROM/flexibility.
The aims are to reduce pain, increase strength, flexibility, and ROM at the quads. Exercises included adductor squeeze, knee extensions, lunge, isometric stretches all exercises were prescribed for 3 sets, 6-12 reps to help increase strength. Stretches for hip flexors/quads this was for 3 sets, hold stretch for 30 seconds. RPE scale can be used to help identify improvements and physical activity intensity level.