1. 1. PIP
1.1. Activity Limitations
1.1.1. Sit < 30 minutes
1.1.2. Unable to Run
1.1.3. Stand < 30 Minutes
1.1.4. Antalgic Gait/Run
1.2. Participation Restriction
1.2.1. Unable play soccer
1.2.2. Unable to cycle
1.2.3. Unable to dance
2. 2. Examination Plan
2.1. Standing
2.1.1. Obsevation
2.1.2. Functional Tests
2.1.2.1. Squat
2.1.2.2. Step Down
2.1.2.3. SLS
2.1.3. Lumbar AROM
2.1.4. Thessaly
2.2. Sitting
2.2.1. MMT Knee
2.2.2. McConnell Test
2.3. Lying
2.3.1. Hip, Knee, Ankle ROM
2.3.2. Joint Mobility
2.3.3. Swelling Assessment
2.3.4. Valgus Stress Test
2.3.5. McMurray Test
2.3.6. ACL Tests
2.3.7. Palpation
3. 5. NPIP's
3.1. Risk Factors
3.1.1. Genu Valgum
3.1.2. Foot Pronation
3.1.3. Pressure for quick return
3.1.4. Female
3.1.5. Soccer Player
3.1.6. Q-Angle
4. 3. Conduct Exam
4.1. Impairments
4.1.1. SLS 10 seconds
4.1.2. Knee ROM 0 - 130
4.1.3. Knee Strength 4/5 MMT
4.1.4. Swelling 3 cm
4.1.5. Decreased medial patella glide
4.2. Activity Restriction
4.2.1. Squat 70%
4.2.2. Step Down pain and valgum
4.2.3. Gait antalgic
5. 4. Analyze Data
5.1. Data
5.1.1. Limited ROM due to pain and swelling
5.1.2. Poor quality of movement functional tasks
5.1.3. Tenderness medial patella
5.1.4. + McConnell Test
5.1.5. + Lachman
5.1.6. Swelling
5.2. Refine Hypothesis
5.2.1. Knee Stability with Movement Coordination Impairments
5.2.1.1. PFPS
5.2.1.2. ACL Sprain I
6. 6. Hypotheses
6.1. Swelling and Pain
6.1.1. Decreased ROM
6.1.2. Decreased Strength
6.1.3. Increased Girth Measurements
6.1.4. Antalgic Gait
6.2. Strength and NMR
6.2.1. Balance
6.2.2. Quality of Movement and Control
6.2.3. PFPS
6.3. ACL Strain
6.3.1. + Lachman
6.3.2. Q-Angle
6.3.3. Female Soccer player
7. 7. Establish Goals
7.1. Decrease mid-patellar swelling by 2 cm in 5 days
7.2. Patient to sit for 1 hour during class with knee pain </= 3/10 in 2 days
7.3. Improve knee flexion and extension to 5/5 MMT in 4 weeks
7.4. Patient to descend 8-inch step with no pain and controlled valgum independenty in 4 weeks
7.5. Patient to return to soccer practice without restriction and with pain < 2/10 NPRS in 4 weeks
7.6. Patient to SLS left with EC for 30 seconds
7.7. Patient to score < 5 on LESS in 4 weeks
8. 8. Establish POC
8.1. Frequency
8.1.1. 2 x week x 4 weeks
8.2. Interventions
8.2.1. Manual Techniques
8.2.1.1. Patellar Mobilization decrease pain
8.2.2. Therapeutic Exercise improve strength
8.2.3. NMR to reduce genu valgum
8.2.4. Modalities for inflammation
8.2.5. Functional Optimization and Agility
8.3. Functional Outcome: KOS
8.4. Performance Measure: LESS
9. 9. Reassessment
9.1. 2 Weeks and 4 Weeks
9.2. If Goals met - Discharge
9.3. Goals not met
9.3.1. Are Hypotheses Correct?
9.3.2. Are the Testing Criteria Correct?
9.3.3. Is the Treatment Correct?
9.3.4. Are the goals viable?