Physiotherapy Follow-Up

Physiotherapist Note Subjective: Patient reports an overall 30% improvement in left knee pain since the last session, specifically noting reduced stiffness in the mornings. However, she experienced a slight setback yesterday after gardening for an extended period, leading to a dull ache (4/10 intensity) around the patella, lasting approximately 2 hours. The pain is primarily located anteriorly and medially in the knee. Previously, the pain was sharp (6/10) with stairs, but this has now reduced to a mild discomfort (2/10). She has been consistent with her prescribed exercises. Applying a cold compress after gardening helped to relieve the ache. Objective: Left knee active range of motion (AROM) flexion 130 degrees (increased from 120 degrees), extension 0 degrees (unchanged). Quadriceps strength 4/5 bilaterally (improved from 3/5 on the left). Palpation reveals mild tenderness over the medial patellofemoral ligament, reduced from moderate tenderness previously. Special tests: Negative for meniscal tears (McMurray's, Apley's). Gait analysis shows improved weight-bearing on the left leg with less compensatory sway. Reviewed 'Quad Sets' and 'Straight Leg Raises'; patient demonstrates good form and understands progression. Analysis: Impression - Patellofemoral Pain Syndrome, improving. Patient shows good progress with reduced pain and improved ROM and strength, despite a minor flare-up from activity. Plan: FU 3 weeks Rv Left knee pain, functional ability with stairs and prolonged activity, adherence to exercise programme. Progs Increase repetitions for Quad Sets (3 sets of 15), introduce mini-squats (3 sets of 10) with proper form guidance.