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					Shawn Hanlon
Dr.Sterner
Case Study Abstract
1/27/11

         Objective: This case study will examine the pathomechanics, predispositions and management
of Patellofemoral Pain Syndrome otherwise known as runner’s knee. Background: A twenty year old
Track and Field athlete entered the athletic training facility after running one hundred meter sprints. The
athlete complained of sharp pain on the medial aspect of the knee forcing him to stop his sprint. He was
soon after unable to lightly jog due to overwhelming pain. He graded his pain a 9/10 when jogging, and
presented no pain with stairs. There was no presence of swelling or discoloration. He exhibited full
active and passive range of motion. He also displayed full strength in all planes. Upon further evaluation
he presented point tenderness vastus medialis muscle belly and showed no point tenderness over the
patella, femoral condyles, tibial tuberosity, fibular head, gerdy’s tubercle, both menisci, and the medial
and lateral joint line. It was determined that there was no laxity in the knee joint the patient having a
negative Lachman’s Test, Valgus and Varus Stress Tests, Posterior Drawer, Anterior Drawer. Also there
was no evidence of a meniscal tear by the performance of a negative Mcmurray’s test and Bounce
Home. On November 30th, 2010 the impression given was a Grade 1 Vastus Medialis Strain. Being able to
participate with no limitations and after rehabilitating the injury minimally for over a month, now early
January, the athlete has developed Pes Anserine Bursitis and associated patellofermoral pain syndrome.
Differential Diagnosis: At the time of first injury, Suprapatellar Tendinitis could present similar
symptoms. After still being symptomatic for a month and developing Pes Anserine Bursitis, A gracillis or
adductor strain, or patellar tendinitis could be considered due to the compensatory gait patterns he has
been using since the first injury. Treatment: Strecthing of the hamstrings, quadriceps, hip abductors
and hip external rotators. Strengthening of the quadriceps, hip adductors, and hip internal and external
rotators. Lumbosacral and thoracolumbar strengthening and stabilization are very important as well.
Also correcting patella maltracking. Using ice and electric stimulation for pain modulation. And using
non-impact cardiovascular exercise to limit further damage. Uniqueness: The case displays what can
occur with poor management of an acute injury. A quadriceps strain developed into pes anserine
bursitis while subsequently developing patellofemoral pain syndrome. Conclusion: This will provide
reasoning for the development of a chronic pathology and how to manage and correct pathomechanics
of the knee joint for a long distance runner. Keywords: Patellofemoral, pes anserine, runner’s knee,
medial structures.

				
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