The patient is a 62-year-old teacher who spends a lot of time standing and walking around as part of her job. Since 6 months ago, she has been suffering chronic knee pain aggravated by prolonged standing and walking. Patient has no history of traumatic knee injury but has reported occasional knee discomfort in the past. When she had a physical a few years back, the X-ray results showed mild degeneration in the patellofemoral joint consistent with early osteoarthritic changes.
The patient reports a pain of 5 to 6 during prolonged standing, which may sometimes increase to a 6 to 7 out of 10 after a long day of standing. The pain is achy and focused around the patella. Her range of motion is unremarkable, but has mild discomfort in knee flexion. Upon palpation, there is tenderness around the patella and quadriceps tendons. There is slight swelling both on the right and left side. Mild knee valgus can be observed during standing and walking, likely due to muscle fatigue and weakness in stabilizers.
After the second weekly treatment, the patient noted some reduction in pain, now going down to a 3 to 4 out of 10. She was able to teach for about 2 hours before starting to feel the pain. She noted a temporary reduction in pain following each session, with less tightness around the knee joint, but mentioned that it did come back after a couple days. Patient was convinced to come in biweekly instead of on a weekly basis. After another two weeks in treatment, pain was further reduced, and this time the swelling seemed to have resolved. Her gait was noticeably more stable. And after another week she was discharged.