week 4 reflection 3

I had a patient today with bilateral patello-femoral pain. Her knees sat so laterally...to the point where, on a lateral glide, her patella clunked over the trochlea and essentially dislocates....and her medial glide was nil. We decided that the cause of her problem was insanely tight lateral quads and ITB and under active VMO. Part of my treatment included trigger point release of the lateral quads and DTM of ITB. Her trigger points were so big and tender that they made her cry. I found it quite difficult at that moment. She obviously wanted me to keep going as she found it gave her up to a months relief from her knee pain...but it was horrible. Looking back, i definitely don't think I pushed as hard a I could have because I didn't want to hurt her...but in the long run, that's not going to be as helpful for her. After the treatment her patella's did sit more centrally so I did help her problem to some degree. The rest of the week was the quietest yet....it's amazing how many people re-schedule when it's raining:)