

Patient with 12 weeks history of medial knee pain following a sudden knee twist during football on a sandy beach. Swelling is very mild and no evidence of inflammation. His current problems are occasional dull deep ache during static positions (sitting and standing), medial knee pain during end range flexion but symptoms are not actually limiting the functional activities that much, he been advised to visit you (physiotherapist) for advices and management plan if necessary. Your management for day one may include (it is about decision making here): note you live on a quiet island in the ocean where MRI does not exist.
1-Apply Active/passive ROM test - Assess gluts activity -use functional testing as an outcome measures to come up with a problem list to guide your treatment selection e.g. mobilisation at end range - activation of gluts, quads and hamstring - advice to avoid static knee postures.
2- Apply knee valgus test, McMurray test, Thessaly's test to differentiate between MCL and meniscus origin of symptoms if any positive apply passive modalities e.g. US, Interferential, low-level laser and advice him to limit the knee movement for more 6 weeks.
1-Apply Active/passive ROM test - Assess gluts activity -use functional testing as an outcome measures to come up with a problem list to guide your treatment selection e.g. mobilization at end range - activation of gluts, quads and hamstring - advice to avoid static knee postures.