Luca B is a 25-year-old factory worker, who works mostly in the standing position. He is an amateur soccer player, playingsoccer 3 times a week. Luca was assessed on the 15th of March,when he presented with an acute antero-lateral pain in his right knee (PaMax), which, in general, he felt when he was walking and runningand, in particular, during knee flexion. Pain intensity varied from a minimum of 1 to a maximum of 7 on the VRS scale and this problemhad been intermittent overthe last four years, presenting at irregular intervals. The pain had beenparticularly acute for one day.
There was also concomitant pain (PA CONC) that referred to the superior region of the sternum bilaterally on forced inspiration. This PA CONC appeared one month ago and varied from a minimum of 1 to a maximum of 3. Most recently it had accentuated 3 days ago. The only PA PREVthat Luca reported was a strain of the right iliopsoas muscle one year ago. This strain had kept himaway from sport for 10 days. No surgery, fractures or internal dysfunctions were reported. From a postural viewpoint he had a mild dorsal kyphosis.
By considering the patient’s history, we can now formulate a hypothesis regarding the origin of the presenting pain, and elaborating a timeline of the appearance of the symptoms can be useful in this phase of the assessment:
GE CX TH
Having defined the timeline of the symptoms, the next step is to select the segments to evaluate. I chose THbilaterally, GE rt and PE rt (the latter was considered because it is the extremity of the limb).
Therefore, movement verification (MoVe) of the selected segments was performed and only the most significative signs were reported. The next step was the palpation verification (PaVe) of the same segments and, once again, the most significant findings were reported on the assessment chart in an attempt to identify an agreement.
By observing the assessment chart, the sagittal plane appeared to be the most altered and, therefore, treatment was carried out on ANTE-TH rt ANTE-TH lt, ANTE-GE rt, ANTE PE rt, starting from AN-GE,which, according to the timeline, was the oldest area.
Having treated all of the points that were taken into consideration, the MoVe was reassessed and the patient referred an improvement of almost 50%, in particular, in the GE segment.
A second treatment was then planned for the following week.