This case study is about a fifty-three year old male plumber. He is a volleyball player who has a pain on the right anterior of his knee, during and post activity. On observation around the injured area the right patella is higher than the right and both feet over pronate, on quick touch it is slightly warmer on injured side. It could be a chronic injury because it has bothered the client on and off for the last two months, in terms of previous injuries the client had an ankle inversion sprain nine months ago that was never rehabilitated which could play significance to the injury. On active movements and isometric testing the quadriceps and the rectus femoris flagged up ...view middle of the document...
When he is kneeling and squatting the same type of pain is generated, however it then becomes p2 for several hours after activity, this is high irritability due to the fact it takes hours to subside and is caused from one immediate action. Rest helps p1 immediately, while stretching and icing eases p2 in thirty to sixty minutes. Based on the aggravating and easing factors and the timescales the irritability of the injuries considered to be high because it takes a few hours for pain to subside.
Nature represents your view of the client's condition. The nature is based on three different factors, chemical, mechanical and neurological. Chemical comes and goes and is worse post doing something and is often related to as a dull pain. Mechanical, is often described as hurt when being moved, the client will refer to it is a sharp or stabbing pain. Finally neurological, is a sharp shooting pain and is an irritation of nerves due to compression of a peripheral nerve. In this particular case the nature is mainly mechanical because the client has pain during active flexion of the knee. Nevertheless there is also a chemical nature as the knee is warm on palpation. As for neurological involvement there is not any contribution due to the type of injury and the aggravating factors involved.
A possible injury for this particular case study is patella tendinopathy. It is also called 'jumpers knee' due to its consistency in jumping sports, such as basketball, high jump and volleyball. Patellar tendinopathy is often a resistant and recurrent condition that primarily affects athletes in jumping sports (Purdam and Jonsson et al., 2004, pp. 395--397) .A study by (Khan and Maffulli et al., 1998, pp. 346--355) found that the blood supply has been proven to the contribution of this injury and it is because tendons are not very vascular and therefore receive less amount of blood. Usually it transpires without warning and in older athletes with no previous injuries in that particular area. Another factor that will provoke this type of injury is bending the knee fully at 90 degrees. When the knee is flexed at 90 degrees, thus putting the tendon under tension, tenderness significantly decreases and often disappears altogether (Khan and Maffulli et al., 1998, pp. 346--355)
In terms of working too, as the client's occupation is plumbing often he will be in a position of squatting or kneeling and if he does not work with knee pads on this will only enhance his problem. The main points from the clinical notes that relate to this injury are; age, sport, irritability, location of P1 and the fact the client has never had this injury before in his past medical history. (B Hamilton & C Purdam 2004) state that 53 percent of élite volleyball players all have symptoms of patella tendinopathy ranging from mild to disabling. Key word in that being disabling which highlights the seriousness of this injury if not dealt with correctly, further testing can be...