A 16 yo ♀ competitive volleyball player with a 2-yr h/o inte…
A 16 yo ♀ competitive volleyball player with a 2-yr h/o intermittent anterior R knee pain and swelling is referred to PT for evaluation and management. 6 wks ago, she had a fat pad debridement surgery and has been going to PT sessions since then at another PT clinic. Each time she returns to volleyball, her pain and swelling returns. The activities required for volleyball include running, cutting, jumping, and pivoting; each of these increases her pain. During the 2 yr prior to surgery, her pain was in the medial aspect of her knee. However since surgery, she experiences pain on both the medial and lateral sides of the knee. In the last 4 weeks, she has been experiencing pain and swelling similar to what she had prior to surgery. With either an increase in practice or game frequency, the anterior knee pain increases to an 8/10 from a baseline of 1/10 on VAS. With 2-3 days rest, her pain and swelling are eliminated. She has tried multiple interventions, e.g. ice, heat, compression, OTC NSAIDs, which provide short duration symptomatic relief and are only effective if she is not playing volleyball. Although she has been in ‘formal’ PT for the last 6 wks, her sx have not been reduced. Her goal is to return to volleyball symptom-free, now that the season has started. Her MD (ortho) has not placed any restrictions on her activity. Generate 3 differential hypotheses stating specifically the information that was listed in the subjective that led you toward this hypothesis?