KNEE-REHAB

SELF-ASSESSMENT CHECKLIST

Level Of Injury
Type Of Knee Pain
Strength Mobility And Balance Assessments

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 Level Of Injury - PAIN SCALE

- Stop running: if pain level over 3/10 with daily activities (walking, stairs, etc.).
- Moderate to sever pain = Stop running and see your health care practitioner.
- Pain wakes you up at night = Stop running and see your health care
practitioner.

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 Level Of Injury - FUCTIONAL IMPAIRMENT
How much can you do?

- Minimal activity: knee pain stops you from doing daily activities like walking.
Stop running. Get your knee checked out by doctor or physical therapist.
- Moderate activity: knee pain stops you from jogging. Stop running.
- Maximal activity: knee pain stops you from running or playing sports. Can
run short distances.

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 Level Of Injury IRRITABILITY
How pissed off is the knee?

- Minimal irritability: Can tolerate a lot of activity. Pain settles down with short
periods of rest. Can run short distance.
- Moderate irritability: Can tolerate moderate activity with moderate pain
levels. Need longer rest periods for pain to settle down. Stop running.
- Maximal irritability: Minimal activity causes severe pain and takes a long time
to settle down. Stop Running. Get your knee checked out by doctor or
physical therapist.

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Type Of Knee Pain
Patellofemoral Pain Syndrome (PFPS)
Where's the Pain? Symptoms
-Pain in front of the knee, along the
kneecap, back of the knee or behind the
kneecap. The main area of pain is front of
the kneecap.
- Clicking, popping, catching or grinding
sensation around and under the kneecap.
- The knee gives out or buckles because of
pain and weakness.
- Swelling, painful to touch, burning and
ache.
- Very sore or tender to touch along the
inner, outer or lower border of the
kneecap.
- Pain came on gradually over a course of
weeks or months.

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 Activities Causing Pain
- Sitting for a long time movie goers sign and when you first stand
up.
- Squatting or lunges which put a lot of pressure on the joint.
- Going up and down stairs or hills.
- With repetitive impact or load bearing activities like walking,
running or jumping.

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 Assessment - Pain With
These Tests

- Single leg squat = have pain along the

kneecap.
- There are painful spots when you press
down along the border of the kneecap.
- Hopping on one leg for 30-60 seconds.

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Patellar Tendinosis
Where's the Pain?

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 Symptoms

- Patellar tendinosis can cause pain along the length of the patellar tendon.
Though pain can be anywhere along the tendon, the most common location is
the attachment site of the tendon just below the kneecap and less common at
the attachment site of the tendon on the shin (tibia).
- There is often complain of stiffness and pain in the front of the knee, which
comes with start of run, gets better once the tissue is warmed up and often gets
stiff and sore after the run.
- As the problem gets worst, pain and stiffness can be present during the run
too. In more severe and chronic cases even simpler day to day activities like
going up and down steps, walking and sit to stand can be painful.
- Often there are cracking and popping sounds with bending and
straightening of the knee.
- Stiffness and pain with movement after resting for a while. i.e. Standing up
and walking after sitting for a while is painful.
- The tendon can be swollen, thickened and very sore to touch. Patients often
present with both patellar tendinosis and PFPS.

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 Activities Causing Pain

- Cutting.
- Jumping.
- Running.
- Going up / down stairs.
- Kicking.
- Kneeling.
- Squatting.

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 Assessment - Pain With These
Tests

- Single leg squat = pain along the

tendon especially at the attachment site
just below the kneecap.
- Press down on the bottom of the
kneecap at the attachment of the patellar
tendon to see if there is tenderness.
- Hopping on one leg for 30-60 seconds.

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Iliotibial Band Syndrome (ITBS)
Where's the Pain?

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 Symptoms

- Swelling, thickening, stabbing or sharp pain, ache and burning along the
outside of the knee. Often its hard to point a specific area of pain and people
point to the whole outside of the knee.
- Though less common, patients also report clicking or snapping sounds with
bending and straightening of the knee, especially while walking or running.
- Symptoms usually start few minutes into the run and at the end of the run.
However, the symptoms start early and can continue throughout the run. In
severe cases, there is sharp or burning pain which can last after just a small
amount of walking.
- Can be tender to touch along the outside of the knee and even all the way
up the outer thigh to the hip. With chronic irritation the iliotibial band can get
thickening and swelling.
- Pain started over a course of few days or on a specific day after running or
bicycling.

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 Activities Causing Pain

- Sitting for long periods with the knee bent can cause pain and stiffness.
- Running, specially hill running.
- Walking up or down steps, but worst going down steps.
- Long running stride.
- Excessive running on a sloped or crowned surface can create the injury.
Running only on one side of the road will trigger it as well.

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 Assessment - Pain With These Tests

- Press down on the bottom portion of the iliotibial band along the outside of
the knee joint and 2-3 centimeters above the joint. Often tender, swollen and
thickened.

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Quadriceps Tendinosis
Where's the Pain?

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 Symptoms

- Pain is felt in the area at the bottom of the thigh, just above the kneecap.
- Symptoms include stiffness, ache, weakness and giving out. Usually
symptoms develop slowly and are worst with higher level activities.
- Often there is swelling and thickening around the quadriceps tendon and the
stiffness is worst with long periods of rest, inactivity or when you first get up in
the morning. The tendon is sensitive or sore to touch.
- Pain and stiffness is often felt when you first start running which settles
down once the tendon warms up, but can return after the run.

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 Activities Causing Pain

- Cutting.
- Jumping.
- Running.
- Going up / down stairs.
- Kicking.
- Kneeling.
- Squatting.

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 Assessment - Pain With
These Tests

- Single leg squat = pain along the

tendon especially at the attachment site
just above the kneecap.
- Press down on the upper part of the
kneecap at the attachment of the
quadriceps tendon to see if there is
tenderness.
- Hopping on one leg for 30-60 seconds.

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 Need to see your health care practitioner if:

Knee pain is not caused by specific activities, movements or positions, or you

had a serious injury and are suffering from severe pain.

- Pain during the night.

- Unexplained weight loss within past six months.
- Pain even when you are resting.
- No change in your pain in past 6-8 weeks
- Bowel or bladder changes.
- Fever or infection.
- Changing positions doesnt help the pain or cant find a comfortable position
to relieve your pain.
- Radiating pain coming from the low back or hip - knee pain can be referred
from your low back or hip.
- Numbness or tingling in the leg or foot.
- Have a stress fracture or complete fracture.

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Strength Mobility And Balance Assessment

Full Squat With Arms Overhead

WHAT ARE YOU TESTING? - Hip, knee, ankle,

shoulder mobility and strength.

GOAL/PASS - Full squat with arms overhead.

ERROR/FAIL - Heels come up, foot turns out,
foot shin and knee not aligned, arms flare out.

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 Single Leg Balance

WHAT ARE YOU TESTING? - Balance,

core, hip, leg and ankle strength.

GOAL/PASS - Single leg balance for 60

seconds.

ERROR/FAIL - Poor torso, pelvis,

leg/foot alignment. Unable to hold for 60
seconds.

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 Single Leg Squat or Pistol
Squat

WHAT ARE YOU TESTING? - Core, hip,

leg and ankle balance, strength and
mobility.

GOAL/PASS - Full one leg squat.

ERROR/FAIL - Unable to do full one leg

squat.

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 Bridgning With Single Leg Lift

WHAT ARE YOU TESTING? - Core

stability and hip strength.

GOAL/PASS - Single leg bridge with

good pelvis and hip alignment for 30
seconds.

ERROR/FAIL - Pelvis drop, hamstring

and low back cramping, unable to hold for
30 seconds.

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 Functional Lunge Position

WHAT ARE YOU TESTING? - Ankle

mobility.

GOAL/PASS - Foot flat, knee touching

the wall.

ERROR/FAIL - Heel comes up, foot turns

out and unable to touch the wall with the
knee.

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 FABER Test

WHAT ARE YOU TESTING? - Hip

mobility - being able to cross one leg over
other.

GOAL/PASS - Able to cross leg keeping

pelvis leveled.

ERROR/FAIL - Pelvis lifts up, pain in hip

or back.

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 Thomas Test

WHAT ARE YOU TESTING? - Hip flexor

and hip joint mobility.

GOAL/PASS - Low back flat and thigh

parallel to ground.

ERROR/FAIL - Low back arched, thigh

lifts up or rolls out.

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 Functional Push Up Plus

WHAT ARE YOU TESTING?

- Functional Push Up Plus.

GOAL/PASS - Hold pushup-plus

position 60 seconds.

ERROR/FAIL - Low back arched,

poor torso alignment, unable to hold
for 60 seconds.

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 Knee Extension Range Of
Motion

WHAT ARE YOU TESTING?

- Straighten knee fully.

GOAL/PASS - Straighten knee

completely and lift heel off ground.

ERROR/FAIL - Unable to straighten

knee, or heel stays on the ground.

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 Hamstring Mobility

WHAT ARE YOU TESTING?

- Hamstring mobility.

GOAL/PASS - Lift leg up to 90

degrees.

ERROR/FAIL - Unable to keep knee

straight and lift leg to 90 degrees.

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 Seated Trunk Rotation

WHAT ARE YOU TESTING? - Torso

mobility - spine and ribcage mobility.

GOAL/PASS - Rotate torso

comfortably and equal on both sides.

ERROR/FAIL - Stiff and unable to

rotate torso equally.

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