CCA OP Summary sheet Student Name: Miqueias Leone 1. Summary statement or !

atient
Mr. A is a healthy and active 48 year old father of two boys (14 and 16). He is a manager of his own business consulting com any which em loys over !"" eo le. He resented to the #$% in August !"1& with an acute onset of '#( 6 wee)s revious when fle*ing forward+ of sub,acute duration and stable rogression. He -w stiffness to the . low bac) radiating anteriorly into the . thigh re orting low bac) morning stiffness for u to 1" minutes and ins and needles on the anterior . thigh. He is systemically unremar)able. H**/ 1081/ 2iagnosis acute lumbar discal in3ury+ atient uncertain of level. 4rauma laying rugby. 444/ hysiothera y and %steo athy successful !""0/ 2iagnosis . 5H osteo hytic growths. (2#/ tennis laying. $uccessful surgical arthrosco y . 5H. !"11/ 2iagnosis . )nee osterior meniscal tear+ atient uncertain which meniscus. Acute trauma snowboarding with no further intervention or surgery. !"1&-"6/ 2iagnosis . )nee medial meniscal tear on M.6. $ym toms/ originally focal low grade . )nee ain on 7# . '89. 5( advised surgery+ but currently atient re orts no ain only stiffness so does not feel surgery is necessary. 8**/ .oad cycling (since 1"y) on a race bi)e (! * wee) for over 6 hours)+ occasional mountain bi)ing and weight training with sons.

Date: 22/11/2013

2. Summary o dys un"tion

:linical signs and sym toms suggested ca sular inflammation '!-'& s inal levels secondary to a li)ely degeneration of the . H6( leading to mm hy ertonicity of . ilio soas+ . '8$ and . e*ternal rotators of the . H6( (2#/ lumbar discal in3ury (1081) ; reduction in lordosis with hinging on mvt at '!-'&. 6ncreased ronation . foot and . )nee meniscal tear (!"11-!"1&) ; increased force transfer through the . H6(. M<s/ 6ncreased demands cycling for long eriods+ long hours at wor) and des) bound 3ob ; increase hysical stress on s ine and elvis and hi (rogress/ Mr A has im roved and has no '#(+ no altered sensation of . anterior thigh and increased confidence on 7-# . '89. ((7 low grade low bac) stiffness and increased .%M of . H6(. He would li)e to continue treatment once a month to maintain this current state and get further advice on e*ercise and stretching.

3. #reatment and Mana$ement P%an:

4otal number of consultations to date/ = treatments all seen by myself. (recautions/ . medial )nee meniscus tear. $hort term/ .educe ain sym toms in '$( and im rove mobility of 4-' and lower 4s ine with H>4. A**+ 4**+ M84 and circumduction . Hi and $6?. 2ecrease muscle hy ertonicity '8$+ ilio soas and iriforms+ @uadrice s with soft tissue techni@ues. Advice on strengthening e** '89 chain focusing on >M% as well as stretches for lower bac) s ine Medium-long term/ 'onger term treatments is aimed at encouraging Mr A to )ee u with e*ercises given and erha s show more advanced ones once he feels re ared for it. 5lobal 444 including H>4 and A** to '-$+ :-4 and %-A 3unction in case there is a decrease in .%M due to changes occurred on . '89 chain.