|
Subjective
|
|
|
History
|
Pain at worst
/
|
|
Pain at Best
/
|
Edema
• • •
|
|
Increased Pain
• • •
|
|
|
Objective
|
|
|
ROM Hip flexion LEFT
|
ROM Hip flexion RIGHT
|
|
ROM Hip extension LEFT
|
ROM Hip extension RIGHT
|
|
ROM Hip abduction LEFT
|
ROM Hip abduction RIGHT
|
|
ROM Hip IR LEFT
|
ROM Hip IR RIGHT
|
|
ROM Hip ER LEFT
|
ROM Hip ER RIGHT
|
|
Strength Hip Flexion LEFT
|
Strength hip flexion RIGHT
|
|
Strength hip extension LEFT
|
Strength hip extension RIGHT
|
|
Strength Hip abduction LEFT
|
Strength Hip abduction RIGHT
|
|
Strength Adduction LEFT
|
Strength Hip adduction RIGHT
|
|
Strength hip IR LEFT
|
Strength hip IR RIGHT
|
|
Strength ER LEFT
|
Strength ER RIGHT
|
|
Palpation
• • •
|
Special Tests
• • •
|
|
Objective Notes
|
|
|
Assessment:
|
|
|
Assessment
|
Rehab Potential
• • •
|
|
Goal 1
|
Goal 2
|
|
Goal 3
|
Goal 4
|
|
Plan
|
Treatment Plan
|
|
Treatment Duration
• • •
|
Treatment Frequency
• • •
|
|
Today's STM
• • •
|
Today's Joint mobilizations
• • •
|
|
Manual Therapy
|
Self Care / pain management
|
|
Exercises
|
HEP
|
