This plan of care translates the evaluation findings into measurable goals, prescribed interventions, and a session schedule. We will revisit and adjust it together as you progress.
Plan period (e.g. "8 weeks"):
Short-Term Goals (2-4 weeks)
Long-Term Goals (8-12 weeks)
[ ] Heat (moist heat / hot pack)
[ ] Cold (cryotherapy / ice pack)
[ ] Therapeutic ultrasound
[ ] Interferential current (IFC)
[ ] Low-level laser therapy
Rationale for selected modalities:
[ ] Soft tissue mobilization
[ ] Instrument-assisted soft tissue mobilization (IASTM)
Regions targeted and grade / approach:
Strengthening, stretching, proprioception, cardiovascular conditioning, and motor control — describe the program with progression principles.
Task-specific drills, return-to-work / sport progressions, ergonomic simulations:
[ ] Pain neuroscience education
[ ] Self-management strategies
Topics, resources, and discussion points:
Home Exercise Prescription (Initial Set)
Initial home program — exercises, sets / reps, frequency, duration:
Precautions & Contraindications
Postoperative weight-bearing status, healing timelines, red flags, modality contraindications:
Re-test schedule (e.g. every 4 weeks):
Objective criteria that signal readiness for discharge from this episode of care:
Patient signature (printed name):
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Physical therapist signature (printed name):
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Your treatment plan is now established. We will track progress against these goals at each re-assessment and adjust the plan to keep you moving forward.