We treat intractable knee pain on a daily basis. Our process is called the PT Solutions Treatment Hierarchy. The treatment hierarchy allows our team to support the diagnosis, reduce pain, and create a clear home plan. Building a treatment framework is a critical component of the plan and it changes based on the key sign, the structural diagnosis, and the trigger management plan. For example, a person with an anterior horn meniscus lesion, we would first normalize painful end range extension of the knee. Once passive extension is pain free, we would start to load their leg with the activity that normally hurts, providing them an exercise like terminal knee extension with the band that will keep their knee extension pain free. Finally we would dig through all of their daily activities that cause symptoms like fast walking or going downhill and stop them from doing it to allow healing.