Strengthening to help decrease patellofemoral knee pain

knee pain

Read here for research on patellofemoral pain

Patellofemoral pain syndrome (PFPS) is one of the most commonly reported injuries in sports medicine, especially with runners. With PFPS, pain occurs behind or around the kneecap. It gets worse with squatting, prolonged sitting and stair climbing. Treatment typically consists of physical therapy, with a focus on exercises that strengthen the quadriceps muscles. This treatment is commonly used, but there is not much evidence to support its effectiveness. The last review of studies on the topic was in 2003. It only found little evidence that exercises were effective for PFPS. An updated review of the available literature-known as a systematic review-was conducted. The goal was to determine the true effectiveness of quadriceps-strengthening exercises for PFPS patients.

Finding research on patellofemoral pain

To conduct the review, researchers performed a search of three major medical databases. They were specifically looking for high-quality studies called randomized-controlled trials (RCTs) that evaluated the effects of quadriceps-strengthening exercises for PFPS. RCTs randomly assign patients to various treatment groups. They are the gold standard for determining whether an intervention works or not. This search led to seven RCTs being included. Three RCTs on 204 participants investigated quadriceps-strengthening exercises alone. Five RCTs on 422 participants investigated quadriceps-strengthening exercises combined with other interventions. The researchers reviewed the findings of these RCTs and compared them to one another. The quality of all included studies was also assessed in order to gauge how reliable their results were.

Does quadriceps-strengthening work for patellofemoral pain?

On the whole, results were supportive of quadriceps-strengthening exercises for PFPS patients. This was true whether exercises were used alone or when combined with other exercises. The exercises were more effective for reducing pain and improving function, than when the patient received advice and information alone. When combined with other interventions, they were found to reduce pain for up to 12 months. The other interventions included hip strengthening, stretching, kneecap taping and home exercises. However, this treatment did not appear to improve function. This lack of improvement may be due to patients self-reporting their function scores, which has a margin for error. Nonetheless, the findings of this systematic review clearly show that quadriceps-strengthening exercises are beneficial to individuals with PFPS, whether used on their own or combined with other interventions. Based on this study, patients who currently have patellofemoral pain should think about seeing a physical therapist. A treatment program including quadriceps-strengthening exercise can help them to improve quickly and safely.

-As reported in the June ’14 issue of JOSPT


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