Patellofemoral Pain – Evidence Based Treatments [Physio Guide]

By dpope2020

July 31, 2024

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Patellofemoral Pain - Evidence Based Treatments [Physio Guide] FPF Show Episode 141

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In today's video we go over Patellofemoral Pain - Evidence Based Treatments [Physio Guide]: FPF Show Episode 141: 

  • 0:00 Introduction
  • 2:43 Patient education
  • 13:21 Does dynamic valgus during movement cause patellofemoral pain or is it as a result of pain?
  • 14:45 Why is "Knee In" bad when squatting?
  • 15:34 Should we correct "abnormal movement" in patients with patellofemoral pain?
  • 23:18 Is strength the magic bullet for patellofemoral pain?
  • 27:14 What types of exercise therapy are effective for patellofemoral pain? (Hip, quad, core, foot & ankle, blood flow restriction)
  • 32:11 Is aerobic exercise effective for patellofemoral pain?
  • 37:28 Activity modification for patellofemoral pain
  • 43:53 Gait re-training for patellofemoral pain
  • 54:18 Is manual therapy helpful for patellofemoral pain?
  • 1:02:24 Other beneficial treatments (taping, orthotics)
  • 1:06:57 What is the BEST treatment for patellofemoral pain?
  • 1:12:04 What is NOT recommended as treatment for patellofemoral pain? (braces, sleeves, modalities, EMG biofeedback, dry needling, manual therapy standalone)

Super knee caps...

- Dan Pope DPT,OCS,CSCS

Show Notes / Relevant Articles:

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Dan Pope DPT, OCS, CSCS

References: 

  1. Patellofemoral Pain Richard W. Willy, Lisa T. Hoglund, Christian J. Barton, Lori A. Bolgla, David A. Scalzitti, David S. Logerstedt, Andrew D. Lynch, Lynn Snyder-Mackler, and Christine M. McDonough Journal of Orthopaedic & Sports Physical Therapy 2019 49:9, CPG1-CPG95

  2. Winters M, Holden S, Lura CB, Welton NJ, Caldwell DM, Vicenzino BT, Weir A, Rathleff MS. Comparative effectiveness of treatments for patellofemoral pain: a living systematic review with network meta-analysis. Br J Sports Med. 2020 Oct 26;55(7):369–77. doi: 10.1136/bjsports-2020-102819. Epub ahead of print. PMID: 33106251; PMCID: PMC7982922.

  3. Rathleff - Patient Education, Exercises and Activity Modifications: http://www.drlanderson.com/pdf/anterior-knee-pain-for-adolescents-protocol.pdf

  4. Current Concepts and Treatment of Patellofemoral Compressive Issues IJSPT 2016 https://www.ncbi.nlm.nih.gov/pubmed/27904792

  5. Dolak KL, , Silkman C, , Medina McKeon J, , Hosey RG, , Lattermann C, , Uhl TL. and Hip strengthening prior to functional exercises reduces pain sooner than quadriceps strengthening in females with patellofemoral pain syndrome: a randomized clinical trial. J Orthop Sports Phys Ther. 2011; 41: 560– 570. https://doi.org/10.2519/jospt.2011.3499

  6. Nunes GS, de Oliveira J, Iacob GS, Signori LU, Diel AP, Schreiner R, Solner MW. Effectiveness of Interventions Aimed at Changing Movement Patterns in People With Patellofemoral Pain: A Systematic Review With Network Meta-analysis. J Orthop Sports Phys Ther. 2023 Dec;53(12):1-13. doi: 10.2519/jospt.2023.11956. PMID: 37707784.

  7. Hansen R, Brushøj C, Rathleff MS, Magnusson SP, Henriksen M. Quadriceps or hip exercises for patellofemoral pain? A randomised controlled equivalence trial. Br J Sports Med. 2023 Oct;57(20):1287-1294. doi: 10.1136/bjsports-2022-106197. Epub 2023 May 3. PMID: 37137673.

  8. Rethman KK, Mansfield CJ, Moeller J, De Oliveira Silva D, Stephens JA, Di Stasi S, Briggs MS. Kinesiophobia Is Associated With Poor Function and Modifiable Through Interventions in People With Patellofemoral Pain: A Systematic Review With Individual Participant Data Correlation Meta-Analysis. Phys Ther. 2023 Sep 1;103(9):pzad074. doi: 10.1093/ptj/pzad074. PMID: 37354454; PMCID: PMC10517194.

  9. Kamel AM, Ghuiba K, Abd Allah DS, Fayaz NA, Abdelkader NA. Effect of adding short foot exercise to hip and knee focused exercises in treatment of patients with patellofemoral pain syndrome: a randomized controlled trial. J Orthop Surg Res. 2024 Apr 1;19(1):207. doi: 10.1186/s13018-024-04688-x. PMID: 38561773; PMCID: PMC10983661.

  10. Kim HJ, Cho J, Lee S. Talonavicular joint mobilization and foot core strengthening in patellofemoral pain syndrome: a single-blind, three-armed randomized controlled trial. BMC Musculoskelet Disord. 2022 Feb 15;23(1):150. doi: 10.1186/s12891-022-05099-x. PMID: 35168620; PMCID: PMC8845242.

  11. Constantinou A, Mamais I, Papathanasiou G, Lamnisos D, Stasinopoulos D. Comparing hip and knee focused exercises versus hip and knee focused exercises with the use of blood flow restriction training in adults with patellofemoral pain. Eur J Phys Rehabil Med. 2022 Apr;58(2):225-235. doi: 10.23736/S1973-9087.22.06691-6. Epub 2022 Jan 5. PMID: 34985237; PMCID: PMC9980495.

  12. Moyano FR, Valenza MC, Martin LM, Caballero YC, Gonzalez-Jimenez E, Demet GV. Effectiveness of different exercises and stretching physiotherapy on pain and movement in patellofemoral pain syndrome: a randomized controlled trial. Clin Rehabil. 2013 May;27(5):409-17. doi: 10.1177/0269215512459277. Epub 2012 Oct 4. PMID: 23036842.

  13. Eckenrode BJ, Kietrys DM, Parrott JS. Effectiveness of Manual Therapy for Pain and Self-reported Function in Individuals With Patellofemoral Pain: Systematic Review and Meta-analysis. J Orthop Sports Phys Ther. 2018 May;48(5):358-371. doi: 10.2519/jospt.2018.7243. Epub 2018 Jan 6. PMID: 29308698.

  14. Sanchis, G.J.B., Nascimento, J.A.S., Santana, R.C. et al. Biomechanical factors associated with patellofemoral pain in children and adolescents. Sci Rep 14, 15490 (2024). https://doi.org/10.1038/s41598-024-64394-w

  15. de Souza Júnior JR, Rabelo PHR, Lemos TV, Esculier JF, Barbosa GMP, Matheus JPC. Effects of two gait retraining programs on pain, function, and lower limb kinematics in runners with patellofemoral pain: A randomized controlled trial. PLoS One. 2024 Jan 10;19(1):e0295645. doi: 10.1371/journal.pone.0295645. PMID: 38198492; PMCID: PMC10781021.