The Best Exercise for Patellofemoral Pain Syndrome

Before I get to the exercise, I got a few videos for you.

What is the Best Patellofemoral Pain Syndrome Exercise?

What is Patellofemoral Femoral Pain Syndrome?

If you are Looking for an Exercise Program to Help you with Patellofemoral Pain Syndrome, check this one out:

What Exercise is Ideal for Clients with Patellofemoral Pain Syndrome due to Muscle Imbalances

Approximately 60% of athletes have patellofemoral pain syndrome (PFPS) sometime in their life, and a long line of research has shown that PFPS is primarily caused by muscle imbalances in the vastus medialis oblique (VMO) and vastus lateralis (VL) muscles.

 

Activation, endurance and strengthening of these muscles is key to PFPS prevention and rehabilitation, but the best exercises for these muscles have not been conclusively determined.
In an effort to help clarify contradictory findings in the exercise science literature on this topic, researchers in the United Kingdom conducted a study designed to test the effect of two closed kinetic chain exercises and one open kinetic chain exercise on VMO and VL muscle activity in healthy individuals.

 

Highlights of the Study

The study’s participants were 11 men and 11 women between the ages of 18 and 40 who were not experiencing any symptoms of PFPS at the time of the study.
Researchers used electromyography (EMG) to measure VMO and VL activity and calculate a VMO:VL ratio while the participants performed three quadriceps-strengthening exercises after a 5-minute indoor cycling warm-up.

 

Other Amazing Stats about Patellofemoral Pain Syndrome

– incident rates in the general population of 25%
– one of the most common injuries in the lower body
– the ratio of VMO:VL should be 1:1 but in people with PFPS it is estimated to be 0.54:1.
– muscle imbalance of VMO:VL leads to a decrease in medial pull leading to patella maltracking

 

Exercises They Tested

The three exercises were:
− double leg squat with isometric hip adduction (pillow between knees)
− open kinetic chain knee extension exercise (sitting on the edge of a table and alternating bodyweight leg extensions)
− lunge exercise (static)

 

Take Home Message

Summing It Up – EMG results showed that the double leg squat and the lunge exercise showed a significantly greater VMO:VL ratio than open-chain knee extension exercise, and the double leg squat produced the largest VMO:VL ratio (1.18:1).
Leg Extension – In contrast, the open-chain knee extension exercise preferentially activated the VL muscle, giving a VMO:VL ratio of 0.72:1.
Men and Women– No significant gender differences were seen on any measurements.
The Lunge – The lunge exercise gave a VMO:VL ratio closest to the theoretical ideal of 1:1 (1.14:1).  The study’s investigators recommend the lunge exercise as the ideal exercise for treating PFPS when correcting VMO/VL imbalances is necessary.
Double Leg Squat with Hip Adduction – The double leg squat with isometric hip adduction is ideal for targeted VMO strengthening.

 

Last Word from Rick Kaselj <==  THE PART TO READ

Want to Focus on VMO – Do the double leg squat with isometric hip adduction.
Want to Focus on VL – Do the leg extension exercise.
Key Point to Remember about Leg Extension – Performing open-chain knee extension exercises may not be a good idea for clients with PFPS because it may induce excessive lateral tracking of the patella due to focus on VL.
Want to Balance out VMO & VL – Do the lunge exercise.

 

Where to Get More Information 

Irish SE, Millward AJ, Wride J, Haas BM, Shum GL. (2010). The effect of closed-kinetic chain exercises and open-kinetic chain exercise on the muscle activity of vastus medialis oblique and vastus lateralis. J Strength Cond Res. 2010 May;24(5):1256-62.
 

If you are interest in fitness education course where I go into more detail when it comes to Patellofemoral Pain Syndrome, check out the course, Exercise Rehabilitation of the Knee.

If you would like more information on how much imbalances can lead to Patellofemoral Pain Syndrome, check out Muscle Imbalances Revealed.

Take care.

Rick Kaselj, MS

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