What is New with Patellofemoral Pain Syndrome (PFPS)

It is research day.

I like research day.

This week I looked at what is new in Journal of Orthopaedic Sports Physical Therapy and International Journal for the Spine.

Patellofemoral Pain Syndrome and the Hip

What they Looked at

It is thought that the hip during weight-bearing activities contributes to patellofemoral pain syndrome.

They looked at knee and hip motion during stair stepping (ascending and descengin) in female athletes with and without PFPS.

What they Found

What they found was females with PFPS descend stairs with the knee in a more flexed position and have the hip in a more adducted and internally rotated position at foot contact during stair stepping at a comfortable speed.

Take Home Message

The take home message is for those with PFPS, their gluteus medius is not working and needs to be addressed.  I go into this in detail in the Core Stability of the Hip program.

Where to get more details – McKenzie K, Galea V, Wessel J, Pierrynowski M. (2010). Lower extremity kinematics of females with patellofemoral pain syndrome while stair stepping. J Orthop Sports Phys Ther. 2010 Oct;40(10):625-32.

How Much does Taping Screw up Muscle Activation?

What they Looked at

They looked at the changes in muscle activity and plantar pressure during running with an augmented low Dye (ALD) tape job.

They had recreational runners run on a treadmill with ALD, control tape and no tape.

What they Found

What they found was an ALD taping significantly altered muscle activity and plantar pressure during treadmill running by delaying the onset of the muscle activation of the gluteus medius, vastus medialis, and vastus lateralis plus increased lateral midfoot plantar pressure.

Take Home Message

An ALD may provide some relief when running but it may not be a long term solution especially with affects on muscles that stabilize the knee and hip.  I go through more in Muscle Imbalances Revealed.

Where to get more details – Kelly LA, Racinais S, Tanner CM, Grantham J, Chalabi H. (2010). Augmented low dye taping changes muscle activation patterns and plantar pressure during treadmill running. J Orthop Sports Phys Ther. 2010 Oct;40(10):648-55.

Do Sedentary Females with PFPS Have Hip Weakness like Athletes?

Hip weakness is common in female athletes with PFPS now is the same true for sedentary females.

What they did was compare the hip strength of sedentary females with either unilateral or bilateral patellofemoral pain syndrome (PFPS) to a control group of sedentary females of similar demographics without PFPS.

What they Looked at

They tested the strength in the six muscle groups (hip abductors, hip adductors, lateral rotators, medial rotators, flexors and extensors) around the hip.

What they Found

The hip muscule strength of sedentary females with bilateral PFPS was statistically weaker by 12%-36% than that of the control group for all muscle groups.

The hip abductors, lateral rotators, flexors, and extensors of the injured side of those with unilateral PFPS group were statistically weaker by 15%-20% than that of the control group, but only the hip abductors were significantly weaker when compared to their uninjured side by 20%.

Take Home Message

Those that are not active and have PFPS need to have hip strengthening added to their exercise program with a focus on hip abduction especially gluteus medius.

Where to get more details – Magalhães E, Fukuda TY, Sacramento SN, Forgas A, Cohen M, Abdalla RJ (2010). A comparison of hip strength between sedentary females with and without patellofemoral pain syndrome. J Orthop Sports Phys Ther. 2010 Oct;40(10):641-7.

All of this stuff is going to be great for my upcoming Exercise Rehabilitation of the Hip course.

I still have some more stuff on platellofemoral pain syndrome, I will get it up soon.

Rick Kaselj, MS

P.S. – If you are looking for a specific exercise program to help you out with your patellofemoral pain sydrome, CLICK HERE.