Abstract
Patellofemoral pain syndrome (PFPS) is one of the most common lower extremity conditions seen in orthopedic practice. The source of PFPS is believed to be multifactorial. Although PFPS is recognized as one of the most common lower extremity disorders encountered in the general population, its etiology and treatment remains controversial. This chapter discusses the efficacy of differing physiotherapy interventions with consideration for proximal, local, and distal factors, taping or bracing, and quadriceps muscle strengthening for PFPS treatment.
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Arroll B, Ellis-Pegler E, Edwards A, Sutcliffe G (1997) Patellofemoral pain syndrome. A critical review of the clinical trials on nonoperative therapy. Am J Sports Med 25:207–212
Balci P, Tunay VB, Baltaci G, Atay AO (2009) The effects of two different closed kinetic chain exercises on muscle strength and proprioception in patients with patellofemoral pain syndrome. Acta Orthop Traumatol Turc 43(5):419–425
Barton CJ, Levinger P, Menz HB, Webster KE (2009) Kinematic gait characteristics associated with patellofemoral pain syndrome: a systematic review. Gait Posture 30:405–416
Barton CJ, Menz HB, Crossley KM (2011) Effects of prefabricated foot orthoses on pain and function in individuals with patellofemoral pain syndrome: a cohort study. Phys Ther Sport 12(2):70–75
Barton C, Levinger P, Crossley K, Webster K, Menz H (2012) The relationship between rearfoot, tibial, and femoral kinematics in individuals with patellofemoral pain syndrome. J Orthop Sports Phys Ther 42:A32
Boldt AR, Willson JD, Barrios JA, Kernozek TW (2013) Effects of medially wedged foot orthoses on knee and hip joint running mechanics in females with and without patellofemoral pain syndrome. J Appl Biomech 29(1):68–77
Boling MC, Bolgla LA, Mattacola CG, Uhl TL, Hosey RG (2006) Outcomes of a weight-bearing rehabilitation program for patients diagnosed with patellofemoral pain syndrome. Arch Phys Med Rehabil 87:1428–1435
Callaghan MJ (2011) What does proprioception testing tell us about patellofemoral pain? Man Ther 16(1):46–47
Callaghan MJ, McKie S, Richardson P, Oldham JA (2012) Effects of patellar taping on brain activity during knee joint proprioception tests using functional magnetic resonance imaging. Phys Ther 92(6):821–830
Cerny K (1995) Vastus medialis oblique/vastus lateralis muscle activity ratios for selected exercises in persons with and without patellofemoral pain syndrome. Phys Ther 75:672–683
Clark DI, Downing N, Mitchell J, Coulson L, Syzpryt EP, Doherty M (2000) Physiotherapy for anterior knee pain: a randomised controlled trial. Ann Rheum Dis 59:700–704
Collins N, Crossley K, Beller E, Darnell R, McPoil T, Vicenzino B (2009) Foot orthoses and physiotherapy in the treatment of patellofemoral pain syndrome: randomised clinical trial. Br J Sports Med 43(3):169–171
Cowan SM, Bennell KL, Hodges PW, Crossley KM, McConnell J (2001) Delayed onset of electromyographic activity of vastus lateralis compared to vastus medialis obliquus in subjects with patellofemoral pain syndrome. Arch Phys Med Rehabil 82:183–189
Derasari A, Brindle TJ, Alter KE, Sheehan FT (2010) McConnell taping shifts the patella inferiorly in patients with patellofemoral pain: a dynamic magnetic resonance imaging study. Phys Ther 90:411–419
Doucette SA, Child DP (1996) The effect of open and closed chain exercise and knee joint position on patellar tracking in lateral compression syndrome. J Orthop Sports Phys Ther 23:104–110
Doucette SA, Goble EM (1992) The effect of exercise on patellar tracking in lateral patellar compression syndrome. Am J Sports Med 20:434–440
Dvir Z, Halperin N, Shklar A, Robinson D, Weissman I, Ben-Shosan I (1990) Concentric and eccentric torque variations of the quadriceps femoris in patello-femoral pain syndrome. Clin Biomech 5:68–72
Dvir Z, Halperin N, Shklar A, Robinson D (1991) Quadriceps function and patellofemoral pain syndrome. Part I: pain provocation during concentric and eccentric isokinetic activity. Isokinet Exerc Sci 11:26–30
Eburne J, Bannister G (1996) The McConnell regimen versus isometric quadriceps exercises in the management of anterior knee pain. A randomised prospective controlled trial. Knee 3:151–153
Grelsamer RP, Klein JR (1998) The biomechanics of the patellofemoral joint. J Orthop Sports Phys Ther 28:286–298
Hazneci B, Yildiz Y, Sekir U, Aydin T, Kalyon TA (2005) Efficacy of isokinetic exercise on joint position sense and muscle strength in patellofemoral pain syndrome. Am J Phys Med Rehabil 84:521–527
Herrington L, Al-Sherhi A (2007) A controlled trial of weight-bearing versus non-weight-bearing exercises for patellofemoral pain. J Orthop Phys Ther 37:155–160
Iverson CA, Sutlive TG, Crowell MS, Morrell RL, Perkins MW, Garber MB et al (2008) Lumbopelvic manipulation for the treatment of patients with patellofemoral pain syndrome: development of a clinical prediction rule. J Orthop Sports Phys Ther 38:297–309
Kaya D, Atay OA, Callaghan MJ, Cil A, Caglar O, Citaker S, Yuksel I, Doral MN (2009) Hallux valgus in patients with patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc 17:1364–1367
Kaya D, Yüksel I, Callaghan MJ, Güney H, Atay OA, Çıtaker S, Huri G, Bilge O, Doral MN (2013) High voltage pulsed galvanic stimulation adjunct to rehabilitation program for patellofemoral pain syndrome: a prospective randomized controlled trial. Turk J Physiother Rehabil 24(1):1–8
Lee SP, Souza RB, Powers CM (2012) The influence of hip abductor muscle performance on dynamic postural stability in females with patellofemoral pain. Gait Posture 36(3):425–429
Lieb FJ, Perry J (1971) Quadriceps function: an electromyographic study under isometric conditions. J Bone Joint Surg Am 53:749–758
Malone TR, Davies GJ, Walsh WM (2002) Muscular control of the patella. Clin Sports Med 21:349–362
Mason JJ, Leszko F, Johnson T, Komistek RD (2008) Patellofemoral joint forces. J Biomech 41:2337–2348
Matthews LS, Sonstegard DA, Henke JA (1977) Load bearing characteristics of the patello-femoral joint. Acta Orthop Scand 48:511–516
McConnell J (1996) Management of patellofemoral problems. Man Ther 1:60–66
McConnell J, Fulkerson J (1996) The knee: patellofemoral and soft tissue injuries. In: Zachazewski JE, Magee DJ, Quillen WS (eds) Athletic injuries and rehabilitation, 1st edn. W.B. Saunders, Philadelphia, pp 693–728
McMullen W, Roncarati A, Koval P (1990) Static and isokinetic treatments of the chondromalacia patella: a comparative investigation. J Orthop Sports Phys Ther 12:256–266
Meira EP, Brumitt J (2011) Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports Health 3(5):455–465
Miller JP, Croce RV (2007) Analysis of isokinetic and closed chain movements for hamstring reciprocal coactivation. J Sport Rehabil 16:319–325
Möller BN, Krebs B, Tideman-Dal C, Aaris K (1986) Isometric contractions in the patellofemoral pain syndrome: an electromyographic study. Arch Orthop Trauma Surg 105:24–27
Munuera PV, Mazoteras-Pardo R (2011) Benefits of custom-made foot orthoses in treating patellofemoral pain. Prosthetics Orthot Int 35(4):342–349
Naslund JE, Odenbring S, Naslund UB, Lundeberg T (2005) Diffusely increased bone scintigraphic uptake in patellofemoral pain syndrome. Br J Sports Med 39:162–165
Nordin M, Frankel V (1989) Basic biomechanics of the musculoskeletal system. Lippincott Williams & Wilkins, London
Post MD, Fulkerson MD (1994) Knee pain diagrams: correlation with physical examination findings in patients with anterior knee pain. Arthroscopy 10:618–623
Powers CM (2010) The influence of abnormal hip mechanics on knee injury: a biomechanical perspective. J Orthop Sports Phys Ther 40:42–51
Powers CM, Bolgla LA, Callaghan MJ, Collins N, Sheehan FT (2012) Patellofemoral pain: proximal, distal, and local factors, 2nd international research retreat. J Orthop Sports Phys Ther 42(6):A1–A54
Roush MB, Sevier TL, Wilson JK, Jenkinson DM, Helfst RH, Gehlsen GM, Al B (2000) Anterior knee pain: a clinical comparison of rehabilitation methods. Clin J Sports Med 10:22–28
Shelton GL, Thigpen LK (1991) Rehabilitation of patellofemoral dysfunction: a review of the literature. J Orthop Sports Phys Ther 14:243–249
Souza RB, Draper CE, Fredericson M, Powers CM (2010) Femur rotation and patellofemoral joint kinematics: a weight-bearing magnetic resonance imaging analysis. J Orthop Sports Phys Ther 40:277–285
Steinkamp LA, Dillingham MF, Markel MD, Hill JA, Kaufman KR (1993) Biomechanical considerations in patellofemoral joint rehabilitation. Am J Sports Med 21:438–444
Stiene HA, Brosky T, Reinking MF, Nyland J, Mason MB (1996) A comparison of closed kinetic chain and isokinetic joint isolation exercise in patients with patellofemoral dysfunction. J Orthop Sports Phys Ther 24:136–141
Suter E, McMorland G, Herzog W, Bray R (1999) Decrease in quadriceps inhibition after sacroiliac joint manipulation in patients with anterior knee pain. J Manip Physiol Ther 22:149–153
Syme G, Rowe P, Martin D, Daly G (2009) Disability in patients with chronic patellofemoral pain syndrome: a randomised controlled trial of VMO selective training versus general quadriceps strengthening. Man Ther 14(3):252–263
Tang SF, Chen CK, Hsu R, Chou SW, Hong WH, Lew HL (2001) Vastus medialis obliquus and vastus lateralis activity in open and closed kinetic chain exercises in patients with patellofemoral pain syndrome: an electromyographic study. Arch Phys Med Rehabil 82:1441–1445
Thomeé R (1997) A comprehensive treatment approach for patellofemoral pain syndrome in young women. Phys Ther 77:1690–1703
Thomeë R, Renstrom P, Karlsson J, Grimby G (1995) Patellofemoral pain syndrome in young women, II: muscle function in patients and healthy controls. Scand J Med Sci Sports 5:245–251
Tiberio D (1987) The effect of excessive subtalar joint pronation on patellofemoral joint mechanics: a theoretical model. J Orthop Sports Phys Ther 9:160–169
Warden SJ, Hinman RS, Watson MA Jr, Avin KG, Bialocerkowski AE, Crossley KM (2008) Patellar taping and bracing for the treatment of chronic knee pain: a systematic review and meta-analysis. Arthritis Rheum 59:73–83
Werner S, Eriksson E (1993) Isokinetic quadriceps training in patients with patellofemoral pain. Knee Surg Sports Traumatol Arthrosc 1:162–168
Witvrouw E, Lysens R, Bellemans J, Peers K, Vanderstraeten G (2000) Open versus closed kinetic chain exercises for patellofemoral pain. A prospective, randomized study. Am J Sports Med 28:687–694
Witvrouw E, Danneels L, Van Tiggelen D, Willems TM, Cambier D (2004) Open versus closed kinetic chain exercises in patellofemoral pain: a 5-year prospective randomized study. Am J Sports Med 32:1122–1130
Yosmaoglu HB, Kaya D, Guney H, Nyland J, Baltaci G, Yuksel I, Doral MN (2013) Is there a relationship between tracking ability, joint position sense, and functional level in patellofemoral pain syndrome? Knee Surg Sports Traumatol Arthrosc 21:2564–2571
Acknowledgments
Authors would like to thank Prof. Inci Yuksel, PT, PhD, and Yigitcan Karanfil, MD, for taking photographs.
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Kaya, D., Nyland, J., Callaghan, M.J., Doral, M.N. (2013). Physiotherapy in Patellofemoral Pain Syndrome. In: Doral, M., Karlsson, J. (eds) Sports Injuries. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-36801-1_122-1
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DOI: https://doi.org/10.1007/978-3-642-36801-1_122-1
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