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Gait Retraining as an Intervention for Patellofemoral Pain

  • Non-Operative Management of Anterior Knee Pain (T Besier and M Fredericson, Section Editors)
  • Published:
Current Reviews in Musculoskeletal Medicine Aims and scope Submit manuscript

Abstract

Purpose of Review

Movement retraining in rehabilitation is the process by which a motor program is changed with the overall goal of reducing pain or injury risk. Movement retraining is an important component of interventions to address patellofemoral pain. The purpose of this paper is to review the methods and results of current retraining studies that are aimed at reducing symptoms of patellofemoral pain.

Recent Findings

The majority of studies reviewed demonstrated some improvement in patellofemoral pain symptoms and overall function. However, the degree of improvement as well as the persistence of improvement over time varied between studies. The greatest pain reduction and persistent changes were noted in those studies that incorporated a faded feedback design including between 8 and 18 sessions over 2–6 weeks, typically 3–4 sessions per week. Additionally, dosage in these studies increased to 30–45 min during later sessions, resulting in 177–196 total minutes of retraining. In contrast, pain reductions and persistence of changes were the least in studies where overall retraining volume was low and feedback was either absent or continual.

Summary

Faulty movement patterns have been associated with patellofemoral pain. Studies have shown that strengthening alone does not alter these patterns, and that addressing the motor program is needed to effect these changes. Based upon the studies reviewed here, retraining faulty patterns, when present, appears to play a significant role in addressing patellofemoral pain. Therefore, movement retraining, while adhering to basic motor control principles, should be part of a therapist’s intervention skillset when treating patients with PFP.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA

    Irene S. Davis & Adam S. Tenforde

  2. Spaulding National Running Center, 1575 Cambridge St, Cambridge, MA, 02138, USA

    Irene S. Davis & Adam S. Tenforde

  3. Sports & Exercise Medicine, Queen Mary University of London, London, UK

    Bradley S. Neal

  4. Department of Health and Human Sciences, Loyola Marymount University, Los Angeles, CA, USA

    Jenevieve L. Roper

  5. School of Physical Therapy & Health Sciences, University of Montana, Missoula, MT, USA

    Richard W. Willy

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Correspondence to Irene S. Davis.

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Irene S. Davis, Adam S. Tenforde, Bradley S. Neal, Jenevieve Roper, and Richard W. Willy declare that they have no conflict of interest.

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Davis, I.S., Tenforde, A.S., Neal, B.S. et al. Gait Retraining as an Intervention for Patellofemoral Pain. Curr Rev Musculoskelet Med 13, 103–114 (2020). https://doi.org/10.1007/s12178-020-09605-3

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