Exercise reduces anterior knee pain risk
Two articles on PainSci cite Coppack 2011: 1. The Complete Guide to Patellofemoral Pain Syndrome 2. Strength Training for Pain & Injury Rehab
PainSci commentary on Coppack 2011: ?This page is one of thousands in the PainScience.com bibliography. It is not a general article: it is focused on a single scientific paper, and it may provide only just enough context for the summary to make sense. Links to other papers and more general information are provided wherever possible.
Perhaps preventive exercises can reduce the chances of developing anterior knee pain (patellofemoral pain included). In this study, 1500 army recruits were given either a specific warm-up designed to prevent knee injuries, hopefully, or one with no expected effect on knee pain.
The knee injury prevention program consisted of exercises for the legs, particularly the hips (including isometric hip abduction, forward lunges, single leg squats, step downs, and stretches of the quads, IT band, hamstrings and calves). Those in the control group were given a standard warm-up, what was already used by the military (slow running, general upper and lower body stretching, abdominal curls and pushups). Participants performed their warm-ups for 14 weeks, and the amount of knee injuries were measured at the end of the study.
The recruits in the knee prevention program had a 75% reduction in anterior knee pain risk compared to the controls! Those are impressive results from a well designed study.
It’s too bad we can’t tell which warm-up exercise mattered the most. They cast a wide net with several quite different kinds of exercises, and it’s unlikely that they were all equally helpful. It’s also possible that it doesn’t matter much: that it’s just plenty of stimulation and activity for the knee that made the difference.
original abstract †Abstracts here may not perfectly match originals, for a variety of technical and practical reasons. Some abstacts are truncated for my purposes here, if they are particularly long-winded and unhelpful. I occasionally add clarifying notes. And I make some minor corrections.
BACKGROUND: Anterior knee pain (AKP) is the most common activity-related injury of the knee. The authors investigated the effect of an exercise intervention on the incidence of AKP in UK army recruits undergoing a 14-week physically arduous training program.
HYPOTHESIS: Modifying military training to include targeted preventative exercises may reduce the incidence of AKP in a young recruit population.
STUDY DESIGN: Randomized controlled trial; Level of evidence, 1.
METHODS: A single-blind cluster randomized controlled trial was performed in 39 male and 11 female training groups (median age: 19.7 years; interquartile range, 17-25) undergoing phase 1 of army recruit training. Each group was randomly assigned to either an intervention (n = 759) or control (n = 743) protocol. The intervention consisted of 4 strengthening and 4 stretching exercises completed during supervised physical training lessons (7 per week). The control group followed the existing training syllabus warm-up exercises. The primary outcome was a diagnosis of AKP during the 14-week training program.
RESULTS: Forty-six participants (3.1%; 95% confidence interval [CI], 2.3-4.1) were diagnosed with AKP. There were 36 (4.8%; 95%CI, 3.5-6.7) new cases of AKP in the control group and 10 (1.3%; 0.7-2.4) in the intervention group. There was a 75% reduction in AKP risk in the intervention group (unadjusted hazard ratio = 0.25; 95% CI, 0.13-0.52; P < .001). Three participants (0.4%) from the intervention group were discharged from the military for medical reasons compared to 25 (3.4%) in the control group.
CONCLUSION: A simple set of lower limb stretching and strengthening exercises resulted in a substantial and safe reduction in the incidence of AKP in a young military population undertaking a physical conditioning program. Such exercises could also be beneficial for preventing this common injury among nonmilitary participants in recreational physical activity.
related content
- “The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials,” Lauersen et al, British Journal of Sports Medicine, 2014.
This page is part of the PainScience BIBLIOGRAPHY, which contains plain language summaries of thousands of scientific papers & others sources. It’s like a highly specialized blog. A few highlights:
- Inciting events associated with lumbar disc herniation. Suri 2010 Spine J.
- Prediction of an extruded fragment in lumbar disc patients from clinical presentations. Pople 1994 Spine (Phila Pa 1976).
- Characteristics of patients with low back and leg pain seeking treatment in primary care: baseline results from the ATLAS cohort study. Konstantinou 2015 BMC Musculoskelet Disord.
- Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Kuyken 2022 Evid Based Ment Health.
- Is there a relationship between throbbing pain and arterial pulsations? Mirza 2012 J Neurosci.