One article on PainSci cites Peters 2013: The Complete Guide to Patellofemoral Pain Syndrome
PainSci commentary on Peters 2013: ?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.
Patellofemoral pain syndrome (PFPS) is a common knee pain disorder that is often harder to solve than a Rubik’s Cube. This review of the existing research on exercise looked at studies of proximal exercises targeting muscles closer to the center of your body, like hip and trunk muscles, compared to more conventional knee exercises targeting muscles of the thigh (quadriceps and hamstrings).
The authors evaluated only better quality studies that precisely defined the type of exercise tested. They found that proximal exercises consistently outperform knee exercises — in both the short and long term — for reducing pain and improving function in people with PFPS. The results were impressive: on average, knee strengthening programs led to a 37% decrease in pain, and 21% increase in function, while proximal (hip) strengthening programs led to a 65% decrease in pain, and a 38% increase in function! None of the studies included in the review were perfect, but such large effects are very encouraging.
Not surprisingly, the authors of this review concluded: “physical therapists should consider using proximal interventions for treatment of patellofemoral pain.”
My bias is so not confirmed by this. I don’t like it. But I will report it anyway. Because that’s what it says.
~ Paul Ingraham
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: Patellofemoral pain syndrome is a common disorder of the knee with multifactorial aetiology. Multimodal treatment, including exercise therapy, has been shown to be effective in the treatment of patellofemoral pain, although some patients continue to experience pain and dysfunction despite treatment. To address this, recent research has started to investigate the lumbo-pelvic and hip girdle in patellofemoral pain.
PURPOSE: The aim of this systematic review was to investigate the effectiveness of proximal exercises, compared with knee exercises, for patients with patellofemoral pain, in improving pain and function.
METHODS: A computer-based search (population: patients with patellofemoral pain,
INTERVENTION: proximal [hip or lumbo-pelvic] exercises, comparator: knee exercises, outcome: self-reported pain and/or functional questionnaire) was undertaken. Medline, Embase, CINAHL, SportsDiscus, Cochrane Library and PEDro were searched for studies published between January 2011 and January 2013. The included studies were appraised independently using the McMaster Critical Review Form for Quantitative Studies. Data was extracted for the exercise prescription and applicable outcome measures, and a descriptive analysis undertaken.
RESULTS: Eight studies (three randomized controlled trials, one clinical controlled trial, three cohort studies and one case series) of moderate to high methodological quality met the inclusion criteria. Proximal exercise programs showed a consistent reduction of pain and function in the treatment of patellofemoral pain. Knee exercise programs had variable outcomes.
CONCLUSION: Proximal interventions provide relief of pain and improved function in the short and long term and therefore physical therapists should consider using proximal interventions for treatment of patellofemoral pain.
LEVEL OF EVIDENCE: 3a.
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:
- Photobiomodulation therapy is not better than placebo in patients with chronic nonspecific low back pain: a randomised placebo-controlled trial. Guimarães 2021 Pain.
- No effect of creatine monohydrate supplementation on inflammatory and cartilage degradation biomarkers in individuals with knee osteoarthritis. Cornish 2018 Nutr Res.
- The CANBACK trial: a randomised, controlled clinical trial of oral cannabidiol for people presenting to the emergency department with acute low back pain. Bebee 2021 Med J Aust.
- Relationships Between Sleep Quality and Pain-Related Factors for People with Chronic Low Back Pain: Tests of Reciprocal and Time of Day Effects. Gerhart 2017 Ann Behav Med.
- Modulation in the elastic properties of gastrocnemius muscle heads in individuals with plantar fasciitis and its relationship with pain. Zhou 2020 Sci Rep.