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Muscular control of the patella

PainSci » bibliography » Malone et al 2002
Tags: etiology, treatment, patellar pain, biomechanics, pro, arthritis, aging, pain problems, knee, leg, limbs, overuse injury, injury, running, exercise, self-treatment

Two articles on PainSci cite Malone 2002: 1. The Complete Guide to Patellofemoral Pain Syndrome2. Patellofemoral Pain & the Vastus Medialis Myth

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.

Patellofemoral patients are among the most common yet most challenging individuals presenting for orthopedic care. The key word in the previous sentence is individual. A single protocol of care is not sufficient for these special “individuals.” Many concepts have been evaluated through review of the peer-reviewed literature with the following highlights: (1) the concept of VMO isolation through specific exercise should no longer be part of our lexicon; (2) patellofemoral patients improve when they are able to enhance quadriceps functional patterns by way of pain-free exercise; (3) patellofemoral patients do not fit into a single “box” but rather require an evaluation-based classification and specific interventional pattern. Many of the special techniques used by clinicians in treating these patients have not been well defined through research and also are lacking in evidence of clinical efficacy. We also must recognize, however, that good clinical observations can be the first step in defining what questions should be asked and how they can be answered. It is vital that we answer the questions without allowing “bad science” through dogma and anecdote to prevail. Likewise, we need to be diligent in determining our successes and failures through well designed and implemented clinical and research studies.

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