PainSci notes on Souza 2009:
Is there any difference in women with patellofemoral pain in their hip kinematics, hip muscle strength and hip muscle activations patterns than women without pain? This is another small (40-subject) fishing expedition for biomechanical problems in people with knee pain (for another good example, see Ferber). They found some modest differences by some measures. As usual, there is no attempt to distinguish between cause and effect: it may well be that women with painful knees use their hip muscles differently because their knees hurt. The authors conclude that their “support the proposed link between abnormal hip function and PFP.” This is over-stated: their results are simply not inconsistent with that hypothesis. There’s a 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.
STUDY DESIGN: Controlled laboratory study using a cross-sectional design.
OBJECTIVES: To determine whether females with patellofemoral pain (PFP) demonstrate differences in hip kinematics, hip muscle strength, and hip muscle activation patterns when compared to pain-free controls.
BACKGROUND: It has been proposed that abnormal hip kinematics may contribute to the development of PFP. However, research linking hip function to PFP remains limited.
METHODS AND MEASURES: Twenty-one females with PFP and 20 pain-free controls participated in this study. Hip kinematics and activity level of hip musculature were obtained during running, a drop jump, and a step-down maneuver. Isometric hip muscle torque production was quantified using a multimodal dynamometer. Group differences were assessed across tasks using mixed-design 2-way analyses of variance and independent t tests.
RESULTS: When averaged across all 3 activities, females with PFP demonstrated greater peak hip internal rotation compared to the control group (mean +/- SD, 7.6 degrees +/- 7.0 degrees versus 1.2 degrees +/- 3.8 degrees; P<.05). The individuals in the PFP group also exhibited diminished hip torque production compared to the control group (14% less hip abductor strength and 17% less hip extensor strength). Significantly greater gluteus maximus recruitment was observed for individuals in the PFP group during running and the step-down task.
CONCLUSION: The increased peak hip internal rotation motion observed for females in the PFP group was accompanied by decreased hip muscle strength. The increased activation of the gluteus maximus in individuals with PFP suggests that these subjects were attempting to recruit a weakened muscle, perhaps in an effort to stabilize the hip joint. Our results support the proposed link between abnormal hip function and PFP.
- “Competitive female runners with a history of iliotibial band syndrome demonstrate atypical hip and knee kinematics,” Ferber et al, Journal of Orthopaedic & Sports Physical Therapy, 2010.
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:
- Cannabidiol (CBD) products for pain: ineffective, expensive, and with potential harms. Moore 2023 J Pain.
- 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.