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Pre-2010 updates to the patellofemoral pain syndrome tutorial

This is a listing of updates made to the patellofemoral pain syndrome tutorial prior to 2010. They are provided for historical interest only, and as a “paper trail” demonstrating how the documents have been maintained. All newer updates are listed in the tutorial itself. Note: most of the links to specific locations within the patellofemoral pain syndrome tutorial will not work, as they are from obsolete editions.


Another new section, practically on top of the last one, , along with a substantial new article offering more detail about ultrasound in general, Does Ultrasound Therapy Work?. I put a considerable amount of research into this topic, and so there are also 34 new records in the bibliography for ultrasound.

Updated the tutorial this morning with a new section, “

Added much more discussion of the study of patellar alignment assessment originally added back in June, in the section .

Today I’ve been adding information to most of my tutorial about Voltaren® Gel, an anti-inflammatory ointment. In the case of this tutorial, this required a full re-write of all of the information about inflammation. So there are three “like new” treatment sections today:

And you can read about Voltaren in a free article as well as here in the tutorial. But the tutorial covers the topic specifically as it relates to patellofemoral pain syndrome, which is quite different than the general subject.

Added information about an interesting reference to a study showing that clinicians can’t agree on patellar tracking syndrome diagnoses (poor inter-rater reliability) — which I always knew, but it’s nice to see some strong scientific evidence of it.

New section: “

The visual design of the site was upgraded over the past several days. Although this is not an update to the content of this tutorial, it is nevertheless a significant upgrade for all of them — like publishing new editions of books with better typesetting and layout. The new design is even cleaner and reader-friendly; it now looks that good in most web browsers; and pages load as much as 50% faster. Many under-the-hood improvements will make it much easier for me to improve tutorial content. The tutorials are now well-oiled machines of digital publishing goodness, vastly superior to the low-production values of most eBooks. More information about the upgrade is published on the front page.

Major restructuring and editing of several sections related to therapies based on the assumption of a tracking problem. See the new section, “.” Particularly noteworthy was the addition of important new evidence from a 2008 paper in American Journal of Sports Medicine showing that a combination of strengthening, stretching and coordination exercises were ineffective at preventing patellofemoral pain syndrome.

Added a small new section about Traumeel, a popular but questionable remedy that I often get asked about. See the section, “,” or the free article, Does Arnica Gel Work for Pain?.

The New England Journal of Medicine just published two fascinating new papers about knee pain, knee osteoarthritis, and knee surgery. I was really pleased to see these papers, because they provide clear and definite scientific support for many key points I’ve made in this tutorial. Kirkley et al’s paper about surgery for osteoarthritis and Englund et al’s fascinating findings about torn menisci have been added to the tutorial.

Added some evidence to the pile concerning alleged knee pain differences between men and women.

Added information about Kinesio Taping® to the section “.”

Revised the first several sections quite thoroughly to make them more clear and readable.

Polishing more or less complete.

Addition of several new sections, a table of contents (finally), and several new images and pull quotes to make it nicer and clearer to read.

Release of major new version of the article, almost three times as long. All traces of “structuralism” have been removed. Much more detailed and useful exploration of the causes of PFPS has been added, as well as many vital new sections of self-treatment. Many more improvements to the document are due over the next couple weeks as this version gets polished.

Expanded several of the introductory sections, added the humourous “graphical definition” of PFPS, and expanded the explanation of patellofemoral tracking syndrome and added the “wide hips” diagram. Added detailed treatment section on , with numerous new footnotes. More major changes are due shortly.

Added section to aid readers in determining the difference between these similar conditions.

Major changes underway working towards a full revision. Started by converting footnotes to new database-driven format. You can now link from footnotes to the database for more complete information about references.