Patellofemoral Pain Syndrome (PFPS for short) is a common condition where pain is present behind and/or around the knee cap. It is twice as common in women as men and has a high occurrence in those who are involved in athletic activities. Physical therapy is an effective treatment to reduce this type of knee pain. Initially, it was theorized that the weakness in the quadriceps, specifically the vastus medialus oblique fibers were to blame for the symptoms because the kneecap would not track correctly and be pulled too far towards the outside of the knee by the rest of the quadriceps muscles. A research article published in Journal of Orthopaedic & Sports Physical Therapy1 tested the theory that hip weakness may actually play a greater role in the prevalence of pain in the affected knee. The kneecap is located in a groove at the lower part of the long femur bone in the upper leg. Rotation of the femur is controlled by muscles at the top of the hip. The author’s theory suggests that the lack of control of the femur bone during functional activities is what causes the inflammation and pain.
In the study mentioned above, patients were divided into two groups: Group A performed 4 weeks of quadriceps strengthening and Group B performed 4 weeks of hip abduction and external rotation strengthening. The group that performed the hip strengthening activities showed lower pain scores at 4 weeks than the group that performed quadriceps exercises. Both groups were then transitioned into a functional strengthening program that included both quad and hip strengthening and both groups saw additional improvement from 4 weeks to 8 weeks.
Here at Pacific Physical therapy, we understand the importance of getting pain relief sooner. It is our responsibility as physical therapists to form our treatment plans around relevant research to give our patients the results they want as soon as possible. Call or stop by today to find out what you can do about your knee pain.
Alicia Gilfoy, PT, MPT is a physical therapist who has been treating in the outpatient orthopedic setting since 2007.
“Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females with Patellofemoral Pain Syndrome: A Randomized Clinical Trial” (J Orthop Sports Phys Ther 2011;41(8):560-570.