Critically Appraised Topic
A young man came to me with bilateral anterior knee pain, or patellofemoral pain syndrome (PFPS), which developed during a rigorous summer backpacking trip. He restricted his weight-bearing exercise for several months and found some relief, but now continues to have pain with activities such as running and stair-climbing. He is concerned that he will not be ready for the upcoming hiking season. I know of various treatment approaches for PFPS such as quadriceps strengthening, patellar taping, and stretching, and have heard that there is evidence that strengthening hip musculature may be beneficial as well. This has led me to inquire whether my patient will have better results if hip strength is addressed in addition to using the traditional treatment approaches.
Is the addition of hip strengthening exercises to traditional treatments of patellofemoral pain syndrome more effective in decreasing patellofemoral pain than traditional treatments alone?
Clinical Bottom Line
Based on the results from Nakagawa et al and Fukuda et al, the addition of hip strengthening exercises to knee strengthening exercise in the treatment of PFPS is likely to be beneficial. With one article showing statistical significance and the other showing improvement that was not statistically significant, hip strength should be addressed in patients with PFPS. No adverse events were reported so there is no risk in applying these exercises with hopes of achieving better outcomes for my patients.
Loosli, Marissa, "The efficacy of traditional approaches with and without hip strengthening in the treatment of patellofemoral pain syndrome" (2011). PT Critically Appraised Topics. 18.