Patellofemoral pain and asymmetrical hip rotation.
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Phys Ther. 2005 Nov;85(11):1201-7.
Full text of article
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A lot of work has been done recently on proximal control issues on PFPS ... it not all about foot orthoses and distal control issues.
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what treatment modalities did you use for this patient?
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http://www.ptjournal.org/PTJournal/Nov2005/v85n11p1201.cfm
I am not sure if its freely accessible to all (it is from here) -
nothing new here
I don't think this anything any of us didn't already know. Cibulka has a long history of looking at asymmetrical hip ROM and its effects on LBP and SI jt dysfunction and has quite extensively covered the topic. Only this time he looked at a case of PFD, with what he reports as an unusual pattern of restricted medial(internal) movement. No big deal. Take home message, hip ROM can influence knee symptoms. Not rocket science.
DaFlip :mad: -
I was just cheking the refs on that paper an found this one from Chris Powers --- i missed it previously:
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Here is a different take on this:
Tibia and rearfoot motion and ground reaction forces in subjects with patellofemoral pain syndrome during walking.
Gait Posture. 2006 Feb 14;
Authors: Levinger P, Gilleard W
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The Role of Hip Muscle Function in the Treatment of Patellofemoral Pain Syndrome
The American Journal of Sports Medicine 34:630-636 (2006)
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Well the tissue stress folks would say that you are looking at position and not moment or force. I have not been really happy with the pronation/ internal rotation theory of patella femoral pain. Transverse plane torque would be a key variable to look at. The idea is that the tibia is internally rotated relative to the femur. A difficult measure and still not torqure. For, me the jury is still out.
Eric -
Hip Muscle Activity is Altered in Patellofemoral Pain: Clinical Implications
Crossley, Kay M.; Bryant, Adam; Cowan, Sallie
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Analysis of hip strength in females seeking physical therapy treatment for unilateral patellofemoral pain syndrome.
J Orthop Sports Phys Ther. 2007 May;37(5):232-8.
Robinson RL, Nee RJ.
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Hip strength in collegiate female athletes with patellofemoral pain.
Cichanowski HR, Schmitt JS, Johnson RJ, Niemuth PE.
Med Sci Sports Exerc. 2007 Aug;39(8):1227-32.
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Re: Here is a different take on this:
"Tibial transverse rotation was not shown to be different in PFPS subjects. However, there was prolonged rearfoot eversion during the stance phase of walking. The earlier appearance of rearfoot dorsiflexion as well as the lower GRFs indicate altered propulsive function of the foot during supination. "
Now this is something that makes perfect sense to me. It encompasses the paper that Craig P. listed and it's findings and includes some references to the timing of eversion during stance phase.
It is amazing to me that anyone would still think that the amount of measured in- or eversion of the heel, or internal rotation of the tibia would really matter. No matter the patient, they will usually fully pronate as much as their joints will allow. It is not a matter of what position they get to, but how long they stay in that position that really matters. This paper seems to verify that issue, to me at least.
I do not find it surprising that there would be a limitation of hip ROM either as this is often a compensation brought on by a stoppage of foot motion or rotation as recorded.
Call it a chicken / egg scenario if you like, but if you do not control for the pathologic foot function, your outcomes will rarely hold just by focusing on the hip musculature alone. IMHO!
Bruce -
Re: Here is a different take on this:
You're too young:p to remember how the PT's and Orthopedic surgeons would recommend quad strengthening exercises for "chondromalacia patella". These also worked temporarily at best. :wacko:
The key is finding and treating the cause, not one of several results. :cool:
Regards,
Stanley -
Re: Here is a different take on this:
You think I am younger than I actually am! I rember those exercises from school and I think it is still in the some of the most current texts, though I could be mistaken.
:drinks
Bruce -
Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run.
Dierks TA, Manal KT, Hamill J, Davis IS.
J Orthop Sports Phys Ther. 2008 Aug;38(8):448-56.
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Predictors of Hip Internal Rotation During Running: An Evaluation of Hip Strength and Femoral Structure in Women With and Without Patellofemoral Pain
Richard B. Souza, Christopher M. Powers
American Journal of Sports Medicine First published on December 19, 2008
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Iliotibial band tightness and patellofemoral pain syndrome: A case-control study
Zoe Hudsona and Emma Darthuy
Manual Therapy Volume 14, Issue 2, April 2009, Pages 147-151
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Press Release:
Hip exercises found effective at reducing, eliminating common knee pain in runners.
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The effect of real-time gait retraining on hip kinematics, pain and function in subjects with patellofemoral pain syndrome
B Noehren, J Scholz, I Davis
Br J Sports Med doi:10.1136/bjsm.2009.069112
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Lower Extremity Kinematics of Females With Patellofemoral Pain Syndrome While Stair Stepping.
McKenzie K, Galea V, Wessel J, Pierrynowski M.
J Orthop Sports Phys Ther. 2010 Sep 1. [Epub ahead of print]
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Electromyographic preactivation pattern of the gluteus medius during weight-bearing functional tasks in women with and without anterior knee pain.
Nakagawa TH, Muniz TB, Baldon RM, Maciel CD, Amorim CF, Serrão FV.
Rev Bras Fisioter. 2011 Mar 4. pii: S1413-35552011005000003. [Epub ahead of print]
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Is Hip Muscle Weakness a Predisposing Factor for Patellofemoral Pain in Female Novice Runners? A Prospective Study
Am J Sports Med June 1, 2011 ; published online before print June 1, 2011, doi:10.1177/0363546511407617
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Press Release:
Stronger hips improved running mechanics, lessened knee pain
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Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females With Patellofemoral Pain Syndrome: A Randomized Clinical Trial
Kimberly L. Dolak, Carrie Silkman, Jennifer Medina McKeon, Robert G. Hosey, Christian Lattermann, Timothy L. Uhl
J Orthop Sports Phys Ther 2011;41(8):560-570
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Proximal and distal kinematics in female runners with patellofemoral pain.
Noehren B, Pohl MB, Sanchez Z, Cunningham T, Lattermann C.
Clin Biomech (Bristol, Avon). 2011 Nov 7
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Lumbopelvic Joint Manipulation and Quadriceps Activation of People With Patellofemoral Pain Syndrome
Grindstaff, Terry L; Hertel, Jay; Beazell, James R.; Magrum, Eric M.; Kerrigan, D. Casey; Fan, Xitao; Ingersoll, Christopher D.
Journal of Athletic Training, Volume 47, Number 1, January-February 2012 , pp. 24-31(8)
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The influence of heel height on patellofemoral joint kinetics during walking.
Ho KY, Blanchette MG, Powers CM.
Gait Posture. 2012 Apr 18.
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Joint Range of Motion and Patellofemoral Pain in Dancers.
Steinberg N, Siev-Ner I, Peleg S, Dar G, Masharawi Y, Zeev A, Hershkovitz I.
Int J Sports Med. 2012 May 4.
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from Lower Extremity Review:
In patients with patellofemoral pain, hip weakness may be result, not cause -
Gluteal muscle activity and patellofemoral pain syndrome: a systematic review
Christian J Barton, Simon Lack, Peter Malliaras, Dylan Morrissey
Br J Sports Med doi:10.1136/bjsports-2012-090953
Last edited: Jun 30, 2013 -
Foot and Hip Contributions to High Frontal Plane Knee Projection Angle in Athletes: A Classification and Regression Tree Approach.
Bittencourt NF, Ocarino JM, Mendonça LD, Hewett TE, Fonseca ST.
J Orthop Sports Phys Ther. 2012 Sep 18. [Epub ahead of print]
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Comparison of Hip Strength and Core Endurance in Males with and without Patellofemoral Pain Syndrome
Bolgla, Lori; Bounds, Matthew; Greavu, Samuel; Rowe, Steven; Earl-Boehm, Jennifer; Emery, Carolyn; Hamstra-Wright, Karrie; Ferber, Reed
Combined Societies Mtg; American Physical Therapy Association; San Diego January 21-24. 2013
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The prevalence of myofascial trigger points in the hip in patellofemoral pain patients
Sean Roach, Eric Sorenson, Barbara Headley, Jun G. San Juan
Archives of Physical Medicine and Rehabilitation (Available online 2 November 2012)
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Isometric Strength Ratios of the Hip Musculature in Females With Patellofemoral Pain: A Comparison to Painfree Controls
Magalhães, Eduardo (PT, MSc); Silva, Ana Paula M.C.C. (PT, MSc Student); Sacramento, Sylvio N. (MD); Martin, RobRoy L. (PT, PhD); Fukuda, Thiago Y. (PT, PhD)
Journal of Strength & Conditioning Research: 30 November 2012
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Prospective Evidence for a Hip Etiology in Patellofemoral Pain.
Noehren B, Hamill J, Davis I.
Med Sci Sports Exerc. 2012 Dec 27.
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Comparison of hip abductor, extensor and external rotator strength in Women with and without patellofemoral pain syndrome
Moradi Z, Akbari M, Nakhostin Ansari N, Emrani A
Modern Rehabilitation 2012;6(3) : 7-7
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Immediate Effects of Lumbopelvic Manipulation and Lateral Gluteal Kinesio Taping on Unilateral Patellofemoral Pain Syndrome
Joseph Miller, Richard Westrick, Angela Diebal, Christopher Marks, J. Parry Gerber
Sports Health: A Multidisciplinary Approach January 24, 2013
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Gluteal muscle activity and patellofemoral pain syndrome: a systematic review
Christian J Barton, Simon Lack, Peter Malliaras, Dylan Morrissey
Br J Sports Med 2013;47:207-214
Last edited: Jul 12, 2013
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