Latest evidence based recommendations for patellofemoral pain

Lateral band walks or "monster walks" are one of the commonly prescribed exercises for patellofemoral pain

Patellofemoral pain (PFP) is one of the most common conditions that we see walk through our doors. Studies suggest that it effects approximately 23% of adults and 29% of adolescents annually. PFP is a persistent problem in about half of those individuals who are affected by this condition. PFP tends to lead to a decrease in physical activity and has been shown to be a predecessor to patellofemoral osteoarthritis.

With our sports medicine focus, our clinicians (doctors, physiotherapists, RMTs and pedorthists) see this condition on a daily basis, gaining us a vast experience and skill in diagnosing and treating PFP.

Every year a group of researchers in the field of PFP gather to review recent studies and make general recommendations based on the current evidence available.

2018 Consensus statement on exercise therapy and physical interventions (orthoses, taping and manual therapy) to treat patellofemoral pain: recommendations from the 5th International Patellofemoral Pain Research Retreat, Gold Coast, Australia.

Collins et al.

Annual recommendations:

1. Exercise therapy is recommended to reduce pain in the short, medium and long terms and improve function in the medium and long terms. It is recommended that exercise targeting the hip and knee is a key component of management for all patients with PFP, particularly when used in combination.

2. Combining hip and knee exercises is recommended to reduce pain and improve function in the short, medium and long terms, and this combination should be used in preference to knee exercises alone.

3. Combined interventions are recommended to reduce pain in adults with patellofemoral pain in the short and medium terms. Combined interventions as a management program incorporates exercise therapy, as well as one of the following: foot orthoses, patellar taping or manual therapy.

4. Foot orthoses are recommended to reduce pain in the short term.

5. Patellofemoral, knee and lumbar mobilizations are not recommended in isolation.

6. Electro-physical agents are not to be used as primary interventions.

How do you know if you are experiencing PFP (sometimes referred to as ‘runner’s knee’)

· Pain in the front of your knee, or around your knee cap

· No obvious sustained injury or experience of a mechanism of injury

· Pain often increased with running, prolonged walking, stairs, prolonged sitting, etc.

· Pain with squatting or kneeling

· Ability to participate in sports or physical activities may be compromised

The main finding in all of the research reviewed is that “exercise therapy remains the intervention of choice for patellofemoral pain”. At Waterloo Sports Medicine Centre we pride ourselves on providing a very active approach to rehab and educating our patients on what is the best current practice.