By: Aaron Adler, PT, DPT and Clinic Manager at ApexNetwork Physical Therapy in Monett, MO
The start of the research began back in 2003 when Ireland, Wilson, et al. wrote an article Hip Strength in Females With and Without Patellofemoral Pain (1). This article displayed a large difference in hip strength in young adults with and without pain. In most cases, the displayed a 10% lack of strength on involved LE with PFP. With this knowledge, biomechanically, there is also more factors that can cause VMO insufficiency, decreased hamstring, quadriceps, or IT band flexibility, patella alta, and femoral anteversion (1). With continual research throughout the years, many articles have displayed benefits, but one pointed out that it would help reduce symptoms but not the load in people with medial knee osteoarthritis. Bennell, Hunt, et al. concluded that very thing with 89 participants with diagnosed knee arthritis back in 2010 (2). For physical therapy benefits, hip strengthening can be a new set of activity for knee derangements. In 2015, Berry, Lee, et al. tested the best practice for hip strengthening. They concluded that during resisted sidestepping, “the hip abductors on the stance limb ar more active than the hip abductors on the moving limb. In the squat posture, the activity of the gluteal muscles are increased, whereas the activity of the TFL is reduced compared to the upright position” (3).
Utilizing this new research will greatly help with better outcomes for knee patients that will affect more long term issues associated with PFP.