Patellofemoral pain treatment for runners
Patellofemoral pain (PFP) is one of the most common running-related conditions that is defined by pain around or behind the patella associated with loading of the patellofemoral joint.
Common treatment of PFP in runners include:
- Education where the focus is on training load management;
- Exercises where lower limb muscles are strengthened;
- Gait-retraining where running style is modified through varying the type of foot strike or the cadence.
In this study, 69 runners aged between 18-45 with a minimal weekly running distance of 15km who have suffered from PFP for at least 3 months were included. They were placed into either the education group, the exercise group or the gait retraining group. Both the exercise and gait retraining groups received treatment from the education group.
The education group were taught on load management and asked to modify running based on symptoms. Some of the suggestions included increasing training frequency, reducing session duration and speed and avoiding downhill running. Pain levels needed to be kept under 2/10 during the run and the pain had to return to pre-training levels 60 minutes post-training.
The exercise group received the education in addition to a progressive strengthening exercise program consisting of 4 phases of 2 weeks, which included drills such as step ups, the hip band pulls, planks and single leg jumps.
The gait retraining group received instructions to increase cadence, run softer and avoid a rearfoot strike pattern.
At the end of the 8-week period, all 3 programmes were effective in improving pain levels and functional issues (measured by KOS-ADLS).
No significant differences were seen between the 3 programmes. This highlighted the need to consider education as a crucial component when treating runners with PFP.
> From: Esculier et al., Br J Sport Med 52 (2018) 659-666. All rights reserved to BMJ Publishing Group Ltd. Click here for the online summary.
