Effectiveness of treatment modalities for managing PFP
The cornerstone of any rehabilitation program has always been patient education. A recent consensus statement recommended the need for further evaluation of the benefit of education in the management of patellofemoral pain (PFP). The following single blinded randomized controlled trial concluded no further benefit of gait retraining or the addition of an exercise program over education in the management of PFP in runners.
Individually, the use of exercise in PFP rehabilitation has been well supported in the literature with most recent evidence supporting the combination of quadriceps and hip strengthening for alleviation of pain and restoration of function. Although exact mechanisms remain unknown, it is theorized the conditioning of soft tissues increase their capacity to resist mechanical load.
Research into gait retraining has focused on alternative running biomechanics that have been found to minimize forces of the patellofemoral joint. This approach has a growing body of evidence supporting increased running economy and optimizing load distribution throughout the kinetic chain.
Despite convincing arguments with the above advances in the treatment of PFP, the authors provide sound evidence using a parallel group clinical trial and found no further benefits of education and exercise or gait re-training versus education alone in the measurement of symptoms or functional limitations.
The addition of an educational directive focusing on training load management in relation to symptom provocation was determined to be an essential component to PFP rehabilitation in runners.
> From: Esculier et al., Br J Sports Med (2017) (Epub ahead of print). All rights reserved to BMJ Publishing Group Ltd. Click here for the online summary.