Barton, C., Lack, S., Malliaras, P. and Morrissey, D. British Journal of Sports Medicine, 2013; 47: 207 – 214.
http://www.ncbi.nlm.nih.gov/pubmed/22945929
Patellofemoral
pain syndrome, often called “runner’s knee”, constitutes great amount of the
knee overuse injuries observed in the sports medicine practice. While aetiology
of the condition is not fully known, variety of intrinsic and extrinsic risk
factors has been presented. Much attention has been placed on the relationship
between hip musculature function and PFPS. It is suggested that impaired
gluteal muscle function may result in increased hip joint adduction and internal
rotation movement during activities such as running, squatting and stair
negotiation. This excessive hip motion is proposed to increase lateral PFJ
stress, associated with PFPS development. Nevertheless, research findings are
somehow inconsistent. To fill that gap, authors decided to put together a
systematic review investigating the role of gluteal muscle activity in the aetiology,
presentation and management of PFPS.
Ten case–control, but no prospective studies were included for final review. All 10 studies evaluated EMG activity of gluteus medium, while 2 studies evaluated gluteus maximus. The majority of studies contained low participant numbers, averaging just 16 PFPS and 18 control participants. According to the results, there is currently moderate to strong evidence that GMed muscle activity is delayed and of shorter duration during stair ascent and descent in individuals with PFPS. In addition, limited evidence indicates that GMed muscle activity is delayed and of shorter duration during running. The findings might therefore be in agreement with the theory that, if gluteal muscle activation is delayed, frontal and transverse plane hip motion control may be impaired, leading to increased stress on the PFJ and subsequent symptoms associated with PFPS. Nonetheless, it still can not be determined from the results, whether this delayed and of shorter duration GMed muscle activity was the cause or the effect of PFPS. Authors recommend implementation of specific interventions (biofeedback, GMed strengthening, gait retraining) targeting these deficits in patients suffering from PFPS.
Ten case–control, but no prospective studies were included for final review. All 10 studies evaluated EMG activity of gluteus medium, while 2 studies evaluated gluteus maximus. The majority of studies contained low participant numbers, averaging just 16 PFPS and 18 control participants. According to the results, there is currently moderate to strong evidence that GMed muscle activity is delayed and of shorter duration during stair ascent and descent in individuals with PFPS. In addition, limited evidence indicates that GMed muscle activity is delayed and of shorter duration during running. The findings might therefore be in agreement with the theory that, if gluteal muscle activation is delayed, frontal and transverse plane hip motion control may be impaired, leading to increased stress on the PFJ and subsequent symptoms associated with PFPS. Nonetheless, it still can not be determined from the results, whether this delayed and of shorter duration GMed muscle activity was the cause or the effect of PFPS. Authors recommend implementation of specific interventions (biofeedback, GMed strengthening, gait retraining) targeting these deficits in patients suffering from PFPS.
Do you
profile your PFPS patients in regards to gluteal muscle function? Are you
observation in agreement with this review?
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reserved to the British Journal of Sports Medicine.
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