patellafemoral pain

[robin]

Hi I am a first year physio student and am currently working on a research assignment comparing the effectiveness of three common conservative treatments for patellafemoral pain: 1)VMO strengthening; 2) foot orthotics; and 3) patellar taping (McConnell method) and I was just wondering if anyone had any input as to what treatment approach they have found to be the most effective......thanks

I would look for rehabilitation using the closed kinetic chain principle. Taping can assist this in the early days, but remember as McConnell herself says, taping is only part of the treatment direction she suggests. Her approach may indeed include all three of the areas you are researching and therefore all three are a McConnell approach.

EMG analysis as to the inappropriate timing of the gluteals and hamstrings may also shed light to a therefore relative overactivity in the quads and may be a more important factor. ie If you have PF pain, then the quads as a unit are overworking. SO WHAT ISN'T???

[janetwalker]

I also work in closed chain in order to achieve good dynamic stability of the lower limb which is often at the root of patellofemoral pain. If the source of the problem appears to be VMO/TFL imbalance with a tight ITB then I would be paying attention to glut med, VMO and tib post in standing. Alternatively the problem may be due to a lack of control of tibial external rotation which can cause maltracking. In this case I would address popliteus recruitment. Since I have been using this approach I have rarely used orthotics and haven't needed to resort to taping.