Physical Therapist Management of Anterior Knee Pain
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NON-OPERATIVE MANAGEMENT OF ANTERIOR KNEE PAIN (M FREDERICSON AND T BESIER, SECTION EDITORS)
Physical Therapist Management of Anterior Knee Pain Shane M. McClinton 1
&
Daniel G. Cobian 2 & Bryan C. Heiderscheit 3
Accepted: 19 October 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review Anterior knee pain is a common musculoskeletal complaint among people of all ages and activity levels. Nonoperative approaches with an emphasis on physical therapy management are the recommended initial course of care. The purpose of this review is to describe the current evidence for physical therapist management of anterior knee pain with consideration of biomechanical and psychosocial factors. Recent Findings The latest research suggests anterior knee pain is a combination of biomechanical, neuromuscular, behavioral, and psychological factors. Education strategies to improve the patient’s understanding of the condition and manage pain are supported by research. Strong evidence continues to support the primary role of exercise therapy and load progression to achieve long-term improvements in pain and function. Preliminary studies suggest blood flow restriction therapy and movement retraining may be useful adjunct techniques but require further well-designed studies. Summary Anterior knee pain includes multiple conditions with patellofemoral pain being the most common. An insidious onset is typical and often attributed to changes in activity and underlying neuromuscular impairments. A thorough clinical history and physical examination aim to identify the patient’s pain beliefs and behaviors, movement faults, and muscle performance that will guide treatment recommendations. Successful physical therapist management involves a combination of individualized patient education, pain management, and load control and progression, with an emphasis on exercise therapy. Keywords Patellofemoral . jumper’s knee . runner’s knee . Exercise therapy
Introduction
This article is part of the Topical Collection on Non-Operative Management of Anterior Knee Pain * Shane M. McClinton [email protected] Daniel G. Cobian [email protected] Bryan C. Heiderscheit [email protected] 1
Doctor of Physical Therapy Program, Des Moines University, Des Moines, IA, USA
2
Department of Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
3
Departments of Orthopedics & Rehabilitation and Biomedical Engineering, University of Wisconsin-Madison, Madison, WI, USA
Anterior knee pain (AKP) is a common musculoskeletal complaint contributing to functional limitation in persons of all ages and activity levels. Symptoms associated with AKP can have a significant adverse impact on a person’s function, overall health, and quality of life [1, 2]. AKP encompasses multiple clinical conditions with patellofemoral pain being the most common. Various clinical findings are associated with AKP including patellar hyper- or hypo-mobility, impaired quadriceps or hip muscle performance,
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