Prevention of Patellofemoral Injuries
Patellofemoral knee injuries account for one in four of all knee injuries in athletes [1], up to 40 % of all physical therapy visits for knee pain [2, 3], and 10 % of total visits to physical therapy clinics [3]. Patellofemoral pain is the most common inj
- PDF / 228,422 Bytes
- 7 Pages / 504.57 x 720 pts Page_size
- 73 Downloads / 189 Views
Prevention of Patellofemoral Injuries Michael T. Benke, Christopher M. Powers, and Bert R. Mandelbaum
Contents
9.1
9.1 Introduction ...................................................
51
9.2 Biomechanics .................................................
52
9.3 Clinical Findings ...........................................
53
9.4 Rehabilitation and Prevention Strategies.....
54
References ...............................................................
55
M.T. Benke (*) • B.R. Mandelbaum Santa Monica Orthopaedic and Sports Medicine Group, Santa Monica, CA, USA e-mail: [email protected] C.M. Powers Musculoskeletal Biomechanics Research Laboratory, Division of Biokinesiology and Physical Therapy, University of Southern California, Los Angeles, CA, USA
A. Gobbi et al. (eds.), The Patellofemoral Joint, DOI 10.1007/978-3-642-54965-6_9, © ISAKOS 2014
Introduction
Patellofemoral knee injuries account for one in four of all knee injuries in athletes [1], up to 40 % of all physical therapy visits for knee pain [2, 3], and 10 % of total visits to physical therapy clinics [3]. Patellofemoral pain is the most common injury in runners [4] and the most common source of knee pain in adolescents [5]. Patellofemoral pain (PFP) is an overuse injury, characterized by retropatellar or peripatellar pain that is made worse by running, prolonged sitting, squatting, jumping, or climbing stairs. The etiology of PFP has previously been credited to lateral patellar maltracking owing to vastus medialis obliquus (VMO) muscle weakness. It is thought that abnormal patella tracking causes increased lateral compressive patellofemoral joint stress [6]. As such, interventions have focused on influencing patellar motion with taping and bracing, patella mobilization, and strengthening of the VMO [7]. While it is generally accepted that conservative treatment of PFP is helpful [8–10], recurrence rates are high and range between 25 and 91 % [1, 11–14]. This suggests that the etiology of PFP is not being addressed with current treatment approaches. More recent literature has focused on the hip musculature and their dynamic effect on patellofemoral mechanics. Given that the patella articulates with the distal femur, abnormal hip motions likely contribute to PFP [7].
51
M.T. Benke et al.
52
9.2
Biomechanics
Considering the wide scope of patellofemoral pain and the impact it has on athletic performance and quality of life, prevention is imperative. Having a sound knowledge of patellofemoral biomechanics is a key part in understanding and prescribing rehabilitation and prevention programs. As mentioned, previous theory that PFP originates from patellar maltracking stemmed from kinematic studies performed under non-weight-bearing conditions with a fixed femur [15–17]. In such a state, the patella tilts and translates lateral on the distal femur [18]. However, under weight-bearing conditions, it has been shown using dynamic MRI that the internal rotation of the femur results in a more significant contribution to relative patellar tilt and t
Data Loading...
