Patellofemoral pain syndrome is characterized by pain around the kneecap that increases with prolonged activity or prolonged sitting. It is more common in females and is associated with weakness of the hip, particularly hip abductors, extensors and rotators (Prins et al. 2009). This weakness is thought to lead to biomechanical deficits at the knee, most notably an increased knee abduction torque, which may alter patellar alignment over the distal femur at the knee. In addition, researchers (Leetun et al. 2004) have found that athletes with weak hip abductors and extensors in pre-participation screenings are more likely to be injured.
Therapeutic exercise programs strengthening the ‘proximal’ musculature (hip and core) have been successful in relieving symptoms of anterior knee pain. One study (Thomee 1997) using Thera-Band® resistance bands reported that 85% of females with anterior knee pain returned to sports after a 12-week exercise program. Recently, a paper in the American Journal of Sports Medicine reported on the outcomes of an eight-week exercise program in a series of young females with patellofemoral pain syndrome. The progressive, three-phase exercise program included “Monster Walks” with Thera-Band® elastic resistance bands. Download the exercise protocol here.
After the eight-week exercise program, 17 out of 19 (89%) of the participants had successful outcomes. They had significant improvements in pain, functional ability, core endurance, and hip strength, as well as improvement in the knee abduction angle during gait. The main limitation of this study was the lack of a true control group, which would be able to identify if the exercise program was responsible for the improvements observed.
In summary, females with patellofemoral pain syndrome can benefit from a proximal strengthening program including Thera-Band Elastic Bands and Band Loops. A long-term follow-up would have been beneficial in further validating the efficacy of the program.
REFERENCE: Earl JE, Hoch AZ. A proximal strengthening program improves pain, function, and biomechanics in women with patellofemoral pain syndrome. Am J Sports Med. 2011 Jan;39(1):154-63. Epub 2010 Oct 7.