Challenging current practice of patellofemoral pain

Challenging current practice of patellofemoral pain

Patellofemoral pain (PFP) is a common problem in young people, with 1 in 6 suffering at any one time. It is unclear which management approach is the optimal method for treating PFP in the long term, with traditional physiotherapy examination focusing on assessing for specific structural dysfunction.

In this case study, a rationale for a different assessment and treatment approach, one that moves the focus away from a biomedical/tissue pathology model towards one directed at the neurophysiology of pain, has been suggested. The patient was a 21 year old male with a 6 year history of PFP with previous failed physiotherapeutic treatment. He reported previous multiple healthcare practitioners’ advice to avoid activities that were painful as reasons for being unable to participate in sporting activities.

No specific structural testing was performed, such as specific muscle strength, length, foot position, patella movement and position, or movement patterns. Descriptions of tissue based pathology models of pain, e.g. patella mal-tracking, were actively discouraged and challenged.

The patient was taught to perform one uncomfortable/painful exercise as part of his rehabilitation programme twice a day. The patient achieved 80% improvement in his symptoms over 7 appointments and a return to physical activity following a 5 month rehabilitation programme purposively designed to elicit pain by means of gradually exercising and loading the tissues.

This case report highlights the need for further research into exercise protocols for patients suffering with PFP based upon neurophysiology models of pain.

Monica TanakaResearch article posted by: Monica Tanaka

Monica is our Physiospot Editor. She is a trained journalist with a keen interest in the physiotherapy profession. As Physiospot Editor, Monica explores stories and physiotherapy news for us with fresh eyes. She is a science and health communicator with experience implementing strategic communications in the not-for-profit, academic, and public sectors. Thanks to physiotherapists, Monica has kept up her love of cross-country skiing and cycling over the years.

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