Proximal and distal influences on hip and knee kinematics in runners with patellofemoral pain during a prolonged run.

Dierks TA, Manal KT, Hamill J, Davis IS

The objective of this study was to investigate the relationships between hip strength and hip kinematics, and between arch structure and knee kinematics during prolonged treadmill running in runners with and without patellofemoral pain syndrome (PFPS). Hip abduction and hip external rotation isometric strength measurements were collected in 20 recreational runners with PFPS before and after a prolonged run, while the arch height index was recorded on all runners before the run. Both groups displayed decreases in hip abductor and external rotator strengths at the end of the run. The PFPS group displayed significantly lower hip abduction strength compared to controls. At the end of the run, the level of association between hip abduction strength and the peak hip adduction angle for the PFPS group was statistically significant. Arch height did not differ between groups and no significant association was observed between arch height and peak knee adduction angle during running.

Runners with PFPS displayed weaker hip abductor muscles that were associated with an increase in hip adduction during running. This relationship became more pronounced at the end of the run.

Journal of Orthopaedic and Sports Physical Therapy, 2008, 38(8), 448-56

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