Altered Hip Mechanics and Patellofemoral Pain. A Review of Literature

Gholamhassan Mirzaie¹, Mehrnaz Kajbafvala², Abbas Rahimi¹, Farideh Dehghan Manshadi¹, Khosro Khademi Kalantari¹

Affiliations

PMID: 28157077
DOI: 10.5604/15093492.1212855

Abstract

Patellofemoral pain (PFP) is a common knee disorder in orthopedic clinics. In the last decade, several investigations have considered the role of proximal factors in addition to local and distal factors in development of PFP. There is a hypothesis which suggests that impaired neuromuscular control and altered hip joint kinematic affect tibiofemoral and patellofemoral biomechanics. Hence, PFP may develop as a result. This article reviews studies assessing the relationship between altered hip mechanics and PFP. The Medline and PubMed databases were searched between January 2004 and October 2014. Two authors independently selected related articles using the same search strategy and key words. Among 149 articles, 16 met the review inclusion criteria. The study results were described in three sections: 1) kinematic studies, 2) muscle activity studies, and 3) postural stability studies. Increased hip adduction and internal rotation, gluteal muscle weakness, and neuromuscular impairment were common findings in patients with patellofemoral pain. Precise assessment of hip mechanics, including hip kinematic, muscle performance and postural stability, should be considered in the examination of patients with patello-femoral pain.

What does this Mean?

CORE Physical Therapy and Sports Performance in Omaha Explains.

Dr. Mark Rathjen PT DPT CSCS, Owner CORE Physical Therapy.

“Precise assessment of hip mechanics, including hip kinematic, muscle performance and postural stability, should be considered in the examination of patients with patello-femoral pain.”

This study is a meta analysis of the condition of Patella Femoral pain, knee pain, or also known knee tendonitis to be more generic. This was a review of 16 qualifying studies that focused around biomechanics, muscle activation and stability. Increased hip adduction and IR, weakness in the glute max and medius, and improper muscle activation where the most common causes of pain and deficiency.

In Physical Therapy, and especially in a sports clinic like CORE, we have known the vast and complicated relationship of the knee and the hip for many decades. It has been studied at nauseam and now able to qualify for a meta analysis.

A meta analysis is the gold standard review of all relevant and valid studies on a particular subject. The studies are grouped and trends are analyzed. This represents the HIGHEST level of evidence of information lies in the META analysis. What does this mean? The results of this study are VALID.

Treating nuromuscular deficiencies, asymmetries and weakness, and mechanic integration of the two will solve the knee pain riddle that plagues the majority of knee pain patients. Find the right clinician with loads of sports experience.

IF the hip is not the focus of the knee treatment, look for another professional.

C.O.R.E. Physical Therapy and Sports Performance PC,

17660 Wright St, Suites 9/10

Omaha, NE 68130

402-930-4027

At CORE Physical Therapy in Omaha, We specialize in the treatment of athletes. We have worked with athletes for a combined 30 years.

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Dr. Mark Rathjen and Dr. Claire Rathjen.

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est. 2015

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