Effectiveness of Physical Therapy Exercises for Knee Pain - by brent dodge

​Special thanks to star physical therapist Brace Hayden, DPT, CSCS of Alpine Physical Therapy for providing this write up on a recent article from Physical Therapy.

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Let’s face it, walking or climbing up and down stairs, moreover prolonged or pounding exercise can make our knees hurt. So why would anyone want to do more exercises to actually reduce knee pain?
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Dr. Clijsen and is Swiss team of  academic research scientists and physical therapists were determined to find the effectiveness of physical therapy exercises for reducing a knee pain, as there is limited research to the incidence of this prevalent problem. They were specifically interested in a common type of knee pain known as ‘Patellofemoral Pain Syndrome’ (PFPS) that hits 15% to 45% of active adolescents and adults under the knee cap.

Most people over the age of 13 have probably felt a twang of pain or a dull ache on the front of their knee under or under their knee cap when hiking down hills or stairs. The cluster of symptoms associated with PFPS is knee pain with running, squatting, stairs, or more strenuous weight-bearing exercise. It is more common in women than men. This syndrome is also known to be ‘self-limiting’, as reducing the provocative motions, naturally improves the knee’s unhappy status.

So what should you do to improve knee pain associated with squatting or stairs? What if I want to stay in shape by running or playing field sports, but my knees do not enjoy the impact? Often, people get in to see their physical therapist for assessing why the knee is in pain and then commit to improving their function with therapeutic exercises.

The cause for pain behind the knee cap can be coming from any number of problems or multiple issues combined. Faulty alignment of the leg joints, insufficient muscle strength, sport training errors and overly tight muscles are the bulk of the prevailing theories on why the knee is overstressed and pained. Correcting each individuals’ “patient reported measures of activity limitations and participation restrictions” by assessing their body mechanical and movement faults is often the goal of doing specific exercises to improve the PFPS.

This research study looked at a comprehensive review of 15 high-quality studies with a total of 748 male and female subjects with pain in their knee cap area. Based on the results of this systematic study, exercise therapy appeared to be an important plan of action to help achieve knee pain and functional improvements.

For example, could a 25 year old female with knee pain during and after track practice (or ‘activity limitation and participation restriction’) improve her discomfort with eight weeks of PT doing resisted leg extensions, hip girdle strengthening and using electrical stimulation over her quadriceps muscle? The verdict looks promising.

This study concluded that exercise therapy was effectively strong at reducing pain and getting participants back into their sporty activities. However, the question of which target exercises their therapist opted to use to yield the strongest effect to diminish their pain and boost their function remains unanswered.

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Ron Clijsen, PhD, et al, Effectiveness of Exercise Therapy in Treatment of Patients With Patellofemoral Pain Syndrome: Systematic Review and Meta-Analysis. In Physical Therapy. 2014; 94:1697-1708.
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For more information on this topic, view our clinical module on knee pain by clicking here.