Intrinsic Risk Factors for the Development of Anterior Knee Pain in an Athletic Population: A Two-Year Prospective Study

Abstract

Many variables have retrospectively been associated with the presence of anterior knee pain. Very few prospective data exist, however, to determine which of these variables will lead to the development of anterior knee pain. It was our purpose in this study to determine the intrinsic risk factors for the development of anterior knee pain in an athletic population over a 2-year period. Before the start of training, 282 male and female students enrolled in physical education classes were evaluated for anthropometric variables, motor performance, general joint laxity, lower leg alignment characteristics, muscle length and strength, static and dynamic patellofemoral characteristics, and psychological parameters. During this 2-year follow-up study, 24 of the 282 students developed patellofemoral pain. Statistical analyses revealed a significant difference between those subjects who developed patellofemoral pain and those who did not concerning quadriceps and gastrocnemius muscle flexibility, explosive strength, thumb-forearm mobility, reflex response time of the vastus medialis obliquus and vastus lateralis muscles, and the psychological parameter of seeking social support. However, only a shortened quadriceps muscle, an altered vastus medialis obliquus muscle reflex response time, a decreased explosive strength, and a hypermobile patella had a significant correlation with the incidence of patellofemoral pain. We concluded that the latter four parameters play a dominant role in the genesis of anterior knee pain and we therefore deem them to be risk factors for this syndrome.

Hip Strengthening Prior to Functional Exercises Reduces Pain Sooner Than Quadriceps Strengthening in Females With Patellofemoral Pain Syndrome: A Randomized Clinical Trial

“…18 Despite being deemed a multifactorial condition with no single cure, PFPS is commonly attributed to muscular dysfunction, for which conservative rehabilitation is the treatment of choice. 19,23,35,45,46 Historically, PFPS has been linked to impairments of the quadriceps muscle. 27,33,35,45 Countless studies have cited quadriceps strength deficits, imbalances, and timing errors as the source of PFPS.…”

“…19,23,35,45,46 Historically, PFPS has been linked to impairments of the quadriceps muscle. 27,33,35,45 Countless studies have cited quadriceps strength deficits, imbalances, and timing errors as the source of PFPS. But more recent research regarding PFPS has focused on strength deficits of the proximal hip musculature as a contributor to this disorder.…”

Avaliação eletromiográfica e ressonância magnética do joelho de indivíduos com síndrome da dor femoropatelar

“…Pain seems to worsen in activities that involve an increase in patellofemoral compressive force, such as remaining seated for long periods, climbing and descending stairs 38 , kneeling or squatting 39 . According to Manske and Davies 40 , this pain may be due to stress in the peripatellar tissues and to deficiency in the patellofemoral cartilage when the knee remains flexed for prolonged periods.…”

The Norwich Patellar Instability Score: Validity, internal consistency and responsiveness for people conservatively-managed following first-time patellar dislocation

“…This is important as the latter group may have different experiences of instability symptoms from both physical/morphological factors in addition to health perceptions and beliefs towards instability and functional capability. [2,3] Furthermore, the responsiveness of the NPI Score over time has yet to be determined. The purpose of this study was therefore to answer the following four research questions: …”