Local and widespread hyperalgesia in female runners with patellofemoral pain are influenced by running volume

Pazzinatto, Marcella Ferraz; Silva, Danilo de Oliveira; Pradela, Juliana; Coura, Maira Bergamaschi; Barton, Christian J; Azevedo, Fábio Mícolis de

doi:10.1016/j.jsams.2016.09.004

Cited by 20 publications

(5 citation statements)

References 26 publications

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“…The lower limit of 18 years was selected as the AEM has been tested primarily in adult populations [7,12,13,27], and due to some evidence that certain pain coping strategies change as a function of age [44] or that there are age-related differences in the impact of pain coping on pain outcomes [45,46]. The upper limit enhances comparability with previous studies in athletes [47,48].…”

Section: Study Sample and Proceduresmentioning

confidence: 99%

Psychosocial subgroups in high-performance athletes with low back pain: eustress-endurance is most frequent, distress-endurance most problematic!

Titze

Fett

Trompeter

et al. 2020

Scandinavian Journal of Pain

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ObjectivesIn non-athletes, fear-avoidance and endurance-related pain responses appear to influence the development and maintenance of low back pain (LBP). The avoidance-endurance model (AEM) postulates three dysfunctional pain response patterns that are associated with poorer pain outcomes. Whether comparable relationships are present in athletes is currently unclear. This cross-sectional case-control study explored frequencies and behavioral validity of the AEM-based patterns in athletes with and without LBP, as well as their outcome-based validity in athletes with LBP.MethodsBased on the Avoidance-Endurance Fast-Screen, 438 (57.1% female) young adult high-performance athletes with and 335 (45.4% female) without LBP were categorized as showing a “distress-endurance” (DER), “eustress-endurance” (EER), “fear-avoidance” (FAR) or “adaptive” (AR) pattern.ResultsOf the athletes with LBP, 9.8% were categorized as FAR, 20.1% as DER, 47.0% as EER, and 23.1% as AR; of the athletes without LBP, 10.4% were categorized as FAR, 14.3% as DER, 47.2% as EER, and 28.1% as AR. DER and EER reported more pronounced endurance- and less pronounced avoidance-related pain responses than FAR, and vice versa. DER further reported the highest training frequency. In athletes with LBP, all dysfunctional groups reported higher LBP intensity, with FAR and DER displaying higher disability scores than AR.ConclusionsThe results indicate that also in athletes, patterns of endurance- and fear-avoidance-related pain responses appear dysfunctional with respect to LBP. While EER occurred most often, DER seems most problematic.ImplicationsEndurance-related pain responses that might be necessary during painful exercise should therefore be inspected carefully when shown in response to clinical pain.

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Section: Study Sample and Proceduresmentioning

confidence: 99%

Psychosocial subgroups in high-performance athletes with low back pain: eustress-endurance is most frequent, distress-endurance most problematic!

Titze

Fett

Trompeter

et al. 2020

Scandinavian Journal of Pain

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“…Thus, greater patellar mobility may potentially explain why presumed morphologically equivalent knees express pain unilaterally, related to focal articular overload in the lateralized patella (dynamic lateralization). On the other hand, AKP patients may also have altered pain modulation mechanisms resulting in local and widespread hyperalgesia [39,40,[45][46][47]57]. which may lead to knee biomechanical alterations [11,36].…”

Section: Discussionmentioning

confidence: 99%

Unilateral anterior knee pain is associated with increased patellar lateral position after stressed lateral translation

Leal

Andrade

Flores

et al. 2019

Knee Surg Sports Traumatol Arthrosc

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Purpose To objectively compare side‐to‐side patellar position and mobility in patients with idiopathic unilateral anterior knee pain (AKP) using a stress‐testing device concomitantly with magnetic resonance imaging. It is hypothesized that the painful knees present greater patellar mobility than the contralateral non‐painful knees. Methods From a total sample of 359 patients, 23 patients with idiopathic unilateral AKP (30.9 years, 23.4 kg/m2, 43% males) were included within the present study. Both knees of all the patients were examined by conventional imaging, including the measurement of trochlear sulcus angle, Caton‐Deschamps index, tibial tuberosity to trochlear groove distance, patellar tilt angle and patellar subluxation (both at rest and upon quadriceps contraction). Additionally, the same patients underwent stress testing (Porto Patella Testing Device); these measurements were taken with the patella at rest, after lateral patellar translation and after lateral patellar tilt. Clinical and functional outcomes were obtained using physical examination and the Kujala and Lysholm scores. Results Painful knees showed statistically significant higher patellar lateral position after stressed lateral translation than non‐painful knees (p = 0.028), 9.8 ± 3.6 mm and 7.1 ± 6.3 mm, respectively. The adjusted multivariate logistic model identified the patellar position after lateral displacement to be significantly associated with AKP (OR = 1.165) and the model (AUC = 0.807, p < 0.001) showed reasonable sensitivity (67%) and specificity (73%). Conclusion Patients with idiopathic unilateral AKP with morphologically equivalent knees showed statistically significant increased patellar lateral position after stressed lateral displacement in their painful knee. The greater lateral patellar mobility quantified by the PPTD testing brings more objectivity to the diagnosis. Level of evidence II.

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“…The eligibility criteria were based in the last PFP consensus statement and previous studies. 14,[19][20][21] The following inclusion criteria for PFP participants were assessed by a clinician (>5y experience) (1) presence of anterior knee pain when performing at least 2 of the following activities: sitting for prolonged time, squatting, kneeling, running, ascending and descending stairs, jumping and landing; (2) insidious onset symptoms lasting at least 1 month; (3) worst pain level in the previous month corresponding to at least 30 millimeters in the visual analog pain scale (VAS); (4) unilateral PFP. Women were included in the pain-free group if they had no signs or symptoms of PFP or other neurological or musculoskeletal condition.…”

Section: Methods Participantsmentioning

confidence: 99%

Patellar Tendon Reflex and Vastus Medialis Hoffmann Reflex Are Down Regulated and Correlated in Women With Patellofemoral Pain

Pazzinatto

Silva

Ferreira

et al. 2019

Archives of Physical Medicine and Rehabilitation

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Local and widespread hyperalgesia in female runners with patellofemoral pain are influenced by running volume

Cited by 20 publications

References 26 publications

Psychosocial subgroups in high-performance athletes with low back pain: eustress-endurance is most frequent, distress-endurance most problematic!

Psychosocial subgroups in high-performance athletes with low back pain: eustress-endurance is most frequent, distress-endurance most problematic!

Unilateral anterior knee pain is associated with increased patellar lateral position after stressed lateral translation

Patellar Tendon Reflex and Vastus Medialis Hoffmann Reflex Are Down Regulated and Correlated in Women With Patellofemoral Pain

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