Here at Elite, our team of physical therapists see a lot of patients, many of them young athletes, who come to us seeking relief to pain in the front of their knee (or knees). These patients typically experience pain around or under their patella, or knee cap, that is often aggravated by running, climbing stairs, squatting, playing sports, and prolonged sitting. They’re often diagnosed with “Patellofemoral Pain Syndrome” by their doctor and referred to physical therapy for help with relieving their pain and to help them return to the activities and sports they love
If you’ve ever treated with a PT at Elite for this type of knee pain, or any type of knee rehab for that matter, you know that we focus a lot on improving your strength – but not just the muscles around your knee such as your quads, hamstrings, and calves, but also your hip and core muscles as well. We do this because there’s been a lot of quality research over the past decade that’s demonstrated that combining hip strengthening with knee strengthening is more effective than just strengthening the muscles around the knee. Why? The simplified answer is that the hip and core muscles play an important role in maintaining optimal hip, knee and ankle alignment and preventing abnormal tracking and loading of the patella, which can often result in common patellofemoral pain.
Just recently, the Journal of Orthopaedic & Sports Physical Therapy published the largest study yet on this topic, a systematic review with meta-analysis, which is the strongest type of evidence-based research. This study, which included 14 trials and over 673 participants, confirmed what previous smaller trials has demonstrated: “This systematic review with meta-analyses provides evidence that hip and knee strengthening is not only effective, but also superior to knee strengthening alone, for decreasing pain intensity and improving activity in people with patellofemoral pain.”  The authors also conclude that strength training of the hip and knee muscles 3 times per week for 6 weeks can be expected to decrease pain and improve activity in people with moderate-to-high levels of patellofemoral pain, and the benefits of this exercise program extend beyond the six week training period.
Here at Elite, we’ve treated many patients over the years with this common condition and have employed this knee-and-hip strengthening approach with very good success. In addition, we may use other techniques, such as stretching for tight muscle groups, core stabilization and balance training, manual therapy, and kinesiotaping, depending on the individual patient. So if you or someone you know is experiencing pain in the front of the knee, a well-designed physical therapy program can help. Don’t let pain keep you on the sidelines…A comprehensive physical therapy evaluation and an individualized PT program may be helpful in reducing your pain and helping you get back to doing what you love!
 Journal of Orthopaedic & Sports Physical Therapy 2018;48(1):30