Posterolateral hip muscle strengthening in decreasing symptoms of patellofemoral pain syndrome: A critically appraised topic

Context: Patellofemoral pain (PFP) is an idiopathic condition characterized by aching pain in the peripatellar area, which is exacerbated by physical activities, such as climbing stairs, squatting, jumping, running, and prolonged sitting. PFP can often be managed by corrective exercise treatment that emphasizes strengthening of thigh and hip musculature, correction of malalignment of the lower extremity, and improvement of patellar incongruence. Evidence is inconclusive whether strengthening of the thigh or hip musculature is more beneficial in the treatment of PFP.

Clinical Question: Does posterolateral hip muscle strengthening compared to quadriceps strengthening help decrease symptoms in individuals presenting with patellofemoral pain?

Summary of Key Findings: A search of the following databases was conducted using search terms of hip strengthening, quadriceps strengthening, anterior knee pain, and patellofemoral pain (Pubmed, SPORTDiscus, EBSCO host, Trip Research, and Google Scholar). Only peer-reviewed studies that were randomized control trials, or systematic reviews were included in the analysis. Of the four articles that were included in this critically appraised topic, all recognized that hip strengthening had positive patient reported outcomes in decreasing symptoms of PFPS.

Clinical Bottom Line: There is moderate evidence that shows decrease in symptoms of pain in patients presenting with PFP that participated in posterolateral hip strengthening compared to thigh musculature training alone.