Efficacy of Adding Patellar Mobilization to Hip and Knee Exercises in Patients With Patellofemoral Pain Syndrome

Patellofemoral pain syndrome is a common source of anterior knee pain. The causes of PFPS may be multifactorial such as biomechanical disorders, muscle weakness which affect the dynamic stability of lower limb and alter patellar tracking in trochlear groove. Moreover, the syndrome associated with muscular tightness of iliotibial band, gastrocnemius, soleus, hamstring and quadriceps. Strengthening and stretching exercises are effective in improving patient's symptoms. However, they do not sufficient in correction of kinematic changes associated with PFPS. Patellar mobilization is effective in improving patient'symptoms in cases with PFPS. However, studies that conducted patellar mobilization were either low quality studies or no study combined patellar mobilization with hip and knee exercises.Therefore, APTA guidelines recommended for conducting high quality study to investigate the effect of adding patellar mobilization to exercise therapy to support the definite recommendation delivered to therapists.

Inclusion Criteria:Age ranging between 18 and 35 yearsTenderness of medial and lateral borders of patellaRetropatellar painDuration of symptoms of patellofemoral pain syndrome is greater than 4 weeksPositive patellar compression testPain intensity is more than 3 at visual analogue scaleHad a history of insidious onsetHad anterior knee pain during 2 or more of provocative activities that include stair ascent or descent, kneeling, prolonged sitting, or squattingExclusion Criteria:Previous patellar realignment surgery or patellar fractureHad a history of traumatic patellar dislocationHad a history of previous knee surgeryHad any form of inflammatory arthritis that include osteoarthritis or rheumatoid arthritisHad a history of knee menisci, ligaments, bursae, or synovial plica syndrome dysfunctionTaking corticosteroids or nonsteroidal anti-inflammatory medicationInability to attend treatment program to the end of sessions