Runners with PFP have altered biomechanics which targeted interventions can modify

(Neal, Barton, Gallie, O’Halloran, & Morrissey, 2016)

Aims: To synthesise prospective, observational and intervention studies that measure clinical and biomechanical outcomes in symptomatic running populations.

Methods: SR, 2 independent reviewers, 28 studies, PeDro scale for quality.

Results: Very limited prospective evidence indicates that increased peak hip adduction is a risk factor for PFP development in female runners; in addition to limited evidence that running retraining changes both symptoms and function via a likely kinematic mechanism of reduced peak hip adduction. This is supported by moderate evidence from cross-sectional research in mixed sex cohorts, with a correlation also identified between PFP during running and increased peak hip adduction, internal rotation and contralateral pelvic drop. Further prospective research is needed to clarify if these relationships are of a causal or associative nature. Limited evidence also indicates that proximal strengthening exercise changes both symptoms and function at short-term follow up, but currently potential biomechanical mechanisms are unclear.

Limitations: In some studies: insufficient data, methodological issues, representativeness of sample, reliability of outcome measure, only 1 HQ and 2MQ, short term 3 months only …

In Practice: Running pattern may be influencing PFP and evaluating and addressing these may help some patients (especially in female group).

Neal, B. S., Barton, C. J., Gallie, R., O’Halloran, P., & Morrissey, D. (2016). Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: A systematic review and meta-analysis. Gait and Posture, 45, 69–82. https://doi.org/10.1016/j.gaitpost.2015.11.018

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