Lumbopelvic manipulation for patellofemoral pain syndrome?

“The knee bone’s connected to the…” – how would you finish that lyric? And, you’re welcome for putting that in your head for the rest of the day!

This week’s research review discusses lumbopelvic manipulation for a common condition – patellofemoral pain syndrome (PFPS).

PFPS is a really common, with an annual prevalence of ~25% in the 2general population. PFPS has been defined as retro/peri-patellar pain that worsens during walking, running, jumping, stair climbing, and prolonged sitting. Improper tracking of the patella over the femoral condyle is thought to play a role in PFPS and weak quadriceps muscles, abnormal Q angle, excessive femoral internal rotation, and patellar hypermobility are considered risk factors for developing the condition. Exercises that strengthen the quadriceps and gluteal muscles to have been shown to correct abnormal patellar excursion as well as excessive femoral internal rotation.

Lumbopelvic manipulation (LPM) has been shown to be promising in the treatment of PFPS, although the findings of studies that have investigated LPM and knee disorders are inconsistent. Therefore, the aim of the current systematic review and meta-analysis was to summarize the evidence from randomized controlled trials (RCTs) and determine the effectiveness of LPM in patients with PFPS.

From Dr. Thistle:

These results emphasize the utility of SMT in the management of PFPS, but also remind us that it shouldn’t be employed as a sole treatment. This makes sense, as there are numerous other treatment techniques that can be useful in these knee pain patients, including soft tissue work, various modalities and exercise/rehabilitation. It is important to reduce pain as fast as possible, which allows the patient to progress to appropriate rehab interventions. From my clinical experience, don’t forget to assess other relevant areas for appropriate mobility and function: 1) the hip (always, for almost any lower body condition!); 2) the proximal tib-fib joint (often restricted/stiff in PFPS patients) and 3) the ankle/foot…think of it as the kinetic chain, or as I would communicate to patients – it is a whole-body approach to movement and health!

RESEARCH REVIEW: Lumbopelvic Manipulation for Pain Reduction in Patellofemoral Pain Syndrome

This paper was published in Life (2024).

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