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Is elastic resistance training effective for treating anterior knee pain?

Anterior knee pain, or patellofemoral pain syndrome is a common condition associated with muscle imbalances, particularly at the hip. These imbalances are thought to lead to biomechanical changes that cause excessive load on the patellofemoral joint and associated structures such as the patella tendon.

Elastic resistance is often prescribed as part of a physical therapy intervention for anterior knee pain, but its overall efficacy remains unclear. I was asked by the journal Sports Health to write a systematic review of the literature on the effectiveness of elastic resistance in the rehabilitation of patellofemoral pain syndrome patients. As you can imagine, there weren’t many studies, but I was able to come up with 8, peer-reviewed clinical studies that specified the use of elastic resistance.

As with most reviews of clinical trials, it was difficult to make a definitive conclusion based on scientific rigor; however, each study found significant improvements in pain but they were designed without being able to isolate the effect of elastic resistance. From a scientific perspective, the conclusion is that elastic resistance training may help reduce pain and improve function and strength. However, from a clinical perspective, it’s clear that elastic resistance training is effective as part of a comprehensive treatment for patellofemoral pain syndrome.

Clinical trials are often limited in clinical applicability because of a quasi-homogenous population—while all subjects may have patellofemoral pain syndrome, there are a variety of causes that may differ between individuals. For example, some pain may be caused by a functional muscle imbalance, while other pain may be caused by structural misalignment. As with any condition, the clinician must design an intervention specific to the patient based on a thorough history and examination.

REFERENCE: Page P. Effectiveness of elastic resistance in rehabilitation of patients with patellofemoral syndrome: What is the evidence? Sports Health. 2011. 3(2):190-94.

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