Hip Strength in Females With and Without Patellofemoral Pain

Journal of Orthopaedic and Sports Physical Therapy

 Mary Ireland  MD, John Wilson MSPT, Bryon Ballantyne, PT, MA. Irene Davis PT, PhD 

 Study Design: Cross-Sectional

 Objectives: To determine if females with anterior knee pain are more likely to demonstrate hip abduction or external rotation weakness than a similar, asymptomatic, age-matched control group

 Background: Diminished hip strength has been implicated as being contributory to lower extremity malalignment and patellofemeral pain. The identification of reliable and consistent patterns of weakness in this population may assist health care professionals establish a more effective treatment plan.

 Results: Subjects with Patellofemeral pain demonstrated 26% less hip abduction strength and 36% less hip external rotation strength then similar age-matched women who are not symptomatic. 

What You Need To Know. 

Key Points:

1. Patellofemeral joint pain (PFP)
1. One of the most common orthopedic complaints (>25%)
1. Females experience greater than males
2. Complaint of pain behind knee cap
2. Cause is multi-factorial
1. Medial quad weakness
2. Decreased hamstring, quad and IT band strength, high patella, femoral rotation (skeletal)
3. Most females athletes with knee pain demonstrate significant hip abductions and external rotation weakness compared to age-matched, nonsymptomatic control

Take Home:

1. Off-season and pre-season training should include specific hip abduction and hip external rotation exercises designed to increase strength
2. Exercises should be specific in regards to build strength and can progress to include sport specific training techniques
3. Any complaint of knee pain should be immediately address through corrective and preventative measures
4. Muscles to strengthen: - 
1. gluteus maximus, gluteus medius, gluteus minimus, tensor fascia lata, sartorius, piriformis
2. Strengthening these muscles may decrease the chances of knee pain