Disclosure: None disclosed. “
“Patellofemoral pain (PFP) is the most common lower extremity diagnosis among those who are physically active.1, 2 and 3 Historically, the etiology of PFP has been attributed to abnormal patella tracking secondary to impairments in quadriceps muscle performance

(eg, weakness TSA HDAC or insufficiency of the vastus medialis oblique relative to the vastus lateralis).4, 5, 6 and 7 As such, conservative interventions (eg, patella taping, vastus medialis oblique strengthening) are commonly prescribed for persons with PFP.8 and 9 Although the ability to selectively strengthen the vastus medialis oblique has been questioned,10 and 11 several clinical trials have shown that quadriceps strengthening is beneficial for persons with PFP.12, 13, 14, 15 and 16 The premise that a strength imbalance between the vastus medialis oblique and vastus lateralis

check details contributes to abnormal patella tracking has been recently challenged. Dynamic imaging studies performed in weight-bearing suggest that lateral patella displacement and lateral tilt are a function of medial rotation of the femur as opposed to patella motion.17 and 18 This suggests that impaired hip muscle performance may be a contributing factor with respect to abnormal patella tracking and PFP. Indeed, biomechanical studies have reported that persons with PFP demonstrate excessive hip internal rotation19 and 20 and hip adduction21 compared with pain-free individuals.

Furthermore, persons with PFP have been reported to exhibit impaired muscle performance Tyrosine-protein kinase BLK of the hip abductors,19, 21, 22 and 23 hip extensors,19, 21 and 23 and external rotators.21 Because of recent focus on the contribution of abnormal hip mechanics to patellofemoral disorders, several randomized controlled trials have sought to evaluate the effects of hip muscle strengthening on PFP symptoms.15, 16, 24, 25 and 26 Khayambashi et al25 reported that 8 weeks of hip abductor and external rotator strengthening resulted in reduced pain and improved health status in women with PFP compared with a control group that did not receive hip strengthening exercises. The improvements in the hip strengthening group were sustained at 6-month follow-up. Studies by Fukuda,15 and 16 Nakagawa,26 and colleagues found that the combination of hip and quadriceps strengthening resulted in a greater reduction in PFP compared with quadriceps strengthening performed in isolation. To date, to our knowledge, only 1 study has compared hip strengthening with quadriceps strengthening in persons with PFP. Dolak et al24 reported that 4 weeks of hip strengthening was superior to 4 weeks of quadriceps strengthening in reducing symptoms in women with PFP. However, the between-group difference was not maintained when followed by an additional 4 weeks of combined hip and knee functional training.