Sagittal Plane Trunk Posture Influences Patellofemoral Joint Stress During Running

Teng, Hsiang‐Ling; Powers, Christopher M.

doi:10.2519/jospt.2014.5249

Cited by 109 publications

(102 citation statements)

References 42 publications

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“…between PFJ stress and trunk flexion in healthy individuals during running tasks. 93 While caution should be placed in comparing relationships between the trunk and knee across pathologies and in a healthy population, it does present with the possibility to provide insight into this altered movement in individuals with PFP.…”

Section: Trunkmentioning

confidence: 98%

Impairment based rehabilitation for patellofemoral pain patients

Glaviano

Saliba

2016

The Physician and Sportsmedicine

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Patellofemoral pain is a common knee pathology that affects a wide range of active individuals. These individuals often seek medical care, with 25% of all patients seen in sports medicine clinics being treated for patellofemoral pain. While conservative treatment produce beneficial short-term results, individuals with patellofemoral pain often have long-term pain and decreased quality of life for many years following their diagnosis. One of the challenges for treating this chronic condition is the heterogeneous presentation of impairments across patients, ranging from soft tissue restriction, muscle weakness, altered movement patterns during functional tasks, and weak core stability. Clinicians need to identify these impairments and develop an individualized impairment-based model for treating patients with PFP. The aim of this review it to provide guidance and recommendations for clinicians who treat PFP in hopes to improve long-term outcomes for the conservative treatment of PFP.

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Section: Trunkmentioning

confidence: 98%

Impairment based rehabilitation for patellofemoral pain patients

Glaviano

Saliba

2016

The Physician and Sportsmedicine

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“…In the context of running in participants with PFPS, changes to VARelements might relate to the loads that are applied to soft tissues during different movement phases. For instance, VARelements may be reduced during the initial or final sub-phase of stance (Hamill et al 1999;Heiderscheit et al 2002) as this is when most stress is applied to the patellofemoral joint and is likely to be most painful (Teng and Powers, 2014). This implies that during chronic pain, changes to VARelements depend on the effect on pain/pathology and function.…”

Section: Altered Varelements For Some Features Of Movement But Not Omentioning

confidence: 99%

Movement variability and pain: Searching for a solution

Bergin¹

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Human movement is inherently variable. In the performance of complex, multi-joint tasks, it is possible to consistently achieve an accurate outcome (i.e. low variability of the goal: VARgoal), with many different combinations of joint movements and patterns of muscle activation (i.e. variability in the elements of the movement: VARelements). It has been proposed that when the nervous system is challenged by acute experimental pain, VARelements might increase to search for a new, less painful movement strategy and then decrease if a less painful solution is found. The changes to VARelements found in situations of chronic musculoskeletal pain are more diverse. In chronic pain VARelements might be reduced, increased, not changed, or a complex interaction of these possible adaptations. All previous studies that investigated VARelements during pain evaluated multi-joint tasks (e.g. walking, pointing) that involve multiple elements. It was unclear whether VARelements would be altered in a similar manner for simple tasks with fewer elements and thus limited potential for VARelements to change.For the series of studies included in this thesis, a simple movement task was developed that involved radial-ulnar deviation of the wrist between two target angle regions. Kinematic data were collected with 3-dimensional recording systems and VARelements were considered in wrist flexionextension and forearm pronation-supination. The effect of pain on VARelements during performance of the radial-ulnar deviation task was evaluated in Studies 1-3, under various pain conditions. Study 1 investigated the influence of acute experimental pain, induced with injection of hypertonic saline, on VARelements during performance of the repetitive radial-ulnar deviation task. This study showed that, unlike that observed in more complex multi-joint systems, VARelements was reduced during acute pain in the simple task with limited elements that could change. The most likely explanation was that the motor system constrained movement in an attempt to reduce pain or exert greater control over joint motion.On the foundation of differences in the changes to VARelements for complex and simple tasks during acute pain, Study 2 investigated whether VARelements would initially increase during acute pain to gain exposure to different movement options in a search for a less painful solution. An experimental paradigm was developed where the simple task provoked moderate pain for most movements, but a less painful or non-painful solution was available that was likely to be experienced as a result of VARelements with repetition of the task. We found participants searched for, and found, a less painful movement strategy, but VARelements was not used as part of this search. Participants did not select III the strategy provided as the least painful solution by the experimental paradigm, but found a less painful strategy with gradual changes to wrist/forearm position over multiple repetitions to explore alternative movement options. The changes to VAReleme...

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“…Sample size was based off previous repeated measure studies that focused on PF kinetics and kinematics. [12][13][14]19 All participants included were rearfoot strikers, as determined by center of pressure at initial contact occurring in the rear most third of the foot during testing. 18 Additional inclusion criteria included five years of recreational running experience, self-reported running routine of >10 miles per week, and a score of at least level five on the Tegner Activity Level Scale (a questionnaire of regular participation with recreational sports which require running).…”

Section: Subjectsmentioning

confidence: 99%

“…16,17 Conservative intervention strategies of PFP often involve attempts to alter running mechanics. 12,13,16 Decreasing step length by 10% results in a 15-20% decrease in patellofemoral joint (PFJ) kinetics, 16 while increasing the runner's cadence by 10% was successful in reducing PFJ forces by 14%. 12 Teng and Powers reported that a 7 degree increase in trunk flexion led to significant decreases in knee extensor energy absorption and generation.…”

Section: Introductionmentioning

confidence: 99%

“…12 Teng and Powers reported that a 7 degree increase in trunk flexion led to significant decreases in knee extensor energy absorption and generation. 13 Another strategy utilized to alter PFJS is adopting a forefoot strike (FFS) pattern during running. A forefoot strike pattern occurs when a runner contacts the ground with the anterior third of their shoe compared to a rearfoot striker (RFS) who contacts the ground with the posterior third.…”

Section: Introductionmentioning

confidence: 99%

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Effect of Heel Lifts on Patellofemoral Joint Stress During Running

Mestelle

Kernozek

Adkins

et al. 2017

Intl J Sports Phys Ther

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Background: Patellofemoral pain is a debilitating injury for many recreational runners. Excessive patellofemoral joint stress may be the underlying source of pain and interventions often focus on ways to reduce patellofemoral joint stress.Purpose: Heel lifts have been used as an intervention within Achilles tendon rehabilitation programs and to address leg length discrepancies. The purpose of this study was to examine the effect of running with heel lifts on patellofemoral joint stress, patellofemoral stress impulse, quadriceps force, step length, cadence, and other related kinematic and spatiotemporal variables. Study Design: A repeated-measures research designMethods: Sixteen healthy female runners completed five running trials in a controlled laboratory setting with and without 11mm heel lifts inserted in a standard running shoe. Kinetic and kinematic data were used in combination with a static optimization technique to estimate individual muscle forces. These data were inserted into a patellofemoral joint model which was used to estimate patellofemoral joint stress and other variables during running.Results: When running with heel lifts, peak patellofemoral joint stress and patellofemoral stress impulse were reduced by a 4.2% (p=0.049) and 9.3% (p=0.002). Initial center of pressure was shifted anteriorly 9.1% when running with heel lifts (p<0.001) despite all runners utilizing a heel strike pattern. Dorsiflexion at initial contact was reduced 28% (p=0.016) when heel lifts were donned. No differences in step length and cadence (p>0.05) were shown between conditions. Conclusions: Heel lift use resulted in decreased patellofemoral joint stress and impulse without associated changes in step length or frequency, or other variables shown to influence patellofemoral joint stress. The center of pressure at initial contact was also more anterior using heel lifts. The use of heel lifts may have therapeutic benefits for runners with patellofemoral pain if the primary goal is to reduce patellofemoral joint stress. Level of Evidence: 3b

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Sagittal Plane Trunk Posture Influences Patellofemoral Joint Stress During Running

Cited by 109 publications

References 42 publications

Impairment based rehabilitation for patellofemoral pain patients

Impairment based rehabilitation for patellofemoral pain patients

Movement variability and pain: Searching for a solution

Effect of Heel Lifts on Patellofemoral Joint Stress During Running

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