Runners With Anterior Knee Pain Use a Greater Percentage of Their Available Pronation Range of Motion

2013 ◽  
Vol 29 (2) ◽  
pp. 141-146 ◽  
Author(s):  
Pedro Rodrigues ◽  
Trampas TenBroek ◽  
Joseph Hamill
Keyword(s):  
At Risk ◽  
Risk Factor ◽  
Range Of Motion ◽  
Motion Capture ◽  
Knee Pain ◽  
Anterior Knee Pain ◽  
System Dynamic ◽  
Motion Capture System ◽  
Alternative Method ◽  
Anterior Knee

“Excessive” pronation is often implicated as a risk factor for anterior knee pain (AKP). The amount deemed excessive is typically calculated using the means and standard deviations reported in the literature. However, when using this method, few studies find an association between pronation and AKP. An alternative method of defining excessive pronation is to use the joints’ available range of motion (ROM). The purposes of this study were to (1) evaluate pronation in the context of the joints’ ROM and (2) compare this method to traditional pronation variables in healthy and injured runners. Thirty-six runners (19 healthy, 17 AKP) had their passive pronation ROM measured using a custom-built device and a motion capture system. Dynamic pronation angles during running were captured and compared with the available ROM. In addition, traditional pronation variables were evaluated. No significant differences in traditional pronation variables were noted between healthy and injured runners. In contrast, injured runners used significantly more of their available ROM, maintaining a 4.21° eversion buffer, whereas healthy runners maintained a 7.25° buffer (P= .03, ES = 0.77). Defining excessive pronation in the context of the joints’ available ROM may be a better method of defining excessive pronation and distinguishing those at risk for injury.

scholarly journals Risk Factors for the Occurrence and Protraction of Anterior Knee Pain in Children and Adolescents: a Prospective Cohort Study of 3 Years

2021 ◽  
Author(s):  
Manato Horii ◽  
Ryuichiro Akagi ◽  
Sho Takahashi ◽  
Shotaro Watanabe ◽  
Yuya Ogawa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Cohort Study ◽  
Children And Adolescents ◽  
Knee Pain ◽  
Prospective Cohort Study ◽  
Anterior Knee Pain ◽  
Prospective Cohort ◽  
Activity Level ◽  
Anterior Knee

Abstract Background: Anterior knee pain (AKP) is a common limitation to children’s participation in social and physical activities. Therefore, to prevent the occurrence and protraction of AKP, it is crucial to identify risk factors. The purpose of this study was to clarify the factors associated with the occurrence and protraction of AKP in children and adolescents. Method: A three-year prospective cohort study was conducted with children and adolescents aged 8–14 in Japan. We recorded the occurrence of AKP, heel buttock distance, straight leg raising angle (SLRA), dorsiflexion angle of the ankle joint, and the Hospital for Special Surgery Pediatric Functional Activity Brief Scale (HSS Pedi-FABS). Logistic regression analysis was performed to calculate the odds ratio (OR) for each predicted risk factor for the occurrence and protraction of AKP among subjects without AKP at baseline. Results: We recruited 1,254 children and adolescents for the present study, and 1,133 children and adolescents who did not have AKP at baseline were included in the analysis. Six to nine percent of the subjects developed AKP annually. A high HSS Pedi-FABS score significantly predicted AKP occurrence (in 2017, OR 1.07, 95% CI 1.02−1.12, p = 0.003; in 2018, OR 1.05, 95% CI 1.01−1.10, p = 0.025). Of the participants, 32.9% developed chronic AKP during the follow-up period. When 8-year-old was used as a reference age, 13-year-old subjects (right side, OR 2.37, 95% CI, 1.00−5.61, p = 0.05) and 14-year-old subjects (right side, OR 2.57, 95% CI, 1.00−6.60, p = 0.049; left side, OR 6.32; 95% CI 1.33−30.00, p = 0.020) were at a significantly higher risk of AKP protraction. Conclusions: This study showed that a greater physical activity level was a risk factor for the onset of anterior knee pain in childhood. In addition, one-third of the children and adolescents developed chronic knee pain, and elderly adolescents were at a higher risk of protraction.

scholarly journals Effect of ultrasound-guided percutaneous neuromodulation applied to the femoral nerve on pain and range of motion in patients with anterior knee pain: A case study

2020 ◽  
Vol 03 (01) ◽  
pp. 030-034
Author(s):  
Paula García-Bermejo ◽  
Carlos Romero-Morales ◽  
Blanca de-la-Cruz-Torres
Keyword(s):  
Range Of Motion ◽  
Knee Pain ◽  
Effect Size ◽  
Anterior Knee Pain ◽  
Femoral Nerve ◽  
Medium Effect ◽  
Ultrasound Guided ◽  
Symptomatic Knee ◽  
Single Intervention ◽  
Anterior Knee

Abstract Introduction Anterior knee pain (AKP) is one of the most frequent reasons for physical therapy consultations, remaining a difficult treatment challenge for professionals. The aim of this study was to evaluate the effects of an intervention using ultrasound-guided percutaneous neuromodulation (US-guided PNM) applied to the femoral nerve on pain and knee flexion range of motion (ROM), in patients with unilateral chronic anterior knee pain. Methods Eight patients received a single intervention of NMP-e on the femoral nerve of the symptomatic knee. The level of pain and ROM were measured before, immediately after and 24 hours after the intervention. Results A decrease in pain and an increase of ROM were observed after the intervention and at 24 hours. For pain values, a medium effect size was observed (ES = 0.63 ± 0.43) after the intervention, and a large effect size (ES = 1.73 ± 0.44) was found at 24h. Concerning ROM, the effect size was large at both moments (ES = − 1.30 ± 1.14; −1.76 ± 0.80, respectively). Conclusion A single intervention of US-guided PNM on the femoral nerve produces a decrease of pain and increases the ROM, which is greater 24h after the stimulation. Level of Evidence Level II-3.

scholarly journals Effect of Patellar Resurfacing on Clinical Outcomes, Range of Knee Motion and Anterior Knee Pain in Patients with Total Knee Arthroplasty

2019 ◽  
Vol 20 (4) ◽  
pp. 309-312
Author(s):  
Ozgur Korkmaz ◽  
Yıldıray Genc ◽  
Osman Cimen ◽  
Ismail Oltulu ◽  
Deniz Gülabi ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Knee Pain ◽  
Knee Arthroplasty ◽  
Anterior Knee Pain ◽  
Knee Society Score ◽  
Clinical Results ◽  
Patellar Resurfacing ◽  
Knee Motion ◽  
Significant Difference ◽  
Anterior Knee

Abstract Objectives: In this study, we retrospectively compare the clinical results, range of knee motion and anterior knee pain in patients on whom we performed knee arthroplasty with and without patellar resurfacing. Thirty-eight patients were evaluated in the study. Knee Society scores, knee range of motion and anterior knee pain before and 12 months after surgery were detected. Patients were divided into two groups: resurfaced patellas and nonresurfaced patellas. There were 18 patients in the resurfaced group and 20 patients in the nonresurfaced group. Mean Knee Society score was 40.72±13.09 in the resur-faced group and 38.55±5.88 in the nonresurfaced group before surgery. Mean Knee Society score was 80.38±7.78 in the resur-faced group and 80.10±3.22 in the nonresurfaced group in the last control. Mean knee range of motion was 92.83±12.12 degrees in the resurfaced group and 91.05±10.10 degrees in the nonresurfaced group before surgery. Mean range of motion was 106.22±9.13 degrees in the resurfaced group and 97.25±8.50 degrees in the nonresurfaced group after surgery. There were twelve patients with anterior pain before surgery in the resur-faced group and 13 patients with anterior knee pain before surgery in the nonresurfaced group. After surgery, there was one patient with anterior pain in the resurfaced group and 9 patients with anterior knee pain in the nonresurfaced group. Anterior knee pain ratio was smaller in the resurfaced group than in the nonresurfaced group, and there was a significant difference in range of knee motion as a result of our study. We offered to resurface the patella.

Evaluating the Coupling between Foot Pronation and Tibial Internal Rotation Continuously Using Vector Coding

2015 ◽  
Vol 31 (2) ◽  
pp. 88-94 ◽  
Author(s):  
Pedro Rodrigues ◽  
Ryan Chang ◽  
Trampas TenBroek ◽  
Richard van Emmerik ◽  
Joseph Hamill
Keyword(s):  
Risk Factor ◽  
Range Of Motion ◽  
Internal Rotation ◽  
Anterior Knee Pain ◽  
Coordination Pattern ◽  
Vector Coding ◽  
Tibial Internal Rotation ◽  
Coupling Relationship ◽  
Foot Pronation ◽  
Anterior Knee

Excessive pronation, because of its coupling with tibial internal rotation (TIR), has been implicated as a risk factor in the development of anterior knee pain (AKP). Traditionally, this coupling has been expressed as a ratio between the eversion range of motion and the TIR range of motion (Ev/TIR) that occurs during stance. Currently, this technique has not been used to evaluate specific injuries or the effects of sex. In addition, Ev/TIR is incapable of detecting coupling changes that occur throughout stance. Therefore, the purpose of this study was to compare the coupling between eversion and TIR in runners with (n = 19) and without AKP (n = 17) and across sex using the Ev/TIR ratio, and more continuously using vector coding. When using vector coding, significant coupling differences were noted in runners with AKP (34% to 38% stance), with runners with AKP showing relatively more TIR than eversion. Similarly significant differences were noted across sex (14%–25% and 36%–47% stance), with males transitioning from a loading to propulsive coordination pattern using a proximal to distal strategy, and female runners using a distal to proximal strategy. These differences were only detected when evaluating this coupling relationship using a continuous technique such as vector coding.

120 Genicular Nerve Radio-Frequency Ablation in The Treatment of Anterior Knee Pain in Patients with Osteoarthritis of The Knee Joint: Systematic Review

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Farrugia ◽  
C Tinning
Keyword(s):  
Knee Pain ◽  
Anterior Knee Pain ◽  
Comparative Studies ◽  
Primary Outcome ◽  
Final Analysis ◽  
Primary Outcome Measure ◽  
Sensory Innervation ◽  
Osteoarthritis Of The Knee ◽  
Pain Scores ◽  
Anterior Knee

Abstract Anterior knee pain is one of the main symptoms in osteoarthritis, resulting from the rich sensory innervation of its capsule. Pain control can be difficult to achieve, with non-responders to conservative and medical therapy often requiring a total knee replacement. Radiofrequency ablation (RFA) is a novel technique that could be beneficial in managing anterior knee pain by targeting the genicular nerves around the knee; however, its routine use is not included in current guidelines. A literature search identified fifty-two results, which underwent screening using a study protocol and the final literature sources, of varying levels of evidence, underwent critical appraisal and analysis. The primary outcome included the significant improvement of pain scores from baseline, against their respective control treatments. The ten studies included in the final analysis consisted of seven comparative studies and three non-comparative studies. Literature showed significant improvement in their mean pain scores, all meeting the primary outcome measure. Most studies also showed significant improvement from the control treatments used. Current literature shows evidence that genicular nerve RFA is an effective and safe treatment modality in the management of anterior knee pain secondary to osteoarthritis. However, the literature available is limited and further comparative studies are required.

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