Education, Gait Retraining, or Exercise for Management of Runners with Knee Pain
Patellofemoral pain, commonly referred to as runner's knee, is one of the most common reasons patients seek care in Physical Therapy clinics. In short, the symptoms are caused by abnormal forces between the knee cap and thigh bone. The condition is effectively treated by Physical Therapy interventions including manual therapy, exercise, and gait retraining. The goal of these interventions is to normalize the forces across the knee joint and improve the capacity of the body to absorb their sport's forces. A recent study compared different Physical Therapy interventions to determine which was most effective for improving patellofemoral pain symptoms.
A randomized controlled trial in the British Journal of Sports Medicine examined the impact of either education on training and symptom management, or exercise and an education program, or gait retraining and an education program on knee pain symptoms among 69 runners (Esculier et al. 2017). The followed the runners on these 8 week programs on outcomes at 1, 4, and 5 months. They were assessed for subjective reports of pain as well as strength and running mechanics. As expected, each group improved over each time period but strength gains were seen in only the exercise group and improved gait mechanics were only seen in the gait retraining group. Importantly, education on symptom management offered the largest impact on the runner's improvements and remained the most important factor for recovery.