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Exercise Once Again is Medicine if Supervised by a Physical Therapist

Evidence based practice

Do you know anyone that has or ever had pain in the front of the knee or around the kneecap? Patellofemoral pain syndrome is the diagnosis, and it's a fairly common problem that affects women more than men. It can be quite a nuisance. Some have to take anti-inflammatory pain medication and often have to limit their activity.

Treatment for kneecap pain has been controversial. Some advocate rest, others exercise. Over the past few years physical therapists have learned more about what types of exercise seem to help. It turns out that hip exercise to stabilize the thigh bone (aka the femur) has some limited proof of effectiveness. But the simple question remains. Is exercise any better than rest?

Exercise Therapy is Better than Rest

Researchers in the Netherlands recently publish a clinical study that concluded, "In patients with patellofemoral pain syndrome, exercise therapy produces better results regarding pain and function at 3 months and at 12 months than usual care." They performed the study on 131 patients with kneecap pain. About half of them were involved in a standardized (the same exercises for everyone) rehabilitation program and the others rested and took medication (the control).

At 3 months, the exercise group was better than the control group. Those that followed the recommendations of their physical therapist were better in the following areas:

  • Pain at rest,
  • Pain with activity,
  • They took less medication,
  • Level of function was better as well at 3 months.

There was no difference in self reported "recovery" (that is, patients who designated themselves as "fully recovered" or "strongly recovered")

For Faster Recovery, Less Medication, and Better Pain Relief - See a Physical Therapist

The good news is that people that have kneecap pain seem to get better in the long run. But, who has time to waste? If less pain, fewer pills and getting back on track faster matter, seeing a physical therapist makes good sense. We have been successfully treating kneecap pain for years. Here again is another good clinical study to reinforce it.
Reference - BMJ 2009;339:b4074

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