From the Guidelines
Knee runners should prioritize a comprehensive management plan that includes individualized exercise therapy, education, and supporting approaches to address patellofemoral pain and improve quality of life. According to the most recent and highest quality study 1, a best practice guide for patellofemoral pain recommends a synthesis of a systematic review, the patient voice, and expert clinical reasoning. This approach emphasizes the importance of objective evaluation to identify key impairments that can influence treatment selection, including hip and knee strength, movement patterns, and tissue tolerance to load.
Key components of the management plan include:
- Individualized knee-targeted exercise therapy (±hip) delivered following a robust assessment of symptom severity and irritability, with exercise parameters modified accordingly 1
- Education to underpin all interventions, providing a rationale for the delivery of a specific intervention plan, building confidence and understanding of the diagnosis, and promoting autonomy and reducing fear 1
- Supporting approaches, such as prefabricated foot orthoses, taping, and manual therapy, to be considered as adjuncts to successful exercise delivery 1
- Movement/running retraining to be considered when symptoms are reasoned to be associated with task-specific biomechanics 1
It is essential to note that the management plan should be tailored to the individual's needs and preferences, taking into account their unique characteristics, symptoms, and goals. By prioritizing a comprehensive and individualized approach, knee runners can effectively manage patellofemoral pain and improve their quality of life. The study 1 provides strong evidence for the effectiveness of this approach, and its recommendations should be considered the gold standard for managing patellofemoral pain.
From the Research
Knee Runner Guidelines
- To prevent and manage knee injuries in runners, several interventions have been studied, including running technique retraining, footwear options, multicomponent exercise therapy, graduated running programmes, and online and in-person injury prevention education programmes 2.
- Low-certainty evidence suggests that running technique retraining to land softer may reduce knee injury risk by two-thirds 2.
- Very low-certainty to low-certainty evidence indicates that running-related patellofemoral pain may be effectively managed through a variety of active and passive interventions, such as running technique retraining, multicomponent exercise therapy, foot orthoses, and osteopathic manipulation 2.
- There is no direct evidence from the provided studies on the use of platelet-rich plasma (PRP) injections for knee runner guidelines, as the studies on PRP injections focus on subacromial impingement syndrome, rotator cuff tears, and general pain management 3, 4, 5, 6.