Anterior knee pain (also known as patellofemoral pain syndrome or PFPS) makes up around 40% of problems reported by patients registered with orthopaedic clinics. There is evidence that impaired muscle timing of VM (Vastus medialis):VL (Vastus lateralis) is a significant factor when focusing on the frequency of these symptoms. Weakened muscles of abductors as well as hip external rotators were observed in patients with PFPS. Tensor Fasciae Latae (TFL) is an abductor and at the same time a hip internal rotator. It can increase lateral displacement of the patella by joining its retinaculum with ITB. An increased internal rotation of the hip and the lateral displacement of the patella may contribute to PFPS. It is important to properly do exercises which activate mainly the Gluteus Medius and VM, whereas TFL and VL to a lesser extent.
Assessment of exercises which simultaneously activate the VM, VL, Gluteus Medius and the TFL taking into account the dependency of a greater activation of the VM:VL and Gluteus Medius:TFL.
Material And Methods
Literature contained in the databases of PubMed, EBSCO and ScienceDirect, published in the years from 2004 to 2014, was reviewed using a combination of the following search results: VM exercises, VM:VL, gluteus medius exercises, PFPS, ELPS, EMG, sEMG, TFL.
The literature contains numerous studies onto sets of exercises controlled by EMG which activate VM to a higher degree than VL and Glut Med more than TFL. However, no exercises have been found that examine both these dependencies in the same time. Attention was most often drawn to VM:VL timing. Stimulation of the Gluteus Medius in the context of pelvis stabilization has been studied as well. Independent researchers frequently described three exercises: a squat with the lower limb adduction, lower limb extension in the knee joint in OKC and step climbing.
The sistematic review allowed drawing conclusions that it would be advisable to select certain exercises, tested under the control of EMG, which activate muscles with a clear stimulation of the VM and the Gluteus Medius. The subject of our further research will focus on checking the effectiveness of the exercises in patients with PFPS.