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  • Should we consider changing traditional physiotherapy treatment of patellofemoral pain based on recent insights from the literature?

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Editorial
Should we consider changing traditional physiotherapy treatment of patellofemoral pain based on recent insights from the literature?
  1. Christian J Barton1,2,
  2. Kay M Crossley1,2,
  3. Erin M Macri3,4
  1. 1 La Trobe Sports and Exercise Medicine Research Centre, School of Allied Health, La Trobe University, Bundoora, Victoria, Australia
  2. 2 Department of Surgery, St Vincent’s Hospital, University of Melbourne, Melbourne, Victoria, Australia
  3. 3 Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada
  4. 4 College of Health Sciences, University of Delaware, Newark, Delaware, USA
  1. Correspondence to Dr Christian J Barton, La Trobe Sports and Exercise Medicine Research Centre, Bundoora, VIC 3086, Australia; christian{at}completesportscare.com.au

http://dx.doi.org/10.1136/bjsports-2017-098695

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    The 2016 international patellofemoral pain (PFP) consensus statement1 suggested exercise therapy targeting the hip and knee, combined interventions and prefabricated foot orthoses can be used to improve pain and function in people with PFP. These recommendations are based on strong foundations including synthesis of multiple high-quality systematic reviews combined with voting from the International Patellofemoral Research Network group.

    But, is this current focus on traditional physiotherapy optimal?

    A recent prognostic paper indicated that nearly 50% of people with PFP are likely to benefit from traditional physiotherapy in the longer term.2 However, 57% report unfavourable outcomes 5–8 years after being enrolled in a traditional physiotherapy clinical trial, indicating a need for alternative approaches in these individuals.2

    Importantly, patient outcomes may be improved by providing interventions tailored to their needs. Efforts are under way to optimise subgrouping of patients in order to target traditional physiotherapy interventions. The purpose of this Editorial is a ‘call to action’ for researchers and clinicians (see box 1) to also consider exploring, incorporating and tailoring non-traditional physiotherapy interventions to optimise patient outcomes. Based on recent insights contained within two systematic reviews and one randomised clinical trial published in the British Journal of Sports Medicine, this may include weight management, addressing psychological factors …

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    Footnotes

    • Contributors CJB conceived the idea and drafted the original manuscript. EMM and KMC contributed to the manuscript. All authors approved the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.