Low-tech rehabilitation of bilateral patellofemoral knee pain in a runner: a case study.

Patellofemoral pain is a common ailment within both the running and general populations. Many of the structures of the anterior knee that comprise the patellofemoral joint can be the source of chronic pain and inflammation that is associated with this condition. Much of the evidence in the literature points to a delay in activation of the vastus medialis oblique muscle as compared to the vastus lateralis, vastus medialis weakness, and ultimately faulty patellar tracking as the chief causative factors in the development of patellofemoral pain. This is a single case study of a 51-year-old recreational runner with an 18-month history of bilateral patellofemoral knee pain. Treatment included the use of low-tech in office rehabilitation strategies known to affect those causative factors responsible for patellofemoral pain. Evidence based treatment modalities were utilized in combination, which included patellar mobilization, spinal manipulation, proprioceptive and strength training, and semi-rigid orthotic use, to effect vastus medialis oblique vs. vastus lateralis activation, vastus medialis strength, and patellar movement. The patient responded very well to a 12 week course of treatment and resumed recreational running with minimal to no pain at the six month, one and two year follow-ups.