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Anterior Knee Pain in Female Athletes

Anterior Knee Pain in Female Athletes. Management and Rehab Exercises Monica A. Nickoli, LAT Staff Athletic Trainer Fisher-Titus Medical Center. Anterior Knee Pain. Anatomy Signs and Symptoms Risk Factors & Causes Treatment Exercises Bracing and Footwear. Anatomy. Femoral Groove

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Anterior Knee Pain in Female Athletes

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  1. Anterior Knee Pain in Female Athletes Management and Rehab Exercises Monica A. Nickoli, LAT Staff Athletic Trainer Fisher-Titus Medical Center

  2. Anterior Knee Pain • Anatomy • Signs and Symptoms • Risk Factors & Causes • Treatment • Exercises • Bracing and Footwear

  3. Anatomy • Femoral Groove • Patella • Max contact between femur and patella @ 90 degrees • Forces up to ½ body weight during walking, 3 x during stairs and 7 x while squatting

  4. Signs and Symptoms Risk Factors and Causes • Muscle imbalances • Core, glutes, hips • Patellar hypermobility • Poor flexibility • IT band, hams, quads, calves • Flat Feet • High arches • Hyperextended knees • Poor footwear • Overuse • Overload • Repeated activity, uneven surfaces • Diffuse “achy” pain • Popping or Clicking • Swelling is rare • Pain with prolonged sitting “theatre sign” • Knee “gives out” • Pain with uneven surfaces • Pain with hills • Pain with stairs • Pain with squats/lunges

  5. Treatment • Rest • Remove Irritant • Squats, lunges, etc • Alternate Exercises • Biking, swimming • Reduce Mileage • Ice • NSAIDS • Stretching • Strengthening

  6. Strengthening Exercises • Studies have found anterior knee pain highly correlates to weak hip musculature Study 199 people with overuse anterior knee pain Group 1: Knee/thigh strengthening (6 weeks, 3x week) Group 2: Hip/core strengthening (6 weeks, 3x week) Results: Group 1: 77% reported decrease in pain Group 2: 80.2% reported decrease in pain Difference: Group 1: results felt after 4 weeks Group 2: results felt after 3 weeks

  7. Treatment Phase 1Greatly reduce mileage & introduce low impact activities (bike, swim, elliptical) Strengthening 3 sets of 15 • Quad sets • Calf raises • Squats • 4 way leg raises • lying vs standing • Bridges • Clamshell Stretching 3 x 30 sec hold • Hamstrings • Quads • IT Band

  8. Treatment Phase 2Begin to increase mileage while decreasing low impact activity Strengthening 3 sets of 15 • Step ups • Side Step ups • Squat walks w/band • Forward/lateral • Bridges w/band • Clamshell w/band Stretching 3 x 30 sec hold • Hamstrings • Quads • IT Band

  9. Treatment Phase 3Full mileage & stop low impact activity Strengthening 3 sets of 15 • Vector Squats • Unilateral Dead Lift • Stool Squats • Step Downs • Lunges • Unilateral Bridges Stretching 3 x 30 sec hold • Hamstrings • Quads • IT Band

  10. Bracing and Footwear • Bracing • Controversial • Patella moves in several planes • Used for subluxations • Footwear • Fit for foot type • Arch Supports/Orthotics • Correct biomechanics

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