PILATES FOR PATELLOFEMORAL PAIN SYNDROME

Chanel DeBerge August 26 2012 South Pasadena

The knee joint is the largest and most complicated joint in the body and is exposed to an enormous workload. The most common runner's knee overuse injuries are patellofemoral pain syndrome. Patellofemoral pain syndrome is a syndrome characterized by pain or discomfort originating from the contact of the posterior surface of the patella with the femur sometimes accompanied by clicking, cracking and crunching noises when bending. The causes for this can be anatomical abnormality (flat feet, overpronation, knock knee and Q-ankle) or deficit of strength and or flexibility in the surrounding muscles. Runners with this syndrome usually have tight and strong outer quadriceps and weak inner side of quadriceps. There has to be a balance. Runners usually underuse gluteal muscles. Weak hip abductors also to contribute to knee pain since it will cause the femur to rotate inwards by causing patella misalignment.

Anatomical description and diagram Page 4 Case study Page 5 Conditioning program Page 6, 7 Reason for program Page 8 Conclusion Page 9 Bibliography Page 10

Maria Sanchez is a 27-year-old woman with patellofemoral pain syndrome. She has always done a variety of sports but her main focus has been running. Maria had started to feel pain in her right knee in the past few months and wants to continue to keep up her normal day routine and activities. Her symptoms have been pain around kneecap, pain at moments when bending and some sounds of cracking and popping. Maria has just recently begun to be interested in Pilates and the way it can help her to rehabilitate her knee. For this particular problem I would create a well rounded program to restore muscular imbalances in the legs by increasing the flexibility of tight hip flexors and hamstrings, strengthen hip adductors, abductors and quadriceps muscles to help keep knee and hip joints more stable.

CONDITIONING PROGRAM Warm up Roll downs before getting on reformer.

Foot Work Parallel heels Parallel toes V position toes Open V Open V toes Calf raises Prances

Supine arm series Extension Adduction Up circles Down circles Triceps

Feet in straps Frog Down circles Up circles Openings

Spinal articulation Bottom lift Bottom lift with extension

Short spine

Short box Round back Flat back Tilt Twist Round about

Long box Pulling straps 1 Pulling straps 2

Full body 1 Up stretch 1 Elephant

Stretches Side split Mermaid Standing lunge

I chose a program with a variety of movements but that also included specific exercises that worked on Hip rotation, stability and mobility. Calf strengthening, and flexibility. Lateral hip strength and stability, abductor and adductor strength. Thoracic extension. Core strength. Hamstring strength. Quadriceps strength.

CONCLUSION In conclusion petellofemoral pain syndrome is very likely but also very treatable. Strengthening muscles around the knee and those that support movement in the horizontal and frontal plane is necessary.

BIBLIOGRAPHY Pilates anatomy Rael Isacowits Web MD www.webmd.com www.google.com www.articlebase.com Interview with Maria Sanchez BASI study guide and reformer books.