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Management of Patellofemoral Pain Syndrome

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  #1  
Old 17th January 2007, 12:44 AM
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Default Management of Patellofemoral Pain Syndrome

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Full text article rom the latest American Family Physician:
Management of Patellofemoral Pain Syndrome
Quote:
Patellofemoral pain syndrome (PFPS) is the most common cause of knee pain in the outpatient setting. It is caused by imbalances in the forces controlling patellar tracking during knee flexion and extension, particularly with overloading of the joint. Risk factors include overuse, trauma, muscle dysfunction, tight lateral restraints, patellar hypermobility, and poor quadriceps flexibility. Typical symptoms include pain behind or around the patella that is increased with running and activities that involve knee flexion. Findings in patients with PFPS range from limited patellar mobility to a hypermobile patella. To confirm the diagnosis, an examination of the knee focusing on the patella and surrounding structures is essential. For many patients with the clinical diagnosis of PFPS, imaging studies are not necessary before beginning treatment. Radiography is recommended in patients with a history of trauma or surgery, those with an effusion, those older than 50 years (to rule out osteoarthritis), and those whose pain does not improve with treatment. Recent research has shown that physical therapy is effective in treating PFPS. There is little evidence to support the routine use of knee braces or nonsteroidal anti-inflammatory drugs. Surgery should be considered only after failure of a comprehensive rehabilitation program. Educating patients about modification of risk factors is important in preventing recurrence. (Am Fam Physician 2007;75:194-202, 204. Copyright © 2007 American Academy of Family Physicians.)
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Old 17th January 2007, 12:58 AM
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Default Re: Management of Patellofemoral Pain Syndrome

Related threads:
Foot pronation and knee pain
Knee abduction impulses and patellofemoral pain
Patellofemoral pain and asymmetrical hip rotation
Patella tracking and patellofemoral pain syndrome
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Old 18th January 2007, 07:41 PM
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Default Re: Management of Patellofemoral Pain Syndrome

Dear All

At the Sports and science meeting in Fiji a few months back, some phd physio who has done alot of work in this area was now chansing the gluteus medius as the culpret.

Can't wait for the hyoglossus to be blamed. It will given enough time.

Using Jones' strain counter strain can fix it in 90 seconds. Done it hundreds of times to people in all walks of life wih patellofem pain from a few weeks to years to loss of career due to pain. etc. selling two storey house due to stairs and pain. could go on.

musmed

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Old 19th January 2007, 03:18 AM
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Default Re: Management of Patellofemoral Pain Syndrome

Quote:
Originally Posted by musmed
Dear All

At the Sports and science meeting in Fiji a few months back, some phd physio who has done alot of work in this area was now chansing the gluteus medius as the culpret.

Can't wait for the hyoglossus to be blamed. It will given enough time.



www.musmed.com.au
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Old 19th January 2007, 02:07 PM
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Default Re: Management of Patellofemoral Pain Syndrome

what is 'Jones strain counter strain'
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Old 19th January 2007, 02:52 PM
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Default Re: Management of Patellofemoral Pain Syndrome

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Originally Posted by dingo
what is 'Jones strain counter strain'
Counterstrain technique for plantar fasciitis
Jones Counterstrain Technique for sesamoiditis
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Old 19th January 2007, 04:08 PM
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Default Re: Management of Patellofemoral Pain Syndrome

Dear All

Jones' strain counterstrain was designed by Lawrence Jones. He was an American Osteopath that found there were many tender points where ligaments or tendons join or cross bones.


You an get his book on Amazon. Itis published by his own company, Jones Publishing.

Jones' points resist all forms of therapy. It does not matter that the sore spot has been rubbed, heated, manipulated, injected etc. It just doen not get better.

There are about 250 Jones' points from the head to the great toe.

What is hard to understand is that the problem is only a Jones' point if the pain is turned off by using his technique/protocol.

Basically the procedure is to place a fingertip on the tender point and then move the joint/limb/head/whatever into flexion/extensio abduction/adduction compression/distraction until the pain stops (CONSTANT feedback from your patient is essential). Once it stops immediately do not move. Hold that place for 90 seconds, return joint etc. to neutral and retest.

There should be a 70+% reduction in pain. Over the following few days it will completely disappear.

I hae posted on my website (pull down on the left hand side) the treatment of sesamoiditis. THis is an unbelievably simple technique that works to the amazement of the patient despite the problem having been there for several years or so.

Have a look. Try it! It works.

Regards
musmed
www.musmd.com.au
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