The Effect of Concurrent Plantar Flexor Stretching and VMO Strengthening in Female Patients with Patellofemoral Pain Syndrome

Patellofemoral pain syndrome (PFPS) is one of the anatomical abnormalities
and one of the most common knee problems, which causes anterior knee pain.
Vastus medialis oblique (VMO) weakness and contracture of plantar flexors are
among the most important factors to cause this syndrome. The purpose of the
present study was to investigate the effect of concurrent planter flexor stretching
and VMO strengthening in females with PFPS. 30 females (age 38.4±3.48 years,
weight 70.5±2.89 kg) with PFPS participated in this study. Participants were
randomly assigned to control and experimental groups. Experimental group
received common medical treatment in addition to eight weeks of concurrent
plantar flexor stretching and VMO strengthening exercises, while control group
received only common medical treatment. The WOMAC questionnaire was
administered to assess pain, physical dysfunction and stiffness. Also, range of
motion of dorsiflexion, knee extension and Q angle were measured before and after
the treatment. ANOVA with repeated measures was administered to analyze the
data (P<0.05). The results after eight weeks of treatment showed a significant
decrease in WOMAC score in both groups (compared to pretest) while the
experimental group showed greater improvement. In the experimental group,
range of motion of dorsiflexion increased significantly after eight weeks (P<0.05)
(compared to pretest and control group). Also, Q angle decreased significantly in
both groups (compared to pretest). Range of motion of knee extension increased
significantly in both groups (compared to pretest) while experimental group gained
more range of motion than control group. It can be concluded that concurrent
planter flexor stretching and VMO strengthening may increase the efficiency of
treatment of patients with PFPS.