Safe Patellofemoral Syndrome Exercises

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Safe Patellofemoral Syndrome Exercises

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Safe Patellofemoral Syndrome Exercises - January 17, 2001 4:11:00 AM

mcap

Posts: 652
Joined: February 8, 2000
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This is a question I have been pondering for some time. For patients with patellofemoral syndrome, you obviously want to use exercises that minimize the patellofemoral joint reaction force. This has led to the closed kinetic chain craze that we have all witnessed. Personally, I think that the argument has not been substantiated and that open chain exercises can be O.K. as well. This leads me to the search for an open chain exercise for PFPS patients.

In the book by Andrews Harrelson and Wilk, open chain knee extension is listed as producing relatively low JR force when performed from 90 to about 45 degrees. In their chart, the opposite is true for closed chain which seems to produce less JRF from 0 to 45 degress of flexion. This was also what I learned in school and I have been treating patients accordingly.

The thing is that if you look at the free body diagram with the force of the quad tendon and patellar tendon and the resulting PFR, it would seem to be always higher from 90 to 45 degrees, open or closed chain. I know that a mitigating factor would be the amount of contact area which is greater in deeper flexion and stress is load per unit area. But this would hold true for both. Why the inconsistency? [IMG]http://www.rehabedge.com/forums/confused.gif[/IMG]