I'd like to know if anyone have references about the influence of lumbosacral ROM on anterior knee pain, because we are conducting a study where we will compare the measuring of people with and without anterior knee pain, and I didn't have success in found this relationship
There are two papers on lumbopelvic manipulation for patellofemoral pain (a synonym for AKP). Iverson et al 2008. Lumbopelvic Manipulation for the Treatment of Patients With Patellofemoral Pain Syndrome: Development of a Clinical Prediction Rule that was published in JOSPT and Crowell et al. Lumbopelvic manipulation in patients with patellofemoral pain syndrome which was published in Journal of Manual and Manipulative Therapy). They might be of interest to you.
Dear Michael... I already have seen these papers. These are very interesting.
I'm looking for too, how a limited lumbosacral ROM could influence anterior knee pain. There is a author that advocate that hamstrings muscles shortness lead to a posterior tilt of the pelvis, thus biomechanical changes will occur in the knee with increase in pressure over the patellofemoral joint.
Thanks a lot
Clinically we've seen anterior deviation of the projection of COP over right or left feet plus anterior tilting of the pelvis in cases like this, e.g. patient describes anterior pain on the right knee, and it is observed (using a pressure plate) an anterior deviation of the COP over the right foot plus an anterior tilting of the right iliac. But I have not read any papers about it.
Good question! However, I would like to turn the question around; can range of motion in lower limbs influence low back pain? If you study this, how will you know what the original cause is?
Dear Rodolfo, you should have a look at the classical papers (textbooks) of orthopaedics. Of course there is a connection between lumbar spine and lower limbs posture, ROM and eventually pain connected to degenerative changes for fixed contractures, etc. You might start with Thomas test (sign) for the relationship of lumbar lordosis to flexion contracture of the hip joint. In these cases the knee has the tendency of hyperextension, eventually this may cause what you call "anterior knee pain". And vice versa (s. Martin's remark).
Dear Marting, in fact I'm looking for the influences of lumbosacral ROM (Schöber test). We have seen that subjects with anterior knee pain have decreased lumbosacral mobility measured by the Schöber test.
Dear Panayot, The Thomas test is a good idea. In our study we employed the Schöber test. In fact, as you stated, this anormal biomechanic lead to a overpressure in the patellofemoral joint, that may cause anterior knee pain
Sure, Schober test is a very useful tool for measuring the flexibilty of the lumbar spine (M. Bechterew, fixed hypolordosis of different etiology, etc.). If the ROM is reduced and fixed contractures, ankylosis, deformity exist, this condition involves the hips, the knees and the feet on the biomechanical chain. It is logic to expect compesatory positions of the lower limb joints and pain syndrome.
Dear all, if you want to look at what causes anterior knee pain you will need to conduct a prospective study with asymptomatic subjects that you follow over time. Looking at patients already in pain makes it impossible to determine if lumbosacral ROM is the cause or the effect of pain.
Dear Rodolfo,
The biceps femoris defines one (of presumably more) important functional-anatomical relation between the lumbo-pelvic region and the knee. We found that pelvic girdle pain patients often have higher tension in their hamstrings, leading to diminished lumbopelvic motion, especially because of limited pelvis rotation in the hipjoints. This increased hamstring tension might als alter knee kinematics. We measure this using ORCA, video based lowback coordination measurement system.
See attached publication.
Dear Jan-Paul, thanks a lot for this paper. It will be very helpful
- Badges
- Science topic
- Similar topics
- Medicine
- Epi
- Age Groups
- Children