Quad Strengthening Protocol for PFPS | Patellofemoral Pain Syndrome

[@Ela-ru6no]

Can you reply on the following question: why aren't you training the quads unilaterally? (one leg at a time) Because this way you are compensating with both legs and you can't focus on the weak leg itself. This is what my physio told me. I'm just curious to know!

[@AnimeeARTs]

Beacuse in that machine u need to put both legs ig. If ur doing manually or without any equipments u can focus on weak leg more

[@berndwalddorf1948]

Hello Andreas! Thank you for your great videos. Could you please explain how the leg press should be executed for best results? Is it necessary to don't go under 90 degrees? Or do I try to improve my range of motion maybe every week (for example)? Where do I have to place my feet? Would be great if you could give me some instructions here. Thank you so much. Best regards, Bernd.

[@TheIceyeddy]

Thanks for the great set of videos on patella femoral pain syndrome! Would love you to keep making these type of videos on other conditions e.g IT band syndrome,

[@Physiotutors]

That's the plan!

[@lovebyspd8997]

Superb friend,,, keep rocking

[@mariocarlesimo6352]

Hello Physiotutors! Thank you for this and all the videos. About this one...what about the the load of the exercises (kg or lbs)? And what should I do to increase it reasonably week after week in a hypothetical patient 70x70 (example). Thanks for your time!

[@Physiotutors]

Load should be adjusted to the patients presentation and skill. Max pain 2/10 and any irritation settles within 24 hours max. Rule of thumb to increase volume would be around 10%, but that's not a magical number whatsoever. adding a few reps here and there or a few kilos is sufficient.

[@bome7sen]

some therapists said dont streangth quads just gluts mussels what do u think ?

[@joshuahankins2613]

Do 4 weeks just glutes . Then add in quad strengthening.

[@bome7sen]

@@joshuahankins2613 i just discover my injury is patellar tendonitis so i dooing tendon isometric and eccentric

[@aernoudvankerkhoven1186]

Hello Physiotutors, Great videos with really helpfull compact content! Just a question, do you distinguish between different underlying pathophysiologies for PFPS in diagnosis and treatment? for example, are treatment approaches different for patellar maltracking causing lateral pressure vs patellar instability due to flat trochlea, or acute patella femoral pain caused by jumpers knee etc.? Thanks a lot!

[@Physiotutors]

You're welcome Aernoud! PFPS is different from patellar instability and also different from jumper's knee. For PFPS it's good load management with quad and hip strengthening. For instability, we'd put more focus on the quads, but approaches are similar. For jumper's knee/patellar tendinopathy load management is very much key as well and a possible start could be isometrics for the quads and general hip strenghtening, followed by concentric and eccentric exercises with a vertical tibia/heels raised. Maybe a good topic for a future treatment video.

[@ZabAzulay]

There isnt a link for the combined knee and hip strength that you mention at the end of the video?

[@Physiotutors]

Hey, yes its still in production but coming on Monday! Sorry for the inconvenience

[@hdenzymes]

Hi guys , what would you recommend for a patient who has pfps however finds full knee extension exercises painful? Would u recommend to exercising to just short of that range ? Thanks so much

[@Physiotutors]

We'd recommend to examine competing hypothesis that could be responsible for the limitation in knee extension, as this is not a common finding in PFPS. Could be the meniscus or fat pad syndrome for example.

[@mutlucankartal9524]

Sir, I do not have 8 weeks.. Even though I am at 26 and I have damn strong quads, patellofemural thing happened to me, now I cannot even bend my leg .. I am a farmer and I have a lot of work to do physically.. I have to snatch 50 kg bags from the ground to the spreader .. I need something lightning fast.. Anything you can recommend?

[@martineilertzen2226]

That's the problem. Your quads are so strong and the rest is not, so you are creating a muscle imbalance. Rehab the glutes and get stronger in those.

[@altaykosova5910]

what about leg extension machine and shear force on knee joint ?

[@Physiotutors]

Nothing wrong with it, the 12RM is also moderate weight. One of our colleagues has a comprehensive write-up: drjarodhalldpt.blogspot.nl/2016/10/why-there-is-nothing-wrong-with-dreaded.html

[@samwinter5522]

1. VMO< VLO 8 week knee quads: - leg press - sitting knee extension

[@Physiotutors]

There is no way to reliably measure VMO

[@ohcomeon1111]

Ive always read that leg extension should be avoided with pfps

[@Physiotutors]

There is no absolutes in rehab. It can be provocative in some patients, but it's also a great option to provide targeted load to the knee joint without the option to compensate for a patient.

[@peterlee3995]

I might have misheard it but did you say "leg press and sitting knee ext at 10RM" ?

[@Physiotutors]

Yes, 10 repetition maximum (=10 RM)

[@GalaxyWorldTV]

Andreas, I'm having trouble finding the actual quad strengthening protocol. Is it just 4 sets of 10 reps (1 min. rest), 3x/week for 8 weeks? Also, I don't see any link in the top-right corner for calculating 1RM. Can you relink? Thank you!

[@Physiotutors]

Hey, here is a quote: "Before each training session, the subjects per- formed standardized stretching for the quadriceps, hamstrings, and gluteal and calf muscles. The ex- ercise program included Bleg press[ on a machine (Tuff Stuff, Pomona, CA) and Bknee extension exercise[ on a weight machine (Apollo 350; Tuff Stuff, Pomona, CA). Each exercise involved four sets of ten repetitions with a 1-min rest between ses- sions. The resistance of the exercise was based on ten repetitions maximum, which was determined in the first training session and the ten-repetition maximum load was adjusted regularly during the period of study." Linked the video, otherwise you can find it on the channel

[@GalaxyWorldTV]

Thank you!