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Exercise therapy offers relief to knee pain sufferers

23 October 2009

Being able to offer people exercise therapy rather than using the traditional ´wait and see´ approach, has the potential to be of huge benefit. Empowering people to actively partake in their own recovery can give them a big boost, especially if they are in pain.

Catherine Potter, Bupa physiotherapist at the Barbican Wellness centre

Exercise therapy eases knee pain and improves function more effectively than the traditional ´wait and see´ approach used by most doctors, according to new research.

The Dutch scientists studied 131 men and women aged between 14 and 40 with knee pain caused by patello-femoral syndrome. Half the men and women had sessions with a physiotherapist, in which they were taught special exercises (exercise therapy), and the rest of the group were treated using the standard 'wait and see' approach, ie to stop all activities that made the pain worse. The exercise therapy group were asked to continue practising their exercises every day for 25 minutes over a three month period.

At the start of the study, each person filled out a questionnaire about their condition. They were asked about their knee pain (how much they had at rest and how much when active), knee function (how well they felt their knee was working) and recovery (how well they felt their knee had recovered). The scientists asked the same questions again three months and then 12 months later.

The results showed that the exercise therapy group had less pain and more function in their knee after three months and at the 12 month follow-up. However, the amount of recovery they felt did not differ from those treated using the standard ´wait and see´ approach.

Another interesting finding was that the ´wait and see´ group reported using four times more painkillers and were twice as likely to need bandages and knee braces than the exercise therapy group.

Catherine Potter, Bupa physiotherapist at the Barbican Wellness centre, said: "Patello-femoral syndrome is a condition we commonly see in our centre, especially among young men and women. Being able to offer them exercise therapy rather than using the traditional ´wait and see´ approach, has the potential to be of huge benefit. Empowering people to actively partake in their own recovery can give them a big boost, especially if they are in pain.

"Another plus for exercise therapy is the fact that during the study fewer painkillers were needed. Any therapy that reduces the need for drug intervention is always a good thing."

Key facts
  • The patello-femoral is a groove at the bottom of your thigh bone that allows your knee joint to bend and straighten smoothly. Patello-femoral syndrome is pain in the joint between the kneecap (patella) and the thigh bone (femur).
  • Patello-femoral syndrome is the most common condition seen by sports medicine doctors.
  • The main symptom is pain around and behind the kneecap that starts gradually and gets worse if you do a lot of activity or sit down for a long time. You may also get a clicking or grinding sound when you bend or straighten your knee.
  • Activities that worsen the condition include long-distance running, squatting, lunging and walking up and down stairs.
  • Women are more likely to have patello-femoral syndrome than men.

Related information

Read the study

Linschoten Rv, Middelkoop Mv, Berger MY, et al. Supervised exercise therapy versus usual care for patellofemoral pain syndrome: an open label randomised controlled trial. BMJ 2009; 339(b4074):published online. doi:10.1136/bmj.b4074

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