Influence of the hip on patients with patellofemoral pain syndrome: a systematic review.

CONTEXT: Patellofemoral pain syndrome (PFPS) is one of the most common conditions limiting athletes. There is a growing body of evidence suggesting that dysfunction at the hip may be a contributing factor in PFPS. DATA SOURCES: MEDLINE (1950-September 2010), CINAHL (1982-September 2010), and SPORTDiscus (1830-September 2010) were searched to identify relevant research to this report. STUDY SELECTION: Studies were included assessing hip strength, lower extremity kinematics, or both in relation to PFPS were included. DATA EXTRACTION: Studies included randomized controlled trials, quasi-experimental designs, prospective epidemiology, case-control epidemiology, and cross-sectional descriptive epidemiology in a scientific peer-reviewed journal. RESULTS: PFPS is associated with decreased hip strength, specifically at the abductors and external rotators. There is a correlation between PFPS and faulty hip mechanics (adduction and internal rotation). CONCLUSIONS: There is a link between the strength and position of the hip and PFPS. These patients have a common deficit once symptomatic. Hip strengthening and a coordination program may be useful in a conservative treatment plan for PFPS.