Prevalence of Myofascial Trigger Points in the Hip in Patellofemoral Pain

Prevalence of Myofascial Trigger Points in the Hip in Patellofemoral Pain is an article in the Physical Medicine and Rehabilitation by a team including our very own Sean Roach.


To determine the prevalence of myofascial trigger points (MTrPs) in the gluteus medius (GMe) and quadratus lumborum (QL) for subjects with patellofemoral pain (PFP), and to examine the relationship between MTrPs and force production of the GMe after treatment.


Randomized controlled trial.


A physical therapy clinic.


Subjects (N=52; mean age ± SD, 30±12y; mean height ± SD, 172±10cm; mean mass ± SD, 69±14kg) volunteered and were divided into 2 groups: a PFP group (n=26) consisting of subjects with PFP, and a control group (n=26) with no history of PFP.


Patients with PFP received trigger point pressure release therapy (TPPRT).

Main Outcome Measures

Hip abduction isometric strength and the presence of MTrPs.


Prevalence of bilateral GMe and QL MTrPs for the PFP group was significantly higher compared with controls (P=.001). Subjects in the PFP group displayed significantly less hip abduction strength compared with the control group (P=.007). However, TPPRT did not result in increased force production.


Subjects with PFP have a higher prevalence of MTrPs in bilateral GMe and QL muscles. They demonstrate less hip abduction strength compared with controls, but the TPPRT did not result in an increase in hip abduction strength.


The study consisted of 52 volunteer subjects (24 men, 28 women; mean age ± SD, 30±12y; mean height ± SD, 172±10cm; mean mass ± SD, 69±14kg). The PFP group (n=26) consisted of subjects with PFP. The control group (n=26) did not have a history of PFP. The human subjects review board at Rocky Mountain University of Health Professions and the University of Oregon approved the protocol for the study. All subjects provided written informed consent before their participation in the study, and the rights of the subjects were protected. Subjects selected for this study met the following criteria for the PFP group: generalized anterior, anterior/medial knee or retropatellar pain for 1 month or longer associated with prolonged sitting, ascending/descending stairs, sports activity, and/or running. Exclusion criteria for both groups included a history of patellar dislocation, cartilage or ligamentous damage, surgery for trauma to the knee, and a known history of osteoarthritis. All subjects completed the Anterior Knee Pain Scale (AKPS), which is a validated questionnaire tool used to subjectively measure normal knee function.17 The AKPS includes 13 self-reported questions that address functional tasks such as running, walking, and climbing stairs.17

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