The Utilization of Core Exercises in Patients With Patellofemoral Pain: A Critically Appraised Topic

in Journal of Sport Rehabilitation
Restricted access

Purchase article

USD  $24.95

Student 1 year online subscription

USD  $76.00

1 year online subscription

USD  $101.00

Student 2 year online subscription

USD  $144.00

2 year online subscription

USD  $192.00

Clinical Scenario: Patellofemoral pain (PFP) is characterized by general anterior knee pain around the patella and is one of the most prevalent knee conditions. PFP is challenging to treat due to a wide range of contributing factors and often has chronic, reoccurring symptoms. Traditional treatment focuses on quadriceps and gluteal strengthening with minimal emphasis on deep trunk musculature. Recently, there has been a growing body of literature supporting the beneficial effects of core stability exercises as a treatment option for PFP. Clinical Question: Are core stability exercises coupled with traditional rehabilitation more effective than only traditional rehabilitation techniques for decreasing pain in patients with PFP? Summary of Key Findings: Three articles met the inclusion criteria and investigated core strengthening exercises as a treatment for PFP. Two studies investigated a 4-week exercise protocol and demonstrated a greater decrease in pain when compared to the control group. The third study examined the effects of a 6-week program where both the intervention and control groups resulted in similar reduction of pain. All articles included received a minimum of 6 on the PEDro scale. Clinical Bottom Line: There is evidence that supports core stability exercise protocols coupled with traditional rehabilitation as being more effective in reducing pain in patients with PFP when compared to traditional rehabilitation alone. Strength of Recommendation:The grade of A is recommended based on the Strength of Recommendation Taxonomy.

The authors are with the University of Connecticut, Storrs, CT, USA.

Zuk (emma.zuk@uconn.edu) is corresponding author.
  • 1.

    Bolgla LA, Boling MC, Mace KL, DiStefano MJ, Fithian DC, Powers CM. National athletic trainers’ association position statement: management of individuals with patellofemoral pain. J Athl Train. 2018;53(9):820836. PubMed ID: 30372640 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Smith BE, Selfe J, Thacker D, et al. Incidence and prevalence of patellofemoral pain: a systematic review and meta-analysis. PLoS One. 2018;13(1):e0190892. PubMed ID: 29324820 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Boling MC, Nguyen AD, Padua DA, Cameron KL, Beutler A, Marshall SW. Gender-specific risk factor profiles for patellofemoral pain. Clin J Sport Med. 2019;31:4956.

    • Search Google Scholar
    • Export Citation
  • 4.

    Glaviano NR, Baellow A, Saliba S. Physical activity levels in individuals with and without patellofemoral pain. Phys Ther Sport. 2017;27:1216. PubMed ID: 28780340 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Lack S, Barton C, Sohan O, Crossley K, Morrissey D. Proximal muscle rehabilitation is effective for patellofemoral pain: a systematic review with meta-analysis. Br J Sports Med. 2015;49(21):13651376. PubMed ID: 26175019 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Bolgla LA, Earl-Boehm J, Emery C, Hamstra-Wright K, Ferber R. Pain, function, and strength outcomes for males and females with patellofemoral pain who participate in either a hip/core- or knee-based rehabilitation program. Int J Sports Phys Ther. 2016;11(6):926935. PubMed ID: 27904794

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Ferber R, Bolgla L, Earl-Boehm JE, Emery C, Hamstra-Wright K. Strengthening of the hip and core versus knee muscles for the treatment of patellofemoral pain: a multicenter randomized controlled trial. J Athl Train. 2015;50(4):366377. PubMed ID: 25365133 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Chevidikunnan MF, Al Saif A, Gaowgzeh RA, Mamdouh KA. Effectiveness of core muscle strengthening for improving pain and dynamic balance among female patients with patellofemoral pain syndrome. J Phys Ther Sci. 2016;28(5):15181523. PubMed ID: 27313363 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Motealleh A, Mohamadi M, Moghadam MB, Nejati N, Arjang N, Ebrahimi N. Effects of core neuromuscular training on pain, balance, and functional performance in women with patellofemoral pain syndrome: a clinical trial. J Chiropr Med. 2018;18(1):918. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Earl-Boehm JE, Bolgla LA, Emory C, Hamstra-Wright KL, Tarima S, Ferber R. Treatment success of hip and core or knee strengthening for patellofemoral pain: development of clinical prediction rules. J Athl Train. 2018;53(6):545552. PubMed ID: 29893604 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11.

    Crossley KM, Bennell KL, Cowan SM, Green S. Analysis of outcome measures for persons with patellofemoral pain: which are reliable and valid? Arch Phys Med Rehabil. 2004;85(5):815822. PubMed ID: 15129407 doi:

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 380 380 134
Full Text Views 17 17 0
PDF Downloads 21 21 0