Research Article

Comparison of selected lower limb biomechanical variables between university of ibadan sportsmen with and without patellofemoral pain syndrome

Ayodeji Ayodele Fabunmi* and Samson Oluwaseyi Oladipupo

Published: 16 August, 2019 | Volume 4 - Issue 3 | Pages: 067-072

Patellofemoral pain syndrome is common among athletes who participate in jumping, running and pivoting sports. The aim of this study was to compare selected lower limb biomechanical variables between University of Ibadan students (athletes) with and without patellofemoral pain syndrome.

The research design for this study was a case control survey and a purposive sampling technique was used to recruit participants. Two hundred and twenty two (191(85.8%) males and 31 (14.2%) females) sportsmen participated in this study. The participants’ age was between 20-29 years. Fourty sportsmen tested positive to Clarke’s test while 27 sportsmen tested positive to Eccentric step test. Measurements of static quadriceps angle, hamstring tightness and navicular height were taken for all participants.

Data were analyzed using descriptive statistics of mean, standard deviation, percentages and inferential statistics of Independent ‘t’ test.

The mean lower limb biomechanical variables of participants with patellofemoral pain syndrome were 13.18 ± 2.37°, 106.46 ± 16.11° and 1.21 ± 0.61 cm while those without were 13.65 ± 2.46°, 128.95 ± 25.36° and 1.03 ± 0.58 cm for static quadriceps angle, hamstring tightness and navicular height respectively. There was no significant difference (p > 0.05) in selected lower limb biomechanical variables between participants with and without patellofemoral pain syndrome.

In conclusion there was no significant difference in static quadriceps angle, hamstring tightness and ankle pronation between participants with and without patellofemoral pain syndrome. It was recommended that PFPS development is probably multifactorial with other functional disorders of the lower extremity apart from the selected variables.

Read Full Article HTML DOI: 10.29328/journal.jsmt.1001046 Cite this Article Read Full Article PDF


Patellofemoral pain syndrome; Hamstring tightness; Static quadriceps angle; Ankle pronation  FullText PDF


  1. Baker V, Bennell K, Stillman B, Cowan S, Crossley K. Abnormal knee joint position sense in individuals with patellofemoral pain syndrome. J Orthop Res. 2002; 20: 208-214. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11918299
  2. Loudon JK, Gajewski B, Goist-Foley HL, Loudon KL. The effectiveness of exercise in treating patellofemoral-pain syndrome. J Sport Rehabil. 2004; 13: 323-342.
  3. Hart H, Ackland D, Pandy M, Crossley K. Quadriceps volumes are reduced in people with patellofemoral joint osteoarthritis. Osteoarthritis Cartilage. 2012; 20: 863-868. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22525223
  4. Dixit S, DiFiori JP, Burton M, Mines B. Management of patellofemoral pain syndrome. Am Fam Physician. 2007; 15: 75: 94-202. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17263214
  5. Collado H, Fredericson M. Patellofemoral pain syndrome. Clin Sports Med. 2010; 29: 379-398.
  6. Brukner P, Khan K, McConnell J, Cook J. Anterior knee pain. In: Brukner P, Khan K. Clinical Sports Medicine. 2nd edn. New York, N.Y: McGraw-Hill RAW: 454-493.
  7. Witvrouw E, Callaghan MJ, Stefanik JJ, Noehren B, Bazett-Jones DM, et al. Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat held in Vancouver, September 2013. Br J Sports Med. 2014; 48: 411-414. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24569145
  8. Natri A, Kannus P, Järvinen M. Which factors predict the long-term outcome in chronic patellofemoral pain syndrome? A 7-yr prospective follow-up study. Med Sci Sports Exerc. 1998; 30:1572-1577. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9813868
  9. Muller K, Snyder-Mackler L. Diagnosis of patellofemoral pain after arthroscopic meniscectomy. J Orthop Sports Phys Ther. 2000; 30: 138-142. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10721509
  10. Hamstra-Wright KL, Swanik CB, Ennis TY, Swanik KA. Joint stiffness and pain in individuals with patellofemoral syndrome. J Orthop Sports Phys Ther. 2005; 35: 495-501. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16187510
  11. Waryasz GR, McDermott AY. Patellofemoral pain syndrome (PFPS): a systematic review of anatomy and potential risk factors. Dyn Med. 2008; 7: 9. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2443365/
  12. Witvrouw E, Bellemans J, Lysens R. et al. Intrinsic risk factors for the development of patellar tendinitis in an athletic population. A two-year prospective study. Am J Sports Med. 2001; 29: 190-195. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11292044
  13. Darracott J, Vernon-Roberts B. The bony changes in “chondromalacia patellae”. Rheumatol Phys Med. 1971; 11: 175-179. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/5128521
  14. Power JD, Cohen AL, Nelson SM, Wig GS, Barnes KA, et al. Functional network organization of the human brain. Neuron. 2011; 72: 665-678. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3222858/
  15. Leppänen M, Pasanen K, Kujala UM, Parkkari J. Overuse injuries in youth basketball and floorball. Open Access J Sports Med. 2015; 6: 173-179. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4447174/
  16. Nejati P, Forogh B, Moeineddin R, Baradaran HR, Nejati M. Patellofemoral pain syndrome in Iranian female athletes. Acta Med Iran. 2011;49: 169. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21681705
  17. Van Gent BR, Siem DD, van Middelkoop M, van Os TA, Bierma-Zeinstra SS, et al. Incidence and determinants of lower extremity running injuries in long distance runners: a systematic review. Br J Sports Med. 2007; 41: 469-480. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/17473005
  18. Rathleff MS, Mølgaard CM, Fredberg U, Kaalund S, Andersen KB, et al. High-load strength training improves outcome in patients with plantar fasciitis: A randomized controlled trial with 12-month follow-up. Scand J Med Sci Sports. 2015; 25: e292-300. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25145882
  19. Wilk KE, Davies GJ, Mangine RE, Malone TR. Patellofemoral disorders: a classification system and clinical guidelines for nonoperative rehabilitation. J Orthop Sports Phys Ther. 1998; 28: 307-322. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9809279
  20. Sanchis-Alfonso V, Roselló-Sastre E, Revert F. Histologic retinacular changes associated with ischemia in painful patellofemoral malalignment. Orthopedicss. 2005; 28: 593-599. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16138473
  21. Fulkerson JP. Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med. 2002; 30: 447-456. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12016090
  22. Fagan V, Delahunt E. Patellofemoral Pain Syndrome - a review on the associated neuromuscular deficits and current treatment options. Br J Sports Med. 2008; 42: 789-95. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18424487
  23. Kwon O, Yun M, Lee W. Correlation between Intrinsic Patellofemoral Pain Syndrome in Young Adults and Lower Extremity Biomechanics. J Phys Ther Sci. 2014; 26: 961-964. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4135215/
  24. Nijs J, Van Geel C, Van der auwera C, Van de Velde B. Diagnostic value of five clinical tests in patellofemoral pain syndrome. Man Ther. 2006; 11: 69-77. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/15950517
  25. Souza T. The knee. In: Hyde TE, Gengenbach MS, editors. Conservative Management Sport Injuries. Baltimore, MD: Wouldiams &Wilkins. 1997; 394-395.
  26. Malanga GA, Andrus S, Nadler SF, McLean J. Physical examination of the knee: a review of the original test description and scientific validity of common orthopedic tests. Arch Phys Med Rehabil. 2003; 84: 592-603. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12690600
  27. Clarkson H. Musculoskeletal assessment: Joint motion and muscle analysis (3rdedn.) 1991 Lippincott Wouldiams and Wilkins. Philadelphia, USA.
  28. Brody TM. Techniques in the evaluation and treatment of the injured runner. Orthop Clin North Am. 1982; 13: 541-558. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/6124922
  29. Vinicombe A, Raspovic A, Menz HB. Reliability of navicular displacement measurement as a clinical indicator of foot posture. J Am Podiat Med. 2001; 91: 262-268. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/11359892
  30. Menz HB. Alternative techniques for the clinical assessment of foot pronation. J Am Podiatr Med Assoc. 1998; 88: 119-129. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9542353
  31. Jaiyesimi AO, Jegede OO. Influence of gender and leg dominance on Q-angle among young adult Nigerians. AJPARS. 2009; 1: 18-23.
  32. Silva Dde O, Briani RV, Pazzinatto MF, Gonçalves AV, Ferrari D, et al. Q-angle static or dynamic measurements, which is the best choice for patellofemoral pain?. Clin Biomech. 2015; 30: 1083-1087. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/26381196
  33. Heino BJ, Powers CM. Patellofemoral stress during walking in persons with and without patellofemoral pain. Med Sci Sports Exerc. 2002; 34:1582-1593. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12370559
  34. Thijs Y, Pattyn E, Van Tiggelen D, Rombaut L, Witvrouw E. Is hip muscle weakness a predisposing factor for patellofemoral pain in female novice runners? A prospective study. Am J Sports Med. 2011; 39: 1877-1882. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21632979
  35. Ramskov D, Jensen ML, Obling K, Nielsen RO, Parner ET, et al. No association between q-angle and foot posture with running-related injuries: a 10 week prospective follow-up study. Int J Sports Phys Ther. 2013; 8: 407-415. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/24175127
  36. Patil S, White L, Jones A, Hui AC. Idiopathic anterior knee pain in the young. A prospective controlled trial. Acta Orthop Belg. 2010; 76: 356-359. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20698457
  37. White LC, Dolphin P, Dixon J. Hamstring length in patellofemoral pain syndrome. Physiotherapy. 2009; 95: 24-28. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19627682
  38. Barton CJ, Bonanno D, Levinger P, Menz HB. Foot and ankle characteristics in patellofemoral pain syndrome: a case control and reliability study. J Orthop Sports Phys Ther. 2010; 40: 286-296. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/20436240
  39. Mølgaard M. Patellofemoral pain syndrome and its association with hip, ankle, and foot function in 16- to 18-year-oldhigh school students: a single-blind case-control study. J Am Podiatr Med Assoc. 2011; 101: 215–222. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/21622633


Figure 1

Figure 1

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More