Knee Strengthening With Hip vs. Ankle Exercises in Women With Patellofemoral Pain Syndrome

This study compared the effects of knee strengthening combined with either hip or ankle joint exercises on dynamic knee valgus (DKV), visual analogue scale (VAS) scores during activity, tendon stiffness, muscle structure, ankle range of motion, and muscle strength in women with anterior knee pain. Forty-five female recreational athletes aged 20-40 with anterior knee pain were randomly assigned to three groups: hip + knee exercises (HK group, n = 15), ankle + knee exercises (AK group, n = 15), and stretching alone (control group, n = 15). The HK and AK groups received supervised telehealth-based exercise sessions (30 minutes/day, 3 times/week for 8 weeks), while the control group received only an educational pamphlet. Assessments were conducted at baseline, 4 weeks, and 8 weeks.

Inclusion criteria

• Female recreational athletes aged 20-40 years who engage in regular exercise
• Experiencing pain in the anterior or surrounding patella during at least two or more of the following activities: walking, running, jumping, kneeling, squatting, climbing stairs, or prolonged sitting
• A pain index of 3 or higher on the Numeric Pain Rating Scale (NPRS) and symptoms persisting for at least 3 months
• Knee pain unrelated to trauma.

Exclusion criteria

• Inability to operate a smartphone or computer
• History of fractures or surgeries involving the hip, knee, ankle, or foot
• History of meniscus, knee ligament injuries, or ankle sprains within the last six months
• Knee ligament laxity, inflammation, swelling, patellar dislocation, or subluxation
• Cognitive impairment or inability to follow simple instructions
• History of cardiovascular or neurological disorders
• Advised by a physician to avoid exercise. Use of over-the-counter pain medication was not an exclusion criterion.