Is hip strengthening the best treatment option for females with patellofemoral pain? A randomized controlled trial of three different types of exercises

Braz J Phys Ther. 2018 Sep-Oct;22(5):408-416. doi: 10.1016/j.bjpt.2018.03.009. Epub 2018 Apr 4.


Objective: To evaluate the effect of three types of exercise intervention in patients with patellofemoral pain and to verify the contributions of each intervention to pain control, function, and lower extremity kinematics.

Methods: A randomized controlled, single-blinded trial was conducted. Forty women with patellofemoral pain were randomly allocated into four groups: hip exercises, quadriceps exercises, stretching exercises and a control group (no intervention). Pain (using a visual analog scale), function (using the Anterior Knee Pain Scale), hip and quadriceps strength (using a handheld isometric dynamometer) and measuring lower limb kinematics during step up and down activities were evaluated at baseline and 8 weeks post intervention.

Results: All treatment groups showed significant improvements on pain and Anterior Knee Pain Scale after intervention with no statistically significant differences between groups except when compared to the control group. Only hip and quadriceps groups demonstrated improvements in muscle strength and knee valgus angle during the step activities.

Conclusion: Hip strengthening exercises were not more effective for pain relief and function compared to quadriceps or stretching exercises in females with patellofemoral pain. Only hip and quadriceps groups were able to decrease the incidence of dynamic valgus during step-down activity. This study was approved by Brazilian Clinical Trials Registry registration number: RBR-6tc7mj (

Keywords: Anterior knee pain; Quadriceps and hip muscles.; Rehabilitation; Step up and down kinematics.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Biomechanical Phenomena
  • Exercise Therapy / methods*
  • Female
  • Hip
  • Humans
  • Muscle Strength
  • Pain Management / methods
  • Patellofemoral Pain Syndrome / physiopathology
  • Patellofemoral Pain Syndrome / therapy*
  • Recovery of Function
  • Single-Blind Method
  • Young Adult