Hello CRM,
Now that's not true. her
original work started with her post grad thesis - she has done her PGD
manipulation and Biomedical Engineering masters. The original study was
conducted at a private boys school and there were definitely more than 3
subjects
Cheers,
Anna
Anna Lee
Principal,
Work Ready
Industrial Athlete Centre
Snail mail:
Suite 3, 82 Enmore
Road,
Newtown NSW 2042
Australia
Tel: (02) 9519 7436
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98
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-----Original Message-----
From: Matt McEwan
<[log in to unmask]>
To:
[log in to unmask] <[log in to unmask]>
Date:
March 30, 1999 3:44 PM
Subject: Re: Patello-femoral OA
>At
09:22 29/03/99 -0800, you wrote:
>>I attended the Combined Sections
Meeting and took a one day course on
>>patella femoral pain. The
presenters emphasized that research has failed
>>to show any
exercise to strengthen the VMO more than the rest of
the
>>Quads.
>
>In my opinion, this conception of
selective "strengthening" of VMO is
>conceptually flawed. In
patients with PFJ pain syndrome, it is not the
>strength, but
activation pattern of the VMO/VL that is at fault. If the VMO
>is not
being activated early enough during weightbearing flexion then the
>VL
(larger xs area) will cause lateral maltracking. Standard rehab for
this
>in Australia is to retrain selective timing/activation of VMO by
using dual
>channel biofeedback in functional, weightbearing positions
(eg lunge, 1/4
>squat, stepdowns), progressing to in-place
plyometrics. Patellofemoral
>taping (a la McConnell) is vital if
maltracking of glide or tilt variety is
>present.
>
I
seem to remember that McConnell's work was originally based on 3 (I
think)
patients. Since then EMG studies have failed to support her
conclusions as
to activation patterns (at least the EMG studies done by
other graduate
students I know did not match what she proposed).
Interestingly I've
noticed that sometimes just controllong the tracking
pattern by manually
controling the movement of the patella can
significantly reduce pain during
the activity(I glide/direct the patella
during weight-bearing lunges). I
also find that Maitlands
compression glides may also reduce symptoms if
there is pain.
The
problem with this discussion is that we are mixing Retro-patellar
pain
syndrome Rx with patellar OA treatment. Two very distinct
problems with
possibly very different treatment approaches. Makes
it easy to see why
results from person to person would vary
alot.