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The “core” is a series of inter-related muscles
that provides the force to stabilize and move
body segments. In the lower extremity, core
could be considered the link between the torso
(i.e.) one’s CORE, and lower extremities. Core
training focuses on pelvic stability. If the pelvis
is stable, the lower back and hips (limbs) are
stable. In treatment of pain and injury around
the knee and kneecap joints, COREmusculature
helps to stabilize the limb under the pelvis.
Indeed one can think of CORE as base or
platform of musculoskeletal strength resulting
in control of the trunk (axial skeleton) upon
which limb activity is optimally performed.
Core muscles (in lower extremity function) are
generally considered to be the muscles of your
lower spine, abdomen, and hip/buttocks. Core
strengthening exercises are most effective when
the torso works as a solid unit and both front and
back muscles contract at the same time; multi
joint movements are performed and stabilization
of the spine is monitored. These exercises are
most effective when they engage many muscles
throughout the torso that cross several joints and
work together to coordinate stability.
The Approach
Analyzing limb strength and extremity kine
matics are the main components that contribute
to the plan of care for the patient with
patellofemoral (PF) pain. Focusing this plan of
care on improving patient symptoms by
improving their lower extremity kinematics has
had high success in our clinical practice for
decreasing PF pain. This approach focuses on
movement-centered therapy with a skilled
physical therapist. The patients’response to each
intervention will help to guide the next step as
well as define the need for further intervention.
Physical therapy should be customized to the
patient’s level of strength and fitness and
whenever possible should be made challenging
to the patient. The exercises themselves should
be increased in intensity and duration as the
patient develops better strength and limb
control in their activities.
This chapter will focus on individual clinical
strategies used in rehabbing the patient who
presents with anterior knee pain [1, 2].
Rehabilitation and CORE
musculature in the
Treatment of
Patellofemoral pain
E.A. Arendt