Components of the physiotherapy intervention
| Treatment component | Frequency of application | ||
|---|---|---|---|
| VAS, visual analogue scale. | |||
| Knee taping | Continuous (day and night) | ||
| Taping of the patella to adjust the components of medial glide, anterior tilt, lateral tilt and unload the infrapatellar fat pad or pes anserinus | Reapplied at weekly intervals by therapist for first four weeks, and by participant thereafter | ||
| Soft tissue massage of the knee performed in extension | 5 min | ||
| Thoracic spine mobilisation | 5 min | ||
| Performed while sitting with symptomatic leg extended and elevated on a chair | Starting in second treatment session | ||
| Exercises | |||
| • Buttock squeeze: isometric gluteal contraction in sitting with co-contraction of hip adductors | 5 s hold × 5 repeats | ||
| • Buttock rock: concentric contraction of the quadratus lumborum with isometric contraction of gluteus maximus in sitting | 10 s hold × 5 repeats on each side | ||
| • Rock and stand: sit to stand exercise with isometric contraction of hip adductors | 5 repeats | ||
| • Half squats: performed with co-contraction of the gluteals and hip adductors | 3 × 5 repeats | ||
| • Step ups: onto a 10 cm step. Isometric contraction of gluteals muscles onto the supporting leg while stepping up with the other leg. Then lower back down to floor | If able to complete 5 repeats with pain <3 cm on VAS | ||
| 5 repeats on each leg | |||
| • Standing balance: with a piece of theraband around the ankles, standing on one leg while moving the other leg backwards on a diagonal | 5 repeats each leg | ||
| After fourth week, increased to 10 repeats | |||
| • Home exercise programme | Three times daily | ||
| • Exercises from the supervised exercise programme | |||