Self-reported, unspecific knee pain is highly prevalent among adolescents. A large proportion
of the unspecific knee pain can be attributed to Patellofemoral Pain Syndrome (PFPS). There
are a number of treatment options for PFPS. Physical therapy has been advocated as one of the
cornerstones in rehabilitation of patients with PFPS. Twenty-five years ago, McConnell
proposed a multimodal approach that combined several treatment options. The regimen included
retraining of the vastus medialis oblique muscle through functional weight bearing
activities. This exercise is combined with patellar taping, patellar mobilization, and
stretching to improve patellar tracking, reduce pain, and enhance vastus medialis oblique
muscle activation. Short term results (<12 months) indicates that multimodal physiotherapy is
more effective than placebo treatment.
While treatment for PFPS may be successful for the short-term, long-term results are less
promising. A recent review covering the long term prognosis for patients diagnosed with PFPS,
reported that only 1/3 of those diagnosed with PFPS and treated conservatively were pain free
12 months after diagnosis. Further ¼ stopped participating in sports because of knee pain.
Predictors of long term outcome (>52weeks) indicate that a long symptom duration, higher age
and greater severity at baseline are associated to poorer outcome after treatment. These
prognostic factors suggest that an early initiation of treatment might lead to a better
long-term prognosis. The purpose of this study is to examine the short and long-term
effectiveness of multi-modal physiotherapy compared to standard wait-and-see treatment
applied at a very early state of disease among adolescents. The investigators hypothesized a
significantly larger proportion of completely recovered patients at three-month follow-up in
the interventions group compared to the control group.