Signs of Nervous System Sensitization in Female Runners with Chronic Patellofemoral Pain.
Brian J Eckenrode, David M Kietrys, Allison Brown and 2 others
PMID 36793566WHAT IT FOUND
Female runners with chronic knee pain had lower pain thresholds to pressure at the knee and remote sites like the shin and thigh.
Heat pain tests and functional balance scores showed no differences between groups. Pressure testing may better identify sensitization in this population.
Key findings
01Pressure pain thresholds were significantly lower in the pain group at all tested sites, including local knee structures and remote sites like the tibia and quadriceps.
02There were no significant differences between groups for heat pain threshold, temporal summation, or conditioned pain modulation.
03Functional performance on the Y-Balance Test did not differ between groups, and no significant association was found between balance scores and pressure pain thresholds.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Small sample size (37 participants analyzed) limits the generalizability of the findings. The study was a pilot with no formal power analysis. Three participants were excluded post hoc for prior knee surgery, which may introduce bias. The population was highly active, which might mask differences in pain modulation or function compared to less active patients. Heat pain threshold was only tested locally, not at remote sites.
The easy way to misread this
Do not assume that normal Y-Balance Test scores or normal heat pain thresholds rule out nervous system sensitization in runners with chronic knee pain. The study found that pressure pain thresholds were significantly altered even when these other measures were not.