Femur rotation increases patella cartilage stress in females with patellofemoral pain

LIAO, TZU-CHIEH; YANG, NICHOLAS; HO, KAI-YU; FARROKHI, SHAWN; POWERS, CHRISTOPHER M.

doi:10.1249/mss.0000000000000617

Cited by 90Lower Extremity Biomechanics and PathologiesKnee injuries and reconstruction techniquesHip disorders and treatments

Femur rotation increases patella cartilage stress in females with patellofemoral pain

LIAO, TZU-CHIEH, YANG, NICHOLAS, HO, KAI-YU, FARROKHI, SHAWN, POWERS, CHRISTOPHER M.·2015·Medicine & Science in Sports & Exercise

DOI 10.1249/mss.0000000000000617

Open this paper in CoChat — free account

Abstract

PURPOSE: This study aimed to test the hypothesis that internal rotation of the femur increases patellofemoral joint stress in persons with patellofemoral pain (PFP). METHODS: Patella cartilage stress profiles of nine female participants with PFP were obtained during squatting using subject-specific finite element (FE) models of the patellofemoral joint (15° and 45° of knee flexion). Input parameters for the FE model included joint geometry, quadriceps muscle forces during squatting, and weight-bearing patellofemoral joint kinematics. The femur of each model was then internally rotated 5° and 10° along its long axis beyond that of the natural degree of rotation. Using a nonlinear FE solver, quasistatic loading simulations were performed to quantify patellofemoral joint stress. RESULTS: Compared with those at the natural position of the femur, mean hydrostatic pressure and mean octahedral shear stress were significantly higher when the femur was internally rotated 5° and 10°. No significant differences in stress variables were observed when the femur was rotated from 5° to 10°. These findings were consistent across both knee flexion angles (15° and 45°). CONCLUSIONS: The finding of elevated hydrostatic pressure and octahedral shear stress with internal rotation of the femur supports the premise that females with PFP who exhibit abnormal hip kinematics may be exposed to elevated patellofemoral joint stress.

Integrity signals

Registry

Crossref · 10.1249/mss.0000000000000617

Cites

1 of 1 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

The posterior rotation of the pelvis is the result of the femur compressing into the acetabulum.
“The posterior rotation of the pelvis is the result of the femur compressing into the acetabulum.37”
From A Biomechanical Review of the Squat Exercise: Implications for Clinical Practice. (2024) · cites this paper as [37]
When end range of hip flexion is reached during squatting, a posterior pelvic tilt will occur.
“When end range of hip flexion is reached during squatting, a posterior pelvic tilt will occur (Figure 4).”
From A Biomechanical Review of the Squat Exercise: Implications for Clinical Practice. (2024) · cites this paper as [37]
Posterior pelvic tilt is coupled with lumbar spine flexion.
“Given that posterior pelvic tilt is coupled with lumbar spine flexion,37,38 compressive and shear forces occur at the lumbar spine.14,15,39”
From A Biomechanical Review of the Squat Exercise: Implications for Clinical Practice. (2024) · cites this paper as [37]

The Influence of Fixed Rotational Deformities of the Femur on the Patellofemoral Contact Pressures in Human Cadaver Knees
Lee, T. Q., Anzel, S. H., Bennett, K. A., Pang, D., & Kim, W. C. (1994) · Clinical Orthopaedics and Related Research · doi:10.1097/00003086-199405000-00013 · Cited by 241 · see citing works

Flagged first, then by citations

Sorted by citations

Runners with patellofemoral pain have altered biomechanics which targeted interventions can modify: A systematic review and meta-analysis
Neal, B. S., Barton, C. J., Gallie, R., O’Halloran, P., & Morrissey, D. (2015) · Gait & Posture · doi:10.1016/j.gaitpost.2015.11.018 · Cited by 193 · see citing works
Reduced knee flexion is a possible cause of increased loading rates in individuals with patellofemoral pain
Silva, D. D. O., Briani, R. V., Pazzinatto, M. F., Ferrari, D., Aragão, F. A., & de Azevedo, F. M. (2015) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2015.06.021 · Cited by 72 · see citing works
A Biomechanical Review of the Squat Exercise: Implications for Clinical Practice.
Straub, R. K., & Powers, C. M. (2024) · International journal of sports physical therapy · doi:10.26603/001c.94600 · Cited by 70 · see citing works
Self-citation
Patellofemoral Mechanics: a Review of Pathomechanics and Research Approaches
Wheatley, M. G. A., Rainbow, M. J., & Clouthier, A. L. (2020) · Current Reviews in Musculoskeletal Medicine · doi:10.1007/s12178-020-09626-y · Cited by 68 · see citing works
Are two-dimensional measured frontal plane angles related to three-dimensional measured kinematic profiles during running?
Dingenen, B., Staes, F. F. G. M., Santermans, L., Steurs, L., Eerdekens, M., Geentjens, J., Peers, K. H. E., Thysen, M., & Deschamps, K. (2017) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2017.02.001 · Cited by 52 · see citing works
Runners With Patellofemoral Pain Exhibit Greater Peak Patella Cartilage Stress Compared With Pain-Free Runners
Liao, T., Keyak, J. H., & Powers, C. M. (2018) · Journal of Applied Biomechanics · doi:10.1123/jab.2017-0229 · Cited by 51 · see citing works
Self-citation
The assessment of movement health in clinical practice: A multidimensional perspective
Dingenen, B., Blandford, L., Comerford, M., Staes, F. F. G. M., & Mottram, S. (2018) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2018.04.008 · Cited by 42 · see citing works
Pain During Prolonged Sitting Is a Common Problem in Persons With Patellofemoral Pain
Collins, N. J., Vicenzino, B., van der Heijden, R. A., & van Middelkoop, M. (2016) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2016.6470 · Cited by 38 · see citing works
Lower Amplitude of the Hoffmann Reflex in Women With Patellofemoral Pain: Thinking Beyond Proximal, Local, and Distal Factors
Silva, D. D. O., Magalhães, F. H., Faria, N. C. S., Pazzinatto, M. F., Ferrari, D., Pappas, E., & de Azevedo, F. M. (2016) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2015.12.017 · Cited by 36 · see citing works
The influence of isolated femur and tibia rotations on patella cartilage stress: a sensitivity analysis
Liao, T., Yin, L., & Powers, C. M. (2018) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2018.03.003 · Cited by 36 · see citing works
Self-citation
Step down tests are the tasks that most differentiate the kinematics of women with patellofemoral pain compared to asymptomatic controls
Ferreira, C. L., Barton, G., Borges, L. D., Rabelo, N. D. D. A., Politti, F., & Lucareli, P. R. G. (2019) · Gait & Posture · doi:10.1016/j.gaitpost.2019.05.023 · Cited by 36 · see citing works
Decisional conflict in surgical patients: Should surgeons care?
Roy, M., Novak, C. B., Urbach, D. R., Mccabe, S. J., von Schroeder, H. P., & Okrainec, K. (2018) · Canadian Journal of Surgery · doi:10.1503/cjs.003217 · Cited by 35 · see citing works
Relationship between knee abduction moment with patellofemoral joint reaction force, stress and self-reported pain during stair descent in women with patellofemoral pain
Waiteman, M. C., Briani, R. V., Pazzinatto, M. F., Ferreira, A. S., Ferrari, D., Silva, D. D. O., & de Azevedo, F. M. (2018) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2018.09.012 · Cited by 34 · see citing works
Contribution of altered hip, knee and foot kinematics to dynamic postural impairments in females with patellofemoral pain during stair ascent
Silva, D. D. O., Magalhães, F. H., Pazzinatto, M. F., Briani, R. V., Ferreira, A. S., Aragão, F. A., & de Azevedo, F. M. (2016) · The Knee · doi:10.1016/j.knee.2016.01.014 · Cited by 33 · see citing works
Does patellar alignment or trochlear morphology predict worsening of patellofemoral disease within the first 5 years after anterior cruciate ligament reconstruction?
Macri, E. M., Patterson, B., Crossley, K. M., Stefanik, J. J., Guermazi, A., Blomqwist, E., Khan, K. M., Whitehead, T. S., Morris, H. G., & Culvenor, A. G. (2019) · European Journal of Radiology · doi:10.1016/j.ejrad.2019.01.033 · Cited by 33 · see citing works
Gait Kinematics in Individuals with Acute and Chronic Patellofemoral Pain
Fox, A. S., Ferber, R., Saunders, N., Osis, S. T., & Bonacci, J. (2017) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001465 · Cited by 30 · see citing works
Relationship between Anatomical Risk Factors, Articular Cartilage Lesions, and Patient Outcomes Following Medial Patellofemoral Ligament Reconstruction
Holliday, C. L., Hiemstra, L. A., Kerslake, S., & Grant, J. A. (2019) · Cartilage · doi:10.1177/1947603519894728 · Cited by 29 · see citing works
Femoral malrotation from diaphyseal fractures results in changes in patellofemoral alignment and higher patellofemoral stress from a finite element model study
Dagneaux, L., Allal, R., Pithioux, M., Chabrand, P. R., Ollivier, M. P., & Argenson, J. (2018) · The Knee · doi:10.1016/j.knee.2018.06.008 · Cited by 28 · see citing works
Defining Our Diagnostic Labels Will Help Define Our Movement Expertise and Guide Our Next 100 Years
Sahrmann, S. A. (2020) · Physical Therapy · doi:10.1093/ptj/pzaa196 · Cited by 25 · see citing works
The Effect of the Mulligan Knee Taping Technique on Patellofemoral Pain and Lower Limb Biomechanics
Hickey, A., Hopper, D. M., Hall, T. M., & Wild, C. Y. (2016) · The American Journal of Sports Medicine · doi:10.1177/0363546516629418 · Cited by 25 · see citing works
Adults with patellofemoral pain do not exhibit manifestations of peripheral and central sensitization when compared to healthy pain-free age and sex matched controls – An assessor blinded cross-sectional study
Rathleff, M. S., Rathleff, C. R., Stephenson, A., Mellor, R., Matthews, M., Crossley, K. M., & Vicenzino, B. (2017) · PLoS ONE · doi:10.1371/journal.pone.0188930 · Cited by 24 · see citing works
Longitudinal analysis of the contribution of 3D patella and trochlear bone shape on patellofemoral joint osteoarthritic features
Liao, T., Jergas, H., Tibrewala, R., Bahroos, E., Link, T. M., Majumdar, S., Souza, R. B., & Pedoia, V. (2020) · Journal of Orthopaedic Research® · doi:10.1002/jor.24836 · Cited by 24 · see citing works
Self-citation
The effect of increased femoral anteversion on the morphological and trabecular microarchitectural changes in the trochlea in an immature rabbit
Kang, H., Lu, J., Li, F., Dai, Y., Dong, Z., Dong, C., & Wang, F. (2020) · Journal of Advanced Research · doi:10.1016/j.jare.2020.02.002 · Cited by 24 · see citing works
A feasibility study of a novel, task-specific movement training intervention for women with patellofemoral pain
Salsich, G. B., Yemm, B., Steger-May, K., Lang, C. E., & Dillen, L. R. V. (2017) · Clinical Rehabilitation · doi:10.1177/0269215517723055 · Cited by 23 · see citing works
Kinematics and muscle forces in women with patellofemoral pain during the propulsion phase of the single leg triple hop test
Alvim, F. C., Muniz, A. M. D. S., Lucareli, P. R. G., & Menegaldo, L. L. (2019) · Gait & Posture · doi:10.1016/j.gaitpost.2019.07.193 · Cited by 22 · see citing works
Which is the best predictor of excessive hip internal rotation in women with patellofemoral pain: Rearfoot eversion or hip muscle strength? Exploring subgroups
Ferreira, A. S., Silva, D. D. O., Briani, R. V., Ferrari, D., Aragão, F. A., Pazzinatto, M. F., & de Azevedo, F. M. (2018) · Gait & Posture · doi:10.1016/j.gaitpost.2018.03.037 · Cited by 21 · see citing works
Tibiofemoral kinematics in the transverse and frontal planes influence the location and magnitude of peak patella cartilage stress: An investigation of runners with and without patellofemoral pain
Liao, T., & Powers, C. M. (2019) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2019.01.003 · Cited by 20 · see citing works
Self-citation
Relationship between kinesiophobia, isometric hip and knee torques to pelvic, hip and knee motion during the single-leg drop jump in women with patellofemoral pain: A cross-sectional study
de Vasconcelos, G. S., da Silva, M. E. C. B., Nunes, G. S., & Serrão, F. V. (2023) · The Knee · doi:10.1016/j.knee.2023.04.002 · Cited by 18 · see citing works
Differences in Hip and Knee Running Moments across Female Pubertal Development
Sayer, T. A., Hinman, R. S., Fortin, K., Paterson, K. L., Bennell, K. L., Timmi, A., Pivonka, P., & Bryant, A. L. (2017) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000001525 · Cited by 18 · see citing works
Subclassification of recreational runners with a running-related injury based on running kinematics evaluated with marker-based two-dimensional video analysis
Dingenen, B., Staes, F. F. G. M., Vanelderen, R., Ceyssens, L., Malliaras, P., Barton, C. J., & Deschamps, K. (2020) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2020.04.032 · Cited by 18 · see citing works
The effect of targeted treatment on people with patellofemoral pain: a pragmatic, randomised controlled feasibility study
Drew, B. T., Conaghan, P. G., Smith, T. O., Selfe, J., & Redmond, A. C. (2017) · BMC Musculoskeletal Disorders · doi:10.1186/s12891-017-1698-7 · Cited by 17 · see citing works
DO MALES WITH PATELLOFEMORAL PAIN HAVE POSTEROLATERAL HIP MUSCLE WEAKNESS?
Hoglund, L. T., Burns, R. O., & Stepney, A. (2018) · International Journal of Sports Physical Therapy · doi:10.26603/ijspt20180160 · Cited by 16 · see citing works
Immediate Improvements in Patellofemoral Pain Are Associated With Sagittal Plane Movement Training to Improve Use of Gluteus Maximus Muscle During Single Limb Landing
Atkins, L. T., James, C. R., Yang, H. S., Sizer, P. S., Brismée, J., Sawyer, S. F., & Powers, C. M. (2021) · Physical Therapy · doi:10.1093/ptj/pzab165 · Cited by 15 · see citing works
Self-citation
Influence of Patellar Morphology Classified by Wiberg Classification on Knee Joint Function and Patellofemoral Tracking After Total Knee Arthroplasty Without Patellar Resurfacing
Cao, L., Sun, K., Yang, H., Wang, H., Zeng, R., & Fan, H. (2021) · The Journal of Arthroplasty · doi:10.1016/j.arth.2021.04.009 · Cited by 15 · see citing works
Activation training facilitates gluteus maximus recruitment during weight-bearing strengthening exercises
Cannon, J., Weithman, B. A., & Powers, C. M. (2022) · Journal of Electromyography and Kinesiology · doi:10.1016/j.jelekin.2022.102643 · Cited by 14 · see citing works
Self-citation
Kinematic and Coordination Variability in Individuals With Acute and Chronic Patellofemoral Pain
Fox, A. S., Ferber, R., & Bonacci, J. (2021) · Journal of Applied Biomechanics · doi:10.1123/jab.2020-0401 · Cited by 12 · see citing works
Patellofemoral joint kinetics in females when using different depths and loads during the barbell back squat
Zavala, L., Flores, V., Cotter, J. A., & Becker, J. (2021) · European Journal of Sport Science · doi:10.1080/17461391.2020.1806935 · Cited by 11 · see citing works
The effects of increased forward trunk lean during stair ascent on hip adduction and internal rotation in asymptomatic females
Atkins, L. T., Reid, J., & Zink, D. (2022) · Gait & Posture · doi:10.1016/j.gaitpost.2022.08.001 · Cited by 11 · see citing works
Decision Making and Management of Anterior Knee Pain in Young Patients With Pathological Femoral Anteversion: A Critical Analysis Review
Sanchis‐Alfonso, V., & Teitge, R. A. (2024) · Journal of the American Academy of Orthopaedic Surgeons · doi:10.5435/jaaos-d-23-01155 · Cited by 10 · see citing works
Persons with patellofemoral pain exhibit altered hip abductor muscle recruitment while performing hip abductor exercises
Selkowitz, D. M., Beneck, G. J., & Powers, C. M. (2022) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2022.2101167 · Cited by 9 · see citing works
Self-citation
The influence of isolated femur and tibia rotations on patellar tendon stress: A sensitivity analysis using finite element analysis
Park, K.-M., Keyak, J. H., & Powers, C. M. (2022) · Journal of Orthopaedic Research® · doi:10.1002/jor.25353 · Cited by 9 · see citing works
Self-citation
Optimizing Rehabilitation and Return to Sport in Athletes With Anterior Knee Pain Using a Biomechanical Perspective
Theisen, B. J., Larson, P. D., & Chambers, C. C. (2022) · Arthroscopy Sports Medicine and Rehabilitation · doi:10.1016/j.asmr.2021.10.028 · Cited by 9 · see citing works
Descending stairs: Good or bad task to discriminate women with patellofemoral pain?
Novello, A. D. A., Garbelotti, S. A., Rabelo, N. D. D. A., Ferraz, A. N., Bley, A. S., Corrêa, J. C. F., Politti, F., & Lucareli, P. R. G. (2018) · Gait & Posture · doi:10.1016/j.gaitpost.2018.06.170 · Cited by 9 · see citing works
The non-invasive evaluation technique of patellofemoral joint stress: a systematic literature review
Wang, B., Mao, Z., Guo, J., Yang, J., & Zhang, S. (2023) · Frontiers in Bioengineering and Biotechnology · doi:10.3389/fbioe.2023.1197014 · Cited by 8 · see citing works
Are Altered Kinematics in Runners With Patellofemoral Pain Sex Specific?
Luz, B. C., dos Santos, A. F., & Serrão, F. V. (2022) · Sports Health A Multidisciplinary Approach · doi:10.1177/19417381221088582 · Cited by 8 · see citing works
A biokinetic approach in primary knee osteoarthritis prevention and management–exploring movement profiles and kinetic chain interactions: Current concepts
Metsavaht, L. F., Gonzalez, F. F., Locks, R., França, B. R., Machado, M., Guadagnin, E. C., Chahla, J. A., & Leporace, G. (2024) · Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine · doi:10.1016/j.jisako.2024.100381 · Cited by 7 · see citing works
Do exist differences in kinematics and EMG of the hip and knee between male runners with and without patellofemoral pain in different running speeds?
Muniz, A. M. D. S., Zeitoune, G., Alvim, F. C., Grassi, G. B. A., Britto, P. A. D. A., & Nadal, J. (2022) · Physical Therapy in Sport · doi:10.1016/j.ptsp.2022.12.006 · Cited by 7 · see citing works
Persons with Patellar Tendinopathy Exhibit Greater Patellar Tendon Stress during a Single-Leg Landing Task
Park, K.-M., Keyak, J. H., Kulig, K., & Powers, C. M. (2022) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000003084 · Cited by 7 · see citing works
Self-citation
Towards a Dynamic Model of the Kangaroo Knee for Clinical Insights into Human Knee Pathology and Treatment: Establishing a Static Biomechanical Profile
Fatima, M., Scholes, C. J., Zhong, E., & Kohan, L. (2019) · Biomimetics · doi:10.3390/biomimetics4030052 · Cited by 6 · see citing works
Distal femoral torsion is correlated with higher‐grade trochlear dysplasia and shorter anterior condyles in patients with patellar dislocation and increased femoral torsion
Hao, K., Niu, Y., Huo, Z., & Wang, F. (2023) · Knee Surgery Sports Traumatology Arthroscopy · doi:10.1007/s00167-023-07628-0 · Cited by 6 · see citing works
Biomechanical characteristics and muscle function in individuals with patellofemoral osteoarthritis: A systematic review of cross-sectional studies
Carvalho, C., de Oliveira, M. P. B., Pisani, G. K., Marolde, I. B., & Serrão, P. R. M. D. S. (2022) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2022.105721 · Cited by 6 · see citing works
“Knees Out” or “Knees In”? Volitional Lateral vs. Medial Hip Rotation During Barbell Squats
Chiu, L. Z. F. (2023) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000004655 · Cited by 5 · see citing works
Relationship Between Hip Frontal Dynamic Joint Stiffness and Frontal and Transverse Plane Hip Kinematics During Gait: Sex Differences
Takano, S., Iwamoto, Y., Ozawa, J., & Kito, N. (2020) · Journal of Sport Rehabilitation · doi:10.1123/jsr.2020-0037 · Cited by 5 · see citing works
Effects of Gluteus Maximus Muscle Activity and Pelvic Width on Dynamic Frontal Plane Hip Joint Stiffness During Gait in Healthy Young Women
Takano, S., Iwamoto, Y., Fujii, N., Konishi, R., Ozawa, J., & Kito, N. (2023) · Journal of Sport Rehabilitation · doi:10.1123/jsr.2022-0322 · Cited by 4 · see citing works
Comparison of electromyographic activity of the gluteal muscles and tensor fascia lata in persons with patellofemoral pain: evaluation of selected, hip-targeted exercises using indwelling fine-wire electrodes
Selkowitz, D. M., Beneck, G. J., & Powers, C. M. (2023) · Physiotherapy Theory and Practice · doi:10.1080/09593985.2023.2215389 · Cited by 4 · see citing works
Self-citation
Females who have undergone anterior cruciate ligament reconstruction exhibit altered patellofemoral joint contact area and alignment
Demirjian, T. A., Souza, R. B., Salem, G. J., Crues, J. V., & Powers, C. M. (2025) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2025.106543 · Cited by 3 · see citing works
Self-citation
Are running biomechanics different between females and males with knee injuries? A systematic review and meta-analysis
Tamer, S., Silva, D. D. O., Pazzinatto, M. F., Crossley, K. M., McCarthy, B. J., Savage, M., Patterson, B., Low, J. K. M.-S., & Mentiplay, B. F. (2026) · Gait & Posture · doi:10.1016/j.gaitpost.2026.110187 · Cited by 3 · see citing works
A new marker cluster anchored to the iliotibial band improves tracking of hip and thigh axial rotations
Gontijo, B. A., Fonseca, S. T., de Araújo, P. A., Magalhães, F. A., Filho, R. G. T., de Faria, H. M. P., Resende, R. A., & Souza, T. R. (2023) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2023.111452 · Cited by 3 · see citing works
The time-continuous association between turnout and axial joint moments in the competitive Irish dance ‘fly’ landing
Wallace, K., Kalogeropoulou, S., & Lamb, P. F. (2021) · Sports Biomechanics · doi:10.1080/14763141.2021.2016927 · Cited by 3 · see citing works
Temporal Activation of Core Muscles and Vasti in Isolated Patellofemoral Osteoarthritis during Stair-Stepping: A Case-Control Study
Adel, J., Balbaa, A. E., Elhabashy, H. R., Ibraheem, M. R., Fayaz, N. A., Abbass, S., ElZawahry, A., Hamda, H. A., & Awad, A. (2022) · Annals of Applied Sport Science · doi:10.52547/aassjournal.988 · Cited by 3 · see citing works
The Effect of the Mulligan Knee Taping Technique on Patellofemoral Pain and Lower Limb Biomechanics: Letter to the Editor
Silva, D. D. O., & de Azevedo, F. M. (2016) · The American Journal of Sports Medicine · doi:10.1177/0363546516656175 · Cited by 3 · see citing works
The Effect of the Mulligan Knee Taping Technique on Patellofemoral Pain and Lower Limb Biomechanics: Response
Wild, C. Y., Hickey, A., & Hall, T. M. (2016) · The American Journal of Sports Medicine · doi:10.1177/0363546516656176 · Cited by 3 · see citing works
The Immediate Effects of Instrument-Assisted Soft Tissue Mobilization on Pain and Function in Female Runners with Patellofemoral Pain
Cho, S. C., & Kim, Y. K. (2025) · Medicina · doi:10.3390/medicina61111912 · Cited by 2 · see citing works
Effects of running technique characteristics on the patellofemoral joint load: A systematic review and meta-analysis
Yu, S., Yuan, P., Xu, Y., Shangguan, Y., Wang, X., Wang, Z., Zhuang, M., & Song, Y. (2025) · Gait & Posture · doi:10.1016/j.gaitpost.2025.110025 · Cited by 2 · see citing works
A Tale of Two Treatments for Patellofemoral Pain
Davis, I. S., Powers, C. M., Tenforde, A. S., & Singh, J. R. (2017) · PM&R · doi:10.1016/j.pmrj.2017.10.012 · Cited by 2 · see citing works
Self-citation
Patellofemoral Pain in the Female Athlete
Cichanowski, H. R., & Chambers, C. C. (2021) · Elsevier eBooks · doi:10.1016/b978-0-323-75985-4.00017-9 · Cited by 2 · see citing works
Patellar articular overlap is better associated with patellar alignment during weight-bearing than traditional measures of patellar height
Demirjian, T. A., Crues, J. V., Ho, K., Tsai, L., & Powers, C. M. (2024) · The Knee · doi:10.1016/j.knee.2024.06.008 · Cited by 1 · see citing works
Self-citation
Effects of Lower Extremity Alignment During Barbell Squat Training on Muscle Volumes
Chiu, L. Z. F., & Fry, A. C. (2025) · The Journal of Strength and Conditioning Research · doi:10.1519/jsc.0000000000005179 · Cited by 1 · see citing works
Patellofemoral joint forces during running are not different between adolescents with and without patellofemoral pain—a cross-sectional study
Mazzella, N. L., Trowell, D. A., Fox, A., Saunders, N., Vicenzino, B., & Bonacci, J. (2026) · Frontiers in Sports and Active Living · doi:10.3389/fspor.2026.1762881 · Cited by 1 · see citing works
Bridging postural biomechanics and knee arthroplasty success
Migliorini, F., Maffulli, N., Schäfer, L., Kobbe, P., Bell, A., Vaishya, R., & Eschweiler, J. (2026) · Arthroplasty · doi:10.1186/s42836-026-00411-9 · Cited by 1 · see citing works
Is There a Surgical Treatment of Patellofemoral Pain?
Sanchis‐Alfonso, V., Ramírez‐Fuentes, C., Ferràs-Tarragó, J., & Teitge, R. A. (2020) · Springer eBooks · doi:10.1007/978-3-662-61097-8_11 · Cited by 1 · see citing works
Patellofemoral Overuse Injuries and Anterior Knee Pain
Canata, G. L., Casale, V., Pastrone, A., Vascellari, A., & Venturin, D. (2021) · Springer eBooks · doi:10.1007/978-3-030-60216-1_20 · Cited by 1 · see citing works
Development and Validation of a Kinematically-Driven Computational Model of the Patellofemoral Joint
Gustafson, J. A. (2017) · D-Scholarship@Pitt (University of Pittsburgh) · Cited by 1 · see citing works
The Flat Earth Theory: is Evidence-Based Physiotherapy a Sphere?
Maselli, F., & Mourad, F. (2021) · Journal of Manual & Manipulative Therapy · doi:10.1080/10669817.2021.1890902 · Cited by 1 · see citing works
Influence of female pubertal development and athletic footwear on lower limb biomechanics: implications for non-contact ACL injury and patellofemoral pain
Sayer, T. A. (2017) · Minerva Access (University of Melbourne)
Atividade elétrica muscular de vasto medial, vasto medial oblíquo, vasto lateral, glúteo médio e tensor da fáscia lata no exercício footwork realizado no reformer segundo o método Pilates
Lemos, L. P. M., Souza, C., Bonezi, A., Neto, E. S. W., Tosetto, K. O. M., López, M. C. P., & Loss, J. F. (2019) · Fisioterapia Brasil · doi:10.33233/fb.v20i4.3066
Restrictions in ankle dorsiflexion range of motion and its effect on landing mechanics
Howe, L. (2020)
Surgical Treatment of Anterior Knee Pain. When is Surgery Needed?
Sanchis‐Alfonso, V., & Teitge, R. A. (2023) · Springer eBooks · doi:10.1007/978-3-031-09767-6_9
Patellofemoral Pain: An Overview
Sanchis‐Alfonso, V., & Grelsamer, R. P. (2023) · Springer eBooks · doi:10.1007/978-3-031-09767-6_1
Novel Technologies Used in the Assessment of Patellofemoral Pain: A Scoping Review
Arın, G., Bayrakci-Tunay, V., Benedetti, M. G., Leardini, A., Vismara, F., & Belvedere, C. (2023) · Applied Sciences · doi:10.3390/app131910825
The effect of femoral strapping on hip internal rotation and pain response in females with patellofemoral pain
Selkowitz, D. M., Souza, R. B., & Powers, C. M. (2024) · Gait & Posture · doi:10.1016/j.gaitpost.2024.10.007
Self-citation
Anterior Knee Pain
Sanchis‐Alfonso, V., & Montesinos‐Berry, E. (2024) · Springer eBooks · doi:10.1007/978-3-030-65430-6_107-1
Altered tensor fasciae latae activation during functional movements in women with patellofemoral pain
Clark, D., Martinez-Sepanski, S. C., Caputo, J., Mehls, K. D., Stevens, S. L., & Coons, J. M. (2025) · Turkish Journal of Kinesiology · doi:10.31459/turkjkin.1571373
Effects of comprehensive physiotherapy on pain, functionality, strength and joint space in male members of the military with dynamic knee valgus: a randomised controlled trial
Shadmanfar, S., Shakibaee, A., Mohtashami, R., Alishiri, G. H., & Raei, M. (2025) · International Journal of Therapy and Rehabilitation · doi:10.12968/ijtr.2024.0094
Effect of Adding Single-Leg Balance Training With a Hip Muscle Activation Program on Frontal Plane Movement Quality: A Randomized Controlled Trial in Adult Females
McCallister, E., Bonvillain, A., Christy, A., Sensley, C., & Flowers, D. W. (2025) · Women in Sport and Physical Activity Journal · doi:10.1123/wspaj.2024-0091
Runners’ lower limb kinematics and training characteristics interactions associated with the occurrence of patellofemoral pain
Machado, E. D. M., Mendonça, L. D. M., dos Santos, A. F., Luz, B. C., & Serrão, F. V. (2025) · Journal of Biomechanics · doi:10.1016/j.jbiomech.2025.112874
Meniscal stress biomechanics in Tai Chi’s Brush knee and Twist Step for elderly
Chen, F., Chen, H., Chen, S., & Lin, J. (2025) · Frontiers in Bioengineering and Biotechnology · doi:10.3389/fbioe.2025.1620228
Identification of Subgroups of Individuals Experiencing Patellofemoral Pain with Kinematic and Kinetic Features During Overground RunningPreprint
Brancati, R. J., Hoogkamer, W., Martini, D. N., & Boyer, K. A. (2026) · medRxiv · doi:10.64898/2026.01.13.26344049
Movement matters: the path to professional impact
Powers, C. M. (2026) · Physical Therapy · doi:10.1093/ptj/pzag086
Self-citation

The influence of isolated femur and tibia rotations on patella cartilage stress: a sensitivity analysis
Liao, T., Yin, L., & Powers, C. M. (2018) · Clinical Biomechanics · doi:10.1016/j.clinbiomech.2018.03.003 · Cited by 36 · see citing works
Self-citation
The influence of femoral internal and external rotation on cartilage stresses within the patellofemoral joint
Besier, T. F., Gold, G. E., Delp, S. L., Fredericson, M., & Beaupré, G. S. (2008) · Journal of Orthopaedic Research® · doi:10.1002/jor.20663 · Cited by 113 · see citing works
Individuals with patellofemoral pain exhibit greater patellofemoral joint stress: a finite element analysis study
Farrokhi, S., Keyak, J. H., & Powers, C. M. (2010) · Osteoarthritis and Cartilage · doi:10.1016/j.joca.2010.12.001 · Cited by 252 · see citing works
Self-citation
Influence of sex and knee joint rotation on patellofemoral joint stress
Takabayashi, T., Edama, M., Inai, T., Tokunaga, Y., & Kubo, M. (2022) · Acta of Bioengineering and Biomechanics · doi:10.37190/abb-02115-2022-03 · Cited by 4 · see citing works
Influence of Sex And Knee Joint Rotation On Patellofemoral Joint Stress Through A Mathematical Modelling StudyPreprint
Takabayashi, T., Edama, M., Inai, T., Tokunaga, Y., & Kubo, M. (2021) · Research Square · doi:10.21203/rs.3.rs-969669/v1

Authors: LIAO, T.-C., YANG, N., HO, K.-Y., FARROKHI, S., & POWERS, C. M.
Affiliations: University of Southern California (US)
University of Nevada, Las Vegas (US)
University of Pittsburgh (US)
ORCID: LIAO, TZU-CHIEH
HO, KAI-YU
FARROKHI, SHAWN
POWERS, CHRISTOPHER M.
Venue: Medicine & Science in Sports & Exercise
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2015-09
Volume: 47
Issue: 9
Pages: 1775-1780
ISSN: 0195-9131 (ISSN-L)
DOI: 10.1249/mss.0000000000000617
OpenAlex: W1969179264
Cited by: 90
References: 1
Citations by year: 2026: 5 · 2025: 10 · 2024: 6 · 2023: 10 · 2022: 10 · 2021: 7 · 2020: 9 · 2019: 7 · 2018: 9 · 2017: 9 · 2016: 6 · 2015: 2
FWCI: 4.31
Type: journal article
Language: en
Open access: closed
Locations: Medicine & Science in Sports & Exercise (publishedVersion)
PubMed (publishedVersion)
Digital Scholarship - UNLV (University of Nevada Reno) (submittedVersion)
Topics: Physical Sciences › Engineering › Biomedical Engineering › Lower Extremity Biomechanics and Pathologies
Health Sciences › Medicine › Surgery › Knee injuries and reconstruction techniques
Health Sciences › Medicine › Surgery › Hip disorders and treatments
Keywords: patellofemoral pain, femoral internal rotation, patellofemoral joint stress, patellar cartilage, hydrostatic pressure, octahedral shear stress, squatting, female athletes, hip kinematics, subject-specific finite element models, knee flexion angle
MeSH terms: Adult, Biomechanical Phenomena, Cartilage, Articular, Female, Femur, Humans, Rotation, Stress, Mechanical, Arthralgia, Quadriceps Muscle, Patellofemoral Joint

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review

Femur rotation increases patella cartilage stress in females with patellofemoral pain

Abstract

Integrity signals

Claims the paper makes

Claims other papers make about this one

Cites

Cited by

Related

Record

About these checks