title: Local and widespread hyperalgesia in female runners with patellofemoral pain are influenced by running volume.
abstract: OBJECTIVE
  To compare pressure pain threshold (PPT) around the knee (local hyperalgesia) and at a site remote to the knee (widespread hyperalgesia) between female runners with and without patellofemoral pain (PFP); and to evaluate the relationship between running volume, self-reported knee function and PPT measures.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Twenty female runners with PFP and twenty pain-free female runners participated in the study. PPTs were measured using a handheld pressure algometer at four sites in the patellar region: quadriceps tendon, medial patella, lateral patella and patellar tendon; and on the contralateral upper limb. Additionally, all participants were asked to report their average weekly running volume in a typical month and answer the anterior knee pain scale (AKPS) questionnaire.
  
  
  RESULTS
  For all sites, female runners with PFP presented lower PPT measures in comparison with control group (P<0.017). There were negative correlations between AKPS and running volume (ρ=-0.88; P<0.001) and between all PPTs and the running volume in the PFP group with correlation (ρ) values ranging between -0.46 and -0.70 (P<0.022). There were positive correlations between all PPTs and AKPS with correlation (ρ) value from 0.50 to 0.69 (P<0.030).
  
  
  CONCLUSIONS
  Lower PPTs locally and remote to the knee in female runners with PFP indicate the presence of local and widespread hyperalgesia. Additionally, this hyperalgesia, which is related to self-reported knee function, appears to be increased by greater running volumes. Development and evaluation of non-mechanical interventions for the management of running-related PFP in females may be needed to address this apparent hyperalgesia.
authors.affiliation: Physical Therapy Department, University of São Paulo State, School of Science and Technology, Brazil.
authors.forename: Marcella Ferraz
authors.initials: MF
authors.lastname: Pazzinatto
authors.affiliation: Physical Therapy Department, University of São Paulo State, School of Science and Technology, Brazil.
authors.forename: Danilo
authors.initials: D
authors.lastname: de Oliveira Silva
authors.affiliation: Physical Therapy Department, University of São Paulo State, School of Science and Technology, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Pradela
authors.affiliation: Physical Therapy Department, University of São Paulo State, School of Science and Technology, Brazil.
authors.forename: Maira Bergamaschi
authors.initials: MB
authors.lastname: Coura
authors.affiliation: School of Allied Health, College of Science, Health and Engineering, La Trobe University, Australia; Centre for Sports and Exercise Medicine, Queen Mary University of London, London, UK.
authors.forename: Christian
authors.initials: C
authors.lastname: Barton
authors.affiliation: Physical Therapy Department, University of São Paulo State, School of Science and Technology, Brazil. Electronic address: micolis@fct.unesp.br.
authors.forename: Fábio Mícolis
authors.initials: FM
authors.lastname: de Azevedo
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000209:etiology*; D007719:Knee Joint / Q000503:physiopathology*; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology*; D046788:Patellofemoral Pain Syndrome / Q000503:physiopathology*; D012420:Running / Q000293:injuries*; D057566:Self Report; D018709:Statistics, Nonparametric; D055815:Young Adult
keywords: Anterior knee pain; Athlete; Hyperalgesia secondary; Knee; Pain; Patellofemoral joint