The Additional Effect of Hallux Valgus Correction on Runners With First Ray Instability and Patellofemoral Pain Syndrome

The Additional Effect of First Metatarsophalangeal Joint Correction on Runners With First Ray Instability and Patellofemoral Pain Syndrome

The study purpose is to investigate the effectiveness of a program combining biomechanical taping with lower extremity neuromuscular exercises for runners with patellofemoral pain syndrome (PFPS) and hallux valgus

This will be a single-blind, experimental study with two treatment groups. A total of 30 college athletes with PFPS and hallux valgus and majoring in long distance running or soccer, or recreational runners in Taipei metropolitan area will be recruited. A set of clinical examination will be conducted to rule out abnormal knee structures, pathologies, or injuries apart from PFPS. The lower extremity alignment as well as hip and knee kinematics during a step down test will be tracked using Noraxon's myoMOTION system. Muscle activation of the muscles controlling the hip and knee movements during the step down test will be recorded using TELEmyo DTS of Noraxon. Hallux valgus angle will be measured with surface markers on photographs. Knee pain level will be rated in a visual analog scale. The investigators will analyze the data with Statistical Product and Service Solutions (SPSS) for Windows. Repeated-measure ANOVAs will be used to examine group-by-time interaction on all the outcome variables. All significance level will be set at 0.05.

Inclusion Criteria:

• High physical activity level (running at least 5 times/week and at least 2 hours/time)
• Presenting anterior/retropatellar knee pain in the past 6 months
• At least two of the following activities provocated symptom: Prolonged sitting, ascending and/or descending stairs, squatting, kneeling, running, limping
• Not having any pathologies of knee joint (ligament tear, menisci injury, patellofemoral joint dislocation, tendinitis, bursitis…etc.)
• With hallux valgus angle>15°
• With 1st metatarsophalangeal joint instability
• 20~40 y/o

Exclusion Criteria:

• Lower extremities osteoarthritis
• Systematic diseases such as rheumatoid arthritis, systemic lupus erythematosus, DM…etc.
• Lower extremities fracture history
• Surgical history of lower extremities
• Neurological pathology that would interfere with gait
• Hallux could not be corrected to neutral through passive correction
• Low back pain and/or sacroiliac joint dysfunction in the past six months
• Excessive femoral anteversion