Patellar Taping Increases Vastus Medialis Oblique Activity

Journal of Electromyography and Kinesiology 14 (2004) 495–504 www.elsevier.com/locate/jelekin

Patellar taping increases vastus medialis oblique activity in the presence of patellofemoral pain
Evangelos A. Christou Ã
Department of Integrative Physiology, University of Colorado, Boulder, CO 80309-0354, USA Received 21 April 2003; received in revised form 22 July 2003; accepted 3 October 2003Abstract A common rehabilitation strategy for patellofemoral pain syndrome (PFPS), which lacks scientific evidence, includes pulling the patella medially with tape to reduce pain and increase the vastus medialis oblique (VMO) muscle activity. The purpose of this study was to examine the effect of various patellar taping procedures on force production, EMG activity of the VMO and vastus lateralis(VL) muscles, and perceived pain experienced by 30 women (27:3 Æ 1:53 years), half diagnosed with PFPS. The perceived v pain, force, and EMG of the VMO and VL, were recorded while subjects performed maximal isokinetic leg presses at 30 /s for each of the following patellar taping conditions: no tape (control), no glide (placebo), medial and lateral glide (experimental). The medial and placeboprocedures significantly (P< 0:01) reduced perceived pain (70–80%) in PFPS subjects. Although patellar taping did not influence leg press force (P> 0:05), it increased the VMO activity and decreased the VL activity in PFPS subjects but had the opposite effect in healthy subjects. The findings suggest that taping the patella medially can contribute positively to PFPS rehabilitation. Because the medial glideand placebo taping conditions had similar effects, it is proposed that the benefits of patellar taping are not due to a change in patellar position but rather due to enhanced support of the patellofemoral ligaments and/or pain modulation via cutaneous stimulation. # 2003 Elsevier Ltd. All rights reserved.
Keywords: VMO; VL; Force; Perceived pain; Leg press

1. Introduction The major complaint ofindividuals with patellofemoral pain syndrome (PFPS) is anterior knee pain or pain behind the patella (retropatellar pain) and is experienced usually during running, squatting, and stair climbing [22,31,35]. The occurrence of patellofemoral pain is two to three times more prevalent in women compared with men [27]. Numerous biomechanical characteristics of the lower body such as decreased jointflexibility, large quadriceps angle (Qangle), and increased subtalar joint pronation have been proposed to explain its onset [9,13]. Nonetheless, the leading etiological factor is a decline in the activation of the vastus medialis oblique (VMO) muscle v [22,31]. Anatomically, the VMO attaches at a 40–55
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angle to the long axis of the femur on the medial side of the patella [15]. The functional importance of the VMO, therefore, is to dynamically stabilize the patella on the medial side and prevent lateral deviation and rotation of the patella caused by the lateral pull of the larger vastus lateralis (VL) muscle [16,28]. A common rehabilitation strategy to alleviate patellofemoral pain andimprove patellar tracking within the trochlea of the patellofemoral joint includes taping of the patella, stretching of tight lateral structures, correction of lower body biomechanics, and selective quadriceps exercises to increase the activity of the VMO [8,9]. The use of tape became popular following McConnell’s original publication [28], which proposed that pulling the patella medially withtape (medial glide) will correct the patella position, stretch the tight lateral structures, increase the activity of the VMO muscle, decrease pain and thus allow the patient to begin strengthening exercises of the quadriceps.

1050-6411/$ - see front matter # 2003 Elsevier Ltd. All rights reserved. doi:10.1016/j.jelekin.2003.10.007

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