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Title: The role of and relationship between hamstring and quadriceps muscle myofascial trigger points in patients with patellofemoral pain syndrome
Authors: Smith, Karen Louise Frandsen 
Issue Date: 2012
Purpose: Patellofemoral Pain Syndrome is a common condition in all age groups, with a multifactorial
etiology. This study aimed to investigate the association between the Quadriceps
femoris muscle group, Hamstring muscle group and Adductor muscle group, and to establish
the relationship between myofascial trigger points (MFTP’s) in these muscle groups and
patellofemoral pain syndrome (PFPS).
Methods: A cross-sectional, observational, quantitative non-intervention clinical assessment
study was conducted at the Chiropractic Day Clinic at Durban University of Technology (DUT),
to determine the extent of the PFPS, the MFTPs and thus the relationship between the two. The
study included eighty patients with PFPS, who were recruited by convenience sampling. The
results were captured using Microsoft excel and SPSS version 15.0 was used to analyze the
Results: Quadriceps femoris muscle group MFTPs were noted in 92.5% of the patients (most
prevalent being Vastus medialis TP1 (63.8%), Vastus lateralis TP1 (33.8%) and Vastus
intermedius at 27,5%). Least common was Vastus lateralis TP2 only presenting in 2,5% of the
patients. Hamstring muscle group MFTPs were found overall in 86.3% of patients (most
prevalent being in Biceps femoris muscle (66%), and least prevalent being in Semitendinosus
muscle (11,3%)). MFTPs were present in 64% overall of the Adductor muscle group (Adductor
magnus muscle being the most common). Significant associations were made between the
presence of MFTPs in the Vastus lateralis TP2 (p=0.00), Vastus medialis TP1 (p=0.046; 0.005;
0.004), the NRS and the PPSS. Also significant was the relationship between the NRS, PPSS
and the Semimembranosus and Adductor magnus muscles indicated that these muscles were
the most likely causes of pain even though they had fewer MFTPs than other comparable
Conclusion: The outcomes of this study supports previous research indicating that an extensor
dysfunction of the Quadriceps femoris muscle group may be of MFTP origin and indicates that
other muscles in the thigh require further research indicating their role in the development of
Mini-dissertation submitted in partial compliance with the requirements for the
Master’s Degree in Technology: Chiropractic, Durban University of Technology, Durban, South Africa, 2012.
Appears in Collections:Theses and dissertations (Health Sciences)

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