Chronic Patellofemoral Pain

One Patients Story to Treatment and Recovery

““The AlterG is a vital piece of equipment when assisting in the rehabilitation of those with a weight bearing restriction or joint pain from arthritis. We are able to help our patients walk in a safe, controlled, and pain-free environment.””

Stephanie Frager, Therapy Director, Southlake Village Rehabilitation and Care Center

One Patients Treatment for Chronic Patellofemoral Pain

Nicole Archambault, DPT


The patient is 12 year-old female competitive cheerleader with history of chronic bilateral patellofemoral knee pain. Running, jumping, tumbling, flips, and squats aggravate the patient’s symptoms.

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  • Restore normal gait and running mechanics
  • Increase hip and lower extremity strengthening bilaterally
  • Restore normal jumping, squatting, and lunging mechanics
  • Return to competitive cheerleading without symptoms

History / Progression

  • Patient has a history of bilateral knee pain aggravated by jumping, tumbling, flips, running, and squatting
  • Patient had no diagnostic studies completed
  • Patient underwent recent growth spurt
  • Patient presented with bilateral hip weakness and positive test for bilateral knee valgus with double/single leg squat, double single leg lunge, and double/single leg jump
  • Patient demonstrated altered gait and running mechanics with increased knee valgus and toe out bilaterally
  • The patient initiated a running program on the AlterG Anti-Gravity Treadmill at 50% of her body weight at 4.5 mph and no incline
  • The protocol included gait training on the AlterG and level ground, hip strengthening and stability training, balance training, and plyometric return to sport drills
  • Rehab program duration was 9 weeks

Download Case Study to see progression table


Pain, soreness, and gait deviations were considered when progressing ambulation on the AlterG. Speed, incline, and body weight percentage were increased to patient tolerance.


The patient was seen 1x/wk for 8 weeks, then once 2 weeks later for last appointment in the 9-week physical therapy exercise program. The patient began with moderate to severe infrapatellar pain bilaterally, which was monitored throughout the program.

At the initial evaluation, the patient reported an average pain of 4-6/10 and a maximum of 6-7/10 in bilateral knees sub patellar.  The patient had bilateral hip weakness with valgus moments at bilateral knees with squatting, lunging, jumping, running, and minimally during walking, which was monitored throughout the program.

The AlterG Anti-Gravity Treadmill, cutting edge physical therapy equipment, was utilized early in the rehab process in order to restore normal gait and running mechanics.  The patient had excellent carry over from AlterG training and was able to demonstrate normal gait and running mechanics outdoors on level ground at the end of the treatment session.  By the end of week 5, the patient was able to achieve normal gait and running mechanics on level ground without warm-up or training on the AlterG. The patient continued to progress running for endurance training on level ground as part of home exercise program.

The patient was able to achieve all her goals and return to full time competitive level cheerleading without symptoms.