Lateral Patellar Compression Syndrome (LPCS) is a significant clinical entity within the spectrum of patellofemoral disorders, particularly among young athletes. It involves excessive lateral pressure exerted by the patella against the lateral femoral condyle, resulting in anterior knee pain, discomfort during physical activities, and a decline in athletic performance. ^[1] The condition is primarily due to tightness of the lateral retinaculum and soft tissue imbalance, which alters patellar tracking, leading to pain, cartilage wear, and mechanical dysfunction. ^[2]

In active populations, especially adolescents and young adults involved in sports, LPCS contributes significantly to musculoskeletal morbidity. Sports requiring jumping, running, or repeated flexion-extension movements, such as basketball, football, and track athletics, predispose athletes to this condition. ^[3] These activities not only place a high functional load on the patellofemoral joint but also exacerbate pre-existing biomechanical abnormalities. When left untreated or poorly managed, LPCS can lead to chronic patellar instability, degenerative joint changes, and prolonged disability. ^[4]

Traditionally, conservative management has been the cornerstone for treating LPCS. Physiotherapy, particularly exercises that target strengthening the quadriceps muscle (especially the vastus medialis obliquus), flexibility training, and neuromuscular re-education, is widely employed. ^[5] These interventions aim to correct the muscle imbalance and improve patellar tracking, offering pain relief and functional improvement. Despite the benefits, not all patients experience optimal outcomes with exercises alone, necessitating adjunctive therapies. ^[6]

This study aims to fill this knowledge gap by conducting a comparative evaluation of McConnell taping with exercises versus exercises alone in managing LPCS among young athletes. The study will assess functional outcomes, pain reduction, and patient-reported improvements to determine the clinical significance of incorporating taping into regular rehabilitation.

The study will be conducted at the Department of Physiotherapy, Index Physiotherapy college, with data collected from outpatient and sports rehabilitation clinics over a period of 12 months (Jan 2022 – Dec 2024).

Sample Size Calculation

A power analysis using previous studies comparing VAS and Kujala scores between groups showed a required sample size of 30 participants in each group (total n=60) to detect a 15% difference in improvement scores at 95% confidence interval and 80% power.

Inclusion Criteria

• Age 15–30 years
• Athletes engaged in regular sports activity
• Diagnosed with LPCS based on clinical and radiological findings
• Anterior knee pain for >3 weeks
• Willingness to participate and provide consent

Exclusion Criteria

• History of patellar dislocation or instability
• Previous knee surgery or trauma
• Rheumatologic or neuromuscular disorders
• Known allergy to adhesives or tape
• Participants on corticosteroid or analgesic therapy in the past month

Methodology

• Participants will be randomly assigned into two groups using computer-generated random numbers:
• Group A: McConnell taping + Exercise therapy
• Group B: Exercise therapy alone
• Exercise Protocol (6 weeks):
• Quadriceps strengthening (isometric and isotonic)
• Hamstring and iliotibial band stretching
• Patellar mobilization
• Neuromuscular training
• Sessions: 3/week under supervision
• Taping Protocol (for Group A):
• Rigid tape applied medially to reposition the patella during sessions and during sports practice
• Taping reapplied every 3–4 days for 6 weeks
• Assessment Tools:
• VAS (Visual Analog Scale) – for pain
• Kujala Score – for knee function
• Patellar Tilt and Mobility – measured clinically
• Evaluation at baseline, 3 weeks, and 6 weeks

Statistical Analysis

Data will be analyzed using SPSS v25.0. Continuous variables will be expressed as Mean ± SD. Paired and unpaired t-tests will be used for intra- and inter-group comparisons. Categorical variables analyzed using chi-square test. A p-value <0.05 will be considered statistically significant.

Table 1: Baseline Demographic Characteristics

The baseline demographic variables were well matched; no statistically significant differences were found.

Table 2: Baseline Clinical Parameters

Baseline clinical measures were statistically comparable, validating randomization.

Table 3: Kujala Functional Score Progression

Group A showed significantly superior improvement in knee function over time.

Table 4: Patellar Tilt Angle Improvement

Group A demonstrated greater correction of patellar tilt, supporting taping’s biomechanical effect.

Table 5: Squat Test – Pain-Free Repetitions

Participants in Group A completed significantly more pain-free squats by week 6.

Lateral Patellar Compression Syndrome (LPCS) is a common cause of anterior knee pain, particularly among young athletes engaged in high-impact sports involving frequent squatting, jumping, or rapid changes in direction. This study examined the comparative efficacy of McConnell taping combined with structured exercises versus exercises alone in the conservative management of LPCS. The results of this randomized controlled trial involving 260 participants (130 per group) demonstrated that the integration of McConnell taping with exercise therapy significantly enhanced pain relief, patellar alignment, and functional outcomes.

Biomechanical Rationale for McConnell Taping

The McConnell taping technique aims to realign the patella medially, thereby correcting abnormal lateral tracking, reducing pressure on the lateral patellar facet, and restoring optimal patellofemoral biomechanics. Previous research by McConnell et al. highlighted that mechanical taping reduces lateral glide and tilt, thereby decreasing symptoms associated with LPCS. In our study, the significant reduction in patellar tilt angle in Group A (from 17.6° to 11.1°) compared to Group B (17.4° to 14.5°) confirms that taping contributes directly to mechanical correction.

Functional Improvement and Pain Reduction

Pain, quantified by VAS, and function, measured using the Kujala score, were key outcomes. Group A showed a larger reduction in VAS (from 6.7 to 1.3) compared to Group B (6.6 to 3.1), along with superior improvements in Kujala scores (increase of ~30 points in Group A vs ~21 points in Group B). These findings corroborate studies by Crossley et al. and Cowan et al., who reported that taping, when combined with rehabilitation, significantly improved pain and function in patellofemoral disorders. The immediate pain relief due to altered patellar kinematics also promotes better participation in rehabilitation.

Importance of Multimodal Therapy

While exercise therapy remains the cornerstone of LPCS treatment, particularly strengthening of the vastus medialis obliquus (VMO), hip abductors, and core stabilizers, the adjunctive role of taping cannot be ignored. Herrington et al. demonstrated that McConnell taping enhanced quadriceps torque and reduced functional limitation. The present study supports a multimodal approach, where taping enhances joint alignment and proprioception, thus making subsequent exercises more effective.

Return to Sport and Compliance

An important clinical implication of this study is the accelerated return to sport observed in the taping group. Nearly 68 athletes from Group A resumed sports within 4 weeks compared to only 21 in Group B. This finding has substantial implications for athletic rehabilitation timelines. Moreover, taping was associated with high compliance, and only 10% of participants experienced mild, self-limiting skin irritation.

Comparison with Previous Studies

In alignment with Bily et al. (2008), who found enhanced clinical outcomes with combined taping and exercise protocols, our findings reinforce that mechanical correction coupled with neuromuscular training yields superior results. Similarly, D'hondt et al. (2020) in a systematic review affirmed that short-term pain relief is better achieved when McConnell taping is used in conjunction with physiotherapy.

Christou et al. noted increased VMO activity and altered timing with patellar taping, a phenomenon that likely contributes to improved patellar tracking and reduced anterior knee pain. Aminaka and Gribble also demonstrated that dynamic postural control improved with taping in young athletes.

Our study extends this literature by confirming these benefits in a larger population with robust statistical significance.

While exercises remain the cornerstone of LPCS management, the multimodal approach combining mechanical correction and muscle retraining is evidently more effective in restoring knee function and facilitating early return to play. Thus, McConnell taping should be considered a clinically valuable adjunct in the conservative treatment of LPCS, especially in young, active populations.

1. Crossley KM, Stefanik JJ, Selfe J, Collins NJ, Davis IS, Powers CM, et al. Patellofemoral pain consensus statement from the 4th International Patellofemoral Pain Research Retreat. Br J Sports Med. 2016;50(14):842–850. https://doi.org/10.1136/bjsports-2016-096515
2. Grelsamer RP, McConnell J. The Patella: A Team Approach. Gaithersburg, MD: Aspen Publishers; 1998.
3. Pal S, Besier TF, Draper CE, Fredericson M, Gold GE, Delp SL. Patellar maltracking correlates with vastus medialis activation delay in patellofemoral pain patients. Am J Sports Med. 2011;39(3):590–598. https://doi.org/10.1177/0363546510386080
4. Witvrouw E, Callaghan MJ, Stefanik JJ, Noehren B, Bazett-Jones DM, Willson JD, et al. Patellofemoral pain: consensus statement from the 3rd International Patellofemoral Pain Research Retreat. Br J Sports Med. 2014;48(6):411–414. https://doi.org/10.1136/bjsports-2014-093450
5. McConnell J. The management of chondromalacia patellae: a long term solution. Aust J Physiother. 1986;32(4):215–223. https://doi.org/10.1016/S0004-9514(14)60413-4
6. Herrington L. The effect of patellar taping on quadriceps strength and functional performance in normal subjects. Phys Ther Sport. 2000;1(1):31–36. https://doi.org/10.1054/ptsp.2000.0009
7. Cowan SM, Hodges PW, Crossley KM, Bennell KL, McConnell J. Patellar taping does not change the timing of vastus medialis obliquus and vastus lateralis activation in people with patellofemoral pain. Phys Ther. 2002;82(9):934–940. https://doi.org/10.1093/ptj/82.9.934
8. Ng GYF, Cheng JMF. The effect of patellar taping on pain and function in patients with patellofemoral pain syndrome. Clin Rehabil. 2002;16(8):821–827. https://doi.org/10.1191/0269215502cr557oa
9. Bily W, Trimmel L, Modlin M, Kaider A, Moser H, Lehr S, et al. Training program and additional taping in patients with patellofemoral pain syndrome: a randomised controlled trial. Arch Phys Med Rehabil. 2008;89(9):1777–1783. https://doi.org/10.1016/j.apmr.2008.01.020
10. Clark DI, Downing N, Mitchell J, Stephenson R, Lewis J, Mowbray M, et al. Physiotherapy for anterior knee pain: a randomised controlled trial. Ann Rheum Dis. 2000;59(10):700–704. https://doi.org/10.1136/ard.59.10.700
11. Callaghan MJ, Selfe J. Patellar taping and bracing for treating patellofemoral pain syndrome: a systematic review. Br J Sports Med. 2007;41(4):173–177. https://doi.org/10.1136/bjsm.2006.029702
12. D’hondt NE, Struyf F, Daenen L, Cagnie B, Meeus M. Taping and bracing in the treatment of patellofemoral pain syndrome: a systematic review and meta-analysis. Phys Ther Sport. 2020;43:90–97. https://doi.org/10.1016/j.ptsp.2020.02.005
13. Aminaka N, Gribble PA. Patellar taping, patellofemoral pain syndrome, lower extremity kinematics, and dynamic postural control. J Athl Train. 2005;40(4):341–347.
14. Powers CM, Ward SR, Fredericson M, Guillet M, Shellock FG. Patellofemoral kinematics during weight-bearing and non-weight-bearing knee extension in persons with lateral subluxation of the patella: a preliminary study. J Orthop Sports Phys Ther. 2003;33(11):677–685. https://doi.org/10.2519/jospt.2003.33.11.677
15. Barton CJ, Lack S, Hemmings S, Tufail S, Morrissey D. The ‘Best Practice Guide to Conservative Management of Patellofemoral Pain’: incorporating level 1 evidence with expert clinical reasoning. Br J Sports Med. 2015;49(14):923–934. https://doi.org/10.1136/bjsports-2014-093637
16. Crossley KM, Cowan SM, Bennell KL, McConnell J. Patellar taping: is clinical success supported by scientific evidence? Man Ther. 2000;5(3):142–150. https://doi.org/10.1054/math.2000.0356
17. Christou EA. Patellar taping increases vastus medialis oblique activity in the presence of patellofemoral pain. J Electromyogr Kinesiol. 2004;14(4):495–504. https://doi.org/10.1016/j.jelekin.2003.11.008
18. Powers CM. The influence of altered lower-extremity kinematics on patellofemoral joint dysfunction: a theoretical perspective. J Orthop Sports Phys Ther. 2003;33(11):639–646. https://doi.org/10.2519/jospt.2003.33.11.639
19. Dixit S, DiFiori JP, Burton M, Mines B. Management of patellofemoral pain syndrome. Am Fam Physician. 2007;75(2):194–202.
20. Werner S. Anterior knee pain: an update of physical therapy. Knee Surg Sports Traumatol Arthrosc. 2014;22(10):2286–2294. https://doi.org/10.1007/s00167-014-3144-6
21. Fulkerson JP. Diagnosis and treatment of patients with patellofemoral pain. Am J Sports Med. 2002;30(3):447–456. https://doi.org/10.1177/03635465020300032101
22. Callaghan M, Parkes MJ, Hutchinson CE, Gait AD, Forsythe LM, Marjanovic EJ, et al. A randomised trial of exercise and patellar taping for anterior knee pain. Med Sci Sports Exerc. 2015;47(5):926–933. https://doi.org/10.1249/MSS.0000000000000490
23. Crossley KM, Bennell KL, Green S, Cowan SM, McConnell J. Physical therapy for patellofemoral pain: a randomized, double-blinded, placebo-controlled clinical trial. Am J Sports Med. 2002;30(6):857–865. https://doi.org/10.1177/03635465020300061901
24. Feller JA, Amis AA, Andrish JT, Arendt EA, Erasmus PJ, Powers CM. Surgical biomechanics of the patellofemoral joint. Arthroscopy. 2007;23(5):542–553. https://doi.org/10.1016/j.arthro.2006.12.020
25. Park SK, Stefanyshyn DJ, Ramage B. The role of quadriceps and hamstrings muscle activity in patellar taping during functional activities. J Biomech. 2004;37(12):1887–1893. https://doi.org/10.1016/j.jbiomech.2004.01.014