Foot orthoses versus hip exercises and the effect of greater foot mobility in the management of patellofemoral pain: PhD Academy Award

I investigated if we could optimise who should receive foot orthoses in the management of people who have patellofemoral pain. I did this by investigating if a patient’s presenting characteristic—foot mobility—helps to determine who benefits most from foot orthoses, compared with hip exercises, in a large multicentre randomised clinical trial in Australia and Denmark. I was driven by clinical curiosity. Patellofemoral pain is considered a multifactorial condition with underlying biomechanical, neuromuscular and/or psychological contributors. International consensus1 and clinical guidelines2 recommend exercise therapy targeting the hip muscles and/or the knee and a distal consideration of foot orthoses. The recommendation of proximal and distal approaches presents two clinical quandaries. First, which individual’s presenting characteristic(s) may help guide clinicians which end of the lower limb to prioritise (ie, foot orthoses or hip exercises) and second, which of these treatments …