Reduced Lower Extremity Strength, Altered Muscle Activation, and Unchanged Kinetics During Single-Leg Squatting in Males With Patellofemoral Pain Versus Pain-Free Males: A Cross-Sectional Analysis

Authors

• Lisa T. Hoglund, Thomas Jefferson UniversityFollow
• Amy H. Amabile, Thomas Jefferson UniversityFollow
• Thomas Alexander Hulcher, Thomas Jefferson UniversityFollow
• Victoria K. Polansky, Thomas Jefferson University
• Erin L. Dopke, Thomas Jefferson UniversityFollow

Document Type

Article

Publication Date

8-1-2026

Comments

This article is the author's final published version in Clinical Biomechanics, Volume 138, 2026, Article Number 106902.

The published version is available at https://doi.org/10.1016/j.clinbiomech.2026.106902. Copyright © The Author(s).

Abstract

BACKGROUND: Patellofemoral pain is frequently a cause of reduced quality of life in physically active males. The cause of patellofemoral pain is theorized to include aberrant biomechanics during weight-bearing activities. Altered biomechanics of females with patellofemoral pain have been reported, but there is a dearth of research for males with this condition. This study aimed to compare males with and without patellofemoral pain for hip and knee joint moments and muscle activation during single-leg-squatting and proximal muscle strength.

METHODS: Twenty males with patellofemoral pain and 20 pain-free males aged 20-39 years performed single-leg-squatting while motion, ground reaction force, and proximal muscle electromyographic activity were captured. Isometric muscle strength of the hip extensors, hip abductors, knee extensors, and knee flexors were measured with a dynamometer. Triplanar joint moments of the weight-bearing hip and knee, proximal muscle activation, and isometric strength of the groups were compared using mixed model ANOVAs.

FINDINGS: Males with patellofemoral pain had greater gluteus maximus activation during single-leg-squatting than pain-free controls (p = 0.045) but no difference for hip and knee joint moments (p > 0.05). Patellofemoral pain participants had lower hip and knee muscle strength than controls with significantly reduced strength for hip abductors (peak torque/body mass group means: patient = 1.23; control = 1.48; p = 0.012) and knee flexors (peak torque/body mass group means: patient = 1.06; control = 1.39; p = 0.004).

INTERPRETATION: Males with patellofemoral pain may have proximal muscle weakness which may cause compensatory increased hip and knee muscle activation to perform weight-bearing activities. Clinicians should consider knee flexor strengthening in management of males with patellofemoral pain.

Recommended Citation

Hoglund, Lisa T.; Amabile, Amy H.; Hulcher, Thomas Alexander; Polansky, Victoria K.; and Dopke, Erin L., "Reduced Lower Extremity Strength, Altered Muscle Activation, and Unchanged Kinetics During Single-Leg Squatting in Males With Patellofemoral Pain Versus Pain-Free Males: A Cross-Sectional Analysis" (2026). Department of Physical Therapy Faculty Papers. Paper 50.
https://jdc.jefferson.edu/ptfp/50

Creative Commons License

This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

PubMed ID

42364262

Language

English