Gait Retraining for Patellofemoral Pain Syndrome: A Biomechanical Approach to Pain Relief and Performance Optimization

Clin J Sport Med. 2026 Oct 13. doi: 10.1097/JSM.0000000000001519. Online ahead of print.

ABSTRACT

OBJECTIVE: Patellofemoral pain syndrome (PFPS) is common among runners and is linked to biomechanical dysfunctions that increase patellofemoral joint stress. Gait retraining has been proposed to redistribute this loading, but the effectiveness of different retraining strategies and their long-term impact remain unclear. This scoping review synthesizes existing evidence on gait retraining strategies for PFPS, focusing on pain, function, and biomechanics.

DATA SOURCES: MEDLINE, Cochrane CENTRAL, Scopus, PEDro, and Web of Science were searched, following the methodological framework of the Joanna Briggs Institute for scoping reviews. Studies investigating gait retraining interventions in runners diagnosed with PFPS were included. Key outcomes were pain reduction, functional improvement, biomechanical adaptations, and adverse effects.

MAIN RESULTS: Three randomized controlled trials met the inclusion criteria, examining cadence modification, impact reduction, and foot strike adjustments. Intervention groups experienced significant pain reduction, with Visual Analog Scale scores improving by 2 to 4 points, alongside functional gains reflected by increased Kujala and Knee Outcome Survey of the Activities of Daily Living Scale scores. Biomechanical adaptations included decreased patellofemoral joint stress, lower impact forces, and improved load distribution. Some participants reported transient calf discomfort during the adaptation period, which resolved over time.

CONCLUSIONS: Gait retraining is an effective intervention for runners with PFPS, showing sustained pain relief, functional improvement, and biomechanical benefits. Individualized protocols and gradual implementation are essential to optimize outcomes and minimize discomfort. Future research should address long-term retention of gait modifications, optimal training parameters, and applicability beyond runners.

PMID:42864740 | DOI:10.1097/JSM.0000000000001519