OBJECTIVES: Adolescent females with PFP have localised (around the knee) and distal (tibialis anterior muscle) hyperalgesia assessed by decreased pressure pain thresholds (PPT). This may have implications for treating PFP as both localised and central pain mechanisms may contribute to the manifestations of pain. The objective of this study was to compare the change in localised and distal hyperalgesia among female adolescents with patellofemoral pain (PFP) deeming themselves recovered compared to those not recovered 3 months after patient education with or without exercise therapy. METHODS: This is an ancillary analysis of a cluster randomized controlled trial investigating the effect of patient education with or without exercise therapy on self-reported recovery in 121 adolescents with PFP. PPTs were measured at four sites around the knee and on tibialis anterior in a random subsample of 57 female adolescents. Changes in localised and distal hyperalgesia from baseline to follow-up were compared to self-reported recovery. Adolescents were categorized as recovered if they rated themselves as "completely recovered" or "strongly recovered" (category 1 or 2) on a 7-point Likert scale. RESULTS: 39 adolescents (68%) were available for follow-up at three months and 10 adolescents reported being recovered. Recovered adolescents had a 68kPa (95%CI 1 to 136, p = 0.047) larger improvement in PPT around the knee and a 76kPa (95%CI -29 to 181, p = 0.16) non-significant improvement in PPT on the tibialis anterior compared to adolescents not recovered. CONCLUSION: Female adolescents with PFP who rated themselves as recovered had a larger reduction in localised hyperalgesia compared to those not recovered.

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