IJPR.2026.134
Type of Article: Original Research
Volume 14; Issue 3 (August 2026)
Page No.: 4991-4995
DOI: https://dx.doi.org/10.16965/ijpr.2026.134
Correlation Between Q Angle and Hip Abductor Strength in Patellofemoral Pain Syndrome
Priya S 1, Harish S Krishna 2, Denson Alphonse *3.
1 Associate Professor, Laxmi Memorial College of Physiotherapy, Upper Bendoor 2nd Cross Rd, Bendoor, Mangaluru, Karnataka 575002, India.
2 Professor, Laxmi Memorial College of Physiotherapy, Upper Bendoor 2nd Cross Rd, Bendoor, Mangaluru, Karnataka 575002, India.
3 Second year MPT student, Musculoskeletal science, Laxmi Memorial College of Physiotherapy, Upper Bendoor 2nd Cross Rd, Bendoor, Mangaluru, Karnataka 575002, India. ORCiD: 0009-0009-6786-9791
Corresponding Author: Dr. Denson Alphonse, Physiotherapist, Thevarkunnnel (H) Ullickal P.O, Iritty, Kannur, Kerala, India. E-Mail: densonalphonse7@gmail.com
ABSTRACT
Background: Young active females are frequently exposed to dynamic lower limb loading during physical activity, rendering them susceptible to patellofemoral pain syndrome (PFPS). The quadriceps angle (Q angle) and hip abductor strength are critical biomechanical parameters influencing patellar tracking and patellofemoral joint stress. Alterations in these factors may contribute to or result from patellofemoral dysfunction.
Context and Purpose of Study: To evaluate the correlation between Q angle and hip abductor strength (HAS) in young female individuals diagnosed with patellofemoral pain syndrome.
Results: Karl Pearson’s correlation analysis revealed a statistically significant moderate negative correlation between Q angle and HAS (r = −0.599, p < 0.001) among 55 young female patients with PFPS. The mean Q angle was 20.90 ± 3.10 degrees, and the mean hip abductor strength was 12.90 ± 5.06 kg. As Q angle increased, HAS consistently decreased across the study cohort.
Conclusion: Young female patients with PFPS exhibit a significant inverse relationship between Q angle and HAS, indicating that structural malalignment and proximal muscular weakness jointly contribute to patellofemoral dysfunction. These findings reinforce the clinical value of incorporating hip abductor strengthening into rehabilitation protocols for PFPS management in young females.
KEYWORDS: Hip Abductor Strength, Patellar Malalignment, Patellofemoral Pain Syndrome, Quadriceps Angle.
REFERENCES
[1]. Boling M, Padua D, Marshall S, Guskiewicz K, Pyne S, Beutler A. Gender differences in the incidence and prevalence of patellofemoral pain syndrome. Scandinavian Journal of Medicine and Science in Sports. 2010 Oct;20(5):725-30.
https://doi.org/10.1111/j.1600-0838.2009.00996.x
PMid:19765240 PMCid:PMC2895959
[2]. Callahan EA, Chin KE, Chu SK. Current evidence of evaluation and management of the athlete with patellofemoral pain syndrome. Current Physical Medicine and Rehabilitation Reports. 2025 Aug 5;13(1):30.
https://doi.org/10.1007/s40141-025-00502-9
[3]. Smith BE, Selfe J, Thacker D, Hendrick P, Bateman M, Moffatt F, Rathleff MS, Smith TO, Logan P. Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis. PLoS One. 2018 Jan 11;13
https://doi.org/10.1371/journal.pone.0190892
PMid:29324820 PMCid:PMC5764329
[4]. Loudon JK. Biomechanics and pathomechanics of the patellofemoral joint. International Journal of Sports Physical Therapy. 2016 Dec;11(6):820.
[5]. Skouras AZ, Kanellopoulos AK, Stasi S, Triantafyllou A, Koulouvaris P, Papagiannis G, Papathanasiou G, Kanellopoulos A. Clinical significance of the static and dynamic Q-angle. Cureus. 2022 May 11;14(5).
https://doi.org/10.7759/cureus.24911
[6]. Besier TF, Pal S, Draper CE, Fredericson M, Gold GE, Delp SL, Beaupré GS. The role of cartilage stress in patellofemoral pain. Medicine and Science in Sports and Exercise. 2015 Nov;47(11):2416.
https://doi.org/10.1249/MSS.0000000000000685
PMid:25899103 PMCid:PMC4609225
[7]. Nakagawa TH, Moriya ÉT, Maciel CD, SerrãO FV. Trunk, pelvis, hip, and knee kinematics, hip strength, and gluteal muscle activation during a single-leg squat in males and females with and without patellofemoral pain syndrome. Journal of Orthopaedic and Sports Physical Therapy. 2012 Jun;42(6):491-501.
https://doi.org/10.2519/jospt.2012.3987
PMid:22402604
[8]. Xie P, István B, Liang M. The Relationship between Patellofemoral Pain Syndrome and Hip Biomechanics: A Systematic Review with Meta-Analysis. Healthcare (Basel). 2022 Dec 28;11(1):99.
https://doi.org/10.3390/healthcare11010099
PMid:36611559 PMCid:PMC9818693
[9]. Meira EP, Brumitt J. Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports health. 2011 Sep;3(5):455-65.
https://doi.org/10.1177/1941738111415006
PMid:23016043 PMCid:PMC3445210
[10]. Almeida GP, Carvalho AP, França FJ, Magalhães MO, Burke TN, Marques AP. Q-angle in patellofemoral pain: relationship with dynamic knee valgus, hip abductor torque, pain and function. Revista Brasileira de Ortopedia (English Edition). 2016 Mar 1;51(2):181-6.
https://doi.org/10.1016/j.rboe.2016.01.010
PMid:27069887 PMCid:PMC4812005
[11]. Ireland ML, Willson JD, Ballantyne BT, Davis IM. Hip strength in females with and without patellofemoral pain. Journal of Orthopaedic and Sports Physical Therapy. 2003 Nov;33(11):671-6.
https://doi.org/10.2519/jospt.2003.33.11.671
PMid:14669962
[12]. Meira EP, Brumitt J. Influence of the hip on patients with patellofemoral pain syndrome: a systematic review. Sports health. 2011 Sep;3(5):455-65.
https://doi.org/10.1177/1941738111415006
PMid:23016043 PMCid:PMC3445210
[13]. Cichanowski HR, Schmitt JS, Johnson RJ, Niemuth PE. Hip strength in collegiate female athletes with patellofemoral pain. Medicine & Science in Sports & Exercise. 2007 Aug;39(8):1227-32.
https://doi.org/10.1249/mss.0b013e3180601109
PMid:17762354
[14]. Prins MR, Van der Wurff P. Females with patellofemoral pain syndrome have weak hip muscles: a systematic review. Australian Journal of Physiotherapy. 2009 Jan 1;55(1):9-15.
https://doi.org/10.1016/S0004-9514(09)70055-8
PMid:19226237
