| Experimental | Comparator |
---|---|---|
Month 0–1 | Phase 1 • Break from sports and moderate-to-vigorous physical activity • Daily high-volume low load isometric training • High-load hip-abductor training every other day • Introduction to a pain-model for progression of exercises and exposure to sport/moderate-to-vigorous physical activity • Education on pain science and management | • Introduction of progressive balance and alignment exercises every other day and continued • Introduction of daily progressive quadriceps stretching • Advice on approaches for preventing/treating pain flares: • Cryotherapy after activity if painful • Sports taping • Handout and instructions in using a patella strap • Advice on potential prognosis • Advice participation in sports and physical activity when experiencing pain |
Months 2–3 | Phase 2 • Self-managed introduction of gradual exposure to sport based on the pain-model • Once acceptable sport-level achieved, self-managed gradual exposure to vigorous physical activity is introduced •Introduction of progressively more loaded isometric and subsequent dynamic weight-bearing exercises for the knee extensors • Continued high-load hip-abductor training every other day | |
Months 4–5 | Self-management phase • Complete self-management of pain vs. loading from participation in sports and physical activity • Potential self-management of self-chosen exercise dose | Self-management phase • Complete self-management of pain vs. loading from participation in sports and physical activity • Potential self-management of self-chosen exercise dose |