Abstract
Background Patellofemoral pain (PFP) is a prevalent musculoskeletal condition, particularly among adolescent and young adult females, often associated with sports involving high knee loads, such as volleyball. While previous studies have examined local and distal factors contributing to PFP, the role of trunk muscle strength remains underexplored, particularly in elite athletes. Objective The objective of this study is to investigate the correlation between PFP and trunk muscle strength in elite adolescent female volleyball players. Methods A retrospective analysis was conducted on 23 elite adolescent female volleyball players (mean age: 15.59 years) from the Hellenic National Team. Trunk muscle strength was measured using isokinetic dynamometry (Biodex System 4 Pro, Biodex Medical Systems, Inc., Shirley, NY, USA) during maximum flexion and extension at 90° of trunk inclination. Participants were categorized into PFP (n = 11) and non-PFP groups (n = 12) based on clinical evaluation. Statistical analysis included comparison of peak torque (Nm/kg), mean power, and agonist-antagonist ratios between groups. Results No significant differences were found in trunk flexion strength (p = 0.449), trunk extension strength (p = 0.423), or agonist-antagonist ratios (p = 0.601) between PFP and non-PFP groups. Trunk extension strength was consistently greater than flexion strength across all participants. Most athletes with PFP reported pain onset linked to increased training loads. Conclusions Despite the hypothesized correlation, this study did not identify significant differences in trunk muscle strength between volleyball players with and without PFP. These findings contrast with prior research on non-athletic populations, suggesting that elite athletes may possess compensatory mechanisms. Further studies are warranted to clarify the role of trunk strength in PFP pathophysiology and inform targeted prevention and rehabilitation strategies in elite sports.