Popliteus Muscle Release Versus Patellofemoral Mobilization in Patellofemoral Pain Syndrome (PFPS)

This study will be conducted to compare the effect of popliteus muscle release and patellofemoral mobilization on pain intensity, function, and quadriceps muscle strength in patients with patellofemoral pain syndrome?

Study Overview

• Status: Not yet recruiting
• Conditions: Patellofemoral Pain Syndrome
• Intervention / Treatment: Other: Popliteus Muscle Release; Other: traditional therapy; Other: Patellofemoral Mobilization

Detailed Description

The gradual development of diffuse anterior knee pain is characteristic of patellofemoral pain (PFP), which is made worse by activities that put stress on the patellofemoral joint, such as running, stair climbing, and squatting. While 23% of the overall population has PFP, athletes can have a prevalence of 35%.Patellofemoral pain syndrome (PFPS) is a widespread disease with a significant impact on society, with a 22.7% prevalence in the general population.The patella is the largest sesamoid bone in the body and acts as a fulcrum to improve the mechanical advantage of the quadriceps. In full knee extension the patella does not articulate with the femoral condyles, and related to the lack of articular congruency, is able to glide more freely. The inferior patellar facet first contacts the femoral condyle around 20-30o of knee flexion.The popliteus tendon is a primary stabilizer of external knee rotation and has been described as the "fifth ligament of the knee." Injuries involving the posterolateral corner of the knee commonly involve the popliteus tendon; isolated injury to the popliteus tendon is relatively rare and usually involves a rotatory injury mechanism and symptoms of instability and pain.Myofascial release has been shown to improve pain, range of motion, and functional outcomes in individuals with knee disorders. By targeting fascial restrictions around the quadriceps, hamstrings, iliotibial band, and peri-patellar tissues, myofascial techniques help reduce tissue stiffness and abnormal tension that may contribute to altered patellar tracking and joint loading.Patellofemoral mobilization is considered an important intervention in the management of PFPS, particularly in patients presenting with pain, stiffness, or altered patellar tracking.Although both techniques are used to reduce anterior knee pain and improve function, current evidence is insufficient to determine which intervention is more effective. Therefore, further randomized controlled trials are needed to compare their effects on pain and functional outcomes in individuals with PFPS.

• Study Type: Interventional
• Enrollment (Estimated): 48
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: mohamed Bahig, master; Phone Number: 0 11 41644884; Email: mohamed.bahig@the.suezuni.edu.eg

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Male and female participants aged 18-30 years.
• minimum history of 3 months of unilateral PFP.
• pain intensity score of ≥3 on a 10-cm Visual Analog Scale (VAS) for worst pain experienced during the previous week.
• Pain reproduced during at least two of the following functional activities: stair ascent or descent, running, hopping, prolonged sitting, squatting, or kneeling.
• Presence of pain on at least one of the following clinical tests: patellar compression test or palpation of the patellar facets.

Exclusion Criteria:

• Clinical, x-ray, or MRI findings indicative of other specific pathology including osteoarthritis, meniscal, ligament or cartilage injury, apophysitis.
• Recurrent patellar subluxation or dislocation.
• Cortisone use over an extended period of time.
• Previous surgery to the knee joint; trauma to the knee joint affecting the presenting clinical condition.
• Lower limb deformities.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Popliteus Muscle Release; Sixteen patients with patellofemoral pain syndrome will receive popliteus muscle release. plus traditional physical therapy three times a week for 4 weeks.	Other: Popliteus Muscle Release; the participant will lie supine and relaxed on a treatment bench. The therapist will begin the treatment by flexing the participant's knee to approximately 15-25 degrees. Then, the therapist will apply pressure to the popliteus muscle while simultaneously extending the knee to approximately 5 degrees of flexion. When the knee is extended, the pressure will be released. The therapist will repeat this procedure for up to 2 minutes plus tradional therapy; Other: traditional therapy; patients will receive quadriceps muscle strength, hip extension strength, hamstring stretch.
Experimental: Patellofemoral Mobilization; Sixteen patients with patellofemoral pain syndrome will receive patellofemoral mobilization plus traditional physical therapy three times a week for 4 weeks.	Other: traditional therapy; patients will receive quadriceps muscle strength, hip extension strength, hamstring stretch.; Other: Patellofemoral Mobilization; Following the clinical guidelines established by Brukner and Khan, the mobilization will be performed with the patient in a supine position to ensure complete relaxation of the quadriceps musculature, thereby minimizing joint compressive forces. The intervention will include multidirectional glides tailored to specific functional deficits:Superior glides,Inferior glides,Medial-lateral excursions and tilt mobilization.Each mobilization will be applied as a gentle sustained glide for duration of 30 to 60 seconds per repetition
Active Comparator: traditional therapy; Sixteen patients with patellofemoral pain syndrome will receive traditional physical therapy three times a week for 4 weeks.	Other: traditional therapy; patients will receive quadriceps muscle strength, hip extension strength, hamstring stretch.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
pain intensity	The scale used will be the visual analogue scale (VAS), which consists of a line, usually 10 cm long, the patient will be instructed to place a vertical mark on to indicate his/ her pain, ranging from no pain or discomfort (0), to the worst pain that could possibly feel	up to four weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
knee disability	The Kujala Arabic version will be used to assess knee disability. it is 13 items on the scale are used to assess subjective symptoms and functional restrictions. A score can have a minimum of 0 points or a maximum of 100 points.Lower scores reflect greater pain and disability	up to four weeks
quadriceps muscle strength	A handheld dynamometer will be used to assess quadrecips muscle strength	up to four weeks

Collaborators and Investigators

• Sponsor: Cairo University

Study record dates

Study Major Dates

• Study Start (Estimated): July 15, 2026
• Primary Completion (Estimated): November 1, 2026
• Study Completion (Estimated): November 1, 2026

Study Registration Dates

• First Submitted: July 7, 2026
• First Submitted That Met QC Criteria: July 7, 2026
• First Posted (Actual): July 13, 2026

Study Record Updates

• Last Update Posted (Actual): July 13, 2026
• Last Update Submitted That Met QC Criteria: July 7, 2026
• Last Verified: July 1, 2026

More Information

Terms related to this study

• Keywords: Patellofemoral Pain Syndrome; Popliteus Muscle Release; Patellofemoral Mobilization
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Joint Diseases; Patellofemoral Pain Syndrome
• Other Study ID Numbers: P.T.REC/012/006557

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No