Assessing Impact of Myofascial Release versus Dry Needling for Chondromalacia in Adult females. The study employed a Randomized Controlled Trial (RCT) design.

A total of 45 female patients diagnosed with chondromalacia and confirmed by physical examination using a patellar grind test to confirm Clarke's sign were recruited for this study from the out patient clinic and Soad Kafafi's educational hospital , Investigations that analyzed the H/Q ratio by the use of gravity corrected isokinetic strength testing.

Inclusion criteria were:

• Age between 18-50 years old, the anterior knee pain recorded while one of the following activities at least :ascending and descending stairs, prolonged sitting and kneeling.
• Subject experiences pain during palpation of patellar facets or while performing a 25-cm step down test or double legged squat.
• Exclusion criteria included meniscal or intra-articular pathological conditions, cruciate or collateral ligaments involvement, tenderness over the patellar tendon .
• These participants were randomly assigned to one of three groups, each consisting of 15 patients all received treatment for 3 weeks, 2 sessions per weak.

Group 1: Received dry needling combined with traditional treatment( straight leg raising and isometric quadriceps exercises) for 3 weeks, 2 sessions per weak.

Group 2: Received myofascial release in addition to traditional treatment for 3 weeks, 2 sessions per week. Evaluation of fascial restriction was assessed using the therapists elbow.

Myofascial chain release:

Position of the patient: Supine lying, prone lying and side lying Position of the therapist: Side of the patient limb to be treated

-Technique: Using the therapist elbow a vertical release proximal to the attachment of the muscle belly or fascia was applied. Once an end-feel was reached a slow stroke down the length of the target tissue was performed along with monitoring the indirect feedback and tissue tension to identify any additional restrictions. The long stroke was repeated in a line parallel to the first stroke. It was continued until an end-feel is reached throughout the entire muscle belly or fascia on the most restricted/ painful points.

Traditional Treatment ( exercise) : Applied uniformly across all groups, comprising straight leg raising and isometric quadriceps exercises (2 days per week).

Group 3: Received only the traditional treatment only for 3 weeks, 2 sessions per weak.

Inclusion Criteria:

• Age between 18-50 years old, the anterior knee pain recorded while one of the following activities at least :ascending and descending stairs, prolonged sitting and kneeling.
• Subject experiences pain during palpation of patellar facets or while performing a 25-cm step down test or double legged squat. (Iiona, 2020)

Exclusion Criteria:

• excluded meniscal or intra-articular pathological conditions, cruciate or collateral ligaments involvement, tenderness over the patellar tendon .
• These participants were randomly assigned to one of three groups, each consisting of 15 patients all received treatment for 3 weaks, 2 sessions per weak.

double blinding