Participants in this arm received Strain Counterstrain (SCS) along with routine physical therapy. SCS involved identifying and holding tender points in positions of comfort for 90 seconds to relieve pain and improve range of motion. Routine physical therapy included TENS, infrared therapy, ultrasound, strengthening exercises (short arc quads, seated knee flexion/extension, terminal knee extension), and stretching exercises (straight leg raises, lying and sitting hamstring stretches). The intervention was delivered 5 days a week for 8 weeks. Education on weight management and joint protection strategies was also provided.

Participants in this arm received Muscle Energy Technique (MET) along with routine physical therapy. MET involved post-isometric relaxation and slow eccentric isotonic stretching techniques targeting hamstrings and quadriceps, helping to restore joint mobility and muscle flexibility. Routine physical therapy included TENS, infrared therapy, ultrasound, strengthening exercises (short arc quads, seated knee flexion/extension, terminal knee extension), and stretching exercises (straight leg raises, lying and sitting hamstring stretches). The intervention was administered 5 days per week over 8 weeks, along with patient education on lifestyle and joint care.

This intervention involves applying the Strain Counterstrain (SCS) technique in combination with standard physical therapy. SCS targets tender points through passive positioning to reduce muscle tension and pain. The patient is positioned in a position of comfort for 90 seconds while monitoring the tender point. This is followed by gradual return to neutral. Routine physical therapy includes electrotherapy (TENS, IR, ultrasound), strengthening (short arc quads, terminal knee extension), and stretching exercises. The therapy is administered 5 days per week over 8 weeks.

Pain intensity was assessed using the Numeric Pain Rating Scale (NPRS), a validated 0-10 scale where 0 indicates "no pain" and 10 indicates "worst possible pain." Assessments were conducted at baseline, 4 weeks, and 8 weeks. A lower score represents improvement.

Range of motion (ROM) of the affected knee was measured using a standard universal goniometer. The focus was on knee flexion and extension. Measurements were taken at baseline, 4 weeks, and 8 weeks to evaluate changes over time.