Participants performed a structured home-based exercise program targeting hip and knee musculature. The program included warm-up, stretching, and progressive strengthening exercises for the quadriceps, hip abductors, hip external rotators, and core stability muscles. Participants were instructed to complete the program at least three times per week for 4 weeks. Exercise technique and progression guidelines were explained in person, and adherence was monitored using weekly exercise diaries and telephone follow-up.

Participants received five sessions of radial extracorporeal shock wave therapy (ESWT) administered at 5-day intervals. Treatment was delivered using the Chattanooga Intelect® RPW device with 2000 pulses per session at 1.8-2.0 bar pressure and 8 Hz frequency. Stimulation was applied to the peripatellar soft tissues, including the medial and lateral patellofemoral retinaculum and the infrapatellar fat pad, while avoiding direct application over the patellar tendon. Pressure was progressively increased across sessions based on tolerance.

Participants performed the same home-based strengthening program as the Exercise group (hip and knee strengthening, ≥3 sessions/week for 4 weeks). In addition, they received five sessions of radial extracorporeal shock wave therapy (2000 pulses; 1.8-2.0 bar; 8 Hz) at 5-day intervals applied to the peripatellar soft tissues while avoiding the patellar tendon.

A structured home-based exercise program targeting hip and knee musculature. The program included warm-up, stretching, and progressive strengthening for the quadriceps, hip abductors, hip external rotators, and core stability muscles. Participants were instructed to perform the program at least three times per week for 4 weeks. Exercise progression and technique were explained individually. Adherence was monitored with weekly exercise diaries and telephone follow-up.

The Visual Analog Scale (VAS) was used to assess the worst knee pain experienced in the previous week during daily or functional activities. Participants rated their pain on a 0-10 scale, where 0 represents no pain and 10 represents the worst imaginable pain. Pain intensity was recorded at baseline prior to intervention, at one week, and at eight weeks after the treatment to evaluate short- and mid-term treatment effects.

The Kujala Anterior Knee Pain Scale was used to evaluate knee-specific functional status. This validated questionnaire consists of 13 items assessing pain, functional limitations, and activities such as running, stair climbing, prolonged sitting, and squatting. Total scores range from 0 to 100, with higher scores indicating better function. Assessments were completed at baseline, at one week, and at eight weeks after the treatment to determine functional improvement over time.