Assessing the Impact of Myofascial Release Versus Dry Needling for Chondromalacia in Adult Females: A Randomized Controlled Trial.
Abstract
Background
Chondromalacia patellae is a common cause of anterior knee pain in adult females and is associated with patellofemoral pain syndrome. Conservative management focuses on pain reduction and restoration of muscle function; however, limited evidence directly compares the effectiveness of myofascial release (MFR) and dry needling (DN). HYPOTHESIS Both MFR and DN would reduce pain and improve quadriceps function, with MFR producing greater improvements in neuromuscular performance. STUDY
Design
Randomized controlled clinical trial. LEVEL OF EVIDENCE Level 2.
Methods
Adult females (N = 45; age, 18-50 years) with magnetic resonance imaging-confirmed chondromalacia patellae were allocated randomly to 1 of 3 groups: DN plus exercise, MFR plus exercise, or exercise alone (control). Participants received 2 weekly treatment sessions for 3 weeks. Pain intensity was assessed using the visual analog scale, whereas the quadriceps peak torque and the hamstring-to-quadriceps (H/Q) peak torque ratio were measured using isokinetic dynamometry before and after treatment. Statistical analyses were performed using 1-way analysis of variance (P < 0.05).
Results
Pain intensity decreased significantly in all 3 groups after treatment (all P < 0.001). Both intervention groups demonstrated greater pain reduction than the control group (P = 0.006 and P < 0.001, respectively), with no significant difference between the 2 intervention groups (P > 0.99). Quadriceps peak torque increased significantly in the MFR plus exercise (P < 0.001) and control (P < 0.001) groups but not in the DN plus exercise group (P = 0.95). The MFR plus exercise group demonstrated greater quadriceps peak torque than the DN group (P = 0.001). The H/Q peak torque ratio improved significantly in all groups, with the MFR plus exercise group demonstrating greater improvement than the control group (P = 0.04).
Conclusion
Both DN and MFR reduced pain effectively in females with chondromalacia patellae. However, MFR combined with exercise produced superior improvements in quadriceps muscle strength and H/Q muscle balance, suggesting greater enhancement of neuromuscular function during rehabilitation. CLINICAL RELEVANCE MFR combined with exercise may be considered a valuable conservative intervention when treatment goals extend beyond pain relief to improving muscle performance and dynamic knee stability.