Assessing the Impact of Myofascial Release Versus Dry Needling for Chondromalacia in Adult Females: A Randomized Controlled Trial
In brief
Myofascial release plus exercise improved quadriceps strength more than dry needling
In a randomized trial of 45 women treated for 3 weeks, myofascial release and dry needling, each combined with exercise, reduced pain more than exercise alone, with similar pain relief from both approaches. Myofascial release also improved quadriceps strength more than dry needling and improved muscle balance versus exercise alone, but the small, short trial leaves longer-term benefits unclear.
- Journal
- Sports health (Q1)
- Published
- 27 September 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Fairouz Hatem Ameen, Mohamed M M Essa, Doaa Saeed, Mina Magdy Wahba, Abd El-Hamied Ibrahim El-Sayed Mohammad El-Sherbini, Bishoy S Lobbos, et al.
- PMID
- 42801270
- DOI
- 10.1177/19417381261486230
Why clinicians should know about it
- Picked for Orthopedics and Sports Medicine (top studies of the week, 4 October 2026): Myofascial release vs dry needling RCT for chondromalacia, not orthopaedic
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.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.