The effect of stretching and transverse friction massage to gastrocnemius for patellofemoral pain syndrome

INTERVENTION: There will be two treatment arms for the study which will be called groups A and B. Group A will be taught home stretches for their gastrocnemius. Group B will be taught the same stretching programme however will also recieve 3 sessions of transverse friction massage which will be applied to the lateral head of gastrocnemius for 10 minutes. CONDITION: Patellofemoral pain syndrome ; Musculoskeletal Diseases PRIMARY OUTCOME: Pain measured on VAS and Eccentric step down test at baseline, 2 weeks and 4 weeks follow‐up SECONDARY OUTCOME: Function measured by Modified Functional Index Questionnaire and Eccentric step down test at baseline, 2 weeks and 4 weeks follow‐up INCLUSION CRITERIA: Participants may be aged from 16 and above, with no upper age limitation. History of characteristic history and symptoms of patellofemoral joint pain for more than 6 weeks, defined as retropatellar pain during physical activities such as jumping, running, squatting and going up and down stairs. Exhibit at least two of the following physical criteria: 1. Pain on direct compression of the patella against the femoral condyles with the knee in full extension 2. Tenderness of the posterior surface of the patella on palpation 3. Pain on resisted knee extension in 15º of flexion 4. Negative findings in the examination of the other knee structures, i.e. ligaments, menisci, bursae, synovial plicae, Hoffa’s fat pad, Iliotibial band, and the hamstrings, quadriceps, patellar tendons and their insertions.