Dry Needling and Knee Pain

This project will evaluate the effects of dry needling on pain, muscle performance, and
function in those with patellofemoral pain syndrome (PFPS) of the knee. Variables of interest
will include self-reported pain scores, self-reported functional outcome and disability
questionnaire scores, and various objective clinical measures including muscle strength,
joint range of motion, and movement patterns during basic tasks related to activities of
daily living. Patients who are referred to physical therapy with PFPS will be recruited.
Patients will be randomly and equally allocated into one of the following groups: 1. Gluteal
dry needling (GLUTE) 2. Quadriceps dry needling (QUAD) 3. Sham gluteal dry needling (SHAM
GLUTE) 4. Sham quadriceps dry needling (SHAM QUAD) 5. Control group (CONTROL) Groups 1-4 will
receive 2 sessions of dry needling or sham dry needling to the gluteal and/or quadricpes
muscles on their painful lower limb over 2 consecutive weeks in addition to standard physical
therapy. The CONTROL group will only receive standard physical therapy. The sham treatment
groups (groups 3-4) will receive a placebo treatment that does not penetrate the skin or
muscles. Measurements will be performed at baseline prior to any physical therapy
interventions and then at week 3.

Inclusion Criteria:

- 18-40 years-of-age

- Referred for physical therapy

- Presence of anterior knee pain around the patella during ascending/descending stairs,
squatting, and/or running for at least 3 months.

Exclusion Criteria:

- Unable to provide consent

- Bilateral patellofemoral pain syndrome

- Received previous dry needling treatments

- Pregnancy

- History of pain less than 3 months

- Imaging demonstrating the presence of confounding internal abnormality (e.g. chondral
defects, ligamentous injury, and/or meniscal pathology),

- History of knee surgery

- Patellar instability

- Presence of a neurological condition that would affect movement

- Contraindications to dry needling techniques (e.g. a history of bleeding disorders,
phobia of needles, an active cancer diagnosis, and presence of other systemic illness
such as fever or signs of infection)