Patellofemoral Pain SyndromeNCT07734051
Effect of Adding Inguinal Ligament Mobilization to Talonavicular Joint Mobilization on Patellofemoral Pain Syndrome
A study testing inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises in people with Patellofemoral Pain Syndrome, run by Cairo University at 1 site in Egypt.
Trial summary
This study will be conducted to: To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain intensity subjects with PFPS To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain threshold in subjects with PFPS. Read more about this study
- Who is it for?
- Ages 18 to 40 years
- Conditions the study is for
- Patellofemoral Pain Syndrome
- What is being tested?
- inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 80 participants
- Where
- 1 siteEgypt
- Study dates
- 1 Mar 2026to Sep 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 40 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- • Diagnosis of PFPS, based on clinical and radiographic criteria (no other knee pathologies) referred by orthopedic physicians.
- Subjects diagnosed with unilateral PFP with at least three months.
- Age of subjects ranges from 18 to 40 years .
- BMI less than 30 kg/ m2.
- Subjects complaining from increasing pain severity after at least two of the following provocative activities as (Stair ascent and descent, Squatting, Kneeling, running, or prolonged sitting).
- Subjects included in the study should record a positive grind test.
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- Subjects with tension of inguinal ligament either "mechanical strain, injury, repetitive movement or pelvic instability as anterior pelvic tilting" which leads to PFPS based on positive inguinal ligament tension test.
- Foot pronation position "mobile type" which leads to PFPS based on positive "The wear test or the wet foot test".
- Q angle in men 18-22 degree and in women 22 25 degree.
Who cannot join
- • Chronic pain conditions unrelated to PFPS.
- Pregnancy or recent trauma to the pelvic or knee region. (Mills et al., 2005).
- History of steroid injection of the knee.
- Ankle arthritis, gouty arthritis.
- History of any surgical intervention of the back, hip, knee or foot.
- Lower limb deformity such as pes-planus, knee valgus or varus deformities.
- Previous lower limb disease such as hip and tibiofemoral osteoarthritis.
- Diabetes or Peripheral neuropathy.
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
About this study
This study will be conducted to:
- To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain intensity subjects with PFPS
- To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain threshold in subjects with PFPS.
- To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on knee function in subjects with PFPS .
- To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on Q angle in subjects with PFPS .
Read the detailed description
Patellofemoral pain syndrome is pain around and under the patella (kneecap). The condition is also known as runner's or jumper's knee and affects both kids and adults. It can also occur in one or both knees . Patellofemoral pain syndrome (PFPS) is one of the most common orthopedic knee afflictions among both adults and adolescents. This syndrome, constitutes 5% of all injuries and 25% of knee injuries. It is characterized by pain in the back of the knee cap that comes in contact with the femur , and it is usually aggravated by walking stairs, deep squatting, kneeling, prolonged sitting, and standing up from sitting.
The treatment of PFPS varies from medication and up to different rehabilitation approaches, including balance and proprioceptive exercises to regain normal activities of daily level and optimizing function. Also, the rehabilitation of PFPS includes conservative treatments of physical therapy for symptoms such as muscle strengthening exercises (quadriceps femoris and hip abductors), flexibility exercises (rectus femoris, hamstring, gastrocnemius, hip flexors), foot orthoses to reduce pronated foot, patellofemoral joint taping, braces, and non-steroidal anti-inflammatory drugs (NSAIDs).
Some studies have reported a pronated foot as an intrinsic risk factor for PFPS, suggesting that it may be a solution to the underlying problem. Abnormal motion of the talonavicular joint due to navicular drop or drift in the pronated foot is an indicator of the overall function of the foot. Similarly, studies have shown a correlation between the pronated foot and PFPS. A pronated foot is defined as the flattening or loss of the medial longitudinal arch (MLA). Changes in the lower extremity alignment can cause calcaneal eversion, tibia internal rotation, valgus knee, and femur internal rotation in the normal structure, altering the angle of muscle contraction of the quadriceps femoris, causing the patella to track in the lateral direction, resulting in lower extremity dysfunction.
Foot interventions in patients with patellofemoral pain have shown significant effectiveness of the talonavicular joint mobilization (TJM) to maintain foot posture and to control hypermobility of the talonavicular joint of the pronated foot which will cause changes in PFPS pain, lower extremity function, valgus knee, foot posture. Foot core strengthening: relevance in injury prevention and rehabilitation for runners.
One potential intervention that has gained attention is inguinal ligament mobilization (ILM), a manual therapy technique designed to address pelvic and hip alignment that could indirectly affect knee mechanics. Inguinal ligament mobilization is thought to improve the mobility and function of the surrounding structures, potentially alleviating PFPS symptoms.
- Conditions
- Patellofemoral Pain Syndrome
- Being tested
- inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises
- Medical subject headings
- Patellofemoral Pain Syndrome
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercisesOther
2 sessions per week for total 4 weeks of treatment
| Study group | Role | What they receive |
|---|---|---|
| group A recieving inguinal ligament mobilization | Experimental | Group A: An intervention group (n = 20) receiving inguinal ligament mobilization (ILM) with conventional physical therapy exercises. Receives: Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises |
| group B recieving talonavicular joint mobilization | Experimental | Group B: An intervention group (n = 20) receiving talonavicular joint mobilization (TJM) with conventional physical therapy exercises. Receives: Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises |
| group C recieving talonavicular joint mobilization and inguinal ligament mobilization | Experimental | Group C: An intervention group (n = 20) receiving combined inguinal ligament mobilization, talonavicular joint mobilization and conventional physical therapy exercises. Receives: Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises |
| group D recieving conventional physical therapy exercises | Placebo comparator | Group D: A control group (n = 20) receiving conventional physical therapy exercises only Receives: Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises |
What is being measured
The primary outcome is the main question the study is designed to answer.
pain intensity
1.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on pain intensity in subjects with PFPS. and it is measured by Visual Analogue Scale (100 mm (10-cm) straight line with descriptive anchors at each extreme to measure pain intensity)
Measured: Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.
pain threshold
2.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on pain threshold in subjects with PFPS. and it is measured by pressure algometer (a handheld diagnostic device used to objectively quantify pain sensitivity by measuring the exact force at which a patient begins to feel pain).
Measured: Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.
knee function
3.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on knee function in subjects with PFPS. and it is measured by Kujala Patelofemoral Pain Questionnaire (in score from 13-question survey used to measure knee pain, function, and symptoms related to the kneecap. It scores from 0 to 100 points, where 100 means no pain or disability).
Measured: Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.
Q angle
4.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on Q angle in subjects with PFPS. and it is measured by Goniometer (in angles)
Measured: Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted29 Jul 2026
- Study start1 Mar 2026
- Primary completionAug 2026 (estimated)
- Study completionSep 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (1)Papers the sponsor has linked to this study.
- Other trials for Patellofemoral Pain SyndromeStudies of the same condition, open and under way.
- More trials run by Cairo UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Model description
- Group A: An intervention group (n = 20) receiving inguinal ligament mobilization (ILM) with conventional physical therapy exercises. Group B: An intervention group (n = 20) receiving talonavicular joint mobilization (TJM) with conventional physical therapy exercises. Group C: An intervention group (n = 20) receiving combined inguinal ligament mobilization, talonavicular joint mobilization and conventional physical therapy exercises. Group D: A control group (n = 20) receiving conventional physical therapy exercises only which is "Straight leg raise "SLR" exercise, Quadriceps setting exercise, Side Lying Hip Abduction, Side lying hip adduction, self stretching exs for Calf, Hamstring, Quadriceps muscles"
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 80 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Cairo University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Mohamed Ismael Mohamed, Cairo University
- Investigators
- mohamed is mohamed, PHD, Principal investigator, doctoral degree in cairo uneversity
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07734051
- Sponsor's protocol ID
- TNJ on PFPS
- Status last verified
- Jul 2026
- First submitted
- 27 Feb 2026
- Last updated
- 29 Jul 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Petersen W, Ellermann A, Gosele-Koppenburg A, Best R, Rembitzki IV, Bruggemann GP, Liebau C. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2264-74. doi: 10.1007/s00167-013-2759-6. Epub 2013 Nov 13.
PubMed 24221245
Study at a glance
From the registry record, last updated by the sponsor on 29 Jul 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effect of Adding Inguinal Ligament Mobilization to Talonavicular Joint Mobilization on Patellofemoral Pain Syndrome
- ClinicalTrials.gov ID
- NCT07734051
- Acronym / sponsor ID
- TNJ on PFPS
- Conditions
- Patellofemoral Pain Syndrome
- Study type
- Interventional
- Recruitment status
- Enrolling by invitation
- Enrolment
- 80 participants (estimated)
- Lead sponsor
- Cairo UniversityUniversity, hospital or other
- Study start
- 1 Mar 2026 (actual)
- Primary completion
- Aug 2026 (estimated)
- Study completion
- Sep 2026 (estimated)
- First posted
- 29 Jul 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This study will be conducted to:
- To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain intensity subjects with PFPS
- To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on pain threshold in subjects with PFPS.
- To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on knee function in subjects with PFPS .
- To assess the effect of adding the inguinal ligament mobilization to talonavicular joint mobilization on Q angle in subjects with PFPS .
Detailed description
Patellofemoral pain syndrome is pain around and under the patella (kneecap). The condition is also known as runner's or jumper's knee and affects both kids and adults. It can also occur in one or both knees . Patellofemoral pain syndrome (PFPS) is one of the most common orthopedic knee afflictions among both adults and adolescents. This syndrome, constitutes 5% of all injuries and 25% of knee injuries. It is characterized by pain in the back of the knee cap that comes in contact with the femur , and it is usually aggravated by walking stairs, deep squatting, kneeling, prolonged sitting, and standing up from sitting.
The treatment of PFPS varies from medication and up to different rehabilitation approaches, including balance and proprioceptive exercises to regain normal activities of daily level and optimizing function. Also, the rehabilitation of PFPS includes conservative treatments of physical therapy for symptoms such as muscle strengthening exercises (quadriceps femoris and hip abductors), flexibility exercises (rectus femoris, hamstring, gastrocnemius, hip flexors), foot orthoses to reduce pronated foot, patellofemoral joint taping, braces, and non-steroidal anti-inflammatory drugs (NSAIDs).
Some studies have reported a pronated foot as an intrinsic risk factor for PFPS, suggesting that it may be a solution to the underlying problem. Abnormal motion of the talonavicular joint due to navicular drop or drift in the pronated foot is an indicator of the overall function of the foot. Similarly, studies have shown a correlation between the pronated foot and PFPS. A pronated foot is defined as the flattening or loss of the medial longitudinal arch (MLA). Changes in the lower extremity alignment can cause calcaneal eversion, tibia internal rotation, valgus knee, and femur internal rotation in the normal structure, altering the angle of muscle contraction of the quadriceps femoris, causing the patella to track in the lateral direction, resulting in lower extremity dysfunction.
Foot interventions in patients with patellofemoral pain have shown significant effectiveness of the talonavicular joint mobilization (TJM) to maintain foot posture and to control hypermobility of the talonavicular joint of the pronated foot which will cause changes in PFPS pain, lower extremity function, valgus knee, foot posture. Foot core strengthening: relevance in injury prevention and rehabilitation for runners.
One potential intervention that has gained attention is inguinal ligament mobilization (ILM), a manual therapy technique designed to address pelvic and hip alignment that could indirectly affect knee mechanics. Inguinal ligament mobilization is thought to improve the mobility and function of the surrounding structures, potentially alleviating PFPS symptoms.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Crossover
- Masking
- Single blind (participant)
- Number of arms
- 4
- Model description
- Group A: An intervention group (n = 20) receiving inguinal ligament mobilization (ILM) with conventional physical therapy exercises. Group B: An intervention group (n = 20) receiving talonavicular joint mobilization (TJM) with conventional physical therapy exercises. Group C: An intervention group (n = 20) receiving combined inguinal ligament mobilization, talonavicular joint mobilization and conventional physical therapy exercises. Group D: A control group (n = 20) receiving conventional physical therapy exercises only which is "Straight leg raise "SLR" exercise, Quadriceps setting exercise, Side Lying Hip Abduction, Side lying hip adduction, self stretching exs for Calf, Hamstring, Quadriceps muscles"
| Arm | Type | Receives |
|---|---|---|
| group A recieving inguinal ligament mobilization | Experimental | Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercisesGroup A: An intervention group (n = 20) receiving inguinal ligament mobilization (ILM) with conventional physical therapy exercises. |
| group B recieving talonavicular joint mobilization | Experimental | Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercisesGroup B: An intervention group (n = 20) receiving talonavicular joint mobilization (TJM) with conventional physical therapy exercises. |
| group C recieving talonavicular joint mobilization and inguinal ligament mobilization | Experimental | Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercisesGroup C: An intervention group (n = 20) receiving combined inguinal ligament mobilization, talonavicular joint mobilization and conventional physical therapy exercises. |
| group D recieving conventional physical therapy exercises | Placebo comparator | Other: inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercisesGroup D: A control group (n = 20) receiving conventional physical therapy exercises only |
Who may qualify
- Ages
- 18 to 40 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (9 listed)
- • Diagnosis of PFPS, based on clinical and radiographic criteria (no other knee pathologies) referred by orthopedic physicians.
Key exclusion criteria (8 listed)
- • Chronic pain conditions unrelated to PFPS.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises2 sessions per week for total 4 weeks of treatment | Other | group A recieving inguinal ligament mobilization, group B recieving talonavicular joint mobilization, group C recieving talonavicular joint mobilization and inguinal ligament mobilization, group D recieving conventional physical therapy exercises |
Primary outcome
pain intensity
Time frame: Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.
1.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on pain intensity in subjects with PFPS. and it is measured by Visual Analogue Scale (100 mm (10-cm) straight line with descriptive anchors at each extreme to measure pain intensity)
pain threshold
Time frame: Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.
2.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on pain threshold in subjects with PFPS. and it is measured by pressure algometer (a handheld diagnostic device used to objectively quantify pain sensitivity by measuring the exact force at which a patient begins to feel pain).
knee function
Time frame: Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.
3.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on knee function in subjects with PFPS. and it is measured by Kujala Patelofemoral Pain Questionnaire (in score from 13-question survey used to measure knee pain, function, and symptoms related to the kneecap. It scores from 0 to 100 points, where 100 means no pain or disability).
Q angle
Time frame: Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.
4.Effect of adding inguinal ligament mobilization to talonavicular joint mobilization on Q angle in subjects with PFPS. and it is measured by Goniometer (in angles)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Jul 2026.
- Background: PubMed 24221245Petersen W, Ellermann A, Gosele-Koppenburg A, Best R, Rembitzki IV, Bruggemann GP, Liebau C. Patellofemoral pain syndrome. Knee Surg Sports Traumatol Arthrosc. 2014 Oct;22(10):2264-74. doi: 10.1007/s00167-013-2759-6. Epub 2013 Nov 13.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
mohamed is mohamed, PHD principal investigator
doctoral degree in cairo uneversity
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing inguinal ligament mobilization or talonavicular joint mobilization or both inguinal and talonavicular joint mobilizations or conventional physical therapy exercises in people with Patellofemoral Pain Syndrome, run by Cairo University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 9 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: enrolling by invitation, as of the sponsor's last update on 29 Jul 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
pain intensity (time frame: Inguinal Ligament Mobilization will last 20 minutes, with 2 sessions per week over 4 weeks.Mobilization of talonavicular Two sets of 5 minutes totally for 4 weeks for two sessions per week.conventional physical therapy 2 sessions per week for 4 weeks.). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07734051, which also lists 1 linked publication.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Jul 2026.