The Immediate Effects of Instrument-Assisted Soft Tissue Mobilization on Pain and Function in Female Runners with Patellofemoral Pain.

Patellofemoral pain, often called runner's knee, is common among female runners, and instrument-assisted soft tissue mobilization (a technique using tools to apply pressure and friction to soft tissue) is sometimes used to treat it. What hasn't been clear is whether treating the hip region in addition to the knee adds any benefit over treating the knee alone. This small trial randomly assigned 28 female runners with patellofemoral pain to receive a single session targeting either the hip and knee together or the knee only, then measured pain, range of motion, strength, and functional performance immediately after and one week later. Both groups improved similarly across nearly all measures, including running-related pain, hip movement, step-down pain, and function, with no statistically significant difference between the two treatment approaches.

Hip rotation strength did not change meaningfully in either group. The improvement after a single session is notable, but because there was no untreated comparison group, it's unclear how much of this reflects the treatment itself versus natural fluctuation or attention effects, and the sample was small.

If you're a female runner dealing with pain around the kneecap, often called runner's knee, you may wonder whether treatment focused just on the knee is enough, or whether the hip needs attention too. This study looked at 28 women with this type of pain, comparing a single session of a massage-like technique using handheld tools, applied either to the hip and knee together or just the knee. Both groups reported meaningful pain relief and improved function right after treatment and again a week later, including easier hip movement and better performance on a functional knee test.

However, there was no clear difference between treating just the knee versus adding hip work, suggesting the extra hip treatment didn't provide additional benefit in this trial. It's worth keeping in mind this was a small, short trial without an untreated comparison group, so it's hard to know how much of the improvement came from the treatment itself versus other factors like time or attention during testing. Larger studies would help clarify this further.

This is a summary of research, not medical advice. Talk to your own healthcare provider about anything affecting your care.

This trial addresses a practical question in patellofemoral pain management: when applying instrument-assisted soft tissue mobilization, does treating proximal hip structures in addition to the knee provide added benefit over knee-focused treatment alone? In 28 female runners randomized to hip-and-knee versus knee-only protocols, both groups showed statistically significant within-group improvements over time in running-related pain, hip adduction range of motion, hip abduction strength, step-down test pain, and patellofemoral function, sustained at one week. Critically, no significant between-group differences emerged on any outcome, meaning the added hip component did not demonstrate superiority over knee-only treatment in this sample. Hip external rotation strength showed no significant change in either group or over time.

Because there was no untreated or sham control arm, these within-group improvements cannot be attributed solely to the intervention; natural variation, repeated testing, or nonspecific attention effects during a single-session protocol may have contributed. The small sample size (14 per group) limits confidence in ruling out a true difference between treatment sites, and the single-session, short-term design does not inform longer-term management decisions. This study contributes preliminary evidence that site selection may matter less than expected for immediate effects, but it does not establish comparative effectiveness or guide protocol selection beyond this narrow scope.