Objective:​ To determine whether manual therapy, specifically myofascial release technique (MRT) and Trigger Point Therapy (TPT) of the quadriceps, directly affects knee-extensor voluntary activation (VA) in patients with patellofemoral pain (PFP).

Methods:​ This study was a randomized controlled trial (RCT). Thirty patients with PFP were recruited and randomized into group 1, who received MRT;​ group 2, who received TPT;​ and group 3, who received a sham ultrasound treatment (control group).

Main outcomes:​ Voluntary activation, subjective knee pain scores (Visual Analogue Scale), subjective functional knee scores (Anterior Knee Pain Score - AKPS), knee-extensor torque (Biodex machine), and quadriceps electromyography (EMG) were measured over a six week experimental period.

Results:​ Pain decreased in all three groups over the six week experimental period and there was a significant increase in % VA for the TPT group at 2 weeks post-baseline (9% increase) and 6 weeks post-baseline (10% increase).

Conclusion:​ The TPT increased % VA, whereas MRT intervention and the control condition did not. Pain decreased in all groups to a similar degree, suggesting that a placebo effect may have produced a decrease in symptoms in this chronic PFP patient group