Effect of Adding Inguinal Ligament Mobilization to Talonavicular Joint Mobilization on Patellofemoral Pain Syndrome

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 .

Inclusion Criteria: * • 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. * 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. Exclusion Criteria: * • 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.