Comparison of INIT and Dry Needling on Trigger Points in Knee OA

MTrPs points will be released with ischemic compression, position of ease will be acquired, and in the last METs will be performed. Ischemic compression applied through thumb on trigger point present in any muscle around the knee joint. Compression will be increased gradually until first resistance will feel and maintained until it resolves, further increases then until no tissue resistance will be felt under thumb. This process is maintained for 30sec and repeated 3-5 times per session. Positional release technique: after applying pressure on trigger point, patient will acquire position of ease that is maintained for 20 sec whether its extension or flexion of knee. This process is repeated 3-5 times per session. Muscle Energy Technique will be applied on the muscle in which isometric contraction is maintained for 7-10sec against 20-25% strength. After completion of muscular contraction, the limb is moved away for muscular stretch and then position is maintained for 30 seconds

"Dry needle will be targeting trigger points (TrPs) using in-and-out techniques such as 'pistoning' or 'sparrow pecking'. 0.25x25mm needle is inserted.~For vastus laterals patient is supine line with knee extended performing an isometric quadriceps contraction, maintaining a clean technique by using gloves and performing an alcohol wipe down bracket the tissue to be treated and inserting needle with direct approach towards the femur, performing pistoning. For vastus medialis patient is supine line with 30 degrees of knee flexion. A headless 0.25x25mm needle fixed between the fingers of non-dominant hand and inserted perpendicularly to the MTrPs with metacarpophalangeal flexion extension of 1st and 2nd fingers of dominant hand. For Gastrocnemius patient is prone lying and bolstered supported slight knee bend, for the upper part anterior medial approach is used and center of muscle belly slight medial anterior approach is used."