Gastrocnemius Myofascial Release in Females With Knee Osteoarthritis

Gastrocnemius MFR Procedures : * Technique 1: With the elbow flexed to 90◦ and take up a contact in the Tendo Achilles. Establish a line of tension in a superior direction. * Technique 2: with the index and middle fingers of each hand to take up a contact on the tendons of the GM at the epicondyles of the femur. Establish a line of tension in an inferior direction. * Technique 3: With the index, middle and ring fingers of each hand to get into the medial and lateral aspects of the calcaneus . The release begins proximally. * (5 minutes× 1 repetition) for the three technique * Gastrocnemius TrP pressure release is repeated for 90 seconds (usually 3 repetitions). * Anterior glide \& Posterior glide (grade IV) * Riding a stationary bike for 5 minutes * Quadriceps set exercise * Terminal knee extension * Step-up exercises for 30 seconds * Lateral Step-up for 30 seconds. * Self-stretching of Hamstring, Rectus femoris ,and Calf muscles. * TENS for 20 minutes

Patient position: Prone, with feet off the end of the table to allow for adequate dorsiflexion. Therapist's position:, facing toward the feet while standing at the patient's side, at around mid-thigh level for techniques. Technique: one hand is positioned at the attachments of the GM at the epicondyles of the femur, and the other at the Achilles tendon without applying significant pressure or tissue deformation. Mimic the hand movements of real myofascial release (e.g., slow stroking, superficial gliding) but avoid: Deep pressure, Skin stretch, and Muscle compression. * Anterior glide \& Posterior glide (grade IV) * Riding a stationary bike for 5 minutes * Quadriceps set exercise * Terminal knee extension * Step-up exercises for 30 seconds * Lateral Step-up for 30 seconds. * Self-stretching of Hamstring, Rectus femoris ,and Calf muscles. * TENS for 20 minutes