Inclusion Criteria:  knee pain for at least eight weeks that was aggravated by activities such as descending and ascending stairs, squatting, and running. knee pain with a positive J sign (lateral tilt of patella) more symptomatic and mal align knee included in case of bilateral involvement and a sign of patellar malalignment on the radiograph.  Exclusion Criteria:  History of knee fracture Patella dislocation knee deformity (e.g., genu varum) Knee Flexion contracture Ligament/meniscal injuries, NSAID or intra-articular injection, or knee Osteo arthritis.