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Trybulski R, Stanula A, Żebrowska A, Podleśny M, Hall B. Acute Effects of the Dry Needling Session on Gastrocnemius Muscle Biomechanical Properties, and Perfusion with Latent Trigger Points - A Single-Blind Randomized Controlled Trial in Mixed Martial Arts Athletes. J Sports Sci Med 2024; 23:136-146. [PMID: 38455447 PMCID: PMC10915622 DOI: 10.52082/jssm.2024.136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 01/12/2024] [Indexed: 03/09/2024]
Abstract
The study aimed to evaluate the immediate effects of a dry needling (DN) therapy session on biomechanical properties, muscle power, perfusion, and pressure pain threshold of the gastrocnemius muscle with latent trigger points. Twenty mixed martial arts athletes (MMA) were randomly divided into two groups: experimental (eDN, n = 10) and sham (qDN, n = 10) to undergo one session of DN either with a real or a qazi needle. The measurements were taken at rest, 1-5 minutes after the DN (Post1-5min) and 24h after the DN (Post24h). DN significantly increased the muscle perfusion (Post1-5min and Post24h, p < 0.001), reduced its tone (Post1-5min and Post24h, p < 0.001) and stiffness (Post1-5min, p < 0.05; Post24 h, p < 0.001), and improved its elasticity (Post1-5min and Post24h, p < 0.001). DN also caused a significant increase in pressure pain threshold (Post1-5min, p < 0.001; Post24h, p < 0.05) and in muscle power (Post24h, p < 0.01). The DN session increased the blood perfusion and improved the biomechanical properties of the gastrocnemius muscle, which led to improved muscle power. The DN also had an analgesic effect. These effects were maintained at 24 h, which suggests that DN could facilitate muscle recovery in a post-exercise period of MMA athletes.
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Affiliation(s)
- Robert Trybulski
- Medical Department of the Wojciech Korfanty Upper Silesian Academy, Poland
| | - Arkadiusz Stanula
- Laboratory of Sport Performance Analysis, Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland
| | - Aleksandra Żebrowska
- Department of Physiology, School of Physiological-Medical Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland
| | | | - Barbara Hall
- Department of Physiology, School of Physiological-Medical Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Poland
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McGowen JM, Hoppes CW, Forsse JS, Albin SR, Abt J, Koppenhaver SL. Myotonometry is Capable of Reliably Obtaining Trunk and Thigh Muscle Stiffness Measures in Military Cadets During Standing and Squatting Postures. Mil Med 2024; 189:e213-e219. [PMID: 37208314 DOI: 10.1093/milmed/usad179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 04/19/2023] [Accepted: 05/04/2023] [Indexed: 05/21/2023] Open
Abstract
INTRODUCTION Low back and lower extremity injuries are responsible for the highest percentage of musculoskeletal injuries in U.S. Army soldiers. Execution of common soldier tasks as well as army combat fitness test events such as the three-repetition maximum deadlift depends on healthy functioning trunk and lower extremity musculature to minimize the risk of injury. To assist with appropriate return to duty decisions following an injury, reliable and valid tests and measures must be applied by military health care providers. Myotonometry is a noninvasive method to assess muscle stiffness, which has demonstrated significant associations with physical performance and musculoskeletal injury. The aim of this study is to determine the test-retest reliability of myotonometry in lumbar spine and thigh musculature across postures (standing and squatting) that are relevant to common soldier tasks and the maximum deadlift. MATERIALS AND METHODS Repeat muscle stiffness measures were collected in 30 Baylor University Army Cadets with 1 week between each measurement. Measures were collected in the vastus lateralis (VL), biceps femoris (BF), lumbar multifidus (LM), and longissimus thoracis (LT) muscles with participants in standing and squatting positions. Intraclass correlation coefficients (ICCs3,2) were estimated, and their 95% CIs were calculated based on a mean rating, mixed-effects model. RESULTS The test-retest reliability (ICC3,2) of the stiffness measures was good to excellent in all muscles across the standing position (ICCs: VL = 0.94 [0.87-0.97], BF = 0.97 [0.93-0.98], LM = 0.96 [0.91-0.98], LT = 0.81 [0.59-0.91]) and was excellent in all muscles across the squatting position (ICCs: VL = 0.95 [0.89-0.98], BF = 0.94 [0.87-0.97], LM = 0.96 [0.92-0.98], LT = 0.93 [0.86-0.97]). CONCLUSION Myotonometry can reliably acquire stiffness measures in trunk and lower extremity muscles of healthy individuals in standing and squatting postures. These results may expand the research and clinical applications of myotonometry to identify muscular deficits and track intervention effectiveness. Myotonometry should be used in future studies to investigate muscle stiffness in these body positions in populations with musculoskeletal injuries and in research investigating the performance and rehabilitative intervention effectiveness.
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Affiliation(s)
- Jared M McGowen
- Department of Health, Human Performance, and Recreation, Baylor University, One Bear Place, Waco, TX 76798, USA
| | - Carrie W Hoppes
- Doctoral Program in Physical Therapy, Army-Baylor University, Joint Base San Antonio, Fort Sam Houston, TX 78234, USA
| | - Jeff S Forsse
- Department of Health, Human Performance, and Recreation, Baylor University, One Bear Place, Waco, TX 76798, USA
| | | | - John Abt
- Children's Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, TX 75024, USA
| | - Shane L Koppenhaver
- Department of Health, Human Performance, and Recreation, Baylor University, One Bear Place, Waco, TX 76798, USA
- Doctoral Program in Physical Therapy, Baylor University, One Bear Place, Waco, TX 76798, USA
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Intelangelo L, Mendoza C, Lassaga I, Barbosa AC, Biurrun Manresa J, Mista C. No Evidence of Short-term Changes in Muscle Activity Elicited by Dry Needling in Chronic Unilateral Shoulder Pain Patients. Clin J Pain 2023; 39:595-603. [PMID: 37440340 DOI: 10.1097/ajp.0000000000001151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
OBJECTIVE The aim of the study was to assess short-term changes in shoulder muscle activity elicited by dry needling in chronic unilateral shoulder pain (USP) patients. METHODS A randomized, double-blind, placebo-controlled clinical trial was conducted, in which 30 volunteers with USP were recruited and randomly assigned to either real or sham dry needling conditions. Pain intensity scores, pressure pain threshold, glenohumeral internal rotation angles, and electromyographic activity during isotonic shoulder tasks (shoulder flexion and extension) were assessed before, immediately, and 72 hours after the intervention in the infraspinatus and deltoid muscles. RESULTS A single application of real dry needling resulted in lower pain intensity scores and a larger range in glenohumeral internal rotation 72 hours after the intervention in comparison with sham dry needling. No differences in pressure pain threshold or muscle activity were observed due to the intervention. DISCUSSION A single application of real dry needling resulted in clinically significant changes in the short term. No differences were detected in muscle activation in the infraspinatus or deltoid muscles. Complementary interventions and longer follow-up times may be required to observe changes in muscle activity.
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Affiliation(s)
- Leonardo Intelangelo
- Musculoskeletal Research Unit-UIM, University Center for Assistance, Teaching, and Research-CUADI, University of Gran Rosario-UGR, Rosario, Santa Fe
| | - Cristian Mendoza
- Musculoskeletal Research Unit-UIM, University Center for Assistance, Teaching, and Research-CUADI, University of Gran Rosario-UGR, Rosario, Santa Fe
| | - Ignacio Lassaga
- Musculoskeletal Research Unit-UIM, University Center for Assistance, Teaching, and Research-CUADI, University of Gran Rosario-UGR, Rosario, Santa Fe
| | - Alexandre C Barbosa
- Department of Physical Therapy, Musculoskeletal Research Group-NIME, Federal University of Juiz de Fora, São Pedro, Governador Valadares, Brazil
| | - José Biurrun Manresa
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB), CONICET-UNER
- Centre for Rehabilitation Engineering and Neuromuscular and Sensory Research (CIRINS), Faculty of Engineering, National University of Entre Ríos, Oro Verde, Entre Ríos, Argentina
| | - Christian Mista
- Institute for Research and Development on Bioengineering and Bioinformatics (IBB), CONICET-UNER
- Centre for Rehabilitation Engineering and Neuromuscular and Sensory Research (CIRINS), Faculty of Engineering, National University of Entre Ríos, Oro Verde, Entre Ríos, Argentina
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McGowen JM, Hoppes CW, Forsse JS, Albin SR, Abt J, Koppenhaver SL. The Utility of Myotonometry in Musculoskeletal Rehabilitation and Human Performance Programming. J Athl Train 2023; 58:305-318. [PMID: 37418563 PMCID: PMC11215642 DOI: 10.4085/616.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
Myotonometry is a relatively novel method used to quantify the biomechanical and viscoelastic properties (stiffness, compliance, tone, elasticity, creep, and mechanical relaxation) of palpable musculotendinous structures with portable mechanical devices called myotonometers. Myotonometers obtain these measures by recording the magnitude of radial tissue deformation that occurs in response to the amount of force that is perpendicularly applied to the tissue through a device's probe. Myotonometric parameters such as stiffness and compliance have repeatedly demonstrated strong correlations with force production and muscle activation. Paradoxically, individual muscle stiffness measures have been associated with both superior athletic performance and a higher incidence of injury. This indicates optimal stiffness levels may promote athletic performance, whereas too much or too little may lead to an increased risk of injury. Authors of numerous studies suggested that myotonometry may assist practitioners in the development of performance and rehabilitation programs that improve athletic performance, mitigate injury risk, guide therapeutic interventions, and optimize return-to-activity decision-making. Thus, the purpose of our narrative review was to summarize the potential utility of myotonometry as a clinical tool that assists musculoskeletal clinicians with the diagnosis, rehabilitation, and prevention of athletic injuries.
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Affiliation(s)
- Jared M. McGowen
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX
- US Army Medical Professional Training Brigade, San Antonio, TX
| | - Carrie W. Hoppes
- Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX
| | - Jeff S. Forsse
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX
| | | | - John Abt
- Children’s Health Andrews Institute for Orthopaedics and Sports Medicine, Plano, TX
| | - Shane L. Koppenhaver
- Department of Health, Human Performance, and Recreation, Baylor University, Waco, TX
- Doctoral Program in Physical Therapy, Baylor University, Waco, TX
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Lucena-Anton D, Luque-Moreno C, Valencia-Medero J, Garcia-Munoz C, Moral-Munoz JA. Effectiveness of Dry Needling of Myofascial Trigger Points in the Triceps Surae Muscles: Systematic Review. Healthcare (Basel) 2022; 10:healthcare10101862. [PMID: 36292308 PMCID: PMC9602116 DOI: 10.3390/healthcare10101862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 11/16/2022] Open
Abstract
This study aims to analyze the effects of Dry Needling (DN) for the release of myofascial trigger points (MTrPs) in the triceps surae muscles (TSM). A systematic review was performed up to February 2022 in PubMed, PEDro, Scopus, CENTRAL, and Web of Science. Selection criteria were studies involving subjects older than 18 years presenting MTrPs in the TSM, without any concomitant acute or chronic musculoskeletal conditions; DN interventions applied to the MTrPs of the TSM; and results on pain, range of motion (ROM), muscle strength, muscle stiffness, and functional outcomes. The PEDro scale was used to assess the methodological quality of the studies, and the Risk of Bias Tool 2.0 to assess risk of bias. A total of 12 studies were included in the systematic review, involving 426 participants. These results suggest that DN of MTrPs in TSM could have a positive impact on muscle stiffness and functional outcomes. There are inconclusive findings on musculoskeletal pain, ROM, and muscle strength. Significant results were obtained in favor of the control groups on pressure pain thresholds. Despite the benefits obtained on muscle stiffness and functional performance, the evidence for the use of DN of MTrPs in the TSM remains inconclusive.
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Affiliation(s)
- David Lucena-Anton
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
| | - Carlos Luque-Moreno
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain
- Correspondence:
| | - Jesus Valencia-Medero
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
| | - Cristina Garcia-Munoz
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
| | - Jose A. Moral-Munoz
- Department of Nursing and Physiotherapy, Faculty of Nursing and Physiotherapy, University of Cadiz, 11009 Cadiz, Spain
- Institute of Research and Innovation in Biomedical Sciences of the Province of Cadiz (INiBICA), University of Cadiz, 11009 Cadiz, Spain
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Tang CT, Song B. Acupuncture and Dry Needling for Sports Performance and Recovery. Curr Sports Med Rep 2022; 21:213-218. [PMID: 35703748 DOI: 10.1249/jsr.0000000000000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Acupuncture and dry needling share many similarities in their proposed mechanisms of action and their sports medicine-related applications. Pain is the most common indication for these needling treatments, but there also are some limited studies on their use for ergogenic purposes. Needling can likely improve muscular strength and power, including increasing jump height, and it also can increase flexibility. In terms of sports recovery, acupuncture can not only be used for pain relief after injury, but also can help with routine recovery, such as in delayed onset muscle soreness. There are numerous case reports of acupuncture and dry needling being used to treat athletes for various diagnoses and conditions, however more high quality studies are needed in order to make more specific evidence-based recommendations. Given the high degree of safety and limited adverse events associated with needling treatments, it can likely be promoted in athletes.
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Affiliation(s)
- Chi-Tsai Tang
- Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Washington University School of Medicine in St. Louis, St. Louis, MO
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