Objective To determine the immediate efficacy of a single session of deep dry needling (DDN) vs ischemic compression (ICT) in a latent myofascial trigger point (MTrP) of the shortened triceps surae from triathletes for ankle dorsiflexion and redistribution of plantar pressures and stability. Design A randomized simple blind clinical trial (NCT03273985). Setting An outpatient clinic. Subjects Thirty-four triathletes with a latent MTrP in the shortened gastrocnemius. Methods Triathletes were randomized to receive a single session of DDN (N = 17) or ICT (N = 17) in a latent MTrP of the shortened triceps surae. The primary outcome was ankle dorsiflexion range of motion (ROM) by a universal goniometer. Secondary objectives were distribution of dynamic and static plantar pressures by T-Plate platform pressure, with measurements both before and after five, 10, 15, 20, and 25 minutes of treatment. Results There were no statistically significant differences (P > 0.05) for ankle dorsiflexion ROM or dynamic and static plantar pressures between the experimental group treated with DDN and the control group treated with ICT before and after treatment. Conclusions DDN vs ICT carried out in latent MTrPs of the shortened gastrocnemius of triathletes did not present differences in terms of dorsiflexion ROM of the tibiofibular-talar joint or in static and dynamic plantar pressure changes before and immediately after treatment.

Several studies have shown that gastrocnemius is frequently injured in triathletes. The causes of these injuries are similar to those that cause the appearance of the myofascial pain syndrome (MPS). The ischemic compression technique (ICT) and deep dry needling (DDN) are considered two of the main MPS treatment methods in latent myofascial trigger points (MTrPs). In this study superficial electromyographic (EMG) activity in lateral and medial gastrocnemius of triathletes with latent MTrPs was measured before and immediately after either DDN or ICT treatment. Taking into account superficial EMG activity of lateral and medial gastrocnemius, the immediate effectiveness in latent MTrPs of both DDN and ICT was compared. A total of 34 triathletes was randomly divided in two groups. The first and second groups (n = 17 in each group) underwent only one session of DDN and ICT, respectively. EMG measurement of gastrocnemius was assessed before and immediately after treatment. Statistically significant differences (p = 0.037) were shown for a reduction of superficial EMG measurements differences (%) of the experimental group (DDN) with respect to the intervention group (ICT) at a speed of 1 m/s immediately after both interventions, although not at speeds of 1.5 m/s or 2.5 m/s. A statistically significant linear regression prediction model was shown for EMG outcome measurement differences at V1 (speed of 1 m/s) which was only predicted for the treatment group (R2 = 0.129; β = 8.054; F = 4.734; p = 0.037) showing a reduction of this difference under DDN treatment. DDN administration requires experience and excellent anatomical knowledge. According to our findings immediately after treatment of latent MTrPs, DDN could be advisable for triathletes who train at a speed lower than 1 m/s, while ICT could be a more advisable technique than DDN for training or competitions at speeds greater than 1.5 m/s.

Objective To compare and predict kinesiophobia and fear avoidance beliefs between athletes with gastrocnemius myofascial pain syndrome (MPS) and healthy athletes. Design Case–control. Setting Outpatient clinic. Subjects Fifty athletes were divided into athletes with chronic gastrocnemius MPS (N = 25) and healthy athletes (N = 25). Methods Kinesiophobia symptoms total and domain scores (harm and activity avoidance) and levels were determined by the Tampa Scale of Kinesiophobia (TSK-11). Fear avoidance beliefs total and domain scores (physical and working activities) were measured by the Fear Avoidance Beliefs Questionnaire (FABQ). Results Significant differences (P < 0.05) with a large effect size (d = 0.81–4.22) were found between both groups, with greater kinesiophobia symptom scores for the TSK-11 activity avoidance domain and total scores, and greater fear avoidance beliefs scores for the FABQ physical and working activities domains and total scores of athletes with gastrocnemius MPS with respect to healthy athletes. TSK-11 total score showed a prediction model (R2 = 0.256) based on the FABQ total score. The FABQ total score showed a prediction model (R2 = 0.741) based on gastrocnemius MPS presence (R2 = 0.665), levels of kinesiophobia (R2 = 0.052), and height (R2 = 0.025). Conclusions Greater kinesiophobia levels, greater total and activity avoidance domain scores (but not for the harm domain), and greater fear avoidance beliefs total and domain scores (work and physical activity) were shown for athletes with gastrocnemius MPS vs healthy athletes. Higher kinesiophobia symptoms were predicted by greater fear avoidance beliefs in athletes. Greater fear avoidance beliefs were predicted by the presence of gastrocnemius MPS, higher levels of kinesiophobia, and lower height in athletes.

Background: The effects of the dry needling technique and pain reduction have been demonstrated in numerous quality studies. However, the mechanical effects of dry needling are largely unknown. Methods: A total of 18 subjects with flexor digitorum brevis muscle myofascial trigger point were evaluated pre- and post-deep dry needling. We measured static footprint variables in a pre–post study. Main findings: We found differences in rearfoot maximum pressure (119.22–111.63 KPa; p = 0.025), midfoot maximum pressure (13.68–17.26 KPa; p = 0.077), midfoot medium pressure (4.75–6.24 KPa; p = 0.035) and forefoot surface (86.58–81.75 cm2; p = 0.020). All variables with significant differences decrease, with the exception of forefoot surface which showed an increase. Conclusions: After flexor digitorum brevis muscle dry needling, midfoot plantar pressures (maximum and medium) and forefoot surface were increased, and rearfoot maximum pressure was decreased.

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