Electromyographic Assessment of the Efficacy of Deep Dry Needling versus the Ischemic Compression Technique in Gastrocnemius of Medium-Distance Triathletes

Abstract

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.

Effectiveness of Dry Needling of Myofascial Trigger Points in the Triceps Surae Muscles: Systematic Review

“…According to the type of participants, athletes and healthy non-athletic subjects were involved in the analyzed studies. It should be remarked that studies involving athletes [ 37 , 38 , 39 , 40 , 41 , 43 ] showed no positive results on any of the outcomes analyzed, except for the study conducted by Devereux et al [ 41 ], which obtained significant results on jump height. Therefore, due to the heterogeneity of the sport modalities included, we cannot provide a categorized overview according to the influence of the characteristics of each sport modality on the outcomes.…”

“…A total of 426 subjects were involved in the studies included in the systematic review, assuming that the studies carried out by De-Pedro et al [ 37 , 38 , 39 ] involved the same participants. Albin et al [ 34 ] is the study with the highest sample size, with 102 participants.…”

“…Six studies included healthy non-athletic subjects [ 34 , 35 , 36 , 42 , 44 , 45 ], and the other six included athletes, all of them presenting MTrPs in the triceps surae muscles. From the studies in athletes, they practiced the following sports: triathlon [ 37 , 38 , 39 ], running [ 40 ], professional ballet dance [ 43 ], and any sport in which jumping, sprinting, twisting, turning, acceleration, and deceleration were important components [ 41 ]. The mean age ranged from 22.4 [ 45 ] to 42.1 [ 40 ] years, with 20–30 years being the most common age in the studies.…”

“…Regarding the protocol, all studies performed the DN to elicit LTR, but many studies stopped when reaching a maximum number of 10 insertions [ 36 , 37 , 38 , 39 , 40 ], and/or until the LTR were exhausted [ 34 , 36 , 37 , 38 , 39 , 40 ]. The remaining studies [ 35 , 41 , 42 , 43 , 44 , 45 ] did not describe it.…”

“…Three studies [ 36 , 41 , 45 ] did not perform any intervention in the control group. Ischemic compression was used in three studies [ 37 , 38 , 39 ], and stretching was used in one study [ 44 ].…”