Comparative Sustained Effects of Stretching and Dry Needling on Ankle Dorsiflexion Range of Motion Direct Original Research
Main Article Content
Keywords
Static Streching, Dry needling, ankle mobility
Abstract
Introduction: This study compared the effects of static stretching and trigger point dry needling on weight-bearing ankle dorsiflexion range of motion (ROM) in individuals with limited dorsiflexion and determined whether changes in ROM persisted up to 60 minutes post-treatment.
Methods: Thirty participants underwent one of two separate treatment sessions: static stretching of the triceps surae or dry needling of the same muscles. Weight-bearing ankle dorsiflexion ROM was measured pre-treatment, immediately post-treatment, and 60 minutes post-treatment. Repeated measures analysis of variance was used to assess ROM changes over time for each intervention.
Results: Static stretching resulted in significant improvements in ankle dorsiflexion ROM both immediately and 60 minutes post-treatment (p < 0.05). In contrast, dry needling of the triceps surae showed no significant change in ROM at any time point (p > 0.05). There was no interaction between treatment type and time on dorsiflexion ROM.
Conclusions: Static stretching of the triceps surae leads to short-term improvements in ankle dorsiflexion ROM, which may reduce compensatory movement patterns during physical activity. However, dry needling of the triceps surae does not appear to affect dorsiflexion ROM in individuals with limited range of motion.
References
2. Etnyre BR, Abraham LD. Gains in range of ankle dorsiflexion using three popular stretching techniques. Am J Phys Med Rehabil. 1986;65(4):189.
3. Medeiros DM, Martini TF. Chronic effect of different types of stretching on ankle dorsiflexion range of motion: Systematic review and meta-analysis. The Foot. 2018;34:28-35. doi:10.1016/j.foot.2017.09.006
4. Young R, Nix S, Wholohan A, Bradhurst R, Reed L. Interventions for increasing ankle joint dorsiflexion: a systematic review and meta-analysis. J Foot Ankle Res. 2013;6(1):46. doi:10.1186/1757-1146-6-46
5. Rabin A, Portnoy S, Kozol Z. The association of ankle dorsiflexion range of motion with hip and knee kinematics during the lateral step-down test. J Orthop Sports Phys Ther. 2016;46(11):1002-1009. doi:10.2519/jospt.2016.6621
6. Taylor JB, Wright ES, Waxman JP, Schmitz RJ, Groves JD, Shultz SJ. Ankle dorsiflexion affects hip and knee biomechanics during landing. Sports Health. 2022;14(3):328-335. doi:10.1177/19417381211019683
7. Hassan KA, Youssef RSEE, Mahmoud NF, Eltagy H, El-Desouky MA. The relationship between ankle dorsiflexion range of motion, frontal plane projection angle, and patellofemoral pain syndrome. Foot Ankle Surg. 2022;28(8):1427-1432. doi:10.1016/j.fas.2022.08.003
8. Lima YL, Ferreira VMLM, de Paula Lima PO, Bezerra MA, de Oliveira RR, Almeida GPL. The association of ankle dorsiflexion and dynamic knee valgus: A systematic review and meta-analysis. Phys Ther Sport. 2018;29:61-69. doi:10.1016/j.ptsp.2017.07.003
9. Radford JA, Burns J, Buchbinder R, Landorf KB, Cook C. Does stretching increase ankle dorsiflexion range of motion? A systematic review. Br J Sports Med. 2006;40(10):870-875. doi:10.1136/bjsm.2006.029348
10. Abassi M, Whiteley R. Serial within-session improvements in ankle dorsiflexion during clinical interventions including Mobilization-With-Movement and a novel manipulation intervention – A Case Series. Int J Sports Phys Ther. 16(4):1158-1168. doi:10.26603/001c.25544
11. Basnett CR, Hanish MJ, Wheeler TJ, et al. Ankle dorsiflexion range of motion influences dynamic balance in individuals with chronic ankle instability. Int J Sports Phys Ther. 2013;8(2):121-128.
12. Cruz-Montecinos C, Cerda M, Becerra P, et al. Qualitative ultrasonography scale of the intensity of local twitch response during dry needling and its association with modified joint range of motion: a cross-sectional study. BMC Musculoskelet Disord. 2021;22(1):790. doi:10.1186/s12891-021-04592-z
13. Nakamura M, Ikezoe T, Umegaki H, Kobayashi T, Nishishita S, Ichihashi N. Changes in passive properties of the gastrocnemius muscle–tendon unit during a 4-week routine static-stretching program. J Sport Rehabil. 2017;26(4):263-268. doi:10.1123/jsr.2015-0198
14. Kim H, Moon S. Effect of joint mobilization in individuals with chronic ankle instability: A systematic review and meta-analysis. J Funct Morphol Kinesiol. 2022;7(3):66. doi:10.3390/jfmk7030066
15. Konor MM, Morton S, Eckerson JM, Grindstaff TL. Reliability of three measures of ankle dorsiflexion range of motion. Int J Sports Phys Ther. 2012;7(3):279-287.
16. Simic L, Sarabon N, Markovic G. Does pre-exercise static stretching inhibit maximal muscular performance? A meta-analytical review. Scand J Med Sci Sports. 2013;23(2):131-148. doi:10.1111/j.1600-0838.2012.01444.x
17. Benito-de-Pedro M, Becerro-de-Bengoa-Vallejo R, Elena Losa-Iglesias M, et al. Effectiveness of deep dry needling vs ischemic compression in the latent myofascial trigger points of the shortened triceps surae from triathletes on ankle dorsiflexion, dynamic, and static plantar pressure distribution: A clinical trial. Pain Med. 2020;21(2):e172-e181. doi:10.1093/pm/pnz222
18. Pérez-Bellmunt A, Casasayas-Cos O, López-de-Celis C, et al. Effects of dry needling of latent trigger points on viscoelastic and muscular contractile properties: Preliminary results of a randomized within-participant clinical trial. J Clin Med. 2021;10(17):3848. doi:10.3390/jcm10173848
19. Hong CZ. Lidocaine injection versus dry needling to myofascial trigger point. The importance of the local twitch response. Am J Phys Med Rehabil. 1994;73(4):256-263. doi:10.1097/00002060-199407000-00006
20. Perreault T, Dunning J, Butts R. The local twitch response during trigger point dry needling: Is it necessary for successful outcomes? J Bodyw Mov Ther. 2017;21(4):940-947. doi:10.1016/j.jbmt.2017.03.008
21. Espejo-Antúnez L, Tejeda JFH, Albornoz-Cabello M, et al. Dry needling in the management of myofascial trigger points: A systematic review of randomized controlled trials. Complement Ther Med. 2017;33:46-57. doi:10.1016/j.ctim.2017.06.003
22. Chys M, De Meulemeester K, De Greef I, et al. Clinical effectiveness of dry needling in patients with musculoskeletal pain—An umbrella review. J Clin Med. 2023;12(3):1205. doi:10.3390/jcm12031205