Immediate Effect of Dry Needling on Calf Muscles Pain Pressure Threshold,Sprint Speed and Functional Performance in Amateur Football Player

This randomised single-blind trial will evaluate the immediate effect of a single session of dry needling versus sham needling on calf muscle myofascial trigger points among amateur football players aged 18-25 years. Primary and secondary outcomes are Pressure Pain Threshold (algometer), Sprint Speed (shuttle run test), and Functional Performance (single-leg hop). Outcomes will be measured immediately pre- and post-intervention. Data analysis will be performed in SPSS version 27 using paired and independent t-tests (p < 0.05).

Study Overview

• Status: Recruiting
• Conditions: Myofascial Pain Syndromes; Trigger Points; Gastrocnemius Muscle
• Intervention / Treatment: Procedure: Dry Needling; Procedure: Sham Needling

Detailed Description

A randomised, single-blind, parallel-group trial recruiting amateur club football players (age 18-25) with active myofascial trigger points in gastrocnemius or soleus. Participants randomised (coin toss) into Group A (Dry Needling) or Group B (Sham Needling). Baseline measures: Pressure Pain Threshold (PPT) using handheld algometer, ankle dorsiflexion ROM with goniometer, sprint speed via shuttle run, and single-leg hop distance. Intervention: a single session of dry needling (sterile single-use filiform needles 0.25-0.30 mm; needles retained ~10 minutes with fast-in/fast-out pistoning to elicit local twitch response) or a non-penetrating sham procedure mimicking needling. Post-intervention assessments are performed immediately after the session. Data will be analysed with SPSS v.27; paired t-tests for within-group and independent t-tests for between-group comparisons (p < 0.05).

• Study Type: Interventional
• Enrollment (Estimated): 60
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Hamza Aliyan, DPT; Phone Number: 03209092006; Email: Hamza.aalyaan@gmail.com
• Study Contact Backup: Name: Marwa Asim, MS-OMPT; Email: marwa@fui.edu.pk

Study Locations

• Pakistan
  • Punjab Province
    • Islamabad, Punjab Province, Pakistan, 46000
      • Recruiting
      • Foundation University College of Physical Therapy
      • Contact: Hamza Aliyan, DPT; Phone Number: 03209092006; Email: Hamza.aalyaan@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Amateur football players aged 18-25 years.

Participation in club-level football for at least one year.

Presence of active myofascial trigger point in gastrocnemius or soleus confirmed by palpation.

Willingness to participate and provide informed consent.

Exclusion Criteria:

• History of calf muscle tear, fracture, or lower limb surgery.

Current use of muscle relaxants or anti-inflammatory medication.

Known bleeding disorders or anticoagulant therapy.

Local infection, skin lesion, or contraindication to dry needling.

Neurological or vascular disorders affecting lower limb function.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Group A - Dry Needling Group; Participants with active trigger points in the gastrocnemius or soleus will receive dry needling using sterile, single-use filiform needles (0.25-0.30 mm diameter; lengths 30-50 mm chosen per muscle depth). Needles inserted nearly perpendicular (or 45-60° oblique when approaching from side to avoid neurovascular structures) to the skin into identified trigger points using a fast-in/fast-out (pistoning) technique to elicit local twitch responses. Insertion depth typically 1-4 cm. Once local twitch response elicited (or after a maximum of ~5 attempts), the needle will remain in place and needles retained for approximately 10 minutes. Needling will be performed with standard infection-control measures (skin disinfection, gloves, sterile disposal). Single session of ~10-15 minutes.	Procedure: Dry Needling; A single-session myofascial trigger point dry needling treatment will be administered to identified trigger points in the gastrocnemius and/or soleus muscles using sterile disposable filiform needles. The objective is to mechanically disrupt the dysfunctional motor end plate, elicit local twitch responses, reduce nociceptive activity, and restore muscle function. The intervention is delivered under aseptic conditions by a trained physiotherapist following standard safety guidelines. Post-procedure monitoring will be conducted for minor adverse effects such as soreness or bleeding.
Experimental: Group B - Sham Needling Group; Sham needling will use a non-penetrating blunted needle housed in an introducer tube placed against the skin over the trigger point. Tactile and auditory cues mimic real needling (a quick tap), but no skin penetration occurs. Pressure, duration, positioning and therapist contact will match the dry needling group. Single session of equal duration.	Procedure: Sham Needling; A simulated needling procedure designed to act as a placebo comparator will be applied without skin penetration. The technique reproduces the visual, tactile, and contextual components of dry needling to maintain participant blinding while avoiding physiological stimulation of the muscle. This allows isolation of the true therapeutic effect of dry needling from psychological or expectancy-related responses.; Other Names: Placebo Needling

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Pressure Threshold	Pressure Pain Threshold will be measured at the identified myofascial trigger point in the gastrocnemius or soleus using a handheld pressure algometer. The participant will indicate the point at which applied pressure first becomes painful. The recorded value (kg/cm²) reflects mechanical pain sensitivity of the trigger point.	Baseline (Day 0, pre-intervention) and Immediately Post-intervention (within 15 minutes after intervention).
Functional Performance	Functional performance will be assessed using Single leg hop test ( distance in centimeters).The Single Leg Hop Test measures lower limb explosive power. Participants will perform three maximal forward hops on one leg. The distance (in centimeters) from the starting line to the heel landing point will be recorded. The average of three trials will be used for analysis. Greater distance indicates improved functional performance.	Baseline (Day 0, pre-intervention) and Immediately Post-intervention (within 15 minutes after intervention).
Sprint Speed	Sprint speed will be accessed by Shuttle run test. The speed and agility of lower limb in calf muscle by time taken to complete a short distance shuttle sprint. It reflects the explosive function of calf muscle which is essential for acceleration and direction change in football. Sprint speed will be assessed using a 20-meter shuttle run test. Participants will run back and forth between two markers placed 20 meters apart as quickly as possible. Two trials will be performed, and the fastest time (in seconds) will be recorded to the nearest 0.1 second. Lower time indicates better sprint performance.	Baseline (Day 0, pre-intervention) and Immediately Post-intervention (within 15 minutes after intervention).

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Range of Motion of Ankle Dorsiflexion	Ankle dorsiflexion will be measured in degrees using a universal goniometer. Three readings will be taken and averaged. Higher degrees indicate improved flexibility.	Baseline (Day 0, pre-intervention) and Immediately Post-intervention (within 15 minutes after intervention).

Collaborators and Investigators

• Sponsor: Foundation University Islamabad
• Investigators: Principal Investigator: Hamza Aliyan, DPT, Foundation University Islamabad

Study record dates

Study Major Dates

• Study Start (Actual): August 29, 2025
• Primary Completion (Estimated): June 1, 2026
• Study Completion (Estimated): June 1, 2026

Study Registration Dates

• First Submitted: April 6, 2026
• First Submitted That Met QC Criteria: April 6, 2026
• First Posted (Actual): April 13, 2026

Study Record Updates

• Last Update Posted (Actual): April 13, 2026
• Last Update Submitted That Met QC Criteria: April 6, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Muscular Diseases; Myofascial Pain Syndromes; Therapeutics; Complementary Therapies; Physical Therapy Modalities; Dry Needling
• Other Study ID Numbers: FUI/FUCP/CTR/01.26/HamzaAliyan

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No