Effectiveness of Dry Needling in Athletes With Chronic Hamstring Strain

April 29, 2026 updated by: Amr Mostafa Kamal Anas, Cairo University

Effectiveness of Dry Needling on Athletes With Chronic Hamstring Strain

This study aims to evaluate the effectiveness of dry needling in reducing pain and improving functional outcomes in athletes with chronic hamstring strain. Chronic hamstring injuries are common among athletes and often lead to persistent pain, reduced performance, and limitations in daily and sports activities.

Dry needling is a therapeutic technique used to target myofascial trigger points and relieve muscle tension. This study will compare the effects of dry needling with conventional physiotherapy interventions to determine its role in managing chronic hamstring strain.

Participants will be athletes diagnosed with chronic hamstring strain. Outcomes will include pain intensity, muscle flexibility, and functional performance. The results of this study may help improve rehabilitation strategies and provide evidence for the use of dry needling in sports injuries.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

Chronic hamstring strain (CHS) is a common musculoskeletal condition among athletes, particularly in sports involving high-speed running and sudden changes in direction. It is characterized by persistent or recurrent symptoms lasting more than three months and is often associated with reduced muscle flexibility, decreased performance, and an increased risk of reinjury.

Dry needling (DN) has emerged as a therapeutic intervention targeting myofascial trigger points to reduce pain, improve muscle function, and restore neuromuscular control. It is believed to act through both mechanical and neurophysiological mechanisms, including reduction of muscle tension and modulation of pain pathways.

This study aims to investigate the effectiveness of dry needling as an adjunct to conventional physiotherapy in athletes with chronic hamstring strain. Participants will be randomly assigned into two groups. The experimental group will receive dry needling combined with a structured physiotherapy program, while the control group will receive the same physiotherapy program without dry needling.

The physiotherapy program will include stretching exercises, strengthening exercises with an emphasis on eccentric loading, and functional training. Dry needling will be applied to identified trigger points in the hamstring muscles using standard clinical techniques.

Outcome measures will include pain intensity, hamstring flexibility, and functional performance. Assessments will be conducted before and after the intervention period.

The results of this study are expected to provide evidence regarding the added value of dry needling in improving rehabilitation outcomes for athletes with chronic hamstring strain.

Study Type

Interventional

Enrollment (Estimated)

38

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • Egypt
    • Alexandria Governorate
      • Alexandria, Alexandria Governorate, Egypt
        • Abu Qir General Hospital
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Male football players aged 18 to 35 years.
  • Diagnosed with chronic hamstring strain (CHS) confirmed by ultrasonography.
  • Injury duration of more than 3 months.
  • Classified as Grade I or Grade II hamstring strain.
  • Currently participating in the competitive phase of football.
  • Body Mass Index (BMI) between 21-25 kg/m².

Exclusion Criteria:

  • Previous exposure to dry needling therapy.
  • Presence of any other current lower limb injuries.
  • Participation in another hamstring rehabilitation program.
  • Active skin infection at or near the treatment area.
  • Bleeding disorders or use of anticoagulant medications.
  • Severe needle phobia or psychological intolerance to needling.
  • Presence of neuromuscular disorders (e.g., muscular dystrophy or peripheral neuropathy).

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Active Comparator: Control Group (A)
Participants will receive only the standard rehabilitation program without dry needling.
Procedure: Standard Rehabilitation Program
Participants will receive a standardized rehabilitation program including stretching and eccentric strengthening exercises for hamstring muscles without dry needling.
Experimental: Intervention Group (B)
Participants will receive dry needling treatment in addition to a standard rehabilitation program for chronic hamstring strain
Procedure: Standard Rehabilitation Program
Participants will receive a standardized rehabilitation program including stretching and eccentric strengthening exercises for hamstring muscles without dry needling.
Procedure: Dry Needling
Participants will receive dry needling treatment applied to active myofascial trigger points in the hamstring muscles (biceps femoris, semitendinosus, and semimembranosus). Sterile filiform needles will be inserted into identified trigger points to elicit local twitch responses and reduce muscle pain and tightness. Treatment will be performed in addition to a standardized rehabilitation program including stretching and strengthening exercises for the hamstring muscle group. Sessions will be administered over the study period according to a predefined treatment schedule.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Pain Intensity
Time Frame: Baseline (pre-intervention) and after 6 weeks of treatment
Pain intensity in chronic hamstring strain will be assessed using the Visual Analog Scale (VAS), a 10-cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). Measurements will be taken at baseline and after completion of the intervention period to evaluate changes in pain perception.
Baseline (pre-intervention) and after 6 weeks of treatment

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Functional Performance
Time Frame: Baseline (pre-intervention) and after 6 weeks of treatment
Functional outcomes will be assessed using the Lower Extremity Functional Scale (LEFS) to evaluate the impact of intervention on daily and sports-related activities.
Baseline (pre-intervention) and after 6 weeks of treatment
Hamstring Muscle Strength
Time Frame: Baseline (pre-intervention) and after 6 weeks of treatment
Hamstring muscle strength will be measured using a handheld dynamometer during maximal isometric contraction.
Baseline (pre-intervention) and after 6 weeks of treatment
Hamstring Flexibility
Time Frame: Baseline (pre-intervention) and after 6 weeks of treatment
Hamstring flexibility will be assessed using the popliteal angle test with a universal goniometer.
Baseline (pre-intervention) and after 6 weeks of treatment
Kicking Speed
Time Frame: Baseline (pre-intervention) and after 6 weeks of treatment
Kicking speed will be measured using a radar gun to assess football-specific performance.
Baseline (pre-intervention) and after 6 weeks of treatment

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Cairo University

Investigators

  • Principal Investigator: Amr Anas, BSc, Cairo University
  • Study Director: Ebtessam Gomaa, PhD, Cairo University
  • Study Director: Marihan Makary, Cairo University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

  • Petersen J, Thorborg K, et al. Eccentric training prevents hamstring injuries. Am J Sports Med. 2011;39(11):2296-2303.
  • Espejo-Antúnez L, et al. Dry needling systematic review. Complement Ther Med. 2017;33:46-57. https://doi.org/10.1016/j.ctim.2017.06.004
  • Ekstrand J, Hägglund M, Waldén M. Muscle injuries in professional football. Am J Sports Med. 2016;44(3):576-585. https://doi.org/10.1177/0363546515621377
  • Dunning J, et al. Dry needling clinical practice review. Phys Ther Rev. 2021;26(5-6):287-307. https://doi.org/10.1080/10833196.2021.1983244
  • Croisier JL. Recurrent hamstring injury risk factors. Sports Med. 2004;34(10):681-695. https://doi.org/10.2165/00007256-200434100-00005
  • Chaabene H, et al. Hamstring strength assessment systematic review. Sports Med Open. 2019;5:23. https://doi.org/10.1186/s40798-019-0198-7
  • Chamorro C, et al. Reliability of handheld dynamometry and isokinetic testing. Open Med. 2014;9(4):382-397. https://doi.org/10.1515/med-2014-0058
  • Canosa-Carro L, et al. Dry needling effects on hamstring flexibility and performance. J Sport Rehabil. 2022;31(3):254-261. https://doi.org/10.1123/jsr.2020-0225
  • Buckthorpe M, et al. Hamstring injuries in football: risk factors and RTP. Br J Sports Med. 2020;54(19):1081-1091.
  • Brukner P. Hamstring injuries: prevention and treatment update. Br J Sports Med. 2015;49(19):1241-1244. https://doi.org/10.1136/bjsports-2014-094427
  • Bourne MN, et al. Eccentric training and hamstring injury risk. Scand J Med Sci Sports. 2017;27(11):1180-1187.
  • Bahr R, et al. Hamstring injury prevention programs: systematic review. Br J Sports Med. 2018;52(17):1077-1085.
  • Bahr R, Thorborg K, Ekstrand J. Nordic hamstring survey and prevention adherence. Br J Sports Med. 2015;49(22):1466-1471. https://doi.org/10.1136/bjsports-2015-094826
  • Askling CM, Tengvar M, Saartok T, Thorstensson A. Acute hamstring injuries in elite football: RCT comparing rehabilitation protocols. Br J Sports Med. 2013;47(15):953-959. https://doi.org/10.1136/bjsports-2013-092165
  • Ahmad CS, Redler LH, Ciccotti MG, Maffulli N, Longo UG, Bradley J. Evaluation and management of hamstring injuries. Am J Sports Med. 2013;41(2):293-302. https://doi.org/10.1177/0363546512466064

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

May 1, 2026

Primary Completion (Estimated)

September 30, 2026

Study Completion (Estimated)

April 30, 2027

Study Registration Dates

First Submitted

April 29, 2026

First Submitted That Met QC Criteria

April 29, 2026

First Posted (Actual)

May 6, 2026

Study Record Updates

Last Update Posted (Actual)

May 6, 2026

Last Update Submitted That Met QC Criteria

April 29, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • P.T.REC/012/006296

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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