Ultrasound-Guided Percutaneous Needle Electrolysis Combined With Therapeutic Exercise May Add Benefit in the Management of Soleus Injury in Female Soccer Players: A Pilot Study

in Journal of Sport Rehabilitation

Click name to view affiliation

Blanca De-la-Cruz-TorresDepartment of Physiotherapy, University of Seville, Seville, Spain

Search for other papers by Blanca De-la-Cruz-Torres in
Current site
Google Scholar
PubMed
Close
*
,
Beatriz Romero-RodríguezDepartment of Physiotherapy, University of Seville, Seville, Spain

Search for other papers by Beatriz Romero-Rodríguez in
Current site
Google Scholar
PubMed
Close
, and
Carlos Romero-MoralesFaculty of Sport Sciences, European University of Madrid, Madrid, Spain

Search for other papers by Carlos Romero-Morales in
Current site
Google Scholar
PubMed
Close
Restricted access

Context: The performance of sprints during male soccer matches usually is slow medium paced, where the soleus and gastrocnemius (ankle plantar flexors) play a very important role. As in male soccer, soleus injuries should be considered in female soccer; but the scientific evidence is very limited in this case. Design: Pilot clinical trial study. Objective: To determine whether adding an ultrasound-guided percutaneous needle electrolysis (US-guided PNE) technique to a specific exercise program improved perceived pain at stretching and at palpation, ankle dorsiflexion range of motion, muscle fatigue, and sport performance in women soccer players with soleus injury. Methods: This pilot study recruited 20 female players with chronic soleus injury (type 1, characterized by hypoechoic image) who were assigned to one of 2 groups: an experimental group (exercise program + US-guided PNE; n = 10) or a control group (exercise program + sham stimulation; n = 10). Pain intensity, dorsiflexion range of motion, knee-flexion heel raise test, curve sprint test, and the global rating of change scale were analyzed at baseline and after treatment (4 wk) and there was no further follow-up. Results: Pain intensity at palpation and at stretching, dorsiflexion range of motion, and heel raise test values showed significant improvements (P < .05) between pretreatment and posttreatment for both groups, however, no significant differences were observed between groups. Curve sprint tests did not show significant differences between pretreatment and posttreatment for either group or between groups. However, the percentage of changes always revealed better values in favor of the PNE group. Both groups showed good player satisfaction with the therapies. Conclusion: The application of the US-guided PNE combined with a specific exercise program may cause clinical benefits in the treatment of female soccer players with soleus injury.

Romero-Morales https://orcid.org/0000-0001-6598-829X

De-la-Cruz-Torres (bcruz@us.es) is corresponding author, https://orcid.org/0000-0001-8499-9760

  • Collapse
  • Expand
  • 1.

    Green B, Lin M, Schache AG, et al. Calf muscle strain injuries in elite Australian football players: a descriptive epidemiological evaluation. Scand J Med Sci Sports. 2020;30(1):174184. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    Kirkendall DT, Krustrup P. Studying professional and recreational female footballers: a bibliometric exercise. Scand J Med Sci Sports. 2022;32(suppl 1):1226. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Barnes C, Archer DT, Hogg B, Bush M, Bradley PS. The evolution of physical and technical performance parameters in the English premier league. Int J Sports Med. 2014;35(13):10951100. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 4.

    Dorn TW, Schache AG, Pandy MG. Muscular strategy shift in human running: dependence of running speed on hip and ankle muscle performance. J Exp Biol. 2012;215(11):19441956. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Draghi F, Bortolotto C, Ferrozzi G. Soleus strain: an underestimated injury? J Ultrasound. 2021;24(2):201203. doi:

  • 6.

    Balius R, Alomar X, Rodas G, et al. The soleus muscle: MRI, anatomic and histologic findings in cadavers with clinical correlation of strain injury distribution. Skelet Radiol. 2012;42(4):521530. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Brukner P, Cook JL, Purdam CR. Does the intramuscular tendon act like a free tendon? Br J Sports Med. 2018;52(19):12271228. doi:

  • 8.

    Torriani M, Kattapuram SV. Musculoskeletal ultrasound: an alternative imaging modality for sports-related injuries. Top Magn Reson Imaging. 2003;14(1):103111. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Loizides A, Gruber H, Peer S, Plaikner M. Muscular injuries of athletes: importance of ultrasound. Radiologe. 2017;57(12):10191028. doi:

  • 10.

    Shah AB, Bhatnagar N. Ultrasound imaging in musculoskeletal injuries-what the Orthopaedic surgeon needs to know. J Clin Orthop Trauma. 2019;10(4):659665. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 11.

    Romero-Morales C, Calvo-Lobo C, Navarro-Flores E, et al. M-Mode ultrasound examination of soleus muscle in healthy subjects: intra- and inter-rater reliability study. Healthcare. 2020;8(4):555. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 12.

    Abat F, Gelber PE, Polidori F, Monllau JC, Sanchez-Ibañez JM. Clinical results after ultrasound-guided intratissue percutaneous electrolysis (EPI®) and eccentric exercise in the treatment of patellar tendinopathy. Knee Surg Sports Traumatol Arthrosc. 2015;23(4):10461052. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Valera-Garrido F, Minaya-Muñoz F, Medina-Mirapeix F. Ultrasound-guided percutaneous needle electrolysis in chronic lateral epicondylitis: short-term and long-term results. Acupunct Med. 2014;32(6):446454. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    De-la-Cruz-Torres B, Albornoz-Cabello M, García-Bermejo P, Naranjo-Orellana J. Autonomic responses to ultrasound-guided percutaneous needle electrolysis of the patellar tendon in healthy male footballers. Acupunct Med. 2016;34(4):275279. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Rodríguez-Huguet M, Góngora-Rodríguez J, Lomas-Vega R, et al. Percutaneous electrolysis in the treatment of lateral epicondylalgia: a single-blind randomized controlled trial. J Clin Med. 2020;9(7):2068. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Iborra-Marcos A, Ramos-Alvarez JJ. Intratissue percutaneous electrolysis vs corticosteroid infiltration for the treatment of plantar fasciosis. Foot Ankle Inter. 2018;39(6):704711. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 17.

    Garcia-Naranjo J, Barroso-Rosa S, Loro-Ferrer JF, et al. A novel approach in the treatment of acute whiplash syndrome: ultrasound-guided needle percutaneous electrolysis. A randomized controlled trial. Orthop Traumatol Surg Res. 2007;103(8):12291234. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    De Miguel Valtierra L, Salom Moreno J, Fernández-de-Las-Peñas C, Cleland JA, Arias-Buría JL. Ultrasound-guided application of percutaneous electrolysis as an adjunct to exercise and manual therapy for subacromial pain syndrome: a randomized clinical trial. J Pain. 2018;19(10):1201. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 19.

    Arias-Buría JL, Truyols-Domínguez S, Valero-Alcaide R, Salom-Moreno J, Atín-Arratibel MA, Fernández-de-Las-Peñas C. Ultrasound-guided percutaneous electrolysis and eccentric exercises for subacromial pain syndrome: a randomized clinical trial. Evid Based Complement Alternat Med. 2015;2015:315219. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 20.

    Lopez-Martos R, Gonzalez-Perez LM, Ruiz-Canela-Mendez P, et al. Randomized, double-blind study comparing percutaneous electrolysis and dry needling for the management of temporomandibular myofascial pain. Med Oral Patol Oral Cir Bucal. 2018;23(4):e454e462. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 21.

    De-la-Cruz-Torres B, Barrera-García-Martín I, Valera-Garrido F, Minaya-Muñoz F,Romero-Morales C. Ultrasound-guided percutaneous needle electrolysis in dancers with chronic soleus injury: a randomized clinical trial. Evid Based Complement Alternat Med. 2020;2020:4156258. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 22.

    Abat F, Valles SL, Gelber PE, et al. An experimental study of muscular injury repair in a mouse model of notexin-induced lesion with EPI® technique. BMC Sports Sci Med Rehabil. 2015;7:7. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Sánchez-Sánchez JL, Calderón-Díez L, Herrero-Turrión J, Méndez-Sánchez R, Arias-Buría JL, Fernández-de-Las-Peñas C. Changes in gene expression associated with collagen regeneration and remodeling of extracellular matrix after percutaneous electrolysis on collagenase-induced achilles tendinopathy in an experimental animal model: a pilot study. J Clin Med. 2020;9(10):3316. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 24.

    Jiménez-Rubio S, Valera-Garrido F, Minaya-Muñoz F. et al. Percutaneous needle electrolysis and exercise reduce the time for return to competition after an injury to the hamstrings: two cases in professional football players. Rev Fisioterapia Invasiva. 2019;2(2):121122. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 25.

    Valera-Garrido F, Jiménez-Rubio S, Minaya-Muñoz F, Estévez-Rodríguez JL, Navandar A. Ultrasound-guided percutaneous needle electrolysis and rehab and reconditioning program for rectus femoris muscle injuries: a cohort study with professional soccer players and a 20-week follow-up. Appl Sci. 2020;10(21):7912. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    De-la-Cruz-Torres B, Romero-Morales C. Muscular echovariation as a new biomarker for the classification of soleus muscle pathology: a cross-sectional study. Diagnostics. 2021;11(10):1884. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 27.

    Downie WW, Leatham PA, Rhind VM, Wright V, Branco JA, Anderson JA. Studies with pain rating scales. Ann Rheum Dis. 1978;37(4):378381. doi:

  • 28.

    Valera-Garrido F, Minaya-Muñoz F. Fisioterapia Invasiva. 2nd ed. Elsevier; 2016.

  • 29.

    Bizzini M, Dvorak J. FIFA 11+: an effective programme to prevent football injuries in various player groups worldwide—a narrative review. Br J Sports Med. 2015;49(9):577579. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 30.

    Hjermstad MJ, Fayers PM, Haugen DF, et al. Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review. J Pain Symptom Manage. 2011;41(6):10731093. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 31.

    Vicenzino B, Branjerdporn M, Teys P, Jordan K. Initial changes in posterior talar glide and dorsiflexion of the ankle after mobilization with movement in individuals with recurrent ankle sprain. J Orthop Sports Phys Ther. 2006;36(7):464471. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 32.

    Lagas IF, Meuffels DE, Visser E, et al. Effects of eccentric exercises on improving ankle dorsiflexion in soccer players. BMC Musculoskelet Disord. 2021;22(1):485. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 33.

    Signorile JF, Applegate B, Duque M, Cole N, Zink A. Selective recruitment of the triceps surae muscles with changes in knee angle. J Strength Cond Res. 2002;16(3):433439. PubMed ID: 12173959

    • Search Google Scholar
    • Export Citation
  • 34.

    Hébert-Losier K, Schneiders AG, García JA, Sullivan SJ, Simoneau GG. Influence of knee flexion angle and age on triceps surae muscle activity during heel raises. J Strength Cond Res. 2012;26(11):31243133. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 35.

    Fílter A, Olivares J, Santalla A, Nakamura FY, Loturco I, Requena B. New curve sprint test for soccer players: reliability and relationship with linear sprint. J Sports Sci. 2020;38(11–12):13201325. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 36.

    Zabaloy S, Villaseca-Vicuña R, Giráldez J, et al. Body composition and physical performance measures in elite female football players: differences across playing positions and associations with kicking velocity and curve sprint performance. Mov Sport Sci. Published online August 10, 2022. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 37.

    Jaeschke R, Singer J, Guyatt GH. Measurement of health status. Ascertaining the minimal clinically important difference. Control Clin Trials. 1989;10(4):407415. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 38.

    Rabusin CL, Menz HB, McClelland JA, et al. Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (the HEALTHY trial): study protocol for a randomised trial. J Foot Ankle Res. 2019;12:20. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 39.

    Feng C, Wang H, Lu N, et al. Log-transformation and its implications for data analysis. Shanghai Arch Psychiatry. 2019;26(2):105109. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 40.

    Kobal R, Freitas TT, Fílter A, et al. Curve sprint in elite female soccer players: relationship with linear sprint and jump performance. Int J Environ Res Public Health. 2021;18(5):2306. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 41.

    O’Connor PJ, Cook DB. Exercise and pain: the neurobiology, measurement, and laboratory study of pain in relation to exercise in humans. Exerc Sport Sci Rev. 1999;27:119166. PubMed ID: 10791016

    • Search Google Scholar
    • Export Citation
  • 42.

    Deyle GD, Allison SC, Matekel RL, et al. Physical therapy treatment effectiveness for osteoarthritis of the knee: a randomized comparison of supervised clinical exercise and manual therapy procedures versus a home exercise program. Phys Ther. 2005;85(12):13011317. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 43.

    Cleland JA, Mintken PE, McDevitt A, et al. Manual physical therapy and exercise versus supervised home exercise in the management of patients with inversion ankle sprain: a multicenter randomized clinical trial. J Orthop Sports Phys Ther. 2013;43(7):443455. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 44.

    Suarez-Arrones L, Nakamura FY, Maldonado RA, Torreno N, Di Salvo V, Mendez-Villanueva A. Applying a holistic hamstring injury prevention approach in elite football: 12 seasons, single club study. Scand J Med Sci Sports. 2021;31(4):861874. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 45.

    Mendiguchia J, Castaño-Zambudio A, Jiménez-Reyes P, et al. Can we modify maximal speed running posture? implications for performance and hamstring injury management. Int J Sports Physiol Perform. 2022;17(3):374383. doi:

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 705 705 179
Full Text Views 3 3 2
PDF Downloads 6 6 4