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Kathleen Geist, Claire Bradley, Alan Hofman, Rob Koester, Fenella Roche, Annalise Shields, Elizabeth Frierson, Ainsley Rossi, and Marie Johanson

Study Design:

Randomized controlled trial.


The aim of this study was to determine the effects of dry needling on hamstring extensibility and functional performance tests among asymptomatic individuals with hamstring muscle tightness.


Dry needling has been shown to increase range of motion in the upper quarter and may have similar effects in the lower quarter.


27 subjects with hamstring extensibility deficits were randomly assigned to side of treatment (dominant or nondominant) and group (blunt needling or dry needling). The first session included measurement of hamstring extensibility and performance on 4 unilateral hop tests, instruction in home hamstring stretching exercises and needling distal to the ischial tuberosity and midbellies of the medial and lateral hamstrings. A second session, 3–5 days following the first session, included outcome measures and a second needling intervention, and a third session, 4–6 weeks following the first session, included outcome measures only. A 2 × 3 × 2 ANOVA was used to statistically analyze the data.


Hamstring extensibility showed a significant side × time interaction (P < .05). The single hop for distance, timed 6-meter hop, and the crossover hop test had a significant main effect of time (P < .05). The triple hop for distance showed a significant side × time × group interaction (P < .05).


It does not appear dry needling results in increased extensibility beyond that of stretching alone in asymptomatic individuals. Our study findings suggest that dry needling may improve certain dimensions of functional performance, although no clear conclusion can be made. Level of Evidence: Intervention, level 2b.

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Natália Barros Beltrão, Camila Ximenes Santos, Valéria Mayaly Alves de Oliveira, André Luiz Torres Pirauá, David Behm, Ana Carolina Rodarti Pitangui, and Rodrigo Cappato de Araújo

Context: Stretching intensity is an important variable that can be manipulated with flexibility training. However, there is a lack of evidence regarding this variable and its prescription in stretching programs. Objective: To investigate the effects of 12 weeks of knee flexor static stretching at different intensities on joint and muscle mechanical properties. Design: A randomized clinical trial. Setting: Laboratory. Participants: A total of 14 untrained men were allocated into the low- or high-intensity group. Main Outcome Measures: Assessments were performed before, at 6 week, and after intervention (12 wk) for biceps femoris long head architecture (resting fascicle length and angle), knee maximal range of motion (ROM) at the beginning and maximal discomfort angle, knee maximal tolerated passive torque, joint passive stiffness, viscoelastic stress relaxation, knee passive torque at a given angle, and affective responses to training. Results: No significant differences were observed between groups for any variable. ROM at the beginning and maximal discomfort angle increased at 6 and 12 weeks, respectively. ROM significantly increased with the initial angle of discomfort (P < .001, effect size = 1.38) over the pretest measures by 13.4% and 14.6% at the 6- and 12-week assessments, respectively, and significantly improved with the maximal discomfort angle (P < .001, effect size = 1.25) by 15.6% and 18.8% from the pretest to the 6- and 12-week assessments, respectively. No significant effects were seen for muscle architecture and affective responses. Initial viscoelastic relaxation for the low-intensity group was lower than ending viscoelastic relaxation. Conclusion: These results suggest that stretching with either low or high discomfort intensities are effective in increasing joint maximal ROM, and that does not impact on ROM, stiffness, fascicle angle and length, or affective response differences.