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December 2024

Combination of Manual Therapy and Dry Needling Effectively Improves Acute Neck Pain and Muscular Tone and Stiffness in Combat Sports Athletes: A Randomized Controlled Study

Authors: Adrian Kuzdzal 1, Filipe Manuel Clemente 2, 3, 4, Sebastian Klich 5, Adam Kawczynski 2, Robert Trybulski 6, 7

Affiliations:

  1. Institute of Health Sciences, College of Medical Sciences, University of Rzeszow, Poland
  2. Department of Biomechanics and Sport Engineering, Gdansk University of Physical Education and Sport, Poland
  3. Escola Superior Desporto e Lazer, Instituto Politecnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Alvares, Portugal
  4. Sport Physical Activity and Health Research & Innovation Center, Viana do Castelo, Portugal
  5. Department of Paralympic Sport, Wroclaw University of Health and Sport Sciences, Wroclaw, Poland
  6. Medical Department Wojciech Korfanty, Upper Silesian Academy, Katowice, Poland
  7. Provita Zory Medical Center, Zory, Poland

Journal: Journal of Sports Science & Medicine - December 2024, Volume 23, Pages 852-862 (DOI: 10.52082/jssm.2024.852)

This study aimed to compare the effects of manual therapy combined with dry needling (MTDN) to a control group, focusing on the impact on pressure pain threshold (PPT), muscle tone (MT), muscle stiffness (MS), muscle strength, and range of motion in the neck muscles of adult combat sports athletes.

A randomized controlled study design was employed, with one group of athletes (n = 15) receiving MTDN intervention, while the other group (n = 15) underwent a control treatment (CG) involving a quasi-needle technique combined with manual therapy. Both groups participated in three sessions, either in the MTDN intervention or the control condition. All athletes, who were experiencing neck pain, were evaluated at rest, after one session, after three sessions, and again 72 hours after the third session. Muscle tone (MT) and muscle stiffness (MS) were measured using myotonometry, pressure pain threshold (PPT) was assessed with an algesiometer, muscle strength was evaluated using a handheld dynamometer, and range of motion was measured with an electronic goniometer.

Group comparisons revealed significantly higher MT in CG compared to MTDN after the 3rd session (p < 0.001; d = 1.50). Additionally, CG showed significantly greater MS than MTDN after the 3rd session (p < 0.001; d = 1.75) and at 72 hours post-session (p < 0.001; d = 2.45). Conversely, MTDN exhibited significantly greater PPT than CG at 72 hours post-session (p < 0.001; d = 1.80).

Our results suggest that MTDN is significantly more effective in improving muscle tone, stiffness, and acute pain compared to manual therapy alone. However, no significant impact was observed on maximal strength or neck range of motion. A combined approach may offer benefits by more rapidly reducing neck pain and better preparing muscle properties for future activities.

 

Keywords: martial arts, exercise recovery, muscle strength, physical therapy modalities, therapeutics

The results of our experimental study reveal that incorporating dry needling into regular manual therapy significantly benefits the recovery of muscle tone and stiffness, as well as increases pain pressure threshold in combat sports athletes with neck pain. However, combining dry needling with manual therapy did not show any statistically significant improvement in isometric maximal strength or range of motion in lateral flexion and rotation movements. This evidence suggests that practitioners should exercise caution when choosing recovery techniques. Dry needling is recommended as a complementary technique primarily for increasing pain pressure threshold or reducing muscle tone and stiffness. For other recovery goals, manual therapy alone may be sufficient to achieve progress over three sessions, thereby avoiding the need for a more invasive technique. Future studies could increase the sample size and diversity of competitive levels, as well as extend the duration of the interventions.

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