Objective: To identify whether a single session of postrace dry needling can decrease postrace soreness and quantity of postrace leg cramps in half-marathon and full-marathon runners. Design: Single-blind, prospective, randomized, controlled trial. Setting: Finish line of 2018 Salt Lake City Marathon & Half-Marathon. Participants: Runners aged 18 years or older who completed a marathon or half-marathon. Interventions: True or sham dry needling of the bilateral vastus medialis and soleus muscles within 1 hour of race completion by 2 experienced practitioners. Main Outcome Measures: The primary outcome measure was numeric pain rating improvements for soreness on days 1, 2, 3, and 7 compared to immediately postrace. Secondary outcome measures included number of postrace cramps and subjective improvement of soreness. Results: Sixty-two runners were included with 28 receiving true and 34 receiving sham dry needling. Objective pain scores showed an increase in pain of the soleus muscles at days 1 and 2 (P ≤ 0.003 and P ≤ 0.041, respectively) in the dry needling group. No differences were seen in postrace pain in the vastus medialis muscles (P > 0.05). No association was seen between treatment group and presence of postrace cramping at any time point (P > 0.05). Subjectively, there was a nonsignificant trend for those receiving dry needling to feel better than expected over time (P = 0.089), but no difference with cramping (P = 0.396). Conclusions: A single postrace dry needling session does not objectively improve pain scores or cramping compared to sham therapy.

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Background BackgroundVarious methods of sham procedures have been used in controlled trials evaluating dry needling efficacy although few have performed validation studies of the sham procedure.

Distal semimembranosus tendinopathy is a relatively uncommon diagnosis that can be responsible for medial knee pain. The semimembranosus tendon inserts on the posteromedial knee and is surrounded by the semimembranosus bursa, with both the bursa and tendon potential sources of pain. Similar to other tendinopathies, semimembranosus tendinopathy often occurs with overuse of the musculotendinous unit and is commonly seen in runners. Diagnosis can be made clinically and may be substantiated with use of ultrasound or magnetic resonance imaging. Scant literature exists evaluating the efficacy of treatments for this condition. Consequently, best practice for treatment is inferred from other similar tendinopathies, clinical expertise, and smaller studies on semimembranosus tendinopathy. Extrapolating from other tendinopathies, rehabilitation should be the cornerstone of initial treatment, with focus on kinetic chain and gait abnormalities, hamstring strength and neuromuscular control, and progressive tendon loading. Recalcitrant cases with a coexisting bursopathy can be treated with an ultrasound‐guided bursal corticosteroid injection. Future studies may help delineate the optimal treatment regimen for this relatively uncommon diagnosis.