Ultrasound‐Guided Percutaneous Needle Electrolysis in Dancers with Chronic Soleus Injury: A Randomized Clinical Trial

Abstract

Damage to intramuscular tendons is very common in sports injuries, specifically in soleus muscle injuries. This study sought to compare the effects of applying ultrasound- (US-) guided percutaneous needle electrolysis (PNE) in combination with an eccentric exercise program on pain and functionality in dancers with chronic soleus injury, located in the central tendon. Thirty dancers with injured central tendon of the soleus muscle were randomly allocated to a PNE group (n = 10), an eccentric exercise group (n = 10), or a combined group (n = 10). Pain, ankle dorsiflexion range of motion (DROM), endurance, the heel raise test, the DFOS questionnaire, and the minimal clinically important difference (MCID) were analyzed at baseline and after treatment (four weeks). Over half (52%) of the dancers had a chronic soleus muscle injury. Variables for pain, DROM, the heel rise test, ADL, technique, DFOS total, and DFOS-subjective variables showed significant differences (P<0.05) in pretreatment and posttreatment in all groups, whereas no significant differences were observed between intervention groups. However, the combined group showed a higher percentage of changes compared to the other groups, and these dancers had greater perceived changes (MCID = 4.70 ± 1.42). The conclusion of the study was that dancers with chronic soleus injury, located in the central tendon, treated with a combination of US-guided PNE and an eccentric exercise program displayed improved outcomes compared to the application of PNE therapy or eccentric exercise alone. The US-guided PNE, combined with an eccentric exercise program, is a useful therapeutic tool for the treatment of chronic soleus injury, located in the central tendon. The trial is registered with NCT04042012.

Ultrasound Imaging Evaluation of Textural Features in Athletes with Soleus Pathology—A Novel Case-Control Study

“…Currently, there is a high interest in studying soleus muscle characteristics due to its importance during sporting activities as well as for a better understanding of its pathological features [ 5 , 6 , 31 , 32 ]. A soleus muscle pathology may be misdiagnosed and underestimated because of its special clinical features and that, in many cases, soleus disturbances do not require athletes to stop training or playing games [ 6 ].…”

Rehabilitative ultrasound imaging for the assessment of selected morphometric parameters of the flexor hallucis longus muscle in healthy individuals: An inter- and intra- rater reliability study

“…In specific populations, however, appropriate assessment of this muscle is essential, such as in dancers who rely on the FHL for dynamic stability of the foot during movements that require alternation between extreme plantar flexion and dorsiflexion [14]. Dancers are high-performance athletes who are particularly susceptible to lower extremities -specially foot-injuries [15][16][17][18][19]. By demonstrating the reliability of USI of the FHL, this study may offer a novel approach to assess and quantify the injury status of the FHL, as well as providing the image guidance needed for invasive therapies (such as needle insertion) targeting this muscle.…”

Muscular Echovariation as a New Biomarker for the Classification of Soleus Muscle Pathology: A Cross-Sectional Study

“…They were divided based on the muscle echogenicity in three groups: Injury Type 1 group, healthy group (Figure 1), Injury Type 1 and Injury Type 2 (Figure 2). As in previous studies [7,24], a central IMT tear in the soleus muscle was identified when patients reported having symptoms for at least six months, and they established a self-rated progressive stiffness value greater than or equal to 4 points during sports exercises or during the soleus stretching, measured using the numeric rating scale (NRS) [25]. The enrollment was carried out in a private clinic specialized in sports injuries.…”