Immediate Effect of Dry Needling on Calf Muscles Pain Pressure Threshold,Sprint Speed and Functional Performance in Amateur Football Player

A randomised, single-blind, parallel-group trial recruiting amateur club football players (age 18-25) with active myofascial trigger points in gastrocnemius or soleus. Participants randomised (coin toss) into Group A (Dry Needling) or Group B (Sham Needling). Baseline measures: Pressure Pain Threshold (PPT) using handheld algometer, ankle dorsiflexion ROM with goniometer, sprint speed via shuttle run, and single-leg hop distance. Intervention: a single session of dry needling (sterile single-use filiform needles 0.25-0.30 mm; needles retained \~10 minutes with fast-in/fast-out pistoning to elicit local twitch response) or a non-penetrating sham procedure mimicking needling. Post-intervention assessments are performed immediately after the session. Data will be analysed with SPSS v.27; paired t-tests for within-group and independent t-tests for between-group comparisons (p < 0.05).

• Dry Needling (Procedure): A single-session myofascial trigger point dry needling treatment will be administered to identified trigger points in the gastrocnemius and/or soleus muscles using sterile disposable filiform needles. The objective is to mechanically disrupt the dysfunctional motor end plate, elicit local twitch responses, reduce nociceptive activity, and restore muscle function. The intervention is delivered under aseptic conditions by a trained physiotherapist following standard safety guidelines. Post-procedure monitoring will be conducted for minor adverse effects such as soreness or bleeding.
• Sham Needling (Procedure), also known as Placebo Needling: A simulated needling procedure designed to act as a placebo comparator will be applied without skin penetration. The technique reproduces the visual, tactile, and contextual components of dry needling to maintain participant blinding while avoiding physiological stimulation of the muscle. This allows isolation of the true therapeutic effect of dry needling from psychological or expectancy-related responses.

Primary outcomes

• Pain Pressure Threshold [Baseline (Day 0, pre-intervention) and Immediately Post-intervention (within 15 minutes after intervention).]: Pressure Pain Threshold will be measured at the identified myofascial trigger point in the gastrocnemius or soleus using a handheld pressure algometer. The participant will indicate the point at which applied pressure first becomes painful. The recorded value (kg/cm²) reflects mechanical pain sensitivity of the trigger point.
• Functional Performance [Baseline (Day 0, pre-intervention) and Immediately Post-intervention (within 15 minutes after intervention).]: Functional performance will be assessed using Single leg hop test ( distance in centimeters).The Single Leg Hop Test measures lower limb explosive power. Participants will perform three maximal forward hops on one leg. The distance (in centimeters) from the starting line to the heel landing point will be recorded. The average of three trials will be used for analysis. Greater distance indicates improved functional performance.
• Sprint Speed [Baseline (Day 0, pre-intervention) and Immediately Post-intervention (within 15 minutes after intervention).]: Sprint speed will be accessed by Shuttle run test. The speed and agility of lower limb in calf muscle by time taken to complete a short distance shuttle sprint. It reflects the explosive function of calf muscle which is essential for acceleration and direction change in football. Sprint speed will be assessed using a 20-meter shuttle run test. Participants will run back and forth between two markers placed 20 meters apart as quickly as possible. Two trials will be performed, and the fastest time (in seconds) will be recorded to the nearest 0.1 second. Lower time indicates better sprint performance.

Secondary outcomes

• Range of Motion of Ankle Dorsiflexion [Baseline (Day 0, pre-intervention) and Immediately Post-intervention (within 15 minutes after intervention).]: Ankle dorsiflexion will be measured in degrees using a universal goniometer. Three readings will be taken and averaged. Higher degrees indicate improved flexibility.

Sex: All, ages: 18 Years to 25 Years

Inclusion Criteria:

* Amateur football players aged 18-25 years.

Participation in club-level football for at least one year.

Presence of active myofascial trigger point in gastrocnemius or soleus confirmed by palpation.

Willingness to participate and provide informed consent.

Exclusion Criteria:

* History of calf muscle tear, fracture, or lower limb surgery.

Current use of muscle relaxants or anti-inflammatory medication.

Known bleeding disorders or anticoagulant therapy.

Local infection, skin lesion, or contraindication to dry needling.

Neurological or vascular disorders affecting lower limb function.

• Hamza Aliyan, DPT, Principal investigator, Foundation University Islamabad