This month the ARTI website will focus on novel new research ARTC’s are engaging in. Each article will focus on a different topic and this month we will focus on Michael Donohoe’s research into the effects of trigger point dry needling on athletic performance and injury reduction.
As part of his Masters by Research, funded by Athlone IT’s President’s Research Fund, Athlone native Michael Donohoe is investigating the effects of myofascial trigger point dry needling on muscle function within the shoulder.
Not only is it an important area of research of therapists, but it is an important step for Athlone IT as this is the institute’s first research study in the field of sports medicine since the development of AIT’s B.Sc. course in Sports Therapy with Rehabilitation, set up in 2012.
Outlining his reasons for conducting this particular study, which will be supervised by Dr Niamh Nic Cheilleachair and Dr Siobhán O Connor, Micheal is optimistic that it will be of benefit to practitioners in helping to understand the clinical implications of latent trigger points, the effectiveness of dry needling as a treatment and perhaps its use for injury prevention.
“Myofasacial trigger points is a topic we learned about in DCU and through clinical practice I observed that treatment of trigger points was very effective in the management of myofascial pain, particularly among athletes.
“Meanwhile, dry needling as a treatment for myofascial trigger points has grown both here in Ireland and worldwide in recent years and so I decided it would be worthwhile to become trained in its application as part of my CPD”, explained Michael.
“Initially, treatment for trigger points was predominantly carried out with the use of manual release, but dry needling is also considered as a very affective modality”, added Michael who felt that when the opportunity arose for research in Athlone, it was something he wanted to investigate further in terms of injury prevention.
Michael sees the key to the study as an attempt to determine if treatment will help reduce certain clinical implications associated with latent trigger points which may prevent them from developing into active trigger points.
“It is theorised that latent trigger points, if continuously stimulated by perpetuating factors, can develop into active trigger points. As well as their potential development into active trigger points they have also been shown to have clinical implications prior to this, such as reduced range of motion, muscle weakness and altered muscle activation patterns. We are trying to see if by treating them before they develop into painful active trigger points if it will enhance the function of the muscles associated with shoulder function”, he explained.
Michael, who began the two-year research in November last year, outlined the details of the study in the following article for AIT’s Science magazine, Quest.
Myofascial or muscular pain is not always appreciated as the primary cause of pain and is frequently only considered as a secondary phenomenon to muscle, tendon, joint or nerve injuries. However, myofascial pain is a common phenomenon recognised by the International Association for the Study of Pain. Myofascial pain is characterised by local and/or referred pain that originates in a myofascial trigger point (MTrP).
MTrPs are hyperirritable points located within a taut band of skeletal muscle or fascia, which cause referred pain, local tenderness and autonomic changes. They are clinically significant because they cause pain and neuromuscular dysfunction. There are two basic types of MTrPs that may be harboured with a muscle; active and latent.
Active trigger points (ATrPs) produce spontaneous pain, tenderness within a taut band of muscle, familiar local or referred pain to the patient, and a local twitch response when stimulated manually or with a needle. In contrast, latent trigger points (LTrPs) are minor, subclinical neuromuscular lesions, which do not cause pain except when stimulated manually or with a needle. Theoretically a trigger point is considered active if on compression the elicited pain is familiar to the patient.
Current research has only recently begun to focus on LTrPs due to their capability to convert into ATrPs, however they have been found to be significantly more complex in nature. They have also been shown to cause clinical implications before conversion into ATrPs, including decreased range of motion, muscle weakness and altered muscle activation patterns. Verification of the proposed clinical implications could show LTrPs have the potential to effect injury incidence and muscle performance. LTrPs are prevalent in healthy populations and may be a source of dysfunction that may affect an athlete’s performance or potentially, if not treated, be a factor in future injury.
While research investigating LTrPs is in its infancy research on ATrPs has been extensive. From the research carried out on ATrPs there are a number of proposed treatment options, of which manual trigger point release and dry needling are the most widely used and researched.
The purpose of this novel research in AIT is to investigate whether treatment of LTrPs using dry needling produces a significant reduction in their proposed clinical implications and whether this causes an improvement in the treated muscle’s performance.