Achilles tendon injuries, and calf injuries in general, are common among active individuals. This is because extreme and forceful loading during reactionary and plyometric activities place the Achilles tendon at risk for calf strains and overuse injuries.
“Mild” Achilles tendon injuries often go untreated and eventually create overuse injuries causing dysfunction and pain up and down the kinetic chain at the foot, knee, and even the hip - increasing the risk of chronic pain and even eventual tendon failure.
However, as always, I think in order to understand why this tendon is susceptible to injury, we should go over what the Achilles tendon actually does, followed by what available treatment options are available if you’ve already sustained this injury.
Anatomy of a Tendon, the Achilles Tendon Specifically
A tendon is the structure that has the primary responsibility to be the bridge "connecting" the muscle and the bone. The Achilles tendon is generally accepted as the largest and strongest tendon in the body, and the tendon that attaches the calf muscle group to the back of the heel (calcaneus).
Despite the calf muscle being commonly thought of as simply one muscle, the “calf,” it is actually comprised of three different muscles - making up the triceps surae complex of the calf. The three muscles that come together to make the Achilles tendon are the Plantaris muscle (which is actually absent in many people - this not being a big factor in Achilles injuries), the Soleus muscle (aka the “walking muscle”), and the Gastrocnemius (Gastroc) muscle. For all extensive purposes, the muscle that you see when you flex your foot forward/stand on your tippy toes with your knees locked in full extension is the 2 large muscle bellies of the gastroc muscle.
The movement/strength responsibilities of these three muscles are primarily pointing the toes forward/down and/or bending the knee. Each muscle is important in its own regard and the corresponding function is relevant to knee joint position in space; however, the take home message in this case is that the Achilles tendon is a powerful tendon composed of up to three separate muscles which work together as a unit to function properly.
Dry Needling Basics - The literal basics
First and foremost, the science behind Dry Needling is complex and can be broken down to explain vast physiological changes that occur within the target structures.
Admittedly, I am fully aware that I am likely one of the few people who is actually interested in diving into the research on how Dry Needling impacts on the hypothalamic-pituitary-adrenal axis or the modulation of the non-opioid descending pain pathway. Thus, while the physiological changes that occur within the tendon are extremely interesting, the depth of these changes are outside of the scope of this blog.
So with that being said, the primary, and simply put, benefits that can be expected with Dry Needling are:
Decreased pain at the target tissue
Improved blood flow
Decreased pain sensitivity with chronic pain conditions
Reduced stiffness
Improved range of motion and flexibility
Improved tissue healing
Subsequent decreased medication usage
For more information on Dry Needling, please refer to the below resources:
But is Dry Needling a proven and viable option for the treatment and management of Achilles tendon injuries?
The 7 benefits listed above are all applicable to management and healing of an Achilles Tendon Injury or Calf Strain, but is there any clinical research that specifically addresses this particular injury?
Well, I never thought you would ask…
A randomized controlled trial (RCT) is the gold standard in collecting evidence surrounding the usefulness of a particular treatment. An RCT is known to minimize bias and eliminate errors that may cause inaccurate results.
At Flow Physical Therapy, we were one of a few Physical Therapy clinics from around the country participating and collecting data in a multicenter RCT on The Effectiveness of Electrical Dry Needling on Mid-Portion Achilles Tendinopathy. This was not only a great honor to collect data for a study that has yet to be released, it was a great opportunity to see the results of this study unfold right in front of my eyes.
I will spare you with the research lingo, as, again, that isn’t the primary intent of this blog; however, I will share the end results uncovered with my clinic participants.
One group (control group) in this study received the standard of care in the current research to treat an Achilles Tendon injury, while the other group (experimental group) received standard treatment plus the addition of a specific electrical dry needling protocol.
While both groups demonstrated improvement (as we know standard PT is appropriate treatment approach), the group that received dry needling demonstrated improvement significantly faster and the benefits remained 6 weeks after treatments concluded.
Results of the Study
Long story short, the addition of Electrical Dry Needling provided far superior outcomes/results compared to Standard PT alone in the treatment of Achilles tendon in the group of participants studied at our clinic.
Where can I receive this cutting edge treatment?
If you are in the Houston, TX area, specifically the North Houston region, including Spring, The Woodlands, Magnolia, Conroe, and many more, then click the button below and head on over to Flow Physical Therapy and Wellness to receive Osteopractic Physical Therapy Services that, not only is up to date with the current research - but is helping write and advance the current research in the treatment of Achilles Tendon and Calf Injuries.
If you are not local to our region, then find an Osteopractic Physical Therapist near you to work with the leaders of the Physical Therapy profession.
Dr. Patrick Thompson, PT, DPT, OCS, Dip. Osteopractic, FAAOMPT
Owner of Flow Physical Therapy and Wellness
832.299.5447
Comments