The Effect of Dry Needling on Suprapatellar Tendonitis: A Case Report

Abstract

Background Patellar tendinitis is common in jumping sports. Pain from patellar tendinopathy is challenging to manage. Dry needling as a stand-alone treatment for tendinopathy is supported. To our knowledge, dry needling has never been used alone. This case report depicts dry needling on the proximal patellar pole.

Case description A 43-year-old male presented with left suprapatellar tendinitis. He was injured four months before beginning dry needling while playing futsal without warming up. The superior pole of the patellar was tender to palpation and caused moderate pain. At 20 degrees of knee flexion, discomfort began during double leg squats. The Clarke’s Sign, Eccentric Step, and Step Up tests showed positive results. The patient received five sessions of DN at the proximal pole of the patella twice weekly. This study’s primary outcomes were the numeric pain rating scale (NPRS), the Kujala Anterior Knee Pain Scale (AKPS), the global rating of change scale (GRC), and the angle of knee flexion during the squat. The researcher collected data at the five stages.

Outcomes The patient’s primary outcome measures improved after three weeks of DN and three months of follow-up. The NPRS showed a reduction in pain, while the AKPS demonstrated a decrease in disability.

Conclusion The successful treatment of a patient with suprapatellar tendinopathy utilizing DN is possibly described for the first time in this case report. This study demonstrated the efficacy of dry needling as a first-line treatment for managing chronic tendinopathy with a history of trauma.

Zusammenfassung

Hintergrund Patellasehnenentzündungen sind im Springsport weit verbreitet. Schmerzen durch das Patellaspitzensyndrom sind schwierig zu behandeln. Dry Needling als eigenständige Behandlung der Tendinopathie wird unterstützt. Nach unserem Wissen wurde Dry Needling noch nie allein verwendet. Dieser Fallbericht zeigt das Dry Needling am proximalen Patellapol.

Fallbeschreibung Ein 43-jähriger Mann stellte sich mit linksseitiger suprapatellarer Tendinitis vor. Er verletzte sich vier Monate, bevor er mit dem Dry Needling begann, als er Futsal spielte ohne sich aufzuwärmen. Der obere Patellapol war palpationsempfindlich und verursachte mäßige Schmerzen. Bei 20 Grad Kniebeugung begannen die Beschwerden bei zweibeinigen Kniebeugen. Der Patient erhielt zweimal wöchentlich fünf DN-Sitzungen am proximalen Patellapol. Die primären Ergebnisse dieser Studie waren die Numeric Pain Rating Scale (NPRS), die Kujala Anterior Knee Pain Scale (AKPS), die Global Rating of Change Scale (GRC) und der Winkel der Kniebeugung während der Kniebeuge. Der Forscher sammelte Daten in den fünf Phasen.

Ergebnisse Die primären Endpunkte des Patienten verbesserten sich nach drei Wochen DN und drei Monaten Nachbeobachtung. Der NPRS zeigte eine Verringerung der Schmerzen, während der AKPS eine Verringerung der Behinderung zeigte.

Schlussfolgerung Die erfolgreiche Behandlung eines Patienten mit suprapatellarer Tendinopathie mit DN wird in diesem Fallbericht möglicherweise erstmals beschrieben. Diese Studie demonstrierte die Wirksamkeit von Dry Needling als Erstlinienbehandlung zur Behandlung chronischer Tendinopathien mit einer Vorgeschichte von Traumata.

Key words

suprapatellar tendonitis - dry needling - jumper knee - tendinopathy

Schlüsselwörter

suprapatellare Sehnenentzündung - dry needling - jumper knee - tendinopathy

Publication History

Received: 10 December 2022

Accepted: 29 March 2023

Article published online:
28 April 2023

• References

• 1 Simpson M, Smith T. Quadriceps tendinopathy – a forgotten pathology for physiotherapists? A systematic review of the current evidence-base. Physical Therapy Reviews 2011; 16: 455-461
• 2 Everhart JS. et al. Treatment options for patellar tendinopathy: a systematic review. Arthroscopy: The Journal of Arthroscopic & Related Surgery 2017; 33: 861-872
• 3 Tiemessen IJ. et al. Risk factors for developing jumper’s knee in sport and occupation: a review. BMC research notes 2009; 2: 1-6
• 4 Nourissat G, Berenbaum F, Duprez D. Tendon injury: from biology to tendon repair. Nature Reviews Rheumatology 2015; 11: 223-233
• 5 Dan M. et al. Biomechanics of the knee extensor mechanism and its relationship to patella tendinopathy: a review. Journal of Orthopaedic Research® 2018; 36: 3105-3112
• 6 Vander Doelen T, Jelley W. Non-surgical treatment of patellar tendinopathy: A systematic review of randomized controlled trials. Journal of science and medicine in sport 2020; 23: 118-124
• 7 Brotzman SB, Manske RC. Clinical orthopaedic rehabilitation e-book: An evidence-based approach-expert consult. 2011 Elsevier Health Sciences
• 8 Krey D, Borchers J, McCamey K. Tendon needling for treatment of tendinopathy: a systematic review. The Physician and sportsmedicine 2015; 43: 80-86
• 9 Stoychev V, Finestone AS, Kalichman L. Dry Needling as a Treatment Modality for Tendinopathy: a Narrative Review. Curr Rev Musculoskelet Med 2020; 13: 133-140
• 10 Kamper SJ, Maher CG, Mackay G. Global rating of change scales: a review of strengths and weaknesses and considerations for design. Journal of Manual & Manipulative Therapy 2009; 17: 163-170
• 11 Uygur E. et al. Dry needling in lateral epicondylitis: a prospective controlled study. Int Orthop 2017; 41: 2321-2325
• 12 McDevitt AW. et al. Treatment of individuals with chronic bicipital tendinopathy using dry needling, eccentric-concentric exercise and stretching; a case series. Physiother Theory Pract 2020; 36: 397-407
• 13 Riggin CN. et al. Ultrasound-guided dry needling of the healthy rat supraspinatus tendon elicits early healing without causing permanent damage. Journal of Orthopaedic Research 2019; 37: 2035-2042
• 14 Chen P-C. et al. Comparative effectiveness of different nonsurgical treatments for patellar tendinopathy: a systematic review and network meta-analysis . Arthroscopy: The Journal of Arthroscopic & Related Surgery 2019; 35: 3117-3131. e2
• 15 Khandare S. et al. Comparison between dry needling and focused ultrasound on the mechanical properties of the rat Achilles tendon: A pilot study. Journal of biomechanics 2021; 120: 110384
• 16 Ludewig PM. et al. Changing our diagnostic paradigm: movement system diagnostic classification. International Journal of Sports Physical Therapy 2017; 12: 884
• 17 Liu L. et al. Traditional Chinese Medicine acupuncture and myofascial trigger needling: The same stimulation points?. Complementary therapies in medicine 2016; 26: 28-32
• 18 Patil S. et al. The role of acupuncture in pain management. Current pain and headache reports 2016; 20: 1-8
• 19 Qin QG. et al. Myofascial trigger point: an indicator of acupoint sensitization. Zhen ci yan jiu=Acupuncture Research 2020; 45: 57-61
• 20 Donelly J. et al. Travell, Simons & Simons’ Myofascial pain and Dysfunction: the trigger point manual. 2019. Philadelfia: Wolters Kluwer;