The Potential Role of Therapeutic Needling with Fascial Hydrodissection for Athletes with Acute Muscle Injuries: A Retrospective Observational Case Series

Background and/or Objectives: Myofascial trigger points (TrPs) are known to cause pain on compression of the muscle and correlate with damaged muscle fibers on the microscopic level. Traditional orthopedic diagnoses usually have underlying trigger points, but evolving evidence suggests that TrPs could sometimes be a risk factor for developing muscle strains rather than the symptom. This can be seen in grade 0 muscle strains especially, which could be the presenting TrP. Identifying and resolving these TrPs in acute injuries could accelerate recovery and reduce musculoskeletal pain. We aim to determine how trigger point injections with hydrodissection can alleviate pain in acute muscle injuries and to characterize how it affects return to play in athletes.

Design: Retrospective observational case series.

Setting : The study was conducted in a clinic working with athletic teams.

Participants : 10 athletes diagnosed with acute muscle strains ranging from grade 0-3.

Interventions: Trigger point injections with ultrasound guided hydrodissection with saline and 1% lidocaine.

Main Outcome Measures: Pain intensity post treatment at the one day mark, return to modified practice, return to unrestricted practice, and return to competition.

Results: All patients returned to competition following TrP injections within 40 days, with no adverse events reported from the injection. 5 out of 10 patients had immediate relief when walking and full range of motion following the injection. One athlete had a repeat injury and was injected again with immediate pain relief following. 6 out of 10 patients returned to modified practice and 3 out of 10 returned to unrestricted practice within 1 week. Out of these 9 athletes, 5 of them also returned to competition within 2 weeks.

Conclusions: TrPs injections can offer relief to athletes needing an immediate solution. Athletes with acute muscle strain can return to their level of play prior to their injury following hydrodissections.