Dry Needling of the Vastus Lateralis

Chris Vi, PhD Candidate (Medicine), B.H&MedSci(Hons), B.BioMedSci

Deeya Mahadooa, MSc Mental Health Psychology, BA(Hons) Psychology 

 

VL background information – Biondi & Varacello, 2020

• The VL is the largest and the strongest muscle of the quadriceps group
• Involved in extension of the knee
• One of the main contributors to patellofemoral dysfunction (knee pain)
• Absorbs majority of the force generated by a heel strike
• Imbalances in the VL comapred to the Vastus Medialis can increase pain in the knee and contribute to joint instability

Tightness or pain in the VL can contribute to  pain in:

Lateral (side) of leg into knee

Front of knee

Back of knee

Lock knee

Study Review – Ma et al. (2020)

• Examined effects of trigger point dry needling on neuromuscular performance and knee pain
• 50 patients: 25 placebo group, 25 dry needling group
• Trigger point needling in VMO, VL and Rectus Femoris (RF): once a week for 6 weeks
• Stretching everyday for both groups
• Assessed using a pain intensity scale and functional status questionnaire

• Before treatment (baseline), 3 week mark, 6 week mark, and 3-months follow up
• Both groups significantly improved at the 3 and 6 week marks compared to baseline
• This shows stretching can have a positive effect on pain reduction and performance improvement, with or without needling
• Dry needling group, results were significantly higher at 3-months follow up, no significant differences for placebo group. This indicates dry needling can provide or increase long-term benefits.

Study Review – Abdelraouf et al. (2019)

• 20 females with patellofermoral pain syndrome (Knee Pain) compared to 20 healthy females
• Examined the effects of backwards and forwards walking on muscle activation of the Vastus Medialis Oblique (VMO) and VL

• Significant difference in VMO activation in backward walking, no difference in VL activation
• No significant differences in VMO/VL activation in forward walking

Backwards walking maintains ideal VMO/VL activation ratio, therefore should be considered in rehab programmes for knee pain. This could also imply the VMO compensates for lack of VL activation.

Subject to copyright, Rehab Plus 2020

 

References

• Abdelraouf, O. R., Abdel-Aziem, A. A., Ahmed, A. A., Nassif, N. S., & Matar, A. G. (2019). Backward walking alters vastus medialis oblique/vastus lateralis muscle activity ratio in females with patellofemoral pain syndrome. Turkish Journal of Physical Medicine and Rehabilitation, 65(2), 169–176. https://doi.org/10.5606/tftrd.2019.2445
• Biondi, N. L., & Varacallo, M. (2020). Anatomy, Bony Pelvis and Lower Limb, Vastus Lateralis Muscle. Treasure Island, FL: StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK532309/
• Ma, Y. T., Li, L. H., Han, Q., Wang, X. L., Jia, P. Y., Huang, Q. M., & Zheng, Y. J. (2020). Effects of trigger point dry needling on neuromuscular performance and pain of individuals affected by patellofemoral pain: A randomized controlled trial. Journal of Pain Research, 13, 1677–1686. https://doi.org/10.2147/JPR.S24037620