Intervention

Following the pre-TDN measurement of gluteus medius strength and muscle activation levels, latent trigger points were identified in the gluteus medius musculature on both the control and intervention sides using the methods proposed by Simons et al.²⁰ Each participant was positioned in side lying with the hip on the side that was assessed in a slightly adducted position so normal muscle fibers were still on slack while the taut bands of muscle were placed under tension, which made them more easily palpable.^11,12,14,15

Participants needed at least two latent trigger points in the gluteus medius muscle on the intervention side in order to receive TDN.¹⁴ Trigger point dry needling was applied to each of the identified latent trigger points in an attempt to elicit a localized twitch response (LTR). Once a LTR was elicited, the needle was manipulated either further into the muscle tissue or at a different angle until no more LTRs were elicited, or if the participant verbally requested the intervention to stop. Once the needle was removed, manual pressure was held at the site of needle insertion for a total of 30 seconds to achieve hemostasis.^25,29 The same process was repeated for all identified latent trigger points within the gluteus medius muscle. The application of TDN was stopped when no more LTR were elicited and there were no more palpable latent trigger points.

Following the application of TDN, each participant was asked to stand up and walk for two minutes in an attempt to assess each participants’ level of soreness with functional movement. Time was managed by the PI for standardization purposes. Following the two minutes, participants were asked to rate their level of soreness on a 0 to 10 scale with a response of 0 representing, “No soreness at all” and a response of 10 representing, “The worst soreness imaginable”.