Abstract
BACKGROUND AND OBJECTIVE: Posterior tibialis tendon dysfunction (PTTD) is a progressive ailment of a lower limb that, if left untreated, can lead to irreversible changes in the structure and function. The authors of the present study hypothesized the damages to the tibias tendon can be countered and reversed using electrical acupuncture and concurrent treatment of the associated muscle. INTERVENTION: The following study details a successful treatment of the early stage PTTD in a group of competitive athletes using a specific Electrical Intra Muscular Stimulation (EIMS) protocol developed and rooted in years of practice and the knowledge of the pathophysiology of the muscle and tendon tissues. Specifically, a combination the posterior and the original EIMS approach was used to stimulate the tendon and muscle concurrently at a frequency of 2 Hz. Analysis of the VAS scores showed a significant improvement following the treatment sessions. CONCLUSION: The success of this combined muscle/tendon stimulation protocol is given a strong correlation between the mechanism of tendon and muscle injury and recovery. The fast rate of healing and the simplicity of the materials required for the treatment offer a great potential for a wide-spread application. The authors extrapolate that the treatment method, with applicable modifications in needling locations, can be used for an array of common ailments involving tendons and muscles of the lower limb and foot, including the over-pronation, which is now common place due to the overweight problem in the general population.
Highlights
Posterior tibialis tendon dysfunction (PTTD) is a common cause of foot pain and dysfunction in adults [1] [2]
The physiologic and pathologic changes occur within the tendon as a result of microtears, inflammation and rupture that occurred as a consequence of repetitive loading [3]
The design of this study was based on a typical Electrical Intra Muscular Stimulation (EIMS) treatment with the needling of affected muscle/tendon with gentle low frequency electrical stimulation such of 2 Hz and intensity determined by visible muscle twitching
Summary
Posterior tibialis tendon dysfunction (PTTD) is a common cause of foot pain and dysfunction in adults [1] [2]. In stage IIA, the foot is still flexible; the tendon is functionally impaired. EIMS has been used in Richmond Muscle & Tendon Clinic for the last 15 years with consistent improvement in different types of soft tissue injuries among a broad spectrum of patients. It was noted that competitive athletes with tibialis posterior responded differently to a standard treatment protocol when compared to a general pool of patients. The current study of athletes with tibialis posterior tendinitis was motivated by the observed lack of recovery progress in an elite athlete in July 2012 following the treatment that was found effective for a general public in the same period of time. The research questions were: 1) What are the optimal EIMS parameters for a successful treatment of PTT in competitive athletes? 2) Is the improvement in health outcomes sustained and consistent between the subjects?
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