Ultrasonographic Validation for Needle Placement in the Tibialis Posterior Muscle.
Stephanie R Albin, Larisa R Hoffman, Cameron W MacDonald and 7 others
PMID 34909259WHAT IT FOUND
Experienced clinicians placed dry needles accurately in the tibialis posterior muscle in all 20 healthy participants without serious adverse events.
However, the needle came within 2.1 mm of the artery and 3.5 mm of the nerve in some cases. This confirms anatomical safety for experts, not efficacy for patients.
Key findings
01Ultrasound imaging confirmed the needle was in the tibialis posterior muscle in all 20 participants, with no serious adverse events.
02The needle was never inserted into the neurovascular bundle, but the shortest distance to the tibial nerve was as close as 3.5 mm and to the posterior tibial artery as close as 2.1 mm.
03The superficial border of the muscle was at a mean depth of 25.8 mm, supporting the use of 50-60 mm needles to reach the muscle belly.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only one experienced clinician performed the needling, so results may not apply to less experienced practitioners. The study used healthy participants, so anatomical landmarks and muscle depth may differ in patients with foot and ankle pathology. The study did not assess the effectiveness of dry needling for any condition, only the accuracy and safety of needle placement.
Declared interests
No conflicts of interest or funding sources were reported in the provided text.
The easy way to misread this
Do not interpret this as evidence that dry needling the tibialis posterior muscle treats foot or ankle pain. The study only confirmed that an experienced clinician could place the needle in the correct muscle in healthy people. It did not test patient outcomes, and the safety profile may not hold for less experienced clinicians.