Abstract
BACKGROUND: Chronic injuries of the medial gastrocnemius muscle are clinically relevant conditions that often result in persistent pain, functional limitations, and delayed return to activity. Although conservative management is usually prescribed, outcomes are not always satisfactory, and minimally invasive approaches such as percutaneous electrolysis (PE) have been proposed as potential therapeutic alternatives. METHODS: This randomized clinical trial included 71 patients with medial gastrocnemius injuries of at least 3 weeks' duration. Participants were randomly allocated to high-intensity PE (n = 23), low-intensity PE (n = 23), or a sham control group (n = 25). Participants received three sessions, once per week for three consecutive weeks. Outcomes were pain during gait and contraction, fatigue, kinesiophobia, and ankle range of motion (ROM), assessed at baseline and after the intervention. RESULTS: High-intensity PE produced significant reductions in pain during gait and contraction compared with the sham group (p < 0.05). Low-intensity PE was associated with a significant reduction in fatigue compared with sham (p = 0.024). No significant between-group differences were observed in kinesiophobia or range of motion. Within-group analyses showed improvements in several outcomes among patients treated with PE (all, p < 0.05). CONCLUSIONS: Percutaneous electrolysis may effectively reduce pain during gait and contraction, as well as fatigue, compared with a sham intervention in patients with subacute to early chronic medial gastrocnemius injuries. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/study/NCT06713200, identifier: NCT06713200.