Acute management of recurrent exercise-associated muscle spasms via dry needling in a Division I basketball athlete: a case report

Abstract

Exercise-associated muscle cramps (EAMC) remain a significant clinical challenge in elite athletics, often attributed to either electrolyte depletion or altered neuromuscular control. While traditional management focuses on stretching and rehydration, these methods may be insufficient for rapid return to play (RTP) in high-stakes settings with minimal downtime before the next competition. This case report explores the acute application of dry needling (DN) to resolve recurrent EAMC in a 23-year-old National Collegiate Athletic Association (NCAA) Division I basketball athlete. The athlete presented with a severe, involuntary spasm of the right adductor magnus (AM) following a single-leg landing. Initial sideline manual therapy and rehydration provided only transient relief; upon RTP, the athlete sustained a recurrence described as a tenfold increase in intensity, necessitating removal from competition. Within 5 hours of injury, trigger point dry needling (TrP-DN) was administered to the ischiocondylar portion of the AM to facilitate a neuromuscular reset. The intervention resulted in immediate resolution of symptoms and a rapid return to prior performance. The athlete successfully returned to competition the following day, participating in two subsequent games within 48 hours without recurrence or performance deficits. This case demonstrates that DN can serve as a safe and highly effective intervention for the acute management of EAMC, in conjunction with traditional interventions. These findings suggest that directly targeting the motor endplate via DN may more effectively downregulate the neuromuscular hyperexcitability compared to traditional manual stretching and rehydration alone.