Dry Needling

Ascent Physical Therapy offers dry needling to manage pain. Read the faq below to find out if dry needling could be for you.

What is Dry Needling?

Dry needling is a procedure where solid filament (acupuncture) needles are inserted into the skin and muscle directly at a myofascial triggerpoint (also known as a knot).

The approach is based on Western anatomical and neurophysiological principles which are not to be confused with the Traditional Chinese Medicine (TCM) technique of acupuncture .

What can Dry Needling help?

Dry needling can be used for a variety of musculoskeletal problems. Conditions which respond to dry needling include, but are not limited to:

Headaches
Tennis elbow
Carpal tunnel syndrome
Golfer's elbow
Leg pain
Hamstring strains
Shin splints
Muscle Spasms
Fibromyalgia
Sciatic Pain
Hip Pain
Knee Pain
Repetitive Strain Injuries

How does Dry Needling work?

The pioneering studies by Dr Shah and colleagues at the National Institutes of Health suggest that inserting a needle into trigger points causes favorable biochemical changes which assist in reducing pain. It is essential to elicit a Local Twitch Response which is a spinal cord reflex and is the first step in breaking the pain cycle.

How does Dry Needling stop this cycle?

A spasmed muscle becomes a damaged muscle. Spasm reduces blood flow in the muscle. This means less oxygen and nutrients to the muscle. Muscle fibers die off and get replaced by scar tissue. This in turn holds the muscle tight, prevents muscle metabolites from leaving the muscle and causes continued spasm and pain.

Putting a needle into a spasmed muscle causes the muscle to relax.

What does Dry Needling feel like?

Generally, needle insertion is not felt, the local twitch response may provoke a very brief pain response. This has been described as cramping sensation. During treatment, patients commonly experience either a heaviness in the limbs or a pleasant feeling of relaxation.

The benefits of dry needling frequently include more than just relief from a particular condition.

Many people find that it can also lead to increased energy levels, better appetite and sleep as well as an enhanced sense of overall wellbeing.

Are the needles sterile ?

Yes, only sterile disposable needles are used.

Are there any side effects?

Most patients report soreness in the treated area and referral zone lasting from a few hours to two days.

How long does it take for the procedure to work?

Typically, it takes several visits for a positive reaction to take place. We are trying to cause mechanical and biochemical changes without any medication. Therefore, we are looking for a cumulative response to achieve a certain threshold after which the pain cycle is disturbed.

Once I am feeling better, how often do I need to come back to maintain my progress?

The musculoskeletal system is under constant pressure from gravity, stress, work etc. A regular exercise program combined with good posture can prevent many problems. If the pain returns, tune-up visits are recommended to treat and prevent injuries.

For further information or for an appointment please contact Ascent Physical Therapy (970) 949-9966

EXERCISE OF THE WEEK - Scapular Isometric

This is a great scapular exercise.

- Take an elastic band of sufficient strength and hold it in both hands palm up.
- Keep the elbows pinned to the side of the body.
- While keeping the shoulders depressed, contract the scapula and externally rotate both arms away.
- Hold the position for 5-10 seconds. Slowly return hands back to starting position.
- Repeat 10-15 times

EXERCISE OF THE WEEK - Shoulder Blade Squeeze

Any abnormality of the shoulder blade (scapula) position can result in secondary effects on the function of the shoulder joint. For instance, if the shoulder blade tilts anteriorly and laterally, the space available for the rotator cuff may be narrowed, resulting in tendon abrasion and injury, known as shoulder impingement syndrome.

Scapular stabilization refers to a set of exercises that strengthen the shoulder girdle muscles to restore normal shoulder blade motion and position. A great exercise to perform would be the Shoulder Blade Squeeze.

(PhysioAdvisor.com)
- Stand or sit with your back straight. Chin tucked in slightly and shoulder should be back
- Slowly move your shoulder blades back and down, so they squeeze together
- Hold for 5 seconds and repeat 10 times.

EXERCISE OF THE WEEK - Chest stretch

There are many reasons why people develop shoulder impingement syndrome, but a major factor is poor posture. When individuals have poor posture, the shoulders tend to roll forward, the chest (pectoral) muscles get tight, and the Shoulder blade (scapular) muscles posteriorly become lengthened and weak. This stretch, using the foam roller is marvelous for stretching out the chest muscles!

(Terre's Photo)

- Sit on one end of the roller and then lay back. Your head should be resting on the roller and your knees should be bent with your feet flat on the floor, shoulder width apart to provide balance.
- Drop arms out to the side. Let gravity stretch the muscles of the chest and shoulders. Hold for 1 minute.
- Bend both elbows to 90 degrees, forearms parallel to the ground. Hold this stretch for 1 minute.
- Move arms up, so they are becoming level with your ears, and hands are above the head (horizontally, not vertically). Hold this stretch for 1 minute.

Check out this video for more information and visual instruction:

TOPIC OF THE MONTH - Shoulder Impingement

Shoulder impingement syndrome is a common cause of shoulder pain. The symptoms can be pain with overhead activities, such as reaching, throwing, tennis serves, or putting clothes on. There may also be painful popping or clicking when you reach your arm overhead. Impingement can be caused by degenerative changes to muscles or bones in the shoulder and/or by shoulder instability and abnormal movement patterns of the joint.

The bony structure of the shoulder (glenohumeral joint) is inherently unstable and is the most commonly dislocated major joint in the body. Shoulder stability is due to a combination of ligaments, joint capsule, the glenoid labrum, and surrounding musculature of the rotator cuff and scapular (shoulder blade).

The cause of shoulder impingement varies from person to person. Repetitive overhead activities, either recreational (such as tennis, swimming, or baseball) or work related (such as construction, electrical work, or serving) are often contributing factors. Diagnosis of impingement syndrome can be made clinically based on symptoms, special tests of the shoulder for impingement, and, if necessary, diagnostic imaging to evaluate bony or structural changes in the shoulder.

Treatment for impingement syndrome has two primary phases. The first phase is to decrease pain and inflammation and the second phase is to change and restore the mechanics of the shoulder.

Initial treatment may include rest, anti-inflammatory medications, physical therapy modalities, and avoidance of aggravating activity. Low level laser therapy is also very effective to decrease the pain and inflammation.

Restoring the appropriate mechanics of the shoulder is achieved by an individualized program to strengthen the muscles of the shoulder and shoulder blade. Stretching short and tight muscles and joint mobilization may also be included in this phase of rehabilitation. Working to correct muscle imbalances of and surrounding the shoulder will allow the joint to again move in the ideal pattern and decrease the stresses on the irritated and impinged structures. By receiving the proper treatment most of the pain from shoulder impingement can be eliminated and can help reduce your risk for shoulder surgery in the future.