Autumn Paul, PT, DPT

You may have heard about dry needling from one of your friends or family members and now you are thinking, “What is dry needling? Could I benefit from it?”

Dry needling is where the practitioner uses a solid filiform needle or hollow-core hypodermic needle (similar to an acupuncture needle) and places it through the skin and enters the muscle. The practitioner’s goal is to place the needle specifically into a myofascial trigger point (hyperactive muscle fibers).

These trigger points can be located in a tense band of muscle. For example, many people have tightness/soreness located in their shoulders/neck from the tension that they carry throughout the day.

These hyperactive muscle fibers (tense bands of muscle) can send signals to other parts of your body which are considered “referred pain”.

The goal of dry needling is to pierce these trigger points in order to allow these muscle fibers to relax, which can help reduce your pain levels.

“So what conditions may dry needling help with?”

● Headaches

● Shoulder/neck pain/tightness

● Lower back pain

● Tennis and golfer’s elbow

● Shin splints

● TMJ/jaw pain

● Plantar fasciitis

● Hip Pain

“Can any physical therapist perform dry needling?”

In order to be able to perform dry needling, the physical therapist is required to go through extensive training. This training includes studying human anatomy and hands-on practice. These training sessions are often a weekend course or even several weekend courses.

“Awesome, I want to see a physical therapist who can assess and see if I could potentially benefit from dry needling. How do I make an appointment?”

First, look online to see what location is closest to you. Then, you can request to schedule an appointment with a physical therapist who is certified to perform dry needling.

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References:

Firth C, Meon J, Price M, Taylor J, Grace S. Dry Needling: A literature Review. Journal of the Australian Traditional-Medicine Society . 2020;26(1):22-28. Accessed January 14, 2021.

http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=143040461&site=eds-live

http://www.kinfolkwellness.com.au/dry-needling-adelaide

Phil Sorensen, PT, CSCS

From Thanksgiving through Christmas & New Years I have had more friends and family members ask me about their painful shoulders than any other body area. Not one had a specific injury. Pain developed with use/reaching, exercise, work and in most cases was interfering with their ability to sleep. The good news for them was their condition is very treatable and responds well with physical therapy. The longer you ignore symptoms and the repetitive pain with daily use, reaching, etc. the more challenging it can become to relieve. Structure of the Shoulder: In most parts of the body, the bones are surrounded by muscles. In the shoulder region, however, the muscle and tendons are surrounded by bone. If you tap the top of your shoulder, you can feel bone immediately under the skin, this is called the acromion of the scapula. Directly under this bone is the rotator cuff, a group of four muscles and tendons. In the image below, the supraspinatus is one of the tendons that are most commonly involved. It along with the bursa (a fluid-filled sack) is positioned right between the humerus (upper arm bone) and the acromion that you tapped. This structure of muscle-tendon between bones is a contributing factor to the development of impingement syndrome (shoulder bursitis, rotator cuff or biceps tendinopathy).

Muscles of the Shoulder: Proper rotator cuff (RC) and scapular muscle strength is critical in both preventing and treating shoulder pain/impingement. The RC role is to keep the ball of the humerus in the correct position with the scapula. The rotator cuff enables the other major muscles of the arm, the deltoid and Latissimus dorsi (“lats”), to properly perform their job during reaching, lifting, pushing, or pulling. Balanced strength around the shoulder blade, in the lower & middle trapezius, rhomboids & serratus anterior (scapulothoracic) muscles, is crucial for shoulder blade movement and shoulder mechanics. Weakness and imbalance in these muscles and/or the RC is another primary factor with impingement syndrome, shoulder bursitis & rotator cuff tendinopathy. Corrective Measures: Learning proper technique to balance the previously mentioned muscles in various positions then progressing to movements can be complex and is where the skills of a PT are of great benefit to optimize your time and efforts. Below is a link to a video demonstrating a great shoulder stability exercise that engages these muscles using a small looped band while doing a small forward reach. CLICK HERE

In addition to developing proper rotator cuff & scapulo-thoracic muscle strength, it’s important to address adequate shoulder, rib cage & thoracic (upper back) mobility. Your physical therapist will assess, treat and instruct you in things you can do to improve your mobility. In most cases, shoulder impingement, bursitis, &/or rotator cuff tendon injuries can be completely rehabilitated and should leave no residual effects once a person has recovered. Shoulder pain can be debilitating by limiting your ability to exercise and perform daily tasks. Start the year out right, be proactive in the care of your shoulder. Call and set up an appointment to see a PT today. The longer a condition is left untreated, the more potential for harm and tissue damage which may lead to a longer recovery process.

The American Physical Therapy Association (APTA) is an excellent resource for learning more about physical therapy as well as locating a physical therapist in your area.