About Dry Needling

When I was in Physical Therapy school in Florida, I was regularly playing soccer on the weekends. I've been hurt a lot in soccer games in my life, but one game I got the weirdest pain on the top of my foot by my big toe. After a few days of no change, I ask my classmates to assess me and try and figure out what was wrong. We were in our 3rd term out of 7 so we knew a little, but definitely newbies. So we were checking for a fracture, testing the muscle flexibility, strength, and joint mobility...all clear. It was survivable pain so I continued in my day to day just dealing with it. It wasn't getting worse but during soccer games it was definitely the worst. Finally, I mentioned it to a professor who saw me as a patient outside of class. He assessed and poked on the outside of my lower leg and OUCH! I felt the pain on the top of my big toe...this was my first experience with referred pain due to muscle and not nerve (we did learn more about this in later terms of school). Long story short, I had a trigger point in my muscle that was referring pain to the top of my foot. Here's a picture basically showing a referral pattern in my situation (my issue was the right picture).

So what did we do to fix it.... you guessed it, Dry Needling! The PT/my professor took a needle similar to that of an acupuncture needle (more on this below), found the spot in my leg that caused the symptom in my foot, and placed the needle there. He pistoned the needle up and down a few times which felt a little weird. When he finished, he poked the spot again and nothing. No pain. He gave me an exercise to do to work those muscles specifically, I did them. I played the next soccer game probably 2 or 3 days later (this was sometime during the week and my games were on Saturdays) and I had no pain during the game. I had no pain after the game. I was so surprised. The next week, still no pain. I had to know the magical treatment that with one needle and one exercise, I was better. I also wanted to know more about how it happened so I didn't have to go through it again. We will never know 100% for sure, but I suppose it was from overcompensations for all my sprained ankles and my lack of a stabilization ligament in my ankle.

So, after PT school, I was so excited to go get my Dry Needling certification. To my sadness, I had moved to Washington state which is one of the few states that does not allow physical therapists to dry needle. So I had to wait. 5 Years later, I am back in Kentucky and finally get to take dry needling courses. So let me explain a little bit about what dry needling really is, what the needle is like, and how it works.

The Definition: Dry needling is a skilled technique performed by a physical therapist using filiform needles to penetrate the skin and/or underlying tissues to affect change in the body structures and functions for the evaluation and management of neuromusculoskeletal conditions, pain, movement impairments and disability

Benefits of Dry Needling: So I had dry needling for the treatment of a trigger point, a hyperirritable, taut band in a muscle that is painful with provoked with a force upon the muscle and usually refers pain to another area. When they inserted the needle, it allowed for increased blood flow into the trigger point which is an area of low blood flow and oxygen which perpetuates the symptoms. The exercise provided helps improve the work of this muscle, maintain blood flow, and improve motor control which all improves healing.

Dry needling is also very helpful as a neuromuscular reset. When your body has a pain, especially for an extended period of time, the neural pathways that go from the brain and spinal cord to the affected muscles can become altered in the way your body/brain interpret the pain. It is found that dry needling disrupts this altered path and resets it by providing a nerve pathway with space, bloodflow, and movement (3 things pain science guru Adrian Louw preaches is required for nerve health). Electrical stimulation is a very useful tool in this reset with dry needling as well.

Research has shown these various changes (improved oxygen, improved vascularity) that occur with dry needling along with improved electrical activity within a muscle, decreased chemicals that provoke pain, and overall improved tissue function.

Both pain and mobility can be improved with dry needling. A few of the things that can improve with dry needling are shoulder and neck pain, low back pain, hip pain, patellofemoral pain syndrome, calf tightness/pain

At Dash Physical Therapy, in Lexington, KY, dry needling is offered as a part of your overall PT session if it is deemed appropriate. If you are curious about if dry needling is right for you reach out to kelsi@dashphysio.com or fill out the contact form to set up your appointment.