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Dry Needling 101: Straight to the Point

Dry needling has been around for most of my physical therapy practice, yet I’m continuously explaining what it is and why it works. 


Dry needling, trigger point dry needling, functional dry needling: all the same thing.


Acupuncture, trigger point injections: not the same thing.  

 

What is dry needling?  

When used by a physical therapist, it is the act of penetrating muscle tissue with a small monofilament needle. There are a variety of different sizes and widths that will be used depending on the targeted tissue. For instance, a longer needle will be used for your glutes versus a much smaller needle will be used for the muscles on the sides of your neck. There is no hole in the needle, so no fluid will be pushed through. That is why it will feel different from a steroid injection, flu shot, etc. Acupuncture is similar to dry needling in the fact that it is the same needle. The biggest difference is the treatment approach and expected outcomes. For example, if you went to an acupuncturist with low back pain, the goal would be to orient the “chi” flow through your body. This is most likely going to involve sticking in areas outside the lower back. 

 

What does dry needling help with?  

In our setting, musculoskeletal dysfunction. When tissue becomes injured, the body creates a natural mechanism of protection. It will either force you into a different movement pattern to avoid the use of injured tissue, or it will decrease that tissue’s ability to “work” to fully relax or contract. This is good and dandy for a short while, but it doesn’t always fix itself. We’ve all been there: woke up with a crick in the neck that goes away in couple days. What happens when it doesn’t? Maybe your muscle(s) have formed a trigger point or “muscle knot”. This is where dry needling can help!  


Let’s talk about another scenario. What happens with chronically injured tissue? That back pain you’ve had for 10 years, or chronic shoulder pain with overhead movement. This will usually take more than one needling session to clear up. Typically, when you get to this point, there’s more going on than just at the muscular level. Here’s where you get changes in your brain map. By targeting some of these tissues, you get a very specific stimulus into the injured tissue that your brain can’t override. It helps to reconnect that mind-muscle connection.   


 What’s actually happening?  

By inserting a needle into the targeted muscle, that muscle will have what we refer to as a “twitch” response. That muscle is forced to respond by rapidity contracting and relaxing. This may happen on a small level, where only a couple motor units respond, or it may happen on a larger scale where you get the entire muscle to contract. (If you’ve been needled by me, this is typically the part where I’m apologizing profusely but not stopping).  

At KPR, we pair the needling with and electrical stimulation that again helps that muscle “twitch” to enable the functionality of the muscle. This can include the muscles ability to relax, activate, or gain positional awareness to strengthen that mind-muscle connection.  

 

As much as I would love to have a simple dry needling session cure all of your pain and dysfunction, it doesn’t work like that. Dry needling is a powerful tool to decrease musculoskeletal pain in order to tolerate the strengthening aspect of training. It is simply hitting the reset button on muscular pain. Best outcomes are going to arise from effectively performing corrective exercises and activities to treat the root cause of mechanical pain. Ultimately, you have to load muscle to build muscle.  



 

Dr. Lauren Sibley is a physical therapist at Kinetic Performance and Rehab and is an orthopedic certified specialist. When she is not treating patients you'll find her adventuring with her husband Jesse and her pups Thor and Stella, perfecting her golf game, fitnessing, or playing volleyball.


If you're dealing with an injury or pain, you can contact Kinetic Performance and Rehab directly below.




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