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Recovery Tip

Did you know that your core muscles, which are the deepest layer of your tummy muscles, should work at all times to brace and protect your back? These muscles switch off due to pain and it takes 50,000 repetitions before they work automatically again to protect your back!

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Thursday
Jan022014

Dry Needling

Dry Needling

Dry needling is a technique commonly utilised at Le Physique Physiotherapy. So why do we choose to use needling and what effects does it have on the body?

What is needling and acupuncture?

Needling and acupuncture has been used as a treatment for thousands of years, having its origins in ancient Chinese medicine. There are many different types and styles of needling, but in most cases it involves the insertion of fine needles into specific points around the body. Traditional acupuncture uses specific points organised into meridians, which correspond to various internal organs. Dry needling focuses on insertion into targeted points in muscles and other soft tissue.

Needling in its various forms has been used for many different human ailments ranging from muscle and joint pain to digestive disorders to depression and anxiety. Some even use it in late pregnancy to try and induce labour! As physiotherapists, the style of needling we employ is focussed on its physiological effects on muscles (length and strength) and also pain modulation via its local, spinal and central effects on the nervous system. By inducing a local muscle fibre response and activating certain neural pathways, we can cause changes in biomechanics and take pressure of painful structures.

Local Effects (what happens right around the spot that is needled):

Without going in to too much depth into the neuromuscular physiology, when a needle is inserted it basically causes:

-       Increased local blood flow

  • The lack of blood flow and oxygen to tight areas of muscle can be a source of pain. Blood flow is also important for delivering nutrients for healing and carting away the toxic waste products!

-       Stimulation of afferent nerve fibres (sensory nerves)

  • This can decrease pain via the pain gate theory (stimulation of one nerve signal can help block the transmission of other signals like pain). This is the same reason we rub our finger after we have shut it in the car door!

-       Decreased muscle tone (muscle relaxation)

  • This allows freedom of movement, blood flow and helps to take away that uncomfortable feeling of tightness in muscles.

-       Increased delivery of endorphins and endorphin receptors

  • Endorphins are the happy hormone! It also decreases your perception of pain.

-       If the needle is inserted into a muscle trigger point (a hyper-contracted segment of muscle, aka a muscle knot), then it sometimes elicits a twitch response in the muscle, which is followed immediately by a release in the tension of that band of muscle.

 

Central Effects (what happens away from the site of the needle):

- Needling can also have effects on the level of the spinal cord that corresponds to the area being needled.  These changes help to partially block incoming pain signals at that level of the spinal cord and can provide effective pain relief.

- There can also be effects in the brain, which activates descending pain inhibitory pathways to help modulate incoming pain signals. This effectively means that the brain can send down a signal to block some of our perception of the pain.

 

Benefits:

Using the above mechanisms, needling can assist in treating ailments by:

-       Waking up inactive muscles

  • This can help stimulate muscle recovery, activation and strength

-       Releasing tight muscles or trigger points (Loosen you off)

-       Reducing pain

-       Improving healing (via improved circulation)

-       Changing movement patterns and biomechanics

  • This can help reshape your posture and help you move in a healthier way. We often use it to improve postural scoliosis (also known as non-structural or functional scoliosis).

 

What will I feel during and after needling?

            As the needle is inserted you will feel a mild prick. Depending on the area being needled you may then feel a twitch or grab of the muscle followed by a deep dull ache around the needle site. This ache usually subsides very quickly within minutes, but on some occasions it can last from up to 24-48 hours. This ache is usually easily distinguishable from your usual symptoms, and is a natural part of the process in causing change in the muscles. Sometimes you may feel very little at all.

            In most cases you will also notice an immediate change in your symptoms whether it is increased range of movement, improved alignment or decreased pain. Others have noted to have a very restful, good night sleep!

Some examples of common conditions we treat with needling.

  • ·      Lower back pain 
  • ·      Knee pain & injury 
  • ·      Osteoarthritis (Knees, Hips, Backs, Shoulders)
  • ·      Shoulder pain and rotator cuff dysfunction
  • ·      Tendonitis (Achilles, Patella, Tennis elbow and others)
  • ·      Ligament strains
  • ·      Headaches
  • ·      Neck Pain and neck and shoulder tightness

 And the list could go on! Basically there are very few conditions that can’t be helped by needling.

Is it safe? 

There are risks to every procedure, but your physios are highly trained professionals. They will discuss the potential risks with you, and you can then make an informed decision about whether you would like to go ahead with the needling or not. There is no pressure to say yes! 

Please let your physio know immediately if you have a bleeding disorder (eg haemophilia) or blood borne infection (HIV, Hep B, etc), are taking anti-coagulants (eg Warfarin), are pregnant, have had a lymph node dissection, have a joint replacement, breast implants or a cardiac pacemaker. These will influence how your practitioner approaches your treatment, and factor into whether the potentials benefits are worth the potential risks in your individual case. 

Blood donors please also note that you can only donate plasma for the 4 months following a dry needling treatment for safety reasons. Please check the Australian Blood Donor website for their most up-to-date information. 

 

What now?:

If you have that painful niggle that’s not going away, come in for a physio session and try some needling. We will never use needling alone as a whole treatment session. We have found that it is most effective when used in conjunction with other therapy techniques.

So next time you’re in for a physio appointment, ask us if needling would be beneficial for you (if we don’t ask you first!).

Whether we decide to needle or not is based on each individual presentation and of course your personal preference.