Monthly Archives: January 2014

App of The Week

PF First

Pelvic Floor First

Stay safe while staying in shape with the Pelvic Floor First fitness app.  This app allows people of all fitness levels and pelvic floor function to undertake pelvic floor safe workouts. Many exercise programs are inappropriate for people with pelvic floor weakness, particularly women returning to exercise after having a baby, and can cause or worsen incontinence. The customised workouts in this app have been designed by a physiotherapist and fitness professional so you can enjoy the benefits of a full workout, knowing your pelvic floor muscles are being protected.

The app also teaches you how to exercise your pelvic floor muscles to maintain or improve bladder control.

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Another Positive Pregnancy Experience

If you live in, or around the Greenville area and are expecting a bundle of joy… Come by Proaxis Physical Therapy located at 200 Patewood Dr, Suite 250 C on January 28th from 6:30-8:00 for a free seminar on all you need to know about staying in shape, managing pain, and preventing post-partum problems.

pregnancy

We will cover topics designed to keep you healthy and fit during your pregnancy and post-partum including:

  • Exercise guidelines during pregnancy
  • Nutrition during pregnancy
  • Preventing and managing low back and pelvic girdle pain
  • Pregnancy support and belts
  • Importance of pelvic floor exercise in preventing urinary incontinence
  • Returning to exercise after child birth
  • What to do about post-partum complications such as low back pain, urinary incontinence, and pelvic pain

RSVP to Kim.Osler@proaxistherapy.com

Dry Needling to Restore Muscle Function… OR… Why I voluntarily submitted myself to 3 days of needle sticks.

functional dry needling FDN needles physical therapy chronic pain

Physical Therapist performing dry needling. Click on the photo for more information.

Let me start out by being completely honest. I have a needle phobia. A strong phobia. A “pass-out when I get a flu shot” type of phobia. I have mild panic attacks at the dentist when I get cavities filled, and specifically try to avoid any type of injection that isn’t completely necessary. BUT- with all of that being said, I spent the last 3 days being voluntarily poked an estimated 75-100 times (likely more). Why would I do that? Am I completely crazy? (possibly) Did I attend some weird desensitization treatment program for people with needle phobias? (in a weird way, yes).

I actually spent the weekend attending Kinetacore’s Level 1 Functional Dry Needling Class with Jenna. And I did it because I had to. Because I recognized that this treatment would be integral in helping my patients get better faster, and get more complete relief. And afterward, I was and am excited. I cannot wait to start using this intervention with my patients, and I hope that you will be just as excited by the end of this.

Brief Story: About 6 months ago, I was working with a wonderful woman who was experiencing pain during sexual intercourse. She had severe trigger points and restrictions in her adductor muscle group, and we had worked on these restrictions for at least 6 visits. They were still there. I finally recommended that she see a co-worker for dry needling to her adductor longus and magnus. The visit afterward, her trigger points were eliminated, and we were able to really improve her pelvic floor flexibility. 2 visits later, she experienced pain-free sexual intercourse.

Yes, it can be that powerful.

But, first, before we go to the why, let’s spend a few minutes discussing what exactly functional dry needling is.   In a sentence, functional dry needling utilizes a fine filament needle inserted into a dysfunctional tissue to treat the neuromuscular system and reduce taut muscle bands, improve motion, and either up-train or down-train a muscle’s activity.  These fine filament needles are thin, solid needles—very different from the hollow hypodermic needles used for giving injections. In fact, these needles are so thin, that they can literally fit inside a hypodermic needle.  These are the same types of needles utilized for acupuncture, however, that’s where the similarities end. Let’s look at some of the differences:

Functional Dry Needling vs. Acupuncture

Functional Dry Needling

Acupuncture

Utilizes solid monofilament needles Utilizes solid monofilament needles
Aims at dysfunctional musculoskeletal tissue based on a neuromuscular and musculoskeletal assessment Aims at specific points based on Chinese Traditional Medicine along specific “meridians”
Utilized to address musculoskeletal and neuromuscular dysfunction Utilized to address dysfunction in “energy-flow” or “chi”

So, as you can see, there are significant differences between acupuncture and dry needling. Now, let’s get into what the needle actually does:

1.      Increase blood flow

Kubo 2010 actually found that blood flow was increased following dry needling. This effect actually increased after the needle was removed and was increased compared to that of a hot pack!

2.      Decrease muscle banding

Those tight irritated trigger points you feel in your muscles? Needling can actually reduce the banding, restore your normal muscle length and improve the efficiency of your muscles.

3.      Decrease spontaneous electrical activity 

Chen 2000 found that spontaneous electrical activity in a dysfunctional muscle quieted after the twitch response that was elicited with dry needling. This leads to a more relaxed muscle that isn’t having to work so hard.

4.      Influence muscle biochemistry

Did you know that the chemicals in your muscles change when they are dysfunctional? They do! And dry needling can help to reverse that! Dry needling has been shown to decrease inflammatory chemicals and pain-modulating chemicals (Substance P, CGRP) and actually increases endorphin levels creating a natural opioid response. (Hseih 2012)

5.      Impact the Central Nervous System

Dry needling creates a sensory and proprioceptive stimulus that will drive the gate control of pain. In addition, neurological changes are seen at the muscle and spinal cord level to change how your body is responding to pain, and decrease the pain chemicals.  (Hseih 2007, Chou 2012)

So, as you can see, the impact can be huge! These responses together help to improve muscle range of motion, decrease pain, and restore a person to function. So what does that mean for pelvic pain? It means that now, I have a new tool in my toolbox to get my patients better faster and more efficiently.  Men and women with pelvic pain often have restrictions in the muscles all around the hips, the abdomen, and of course the pelvic floor. Utilizing dry needling within my treatment approach will help me to reduce dysfunctional tissue more quickly to get my patients back to their normal function as soon as possible! It will also help me in the process of retraining pain perception at the neurological level.  I am very excited to see how this treatment tool works with this population—so far, the results have been awesome!!

Let me know if you have any questions or thoughts! We love hearing from you!

Written by: Jessica Powley, PT, DPT, WCS

References taken from Functional Dry Needling Level 1 Course Manual

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