Trigger Point Dry Needling (TPDN)
Dry Needling is a procedure where a filiform needle is inserted at specific points, muscles, ligaments, and tendons in the body. While needles are used for treatment, dry needling is not Acupuncture or Traditional Chinese Medicine. IDN and TPDN are based on biomechanics, neurology, and physiology. Depending on the case, it is performed with needles alone or in conjunction with electric muscle stimulation.
Dry Needling is not a standalone procedure. It is performed in conjunction with a treatment plan with defined goals and outcomes. Like any procedure, the better you are a candidate for treatment, the better your outcome.
What does Dry Needling Do?
Relaxes Tight Muscles
There are a number of reasons why muscle will become hypertonic. Poor posture, acute trauma, repetitive injury, poor mechanics with exercise or athletics, etc… Regardless the cause, tissue damage and inflammation will cause a muscle contraction to prevent further injury and avoid pain. If left untreated, scar tissue will develop and cause muscle shortening. This can cause a localized ache in the muscle, referral pain like a tension headache, and can even entrap nerves. This is commonly felt and described as a painful knot in the belly of a muscle.
Dry Needling can break-up fibrous adhesions if present and modulate muscle spindle receptors to relax and elongate muscles. The relaxation is typically felt immediately and a carry-over effect because the receptor modulation. In other words, lasting improvement.
Facilitate Inhibited Muscles
An inhibited muscle is not the same as a weak muscle. A weak muscle should still be able to “lock” under load. Muscle inhibition is a neurological phenomenon which prevents full or proper muscle contraction to stabilize a joint. It can occur after an injury causing a shortened but weak muscle. It occurs with joint injury or after surgery in the form of arthogenic inhibition; this is a phenomenon where the muscle which crosses over an injured joint is neurologically “turned-off” from joint trauma. And, chronic muscle tension can reflexively inhibit opposing muscles. Said another way… if your hip flexors (psoas) are always tight, your hip extensors (glutes) will be neurologically “turned-off.”
Improve Joint Mobility
Being able to touch your toes is not the same thing has having good mobility. There is a difference between being mobile and being flexible. Mobility is being able to take your joint(s) through a full range of motion under load, particularly without pain. The amount of mobility may depend on your individual anatomy or maybe some degenerative changes but in general, a stiff joint is not a healthy joint. And a stiff joint is a painful joint. Muscle imbalances and shorted tissues is one of the major causes of poor mobility.
Dry needling improves joint mobility by relaxing tight or shortened muscles. It helps centrate joints, creating proper alignment by reducing muscle imbalances. Muscle imbalances are caused by facilitated and inhibited muscle patterns created by your nervous system in an effort to find a way around an injury (a compensation pattern).
This gets a little involved and complicated… Integrative Dry Needling does this in 3 ways.
- Locally: Dry needling can decrease pain by modulating inflammation. Needle insertion will cause a localized immune response. Histamine and other chemicals signals are released which will increase blood flow to the area. Increased blood flow will 1) bring oxygen to the area, 2) remove metabolic waste products, and 3) prevent fibroblast activity which slows scar tissue development.
- Segmentally: Dry needling stimulates nerves from mechanical receptors and pain fibers. This sends a signal to the spinal cord and which stimulates an interneuron. This interneuron inhibits the pain fiber from traveling to brain where pain is perceived. This phenomenon is called “presynaptic inhibition.” Dry needling will also stimulate a muscle receptors and cause a twitch reflex. This reflex occurs at the spinal cord and resets the muscle receptor. This will change muscle tone and cause relaxation and reduce muscle spasm.
- Centrally: It does this by the “Enkephalinergic” and “Noradrenergic” pathways. These are the body’s built-in pain blocking pathways. When Dry Needling is performed, it activates a pain inhibition reflex from the brain down to the spinal cord at the segmental level being treated. This further inhibits the nerves which communicate pain back up to the brain.
Dry Needling works synergistically to speed recovery and reduce pain
- Muscle relaxation reduces pain from muscle spasms. This also breaks a pain cycle of increased muscle tone causing pain, and that pain causing more muscle spasm.
- It will turn on inhibited muscles which will reduce muscle imbalances and allow the body to better absorb force.
- Improved joint mobility will speed the rehab process, correcting poor movement patterns.
- Reduces pain by activating the body’s built-in pain blocking mechanisms which allow return to activity faster
- Increases circulation to injured tissues to assist in healing
Since were affecting the nervous system, we are helping the brain and body “grove” new and more efficient pathways. This makes changes longer lasting and increasing performance and durability.