on pins and needles..part 2 coming up

Kinetacore started scratching the itch, now I have a full blown addiction to needles, dry needles that is. For years, the deep hard myofascial work has been taking it’s toll, I was reluctant to beat my patients to death using firm foam rolls and hard massage balls, and I always felt there had to be a better way. Well there is. For the past 3 months, I have been recruiting friends and family to be guinea pigs in my attempt to get the requited 200 needling sessions prior to undertaking the final phase of certification in intramuscular trigger point dry needling. Or pins and needles as my peeps call it.

I have hit the sub occipital and Iliac crest boney tissues, the deep multifidus, the superficial fibers of the upper trapezius, and everything north and south of this that is within the level 1 program. My SNT or safe needling technique is down pat, and in no longer drop needles on my unsuspecting volunteers. I have been able to detect the fine differences between the squishy soft adipose (fat) in sub-dermal tissue, and the firmer, less yielding layers of fascia surrounding and between muscles. I can sense the pre-twitch change in muscle tissue as it readies for an involuntary contraction, and steadily increase the pressure of my non-needling hand on the involved limb or body part. I have only been kicked once. I have observed the myriad of sympathetic and parasympathetic responses from mild nausea, to respiratory changes, to sweating. One (male) patient was drooling. Another sweated so much from his hamstrings that I truly thought that he had peed on my table.

Muscles inhibited in lengthening, and inhibited in producing powerful movement have traditionally been massaged, acupressured, muscle energied and beaten to death, then strengthened using exercise programs that smelt of “truthiness”. Many times, in my early career, I felt that I had gotten more of a workout than my patients. Now, I use Functional Movement Screening as a cheat-sheet for dysfunctional movement, and the SFMA breakouts as pre-needling, pre-intervention motion tests. Re-testing after needling gives instant feedback about the neuro-physiological response, with instantly observed deeper squat, higher hurdle, longer SLR (straight leg raise), more comfortable HBN/ HBB (hand behind back, hand behind neck). More specific testing with grip dynamometry, combined ROM positions give more measurable results. My 21 year career happier hands, and my stimulated, inquiring brain, thank me. So do my “victims” (as they like to call themselves).

Now all we need is for NY state education department to review the scope of practice for physical therapists. The Federation of State Boards for Physical Therapy has issued a statement of support. The APTA is en route to doing so also. As a cheap, quick and reliable method of alleviating pain and improving movement, it seems a no brainer. Anyone serious about cost-saving in the health care system, and reforming practice to allow for better outcomes for patients would speed the passage of such a bill. Grumbling patients in pain will vote for it in a heartbeat. As soon as it does, all of my “volunteers” will be first in line at my office, next time, with cash in hand!

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About sineadpt

physical therapist, PhD candidate, bike fiend, swim nut, run loony, multisport athlete, bike fitter, coach, general life enthusiast
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