Tag Archives: ankle rehab

Elite PT Newsletter April 2018 – Running Injuries Part I – Foot/Ankle

Running Injuries – a Spring time tradition

Like the rest of you I’m done with the cold and snow and ready for some nicer weather. It’s that time of year to start thinking about summer which usually means being more active.

For you runners out there it will mean getting outside more and probably increasing your mileage.

For you athletes, it’s time to start thinking about what you’re going to do this summer to make you a better athlete for next year.

Luckily, we’ve got something this month for both of you!

Common Running Injuries
1. Patello-Femoral Pain Syndrome (anterior knee pain)
2. Achilles Tendinitis
3. Plantar Fascitis
4. Hamstring Tendinitis
5. Shin Splints
6. IT Band Syndrome (pain at the hip or lateral knee)
7. Stress Fractures
8. Patellar Tendinitis
9. Lower Back Pain

These are the most common running injuries I found searching running sites and this order is fairly consistent from site to site. We see our fair share of each of them here at Elite PT.

These are also known generically as ‘over use injuries’ – meaning that they are caused over time by repetitive stresses that gradually break down the various tissues involved (tendon, muscle, fascia, bone, etc).

These are also the most common injuries we see in high school sports that involves a lot of running, i.e football, soccer, basketball, track and cross country. So if you’re an athlete of any kind, at some point you are either going to be dealing with one or more of the above OR you should be working to prevent them.

Prevention starts from the ground up

How your foot and ankle function are huge for preventing the obvious conditions in that area but also those further up the chain in the knee, hip, and lower back.

The joints of your foot and ankle must move appropriately and the muscles must do their job to stabilize those joints as your foot hits the ground and then progresses to push off. This is a two pronged approach since the joints require adequate mobility and the muscles must stabilize at just the right times.

This month we’ll cover a few ankle/foot exercises you can use to prevent injury or to rehab from it. Sorry if I get a little deep in the ‘why’ sometimes but I do think its important to know ‘why’ you should perform these exercises.

Ankle Mobility

Here’s a great example of what good ankle mobility looks like. The knee should be able to travel 4″ past the big toe without the heel coming up or the arch collapsing.

Athletes need this much ankle mobility to squat deep, sprint, jump, cut, and so on. If you don’t then your body is going to find a way to compensate around that so you can still squat, sprint, jump, etc. Our compensations are usually what get us into trouble. In this case the common compensations are:

  •  arch of the foot collapses (excessive pronation)
  • foot turns out
  • heel comes up too soon
  • knee collapses inward

There are others but these are the easiest to see. Watch anyone with stiff ankles try to squat deep – its not uncommon to see all of the above.

These compensations put the tissues of our foot, knee and even higher up the chain into more stressful positions. With repetition, i.e. lots of mileage, this will eventually catch up with most athletes causing pain.

What to do about it?

There are two main reasons why your ankle joint may not move enough:

tightness through the muscles of the calf (will feel like stretching in the back of the lower leg)
limitations involving the ankle joint (will feel a pinching sensation in the front of side of the ankle when bending it all the way)

Tight muscles are something you can deal with fairly effectively yourself. Using foam rollers or massage sticks to loosen up the calf muscles followed by stretching are the easiest things to do. Working on ankle mobility in a kneeling posture as in the picture below is one of my favorites.

Kneeling Ankle Mobility

The goal is to get your knee as far past your big toe as possible without your heel coming up. Placing the stick at your 5th toe and taking your knee around the outside of the stick forces you to work the muscles of the foot and keep the arch high. I prefer shoes off so you can actually see what your foot is doing. It could also be done standing if kneeling causes knee pain.

If you experience that pinching sensation in the front or side of your ankle – that is going to be a tougher fix. That’s usually not something you can stretch out on your own. It’s actually a good reason to give us a call because you will need some manual therapy to deal with that stuck joint.

In conclusion

What is happening at your foot and ankle affects every other joint in your body so this is a great place to start. See how far your knee can go past your big toe – if it’s not 4″ (heel down and good arch) then it’s time to get to work.

If you want some other ideas, catch the video below featuring our former student Scott McKeel (who just ran the Boston Marathon this week) demonstrating some great ankle mobility drills.

And even if you don’t consider yourself a runner or an athlete, you still need a mobile ankle and stable foot to walk normal, go up and down stairs, and balance. These are for you too!

If you’re struggling to make gains or you do have that ankle pain I mentioned earlier, feel free to give us a call (231 421-5805). We can set up a free 30 minute assessment to determine if you just need more advanced exercises or you may need physical therapy to break through and get moving again.

I’ll leave this offer open through the end of April so get cracking!.

Have a great rest of April and be sure to look for the next article in our series on running injuries.

Joe Heiler PT

Elite PT January Newsletter – Therapist Spotlight: Kristy Ockert

Hi everyone

Hope you had a great Christmas and New Years.

2017 was a great year for us at Elite Physical Therapy and hopefully 2018 will be more of the same.  It’s a blessing for us to be able to work closely with clients like yourself.  We really love getting to know our clients and helping them to achieve their rehabilitation and training goals.  It’s awesome to be able to do something you love for a living, and hopefully it shows!

Free Screening Day

We’ll be hosting another free screening day coming up in February (date to be announced soon).  This is an annual service we’ve started providing to the following:

  • All past physical therapy clients
  • All present clients who have another problem currently not being treated
  • All loved ones, family, friends, neighbors and co-workers of our past and present patients

If you are having pain or problems with day to day activities such as walking, standing, sitting for long periods, going up or down steps, getting in and out of the car, sleeping or driving, then this is an excellent opportunity to see one of our world-class therapists, find out the cause of your problem, and get some treatment ideas.

I’ll be sending out an email soon with more information on how you can take advantage of this free offer.

Therapist Spotlight – Kristy Ockert MSPT

Kristy Ockert began working at Elite Physical Therapy 2 years ago and overall has been practicing since 2002 in the outpatient setting. She earned her Bachelor’s degree in Kinesiology with a specialization in Health Promotion from Michigan State University and her Master of Science in Physical Therapy degree from the University of Colorado Health Sciences Center. Kristy is a Certified Kinesio Taping Practioner (CKTP) and enjoys treating a wide variety of patient populations including post-operative, athletes, and patients with spinal dysfunctions.

She has enjoyed furthering her education with a Pilates specialization and various manual techniques including Graston Technique, Functional Dry Needling, Muscle Energy Technique (MET), Muscle Release Technique (MRT) and Myofascial Release (MFR). Kristy is passionate about providing one on one care to her patients and taking into account all pieces of their individual health puzzle for restoring optimal wellness and return to function.

Q & A:

What got you interested in physical therapy as a career?

It’s a long story!  When I was younger, I wanted to become a teacher, like my mom.  As I got into high school, I knew I wanted to be a doctor – either a pediatrician or sports medicine physician so I could focus on optimizing health for kids and athletes.

My first glimpse of PT was as a patient when I was injured during my high school senior year softball season.  I had a great PT and PTA work with me, but I didn’t think much of it until my senior year of college at MSU.  I decided that I did not want to go to medical school any longer and was looking for a new career path.

After some research and lots of deliberation, I changed my major from Human Biology to Kinesiology, which is the study of human movement.  I finally loved my classes – movement throughout the lifespan, biomechanics, adaptive movement, etc.  It all seemed to fall into place after that.  I got in touch with my former PTA and asked if I could interview her for a class assignment.  It turned into shadowing and weekly volunteering in a small outpatient clinic.  I was hooked!  If I were to become a physical therapist, I could work in the health care field with people of all ages and teach them about how to optimize their movement for improved quality of life.

Over the past couple years you’ve become certified in Graston Technique and dry needling.  Any other techniques you really like to use?

I also enjoy being a Certified Kinesiotaping Practitioner.  Whether it is to help with swelling, bruising, or scar tissue, working on retraining a muscle with proper activation or even unloading an injured area, Kinesiotape has so many uses.

What are your favorite things about being a PT?

I enjoy working with closely with people whether it’s younger athletes, weekend warriors, middle aged or even geriatric patients interested in remaining active.  If there are a few exercises, hands on techniques, and instruction in daily modifications that can make someone’s life more functional and optimize their movement, I’m happy!  I love seeing the changes that people go through from the start to finish of therapy.

Outside of working at Elite, what kinds of things do you and family enjoy?

I enjoy spending time with my husband of 16 years, Ken, and our three kids Carter (14), Peyton (11), and Emma (8).  We love watching movies, going to the beach, bowling and skiing as a family.  I also have a love-hate relationship with winter running, so I’m going to try snowshoeing with my running buddies this year for our longer distances to gear up for the 2018 racing season!

Kristy Ockert
 

 

 

 

 

 

Testimonial

Thank you, thank you, thank you!! After 5 years of physical therapy at numerous other locations, false diagnosis and lack of improvement, MRI’s that showed nothing, Kristy and Lydia correctly diagnosed the problem with my daughters knee and have fixed the problem! You have got her active again with little to no pain. You have brought a smile to her face and to her parents face as well! Thank you for getting her back to healthy! 5 stars isn’t enough! – M.R. Ludington

Sore Knees???
Pain site does not always equal pain source!

Just because your knee hurts doesn’t necessarily mean that the problem lies only with that knee.  You’ve got numerous joints above and below that must move correctly to take the pressure off the knees.

One of the prime examples (or prime offenders) is the ankle joint.  A stiff ankle will negatively affect your walking and running stride, ability to squat down, walk up/down stairs, balance, and more.

The client from the testimonial above was a great example of this.  Resolving her ankle mobility limitations went a long way toward making her knees feel better.

Check our the link below for a short article/video on how we assess and solve the problem of ankle mobility:  http://www.elitepttc.com/ankle-mobility-update/

This is exactly the kind of thing our free screening day is for!

Til next month

Joe Heiler PT

Elite PT November Newsletter – What PT Should Look Like

Hi guys

Hope you’re having a great week so far!  It’s time for another monthly newsletter so here is what’s going on this month at Elite PT:

  • What High Quality PT Should Look Like (my rant for the month)
  • Manual Therapy – What Can It Do For You?
  • Exercise of the Month – Bird Dog for Lower Back Pain

What High Quality PT Should Look Like

This is my rant for the month.  Twice in the past week we’ve had patients come to us that have failed PT elsewhere and were pretty much ready to give up and ‘just live with it until they were talked into giving us a try by previous clients of ours.

In both cases these folks actually saw their PT’s only briefly then were passed off to the tech, were left to do their exercises on their own most of the time (since the therapist was busy with other patients), and received little to no manual (hands-on) therapy.

Needless to say the results were not what these folks were hoping they would be!

I know I’m tooting our own horn here and I don’t normally like to do this but it really bothers me when the PT factories out there give us smaller practices a bad name.  High quality physical therapy practices should look like this:

  • One-on-one treatment sessions
  • Working closely with a PT, PTA, or Athletic Trainer.  No Tech’s!
  • A healthy dose of hands on manual therapy when needed
  • Exercise is closely supervised by your therapist
  • You know exactly what you need to do at home to make the treatment process a success

At Elite PT, we guarantee all of the above.  If you’re going to spend your hard earned money on physical therapy services then it should be somewhere where the focus is on YOU!

I feel better now.  Thanks for listening!

Manual Therapy – What can it do for you?

Manual therapy can be described simply as hands-on therapy.  Most patients are familiar with massage but there are many beneficial techniques to decrease pain and improve mobility.  There are a number of hands-on techniques we use in addition to using instruments like Graston Technique and Dry Needling.

Exercises and stretching are great but often aren’t good enough to stand alone.  Manual therapies can quickly decrease pain and get you moving again much faster when combined with exercise.

Case in point:  One of our clients,struggling elsewhere, came to us with a very stiff and painful ankle post-surgery.  He was very limited with his motion which was making it difficult to walk and do stairs.  He reported only one session of light massage in his previous 3 weeks of physical therapy and the rest of the time was spent working on stretching and balancing.

Check out the picture below to see how much ankle bend (dorsiflexion) he had walking in the door on day 1:

Ankle Dorsiflexion

The knee is stuck 2″ behind the big toe!

Now check out how much ankle bend he had after one treatment session with us:

Ankle Dorsiflexion 2

The knee is a 1/2″ past the big toe now

He came back for his second visit reporting that pain was reduced significantly and he was walking much better.

This is just one example of how quickly things can change with a little focused hands on therapy and exercise with a purpose.

If you want to learn more about how we use Graston Technique (one of our favorite manual therapies) to treat the foot and ankle then click the link here:  https://youtu.be/Ah2ZUpMuUjk

Exercise of the Month – Bird Dog

The bird dog is a very popular PT exercise plus you’ll find it in a lot of Yoga and Pilates classes as well. It can be used to address strength and stability from the neck down through the hips but there are some very specific things that need to be done to make it truly effective.

Check out the video below to see how we get the most mileage out of a seemingly simple exercise (and another reason why your therapist needs to be working with you one-on-one).  The corrections in this video are specifically for those who are dealing with lower back pain but can also be used to enhance stiffness and strength through the muscles of the core.

https://youtu.be/BC7iSY9PtP4

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Have a great Thanksgiving and enjoy the rest of the month.  Talk to you in December!

Joe Heiler PT

Hip Flexor/Ankle Dorsiflexion March

Elite PT June 2017 Newsletter – Dry Needling for Ankle and Foot Pain, Athlete Updates, and more…

Welcome to this month’s issue of the Elite Physical Therapy and Sports Performance newsletter.  Check out the short article and demo videos on dry needling, see what some of our graduating athletes will be up to in the Fall, as well as our ‘Exercise Tip of the Month’:

I can’t believe it’s already June and school’s just about out!

Here’s what’s new at Elite Physical Therapy this month:


Kristy Ockert MSPT just completed her first Functional Dry Needling course down at Grand Valley State University a few weeks ago.  She had a great time and learned some cool new techniques.  Since then she’s been practicing on Lydia and myself to fine tune her skills.  Follow the link below to see how its going!

We’ve seen numerous clients lately with calf pain, Achilles tendonitis, and plantarfasciits who’ve had great results with the combination of dry needling, Graston Technique, and exercise.  Here is what one of our clients with Achilles tendonitis had to say:

“I had issues walking at work and limited mobility in the ankle before therapy.  I can now walk all day at work and have no pain or swelling in the ankle area.” – K.W. from Grayling

In this case, PT was the last option prior to surgery.  Thankfully we were able to avoid surgery and get her back to work without pain.

There are certainly plenty more conditions that can benefit from dry needling in addition to the other physical therapy techniques that we employ.  Relieving pain and improving muscle function are big benefits of this technique.  To see more on dry needling, how it works, and a demonstration for treating neck pain and headaches, click the link HERE to check out the video on our home page.

If you have any questions about the technique or if you’re wondering if dry needling may work for you, feel free to give us a call at 231 421-5805.  Ask for Joe or Kristy.
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Athlete News

I want to acknowledge some of our past and present clients that will be moving on at the end of this school year to further pursue their athletic dreams.  These guys are a hard working bunch and will be missed!

Chris Kolarevic from St. Francis High School – will be playing football at the University of Northern Iowa.
Michael Hegewald from St. Francis High School – will be playing football at the University of Dayton.
Alec Trautman from Elk Rapids High School – will be playing football at the University of Dayton.
Will Russell from Traverse City East Middle School – will be attending the Steamboat Mountain School in Colorado skiing on their U16 Alpine Team.

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Exercise Tip of the Month

We’ve been talking about treatments for the lower leg and foot the past couple months so I thought I’d stick with this commonly injured area one more time.  Last month I showed a great way to improve the way the foot and ankle move – if you missed it just let me know and I can re-send that to you.  This month we’ll look at an easy way to begin strengthening.

Ankle Marching with mini-band

Place the band around your feet with the feet just wide enough that there is a small amount of tension on the band.  Bring the knees up toward your chest and flex the ankles back as far as possible.  Kick one leg out straight but keep the opposite leg motionless.

Hip Flexor/Ankle Dorsiflexion March

Hip Flexor/Ankle Dorsiflexion March – Start Position

 

Hip Flexor/Ankle Dorsiflexion March

Hip Flexor/Ankle Dorsiflexion March – Finish Position

The leg that remains motionless will actually be the leg that is working the hardest.  Do not let this leg follow the other!  Not only will you feel the muscles in the front of the lower leg working hard but you’ll also feel your hip and stomach muscles.  This exercise is typically done after stretching out the calf muscles and is done for 2 sets of 10 on each side.
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Have a great month and talk to you again in July!

Joe Heiler PT

 

 

Occlusion Cuff

Blood Flow Restriction Training

Blood Flow Restriction training, aka BFR, has actually been around for awhile now but its finally starting to make its way into professional and collegiate sports as well as physical therapy.  Johnny Owens has been the driving force behind BFR in the U.S. after successfully using this technology with veterans recovering from devastating combat injuries.  Since that time he’s been training numerous professional sports teams in the use of blood flow restriction training including the Detroit Lions and Detroit Red Wings.

What the heck is it?

BFR training utilizes a tourniquet-like device which is placed proximally on a limb to limit arterial inflow to the limb while blocking venous outflow.

I should add a word of warning sooner rather than later.  There are commercial devices out there used by trained professionals for this type of training.  Do not make your own tourniquet and try this at home!

Benefits

I’m going to go a bit scientific on you here but just for a moment:

  • Training loads used are only 20-35% of 1 rep max, and often times are just body weight.  The same effects with weight lifting alone must be at least 70 – 85%.  Translation:  same results with less load = happier joints.
  • Higher release of growth hormone, insulin-like growth factor, and other substances known to speed tissue repair and create a positive environment for muscle hypertrophy.
  • Increased recruitment of Type II (fast-twitch) muscle fibers even with sub maximal loads
  • Increased muscle protein synthesis through the inhibition of catabolic substances.
  • Cell swelling : shift in fluid balance into the muscle cell creating a protective response to adapt and grow

Check out the chart below from Dr. Mario Novo at the LiftersClinic.com

LiftersClinic.com

Pretty cool stuff isn’t it?  Even with all the science thrown in.

How do you use it?

We work it into our rehab and training sessions closer to the end of the workout.  The build up of lactic acid will reproduce the ‘muscle burn’ sensation pretty quick causing a good amount of muscle fatigue with only body weight activities.  Body weight squats are usually a great place to start.  They are performed for 30 reps:15 reps:15reps:15 reps with 30 seconds between each set.  These will be the toughest body weight squats you’ve ever done!

The number of exercises performed and time training with blood flow restriction is gradually increased.  So far we’ve seen a rapid increase in tolerance to exercise among our athletes allowing them to do more and more work with BFR.  The results have been excellent too with quicker gains in muscle hypertrophy and strength.  If you notice the last column in the chart above – time to adaptation.  Within 2 weeks we are beginning to see positive changes compared to the traditional higher intensity training.

It might sound like I’m down playing the effects of higher intensity training regimens but I’m not at all.  There are tremendous benefits to lifting heavy and creating a great base level of strength.  BFR just offers a great way to increase training volume and intensity while decreasing load.  Over time the heavy weights will wear down your body – ask any collegiate or NFL football player – but this allows for a certain amount of unloading to happen and still reap all the benefits.

I know you want to try it!

Blood flow restriction training is safe when used with the right person at the right time and monitored appropriately.  It is also a pretty intense workout so definitely not for the faint of heart.

We are currently using BFR with athletes and patients post-knee injury, hamstring injuries, shoulder injuries, ankle sprains, and more.  Athletes that come in strictly to train have been having great success with it as well.  If you’ve struggled to make progress as a patient or hit a plateau in your training this would definitely be worth asking about.  We have a number of unique techniques to promote tissue healing and strength/power gains, and this is just one reason we have been setting ourselves apart from the competition!

Occlusion Cuff Shoulder

If you’re really into the science behind blood flow restriction training and would like to learn more, you can check out the two podcasts with Eoin Cremen (creator of the OcclusionCuff) on SportsRehabExpert.com

Questions?  Joe@eliteptt.com or give me a call at 231 421-5805

Ankle Mobility Drills for Runners

This is the last in our series of dynamic warm-up drills for runners that we use here at Elite Physical Therapy and Sports Performance.  In this video Scott McKeel demonstrates some of our favorite ankle mobility drills to get those ankles moving which will help with a number of common injuries like plantarfascitis, Achilles tendinopathy, IT band syndrome, knee pain, and low back pain.

 

We do small group, and even individual, training sessions for runners which includes the Functional Movement Screen plus other critical tests to find the weak links in mobility and flexibility, strength, and running technique.  If you’re interested contact us:  joe@elitepttc.com

Dynamic Warm-Up for Runners Part III

In this episode Scott McKeel continues with the dynamic warm-up series including drills for lower body warm up and running technique.  These drills are great for those who have been battling common running injuries like plantarfascitis, hip bursitis, IT band syndrome or low back pain.

 

We do small group, and even individual, training sessions for runners which includes the Functional Movement Screen plus other critical tests to find the weak links in mobility and flexibility, strength, and running technique.  If you’re interested contact us:  joe@elitepttc.com

Elite PT Exercise of the Week – Landmine Front Squat to Press

Joe Heiler PT and Nick Lucius SPT

At Elite Physical Therapy and Sports Performance we’re always looking for new ways to challenge our patients and athletes.  The landmine squat to press is one of those exercises that can be used to really stress the entire system without having to utilize a lot of loading so it fits in nicely in higher level rehab and during the training process.

Reasons to use this squat variation include:

1)  Having the weight in front allows the athlete to sit deeper into the squat with a more upright trunk which is great for those dealing with, or recovering from, low back pain.

2)  Keeping both hands on the bar keeps things more symmetrical with the squatting and pressing movement.  Stability requirements are increased with the use of this exercise but are balanced right to left.

3)  Hold the bar in one hand for an asymmetrical loading pattern.  This will load the body differently demanding greater stability throughout the movement.  This is a more advanced technique so 2 hands on the bar to begin.

Technique:

1)  Do not squat lower than your mobility allows!  The weight in front often allows for a deeper movement but do not let the pelvis tuck under and low back to round out.

2)  Heels must stay flat on the floor.

3)  Elbows between the knees (this keeps the knees wide).

4)  When using the asymmetrical single arm loading pattern, you must keep the body centrally aligned – no shifting, leaning, etc.

Give this one a shot and you’ll see what we mean!

BIO

Nick Lucius PicNick Lucius SPT is completing his final year in the physical therapy program at UM-Flint.  Nick is a certified strength and conditioning specialist (CSCS) through the National Strength and Conditioning Association (NSCA), and also works as a strength coach at Barwis Method in Plymouth, MI.  After graduation Nick plans on returning to Barwis Method to work with patients affected by orthopedic and neurological conditions.

Nick played Linebacker at Grand Valley State University in his undergraduate days, and now enjoys anything active from running to weight training, and is always going through a good book.

 

 

 

 

 

Graston Technique Interview – Joe Heiler and Ashli Linkhorn

I recently did an interview on the GT forum along with Ashli Linkhorn (head chiropractor – NCCA Women’s College World Series) in which we discussed the benefits of Graston Technique and how it can be used as part of the rehabilitation process with baseball/softball players.  Some nice info in the interview although I really can’t stand listening to myself on these things.  They will be doing one podcast per month so if you’re interested in GT, or are a practitioner, hopefully there will be some valuable info.

Graston Technique in the Treatment of Injuries to Baseball Players

http://www.conferencingexchange.com/GT

If you have any specific questions about Graston Technique you can email me:  joe@elitepttc.com or head on over to the GT website.

Now at Elite Physical Therapy – Functional Dry Needling

Functional Dry Needling is a very effective manual therapy technique that I’ve been wanting to learn for some time now, and was recently trained though Kinetacore.  I’m very excited to be using this new technique and I’m already seeing some great results.

In this week’s blog post, I want to give some very basic background on what Dry Needling is, and is not.  The article below doesn’t mention this but I want to make it quite clear that this is not acupuncture.  The only similarity is the use of the same type of needle.  Dry Needling performed by a physical therapist requires a thorough musculoskeletal evaluation, and placement of the needle into specific taut bands of muscle (a.k.a. trigger points) that are pain generators and creating dysfunction within the system.

My knowledge of acupuncture is somewhat limited but generally speaking the points that are treated in the body are mapped out along ‘meridians’.  Needles are placed into these preset points and left for a certain amount of time.

There is a lot more to it than just this, and I think it is important to understand that there are differences.  The description of Functional Dry Needling below comes from the Kinetacore website.  It’s a quick primer on the technique.  If you want to see it in action, check out the video at the bottom of the page featuring Terry Bradshaw.

“Dry Needling is a general term for a therapeutic treatment procedure that involves multiple advances of a filament needle into the muscle in the area of the body which produces pain and typically contains a ‘Trigger Point’.   There is no injectable solution and typically the needle which is used is very thin. 

Most patients will not even feel the needle penetrate the skin, but once it has and is advanced into the muscle, the feeling of discomfort can vary drastically from patient to patient.  Usually a healthy muscle feels very little discomfort with insertion of the needle; however, if the muscle is sensitive and shortened or has active trigger points within it, the subject may feel a sensation much like a muscle cramp — which is often referred to as a ‘twitch response’.

The twitch response also has a biochemical characteristic to it which likely affects the reaction of the muscle, symptoms, and response of the tissue. Along with the health of the tissue, the expertise of the practitioner can also attribute to the variation of outcome and/or discomfort.  The patient may only feel the cramping sensation locally or they may feel a referral of pain or similar symptoms for which they are seeking treatment. A reproduction of their pain can be a helpful diagnostic indicator of the cause of the patient’s symptoms. Patients soon learn to recognize and even welcome this sensation as it results in deactivating the trigger point, thereby reducing pain and restoring normal length and function of the involved muscle.

Typically positive results are apparent within 2-4 treatment sessions but can vary depending on the cause and duration of the symptoms, overall health of the patient, and experience level of the practitioner. Dry needling is an effective treatment for acute and chronic pain, rehabilitation from injury, and even pain and injury prevention, with very few side effects. This technique is unequaled in finding and eliminating neuromuscular dysfunction that leads to pain and functional deficits.”

If you have further questions about the technique, or feel that this technique may work for you then feel free to contact us:  joe@elitepttc.com or 231 421-5805231 421-5805.