A Deep Dive into Dry Needling and Pelvic Health - Episode 29
The Marrón Pelvic Health Podcast with Dr. Kari Roberts offers a comprehensive look at dry needling, a therapeutic approach for managing muscle pain and dysfunction. Dr. Kari contrasts this technique with acupuncture, noting differences in application and patient outcomes. She shares insights from her educational journey, illustrating the rigorous certification process for practitioners in Georgia. The episode provides clarity on who might benefit from dry needling and underscores its non-reliance on medications, making it a unique option for many patients with conditions like sciatica, hip pain, and migraines.Book a call with Dr. Kari Roberts today.
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Dr. Kari: If you've heard of dry needling or wondered what it was, or wondered if dry needling is similar to acupuncture and or someone's recommended you for dry needling and you're just not sure of it, then stay tuned to this episode because I'm going to get into it as best as I can and let you know what I know about dry needling.
Welcome to the Marone Pelvic Health Podcast. Hi, I'm your host, Dr. Carrie Roberts.
On this show, we will be discussing a variety of things regarding your pelvic health. These conversations will be a mix of education,
personal experiences and a blend of tips you can apply to have a healthier pelvis. The goal of this show is to normalize conversations around pelvic health and help women stop suffering in silence.
And today I'm going to dive into what is dry needling and why it is helpful for patients and why it's a really good modality that we use here in physical therapy.
So if you've missed me, I have missed you too. I know I'm not super consistent with my podcast and I have to be real with myself. Just like I need my patients to be real with me and just like my patients need to be real with me also.
Did I say that twice? I need to be real with my patients, just like my patients need need to be real with me and then I need to be real with you.
I have not been consistent with my podcast. I'm a busy woman. I'm a woman, one woman show. I am out doing all of the things trying to grow my business and I've just been busy and I took a quarter to really focus on in person networking and in person networking takes a lot of time.
So instead of taking the time where I don't have patience and dive into creat content and expanding my reach with the podcast and emailing and things like that, I have taken the time to expand my reach with in person connections.
So that's what I've been doing with my time.
But I'm back. I'm going to try to be consistent, but you know how that is.
We'll do the best that we can.
Also, what I've been doing since I took my first class the last week of January. I think I've mentioned this on the podcast,
but I have been taking classes with dry needling.
I am dry needle credentialed and I've taken an additional course in dry needle dry needling the pelvic floor and I started seeing patients. Well, let Me just.
Let's go down, let's do a little story time. In the state of Georgia, you need 50 hours of training in excess of your doctorate of physical therapy degree to be able to be credentialed to treat patients with dry needle services.
You also need to be bloodborne certified, I guess, trained, so you know how to dispose of the equipment that we use with dry needling.
So what I did is, well,
most courses are about 27, 24 to 27 hours. So depending which institution you go with,
you need two three day courses or two three day courses in an online course or some however kind of way you need to get to 50 hours. Well, the course that I took was very intensive.
It's three days of education,
which ends up being 27 hours.
I did three days in January,
well, January into February, and then I did three more days of the last weekend of April. And that was able to put me over 50 hours. Extra was 54 hours,
and then I was able to be credentialed. So then I'm now I have extra credentialing on my license in Georgia. So legally I'm allowed to practice dry needling in the state of Georgia.
The reason why I say that is because different states have different requirements. If you're listening, in a different state, some states, I believe have 20 hours, some have 25. Some states have 70 hours.
Some states say we don't care how many hours. You can't do it here.
Some states leave it gray and it's just proceed at your own risk. But here In Georgia, it's 50 hours.
So you do not have to be certified,
but you have to be credentialed. So in order to be credentialed, you need 50 hours of training. And I was able to get my 50 hours of training by May the first.
So I submitted my paperwork to the state of Georgia, I got those credentialing added onto my license so now I can practice.
So I've been treating patients since May 1.
I needle almost every day I go to work.
I love it.
It is helping my patients so much.
So that's just a little bit of my education of what it takes to be a dry needle certified therapist here in Georgia.
Now, what exactly is dry needling?
Dry needling is when you take a very, very, very fine,
fine needle and you pierce it obviously through the skin into a trigger point.
Put simply,
if you're familiar with acupuncture, a lot of physical therapists do use acupuncture needles.
I did meet an acupuncturist when I was in my second class. And that was really interesting because I get a lot of people that ask, what's the difference between dry needling and acupunct?
And initially, my first answer used to be like, I've never been trained in acupuncture, so I really can't speak to what acupuncture is. But what I can do is tell you what dry needling is.
But now I can tell you just a little bit of what I learned from the acupuncturist over lunch that I met with her Acupuncture. They do.
It's a lot more gentler than dry needling. And it's really used, from what I gathered from her, to calm the nervous system down. It also can be used to relax muscles, and it can be used to relax your nervous system, reduce pain,
headaches, things like that.
Needles can be placed just under the skin. They can be placed deeper into the muscle. They can be left for a series of minutes, they can be left for a series of hours.
She even told me about techniques where they will actually cover the needle and they will leave the needle in for a series of days.
So who knew? But that's just a glimmer of what acupuncture is. It's a little bit more gentler than the type of needling that I was trained to do.
Now,
what was the type of needling that I was trained to do, I was trained to do? I call it a little more aggressive because I've seen other physical therapists do dry needling.
And what they do is they'll feel the muscle.
They'll feel for a trigger point. And a trigger point is a part of a muscle where it's not just tight or spasmed like a muscle spasm, which it could be, but it's when it feels.
We can feel a fibrous band or a taut band in the muscle,
and it's painful. So you should be able to press on a muscle and you feel the pressure, but it should not generate pain and it should not feel like a band in there.
So if it A is painful,
B is a tight band,
or C refers pain, meaning I press here, but I feel the patient.
You press here. And I'm going to say it for the folks that aren't looking. You press at someone's,
let's say near their elbow, and then you feel the pain farther up near their shoulders. So that's obviously referred pain.
So just to review, if it is A tender when it shouldn't be,
B has that taut band or C is referring pain. If it has two out of the three, then it qualifies as having a trigger point.
So then what you would do or what the therapist would do is what the proper needle, and with the proper pressure, the therapist would tap the needle into that trigger point and would gently massage that trigger point to release the tension in the trigger point, which will help release the trigger point.
I say massage the trigger point because a lot of my patients are familiar with trigger point releases with massage therapists. So it's easy to kind of understand the two. A massage therapist is usually massaging on the skin, right?
Trying to affect change at the muscle.
With dry needling, you're going through the skin, going directly to the muscle, and you're massaging that area to release the tension in the muscle.
Now, when you're massaging that muscle with the trigger point,
what exactly is going on? What exactly is a trigger point?
Well, a trigger point, as far as I'm understanding, is when a part of the muscle is bound very tight together and it just doesn't function the way that it's supposed to, and blood does not.
It's so tight that on a molecular level, the blood does not pass through that tight bond or that tight section properly.
And so what happens is waste product gets built up in that area.
And as that waste product gets built up, the sensory or the pain receptors in that muscle belly, where it's built up, where it's really tight,
those pain receptors get heightened.
And so they're more sensitive,
which is why they generate more pain easier.
And.
And since the blood flow is constricted, the muscle is not functioning properly.
Something else that happens is that part of the muscle that is bound really tight,
those muscle fibers are really, really tight together.
And then the other ends of the muscle fibers are stretched out.
So what you have over the cr. Over the. Straight over the Spanish of the muscle belly, the muscle is just not functioning properly because the blood flow is impacted. This, the sensory.
What's the word I'm thinking of,
the pain receptors are increased, so they're sending more pain receptors.
And since the fibers are not, they're overstretched in certain areas and super tight in other areas, the muscle is just not functioning the way that it needs to.
So what happens is when we find the trigger point,
we will put the trigger point into that.
We will put the needle into that trigger point, and we will massage that trigger point. And as we are massaging that trigger point,
blood is finally, that blood that has been impeded. That's been kind of pooling on either side, that blood is able to pass through the trigger point. As the blood passes through the trigger point,
those byproducts that have been built up in that trigger point, they get to be flushed out. Because now blood is coming through, flushing out those waste products, bringing in good oxygen into the area.
And as those that good oxygen is coming through and that waste product is going out, that hypersensitivity of the pain receptors slowly gets to be built, gets to be lessened so that it's not going to be so hypersensitive.
And since now the muscle is able to relax now, we can start to do some physical therapy to work on that muscle regaining its proper motion and regaining its proper function so they can function properly.
Since now it doesn't have some parts that are super tight and some parts that are super stretched.
That was a mouthful. I hope that made sense. If it didn't, I think I spoke for about four minutes. Go ahead and go back and listen to it again. Listen to it a couple of times if you need to.
So that, in a nutshell, is what dry needling does on a molecular level. What it's going, what is going on in the muscle now? What types of things could it be used for?
It could be used for a variety of things. It could be used if you've got a muscular injury, if you've got a tendon injury, if you've got chronic pain,
any place where the muscle is just not functioning where it needs to and the muscle has become,
has kind of gone into that protective mode and it's gotten really tight and you've got those trigger points,
then dry needling is going to be perfect.
Also, it's really good to remember that muscles can refer pain just like nerves refer pain.
So that's something else that your physical therapist will want to keep in mind. Because a lot of times when you have an injury, the main thing we want to do is make sure the disc is okay, make sure the joint is okay, the ligaments are okay, the nerves are okay.
But sometimes,
as a whole, the medical community will overlook the fact that the muscles themselves can be generating and referring pain.
So if the muscles themselves are generating and referring pain,
whenever a muscle is referring pain, that's a sign of a trigger point. We can do trigger point release work with the dry needle now that the trigger point has been released.
Now we can follow that up with some really safe physical therapy to help facilitate that muscle to work properly.
So people that have tension headaches,
migraines, chronic back Pain, hip pain, sciatica,
knee pain, shoulder pain. I'm trying to think of the things that I've needled here recently.
Pregnant patients, when they have a lot of that. SPD pain, lower back pain, butt pain, all of that stuff can be helpful.
The great thing about dry needling is the main thing that you need is a clinician that knows what they're doing and a clinician that has the needles and a clinician that has the biohazard dispose container to put the needles once, once they're done.
Because that's it. No medication is involved. Oh, and you need a bed to lay down on. Other than that, no medication is involved.
And you're pretty, you're pretty smooth sailing.
Now who would not be a good candidate for dry needles if you are needle averse? If needles just aren't your vibe or every time you see a needle you pass out or you get lightheaded.
Of course we're not gonna put you through that kind of treatment. If you're super uncomfortable,
if you're very une about it, okay, we're going to pass on that. If you're on blood thinners, that's something that we are definitely going to want to check your bleeding tendency and see.
That may or may not be a good idea for you.
If you've got other precautions from your physician. We don't want to do dry needling on you.
Those are the main precautions. Otherwise people are pretty much good to go. There are certain precautions that we want to be careful with that are more body specific.
Of course, if we're in the, in the lung field, we want to make sure we're not getting close to the lung. We don't want to give you a pneumothorax.
If we are close by the spine, we don't want to hit those nerves coming off your spinal cord and anywhere near big blood vessels like your jugular,
your carotid artery in your neck, the femoral artery vein in your upper thigh,
your sciatic nerve in your upper butt, in your upper thigh area.
Those areas we wanna definitely stay away from cause we don't wanna cause any discomfort.
The needles are very, very fine. So we're never gonna create a hemorrhaging type situation. But we know it's gonna be uncomfortable for you. So we just don't want to make you be uncomfortable.
I think that might be it.
Benefits. I think that dry needling is great. I've had patients that in just a short period of time,
chronic pain, chronic headaches, ringing of the ears, stiffness in the neck has all helped to resolve with me adding dry needling to their course.
Sciatic nerve pain,
it band pain that they thought it was.
Adding that dry needling helped patients that are pregnant. SPD pain, that dull low back pain, inner thigh pain,
pain with transitional movements while pregnant has all been helpful. I had a patient this morning, I dry needled her with her last visit. She able to enjoy her baby shower and go on a baby moon and go to the beach for a week and she forgot about the pain that she had come in with because we needled her.
But that was the change.
We needled her and she was able to go a week with not even think about her pain, which was pretty great.
Also, I've had patients that have had chronic back pain for years,
in and out of therapy for years. Can't get a hold of it, can't get in front of it. We introduced dry needling. We're needling things that you don't think where the pain is going to come from, but that ends up being where the pain is coming from.
And now they're able to get up and do exercises that they thought they couldn't do and really reduce that chronic pain and get over that. So I think dry needling is amazing in the short term.
I've had to practice on friends and when in between taking the class and getting my second class, I was able to practice on friends and family legally.
And I've had patients or friends able to overcome some shoulder tightness, really acute stuff. Maybe they overdid it over the weekend and they've got shoulder issues.
Overdid it over the weekend, playing or you know, moving around, doing household activities. You've got a little elbow pain,
trying to think what else we did back pain.
So it just helps with so many things.
I think that it's awesome. I think it's really great for the pelvic floor.
I have used it for actually the pelvic floor muscles and the muscles around the pelvic floor area.
I've also been able to use it a lot with the abdominal region on the side and the front and the lower back. Also helps with abdominal stuff, helping people with ab separation and dra.
It's just so beneficial. It's kind of like that wildcard because since it does help promote optimal muscle performance, which is the main thing of what physical therapy does,
I can do dry needling for a variety of things. I can do dry needling to stimulate muscle activity or I can do dry needling to do trigger point reduction or I can do dry needling to reduce pain.
So there's just a wide of a wide variety of things reasons I can do dry needling in a wide variety of parts of the body. So I think dry needling is amazing.
If dry needling is legal in your state and you've got a new injury and you just maybe feel like you just need a little tweak and you want to see a physical therapist that's trained, I think it's worth it.
If you've got chronic pain and you think you've tried everything but you haven't tried dry needling,
I encourage you to do so.
If you're in the area and you want to check me out,
then hey, check me out. I might add dry needling to your plan of care.
Anyways, thanks for sticking along with me. This was a little bit of a longer episode, but as you can see, it's very interesting and I just wanted to share with you what I've been learning.
Come back in a couple of weeks and I'll be talking with you all about how I treat patients and with regards to their symptoms and how I deal with that as it changes.
So I'll see you in a couple of weeks.
Thanks. Bye.
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