Dry needling is becoming quite the buzz word these days, and for a good reason!!! There is some amazing science to back it up, and it’s a clinical game-changer for both the provider and the patient!
Even better, it is based on work done by a WOMAN!!!
At Reborn Pelvic Health & Wellness, we utilize dry needling in our practice as part of a holistic approach to get you back to doing the things you want to be doing – without even thinking about your pelvic floor or any other areas of your body that may cause aches and/or pains.
Let’s dive into the good stuff…and NERD out!!!
Dr. Janet Travell, MD (1901-1997) was a pioneer in the study and understanding of muscle trigger points in acute and chronic pain syndromes. She was given the name “Muscle Queen.” It’s from her work that we have continued to develop skill sets like dry needling.
To perform dry needling, we use a thin filiform needle, the same needles as acupuncture, to penetrate the skin and stimulate the underlying myofascial trigger points, musculature and connective tissue to help manage neuromuscular pain. Our goal is to elicit a twitch response to restore homeostasis. Acupuncture has to do with meridian lines, chi energy, acupuncture points and is rooted in Chinese Medicine. Acupuncture and dry needling are completely different things 😉
HUH?!?!? What did you just say????
Let me break it down for you like I do for my patients. We will nerd out a little bit more 😉
You have trigger points in your body (aka “knots”). They are everywhere. You have active trigger points and latent trigger points. Active trigger points are spots in your body that are already painful by just existing. You would be able to point to them and say, “This right here, that is where my pain is.” You know where they are because your brain has registered a painful spot into your conscious awareness to alert you that something is going on. Latent trigger points are spots in your body that you don’t realize are there until you push on them.. They need mechanical pressure to put them over the pain threshold for your brain to bring awareness to your consciousness that it exists. Both active and latent trigger points can affect function.
We know with imaging that a muscle is contracted in a trigger point area. When the tissue is contracted there is decreased blood flow and therefore decreased oxygen (this is the key piece: decreased oxygen), which leads to changes in pH (more acidic). In response to these changes,there is a dumping of painful biochemicals/neuropeptides that signal to the brain a message of pain, tight, stiff, sharp, throbbing, etc (whatever your brain’s interpretation and processing of the message is). We insert the thin filiform needle into the trigger point to stimulate a local twitch response. The twitch response feels like your eyelid twitching, only with some spicey, sparkly, electrical feeling (like an internal pop-rock candy going off inside your muscle with a twitch).
Once this twitch response happens, blood flow to the area returns , oxygen comes back in, pH is restored and the biochemicals/neuropeptides release out of the area. You may have some post-needling soreness, which is similar to a lactic acid feel or DOMS (delayed onset muscle soreness) that you would experience after a hard workout. This is normal and can last for a few hours up to two days.
Done in a clinic, it can seem quite magical, but really it’s science! After the twitch response occurs, you have better range of motion, better activation, improved blood flow, restored homeostasis, and less pain overall pretty immediately following. Dry needling can also have a cumulative effect.. What we mean by that is, over time and over multiple sessions you will see more and more benefits as we work on more trigger points in the complex fascial system.
Let’s now talk about some of the things we utilize dry needling for in our clinic:
- C-section Scars and Perineal Scars
With scar tissue, we insert the needles and twist them. Sounds gruesome, but it is not. The twisting of the needles help take the fascial layers around the scar and “wind them up” so to speak. What this does is stimulate the receptors and then your brain lets go of the guarding around the scar tissue. This can have huge impacts on low back pain, c-section scar pain and painful intercourse. - Preparing for Vaginal Delivery or VBAC
In preparation for birth, we work on one of the facial lines that connects intimately with your pelvic floor. It is called the “deep frontal fascial line.” I recommend that you type that into google to take a look at it (we cannot reproduce the images due to copyrights in this blog). We spend a lot of time balancing the pelvis by needling in the neck, low back, hip flexors and adductors. The adductors are very important to have good mobility to allow for the hips to move well for a vaginal delivery! - Squatting, Lunging, Jumping, Running, Etc.
We use dry needling to allow you to get into optimal positioning for squatting, lunging and jumping both from a range of motion standpoint and from a muscle activation standpoint. Have you heard of “Mom-butt”? Yep, not here! We are able to get those glutes firing and working the way they should be. - Sacroiliac Joint Pain (SIJ)
Often during pregnancy and postpartum, imbalances in the pelvis will be exposed and cause SI joint dysfunction. This is very common, but with dry needling we can work on trigger points that can be causing the imbalance in the pelvis. Once the imbalance is corrected, the pain will resolve. This is always a fun one to treat because it can be life changing! - Pubic Symphysis Dysfunction (SPD)
Similar to SI joint pain, SPD is often due to an imbalance of muscles attaching to the pubic bone. Very commonly for SPD it is those pesky adductors (or inner thigh muscles) that have trigger points in them, causing pull and torque through the pubic symphysis. Usually in a few visits we can have you pain free and back to doing your normal daily activities and working out without pain! - Prolapse
Prolapse is the sensation and/or downward movement of your organs in your pelvis. It can feel like heaviness, pressure, dragging or like a tampon that is falling out. Prolapse is a system problem and often there are muscles, scar tissue and/or fascia that are pulling or tugging and creating shifting to happen within the pelvis, creating a sensation of prolapse. As therapists, we will be able to evaluate where that mobility is limited and perform dry needling on areas that have trigger points to influence the mobility and positioning of your organs on top of the pelvic floor. - Diastasis Recti Abdominis (DRA)
DRA is a system problem just like prolapse. Oftentimes, there are trigger points in the low back muscles, obliques (side abs) and the rectus abdominis (6-pack abs) that can create tension and pulling of the linea alba (fascia between the rectus abdominis that stretches during pregnancy). By dry needling trigger points in any of these muscles, we can often watch diastasis close in front of our eyes. Additionally, we will work on pressure management of the system as well. - Neck Pain And Upper Back Pain From Feeding
As a new mom you often spend time feeding, cleaning bottles and slouched over the crib. Your upper back and neck can take quite the toll from motherhood. We can help address trigger points and headaches that may arise from all of the extra forward work you are doing day in and day out. - Optimization And Performance
We often see a lot of women who want to return to exercise and high activity levels after having a baby as well as stay as active as possible during pregnancy. We use dry needling to enhance performance, get people back to high levels of activity, and do things that they never thought possible. This is our jam!
The exact methods of dry needling are still being studied.. What we do know is that it interacts with the nervous system from a bottom-up approach (addressing trigger points in the muscles) and needs to be combined with other modalities and neuroscience pain education with top-down approaches as well as everything in-between.
Remember you are a whole person, not just one muscle or one trigger point. Make sure to talk with your pelvic floor therapist or other qualified healthcare provider to get guidance on what is best for you and your body.
Do you have pelvic floor dysfunction? Let our expert pelvic health physical therapist start your journey off on the right foot! We are here to help.