What is Dry Needling?
Dry needling (also called trigger point dry needling or myofascial trigger point dry needling) is a treatment technique used by medical professionals to release active, painful trigger points and create positive change in the central nervous system. The clinician inserts an extremely fine, monofilament needle into the targeted tissue. The appropriate needle size is determined based on the depth of the targeted tissue. Dry needling has been a viable treatment technique for myofascial pain since the 1940’s, and has continued to improve with modern medical advances. Thanks largely to the physician-researcher Janet Travell M.D., the use of dry needling has become more popular today.
How does it Work?
Muscles can develop knotted areas called trigger points. When these trigger points cause a pain signal, they are called active trigger points. They can be a source of referred pain (pain that affects another part of the body). Within the trigger point, the muscle is shortened, overlapped, and chemically bound into a tight knot. When the needle is inserted into the trigger point, it releases the chemical bond between muscle fibers. This allows the muscle to release and return to its normal resting length. Hence, you get better mobility and control of your muscles.
Physical Therapy Approach
While dry needling can be an important part of physical therapy treatment, it is best used in combination with your normal physical therapy regimen that includes exercise, range of motion, stretching, posture correction, soft tissue mobilization, and breathing strategies. Interested? Call us at 804-918-8515 to be scheduled with Shaunna Mayers, PT, DPT.
Diastasis recti abdominis (DRA) is a separation and lack of tension across that linea alba that commonly occurs with pregnancy and abdominal weight gain. This can happen due to muscle imbalances, core weakness or nonoptimal muscle recruitment strategies with every day tasks such as getting out of bed and higher level tasks such as core strengthening exercises.
One hundred percent of women have a separation of their rectus abdominis muscles during pregnancy, but the muscles approximate postpartum in many women on their own. If the abdominal wall is unable to maintain tension across the linea alba, the risk for pelvic organ prolapse, pelvic pain, and back pain is greater. It is imperative that women know how to assess for a DRA during pregnancy and postpartum. If your abdominal wall “cones” with activities such as getting out of bed or with exercise you have a clinically significant DRA that needs to be treated by a specialized Physical Therapist. At Progress PT – Midlothian, we assess for DRA by palpation, muscle testing, and rehabilitative ultrasound imaging. Based on our findings, we teach each patient individualized exercises to help tension the abdominal wall and approximate the rectus abdominis muscles during functional tasks. During these times of social distancing, we can also offer virtual visits over numerous digital platforms to assess and treat your abdominal wall dysfunction. Our goal is to help you get back to painfree, safe activity as soon as possible!
Call us at 804-918-8515 for more information.
A 2019 article published in Sexual Medicine Reviews Amy Stein, PT, MPT, DPT, BCB-PMD, IF, Sara K. Sauder, PT DPT, and Jessica Reale, PT, DPT, WCS discuss the role of pelvic floor PT in sexual health for men and women. Amy, Sara, and Jessica reviewed the most updated, peer-reviewed literature and determined that pelvic PTs successfully treat sexual dysfunction through multi-modal, individualized treatment. Pelvic Health Physical Therapists such as Dr. Miller and Dr. Rexrode perform an evaluation for sexual dysfunction by taking a thorough history and performing a complete musculoskeletal screen. This means your PT is looking at you from head to toe to assess for various musculoskeletal impairments such as pelvic stability/mobility, spinal mobility/stability, hip mobility/stability and of course pelvic floor muscle function. Your plan of care is then determined by synthesizing the data from the history and screen, with consideration for your specific goals. The PT or Physical Therapy Assistant (PTA) will select treatments consisting of manual therapies, patient education, muscle re-training, and exercise to address the problems found and help you meet your goals.
An estimated one-sixth of men will suffer from prostate cancer in their lifetime. Radical prostatectomy is the most common therapy for prostate cancer, but often leads to urinary incontinence (UI). In fact, it is reported that up to 80% of men have UI one month post-operatively, and 30-45% continue to have UI at one year. Pelvic floor muscle training is a common conservative treatment to address UI in men and women. Multiple studies have reported on the effectiveness of this approach; most recently, a 2019 meta-analysis published in the Asian Journal of Andrology. Wu, et al. found that the best available and most current research demonstrates pelvic floor muscle exercise guided by a physical therapist post-operatively decreases urinary incontinence and increases quality of life for patients at early and long-term stages. A study by Goode, et al published in JAMA in 2011 shows the efficacy of patient education + individualized physical therapy exercise to reduce the number of incontinence episodes in men with persistent urinary incontinence 1-7 years post-radical prostatectomy.
At Progress PT – Midlothian, our clinicians have specialized training in both oncological rehabilitation and care of the male patient. We apply tools such as pelvic floor muscle re-education, strengthening, and coordination utilizing biofeedback, rehabilitative ultrasound imaging and manual therapies to assist patients in regaining control. Because recovery from prostate surgery/cancer also has an impact on patients’ psychosocial livelihood, comprehensive education as well as use of restorative yoga and diaphragmatic breathing improve our outcomes. Topics may include proper voiding behavior, stress management, common bladder irritants, body mechanics for lifting, as well as nutrition to improve bowel elimination. Our goal is to treat each patient as an individual so their treatment will be unique, as we help them return to activities such as marathon running, golf, gardening and more without worry.