Physical Therapy Services

Possible Treatments that May be employed in Physical Therapy

Postural assessment

Postural assessment

It can be said that the best posture is the next posture. No therapist, trainer and the like will be able to offer you ‘the strength’ to correct your posture. AND no matter how many times you are told to sit up and correct your posture, you will never be able to hold a posture 100 percent of the time. It is so much more complicated than that! Movement and resetting is the key. And if you do hold, with great effort, that ‘perfect’ posture, you will be welcoming other issues including active trigger points, and thus pain.

We have joints in our body for one reason——MOVEMENT; and movement is the essence of how you keep them healthy. Spending large amounts of money on the perfect chair as a means of fixing your posture or taking away your pain is just not the answer. It’s movement. Static postures rob your joints of nutrition! Movement lubricates and offers your joints nutrition. It is that simple. Instead of spending your hard earned money on all of the perfect tools to help you get through your day with great posture, try buying a nice-glass water bottle, fill it up and drink often so that you need to urinate. Because you will need to move and empty your bladder and when you return to your station, you can reset your posture. Remember, the best posture is the next posture and MOVE!!

Posture is also a BALANCE. Find the most lengthened (tall) posture that you can find and do not work extremely hard at holding yourself in a position. The true postural muscles are low load muscles. Overworking muscles that are not supposed to be responsible for your postural maintenance leads to pain and muscle dysfunction. If you are unable to strike a balanced, stacked posture, then you need to see our therapists to help you improve your capacity to balance your posture.
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Trigger point dry needling

Trigger point dry needling

Trigger point dry needling is a safe and valuable treatment for neuromuscular pain. It involves placing a small needle into the muscle at the trigger point (a taut band of muscle) in order to cause the muscle to twitch, release and improve the function and chemical environment of the muscle. Physical Therapist implemented dry needling is more of an inter muscular, mechanical treatment on local tissue.

Trigger points have been extensively researched by Drs Travel and Simons and are found in normal muscle. They become active with overuse, trauma, sustained postures, and with syndromes of chronic pain such as fibromyalgia; at which time they develop a hypoxic and thus acidic environment which causes muscular bands to become taut and shortened resulting in pain and dysfunction. This can occur at the site of the taut band and can refer to other remote locations. An example of this is lower back pain that travels into the lower extremity. This may appear to be a ‘ruptured disc’ , ’sciatic’ symptoms or carpal tunnel syndrome; but there is a possibility that it can simply be addressed by resetting the taut muscular band and impact the nervous system via trigger point dry needling. The needle desensitizes the area, and allows the muscle to return to it’s normal length.

Training in Dry Needling is extensive. First of all, as Physical Therapists, we already have a command of muscle, joints, nerves and arteries via our extensive medical training that includes cadaver anatomy. In order to practice Dry Needling, we review all systems, including understanding depth and layers of tissue, and exhaustively apply the knowledge in classes. I want to be clear about what is not a part of our training. We do not learn or apply eastern methodologies such as the flow of Chi, or meridians. We do not have the vast understanding of all of the thousands of acupuncture points in the body and do not claim to impact any system other than the musculoskeletal system.

Frequently Asked Questions:

  • Does it hurt? How will it feel?
    Some needling can be uncomfortable.  Patients often report a dull aching and pressure sensation.  Sometimes needles go in un-noticed.
  • How long will I benefit from TDN?
    That depends on if the actual band was ‘deactivated’ and it depends on if you follow up with stretching and strengthening exercises suggested by your PT.  Massage and heat are also helpful in promoting change in the muscle tissue.   It is important to continue movement following this procedure.
  • How many session will it take to see improvement?
     That depends on the severity of the issue and how long you have been experiencing the discomfort associated with an active trigger point.  Patients can experience remarkable results with one treatment and it could also take several applications.  It also may depends on the activities that caused the active trigger-point and if you continue doing the same activity without modification and/or exercise.
  • Is it dangerous?
    It is invasive, but considered very safe.  Well trained practitioners are well aware of the danger zones such as the lung field.  PT’s are the only TDN practitioners who have undergone rigorous cadaver gross anatomy and therefore have a vast understanding of underlying tissue layers and structures.
  • How is it different from Acupuncture?
    Physical Therapist implemented TDN does not take into consideration Meridian mapping systems or the flow of chi.  Our treatment is local to the muscle fibers that contain active trigger-points.
  • How long do the needles stay in?
    Depends on the situation and the practitioner.  Some leave them in for a bit of time, some leave them in and use an electric stimulation directly attached to the needle, while others piston the needle until a twitch is achieved and then the needling is removed.  It may also depend on the site that is treated.
  • How long are the needles?
    Depends on the depth of the area to be treated.
  • Will I bleed?
    Sometime this does happen and sometime you might notice some bruising.  But for the most part, you won’t be able to detect the location the needles were inserted.
  • Afterwards can I use heat or cold?
    I typically suggest heat following treatment to continue and amplify in influx of fresh oxygen and the flow out of waste product.
  • Why is this technique called Dry Needling?
    It’s official name is Trigger Point Dry Needling.  Other countries have different wording, such as Intramuscular Therapy (excellent name!)  The needles are filament needles like those used by acupuncturists.  It is essentially a wire and not a typical medical needle used for delivery of medication.  It is extremely thin and it has no lumen for the delivery of medication.  No medication or any liquid is introduced in the delivery of Trigger Point Dry Needling–making the procedure Dry.

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Instrument Assisted Soft Tissue Mobilizaton
Kinesiotaping
McConnel Taping

Joint manipulation

Joint manipulation

The relationship between one bone to another in the interface we call a joint is impacted by mis-alignment and tightness. If a joint is functioning poorly, that joint will be subjected to abnormal forces and can result in pain and swelling. Abnormal joint relationships also impact the soft tissue that surround it, including the joint capsule and the surrounding musculature. We understand normal mechanics of joints and can impact their function by mobilization forces, muscle energy techniques and/or manipulation.
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Spinal Manipulation

Spinal Manipulation

The relationship between one bone to another in the interface we call a joint is impacted by mis-alignment and tightness. If a joint is functioning poorly, that joint will be subjected to abnormal forces and can result in pain and swelling. Abnormal joint relationships also impact the soft tissue that surround it, including the joint capsule and the surrounding musculature. We understand normal mechanics of joints and can impact their function by mobilization forces, muscle energy techniques and/or manipulation.
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Muscle Energy Techniques

Muscle Energy Techniques

The relationship between one bone to another in the interface we call a joint is impacted by mis-alignment and tightness. If a joint is functioning poorly, that joint will be subjected to abnormal forces and can result in pain and swelling. Abnormal joint relationships also impact the soft tissue that surround it, including the joint capsule and the surrounding musculature. We understand normal mechanics of joints and can impact their function by mobilization forces, muscle energy techniques and/or manipulation.
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Advancing the practice of Physical Therapy one patient at a time.
© 2019 Body Logic
Asheville
2 Weaverville Rd. Suite 101
Woodfin, NC 28804
Phone: 828.424.9290
Fax: 828.417.7103
philrolfedpt@gmail.com