Tag Archives: cupping

Gearing up for summer: Summer Specials

From now until the end of February I will be offering some special add on treatments especially for summer.

Getting a sunless tan?

Dry Exfoliation tools

Good for you, it’s the healthiest way to look sunkist!

Add-on a 15 minute full body dry exfoliation to your 1 hour full body relaxation massage. You’ll be exfoliated and moisturised, ready for a tan!

Don’t forget to book your massage a day or so before your tan, so that no oil remains on your skin when get your sunless tan.

Getting bikini ready?

Summer Ready?

Book a 45 minute Manual Lymphatic Drainage treatment with a 15 minute cupping add-on to help reduce the appearance of cellulite.

Cupping can release the tension in the fascial layer between the skin and muscle that can create the rippled effect of cellulite. While lymphatic drainage helps drain excess fluid that may be retained in those areas.

In a 1 hour treatment, two adjacent areas of the body can be targeted; such as the buttocks and back of thighs or stomach and front of thighs. The use of silicone rubber cups means minimal marking and you can get into that bikini within a few days.

I recommend between two and four weekly treatments for best results.

Book 4 treatments for the price of 3!

To book: click Book Now and look for the Summer Special option.
Please don’t hesitate to contact me if you have any queries about treatments or what might be best for you.

Stretching; the when, what and how.

When should I stretch ?

In the first 24-72 hours of injury the best treatment is R.I.C.E.R. (rest, ice, compression, elevation, and referral). At this stage, stretching is not advised. It’s best to rest the injured area and apply ice for 10 minutes of every hour until the swelling goes down.

Head to the emergency department if you think you may have a bone fracture or to your health physician for further investigation.

After the initial 72 hours, with clearance from your health physician, you can start some rehabilitation techniques over the next 10-24 days.

Over the period of 2 to 5 weeks you should aim to regain your flexibility, strength, power, muscular endurance, balance and co-ordination.

Long term, once you have recovered from your injury, it’s time to regain fitness, strengthen the injured area and improve flexibility.

When we talk about injury, this doesn’t always mean a serious injury. It could be anything from also waking up with a stiff neck or straining a muscle while picking something up to tearing a muscle during sport or exercise.

What types of stretches are there?

Static Stretching

Static stretching is used to stretch muscles while the body is at rest. It is composed of various techniques that gradually lengthen a muscle to an elongated position (before the point of discomfort) and hold that position for 30 seconds.

Passive Stretching

Passive stretching is a form of static stretching in which an external force exerts upon the limb to move it into the new position. This is in contrast to active stretching. Passive stretching resistance is normally achieved through the force of gravity on the limb or on the body weighing down on it.

Active Stretching

Active stretching eliminates force and its adverse effects from stretching procedures. Active stretching stimulates and prepares muscles for use during exercise. … Agonist refers to actively contracting muscle or muscles while their opposing muscles are termed antagonists.

PNF Stretching

Proprioceptive Neuromuscular Facilitation (PNF) is a more advanced form of flexibility training that involves both the stretching and contraction of the muscle group being targeted. PNF stretching is a very effective for rehabilitation.

Dynamic Stretching
Dynamic stretching is a form of stretching beneficial in sports utilizing momentum from form, and the momentum from static-active stretching strength, in an effort to propel the muscle into an extended range of motion not exceeding one’s static-passive stretching ability.

When should i use these stretches?

Static and passive stretching should be used in the early days after injuring.

PNF stretching can be used in the later weeks as the muscles are beginning to regain their strength. This type of stretch is often performed with a physical therapist.

Dynamic and active stretches should only be used when the muscles are healed and are strengthening. They should never be forced and always a controlled action.

What techniques do i use to stretch?

  • Focus on the muscles that are sore;
  • Ease into the stretch, do not over stretch or force the muscle into position or into pain;
  • Hold the stretch for 20-30 seconds;
  • Breathe! Oxygen helps the muscle release;
  • Stretch both sides. The other side is likely to be carrying the work of the sore muscle.

Stay tuned!

In the coming weeks I will be adding some fact sheets on stretching routines for each of the major muscles groups, such as the calves, quadriceps and hamstrings, lower back, neck and shoulders, rotator cuff, and forearms.

 

New Availability

Exciting news!

From Friday the 27th of January, 2017 I will be available at 404/434 St Kilda Road, Melbourne on Friday’s only.

I will be offering all my usual remedial massage, cupping and dry needling services and a range of relaxation and corporate massage services for local professionals.

Tell all your friends and please remember to like and share my Facebook page to keep up to date with offers.

New clients who register and book online will receive
a 10% discount.
Use the code: 1C56KN6 when booking. Click here to book

Muscle in Review: Sternocleidomstoid

Sternocleidomastoid muscle highlighted in red

Sternocleidomastoid, regularly abbreviated to SCM is located superficially, either side of the neck.

It originates at the sternum (sterno) and inserts at the clavicle (cleido) and mastoid process of the skull. It’s main function is head rotation and flexion of the neck.

How does SCM become injured?
SCM can be easily injured with sudden movement or jerks of the head, mostly commonly with whiplash.

 

Muscles in Upper Cross Syndrome

 

It is also often innervated in ‘upper cross syndrome’ where the upper neck and lower shoulder muscles are weak, while the upper shoulder and chest muscles are tight. This is largely due to poor posture as we hunch to use the mouse/keyboards or crane our necks over to look at our laptops or mobiles, or while driving.

What are the symptoms of an injured SCM?
A strained SCM can produce swelling and redness along the muscle, at the site of the injury. In severe cases, you also may see bruising along the path of the injury. If the strain results in a muscle spasm, you may notice a twitching or fluttering beneath the surface of the skin along the side of your neck. Stiffness, muscle fatigue and difficulty holding your head upright may occur, along with dull pain along the path of the injury, accompanied by sharp pain when turning or tilting your head.

Trigger points in SCM can cause headache pain in the back of the head, behind the ear, in the forehead but it can also cause a list of other symptoms that some may not normally attribute to muscles.

SCM trigger points

Primary Symptoms include;
Back of Head Pain
Cheek Pain (like Sinusitis)
Dizziness When Turning Head or Changing Field of View
Double/Blurry/Jumpy Print Vision
Dry Cough
Ear Pain
Earaches/Tinnitus (Ringing)/Itch
Feeling Continued Movement in Car After Stopping
Feeling Tilted When Cornering in Car
Front of Chest Pain
Frontal Headache
Headaches or Migraines
Post Nasal Drip
Runny Nose
Sore throat
Tearing/Reddening of Eye, Drooping of Eyelid
Temple and Eyebrow Pain
Temporal Headache (Temples)
Temporomandibular Joint (jaw) Pain
Throat & Front of Neck Pain
Travelling Nocturnal Sinus Stuffiness
Vertex Pain
Visual Perception Problems

How is SCM treated?
Applying ice for 10 minutes several times daily may relieve swelling and redness. Wearing a neck brace supports the weight of your head, temporarily relieving the stress on SCM although may only recommended temporarily and only in severe cases. Over-the-counter nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (Advil, Neurofen) and naproxen (Naprosyn, Aleve) and analgesic rubs can relieve some of the pain associated with the strain.

SCM is very responsive to massage and other soft tissue techniques such as gentle cupping, dry needling, and stretching.

  • Rotate your head to look over your shoulder, as far as is comfortable, not to strain.
  • Then gently tilt the head to the same side, as if trying to reach the ear to the shoulder.
  • Hold for 20-30 seconds, rest and stretch the other side.

 

 

If you are a yogi, some basic yoga poses that can help lateral and anterior neck tension include;

Bitilasana (Cow Pose) and Marjariasana (Cat Pose)

Cow-Cat pose is a gentle up-and-down flowing posture that brings flexibility to the entire spine. It stretches and lengthens the back torso and neck. It’s a wonderful and easy movement to open and create space through the entire neck.
To begin with cow pose, kneel on your hands and knees in a neutral, tabletop position. Be sure to align the hands below the shoulders and knees directly beneath the hips. Looking straight ahead, inhale, and slowly extend through your spine as you look up and forward, softly arching through the back and neck. Take care to expand through your chest and lower your shoulders down and back.

Move into cat pose by reversing the movement as you exhale and bring your chin towards your chest while gently hunching and rounding your back. Repeat this sequence for 7 to 10 cycles, softly flowing with your breath.

Ardha Matsyendrasana (Seated Twist Pose)

The seated twist is a wonderful pose to bring flexibility to the entire spinal column. It provides an inner massage to the abdominal organs and encourages side-to-side flexibility of the neck.

Begin seated on the floor with both legs extended in front of you and hands at your sides. Bend the right knee and draw the right foot to the outside of the outstretched left leg. Sit up tall, inhale, and extend your left arm out to your left. As you exhale, draw your left arm across your body so the elbow joint gently wraps around your right knee. Take your right hand and place it palm down on the floor near your tailbone, fingers pointing away from you. Draw your chin toward your right shoulder, making sure to keep your spine tall, and the crown of your head reaching toward the sky. Bend the right elbow slightly to allow the right shoulder to sink down.

Breathe deeply in this pose for 5 to 7 breaths, making sure to twist (not crank) your spine comfortably. Repeat on the left side to maintain the balance in your body and spinal column.

Ear to Shoulder Pose

This is an easy pose that can be done just about anywhere. The pose facilitates the lateral movement of the neck as well as stretches down into the shoulder and trapezius muscles. This pose can be performed standing or sitting, provided the spine is straight.

Begin by looking straight ahead with your arms down at your sides. Take a deep breath and as you exhale, bring your right ear down toward your right shoulder. Try to avoid leaning your head forward or back so that your head remains in the same plane as your shoulders. Inhale as you draw your head back to center and exhale as you repeat the movement to the left.

To deepen the stretch, place your right hand on the left side of your head as it drops over towards the right shoulder. Don’t pull your head over; just allow the weight of your hand to softly guide it down. Perform this cycle 7 to 10 times per side before returning to centre. (1)

Cupping: what is it and should I get it?

Ancient Chinese cupping

You may have seen the dark, bruise coloured circles on the backs of the Olympic athletes at the current games in Rio. Many of you may be wondering what they are or have heard from the commentators and media articles about this ‘new’ treatment the athletes are receiving called cupping.

What is cupping and where does it come from?
Cupping is not something new. Early records of cupping have existed since ancient Egypt around 1500 BC. Hippocrates, the father of modern medicine, prescribed cupping. The Chinese have been using cupping dating back to 281 AD. The British were using cupping by the 1800’s with observation of Hippocrates writings. However, with the rise of scientific medicine, the practice of cupping has declined in the West in the last century, until a recent resurgence from traditional Chinese medicine (TCM) practitioners practicing here in the West and other physical therapists using it to aid in soft tissue therapies.

The method of cupping uses a cup with vacuum created by a flame, pump or suction applied to the skin. Animal horns, bamboo, hollowed out wood or clay, even shells have been used for cupping practices throughout history. The cups used nowadays are most commonly made from glass, plastic or silicone.

How does it work?
TCM practitioners use cupping to move energy and correct internal imbalances, as well as to clear the effects of external injury and climatic influences such as the cold.1 In myotherapy, remedial massage and other physical therapies the cups are used to stretch the underlying tissues such as muscle and fascia.

What is fascia?
Myers (2014) says that while everyone learns something about bones and muscles, the origin and disposition of the fascinating fascial net that unites them is less widely understood, although that is gradually changing.2

Pith acts like fascia

Connective tissue is an apt description of fascia as its web-like structure binds every cell in the body to it’s neighbour.3 Imagine the pith in a mandarin, how it sticks to each segment and holds the segments to each other, and the skin to the flesh of the fruit. In very basic terms, this is what fascia is like.

It is primarily made up of collagen and keeps our muscles and organs where they should be. It also helps transport proteins and nutrients around the body as well as supporting the circulatory and nervous systems.

‘In short muscle is elastic, fascia is plastic’

Fascia is different to muscle in that, when stretched it won’t easily ‘recoil’ to it’s original form. Stretched quickly, it will tear. Stretched slowly it will warp and deform. In short muscle is elastic, fascia is plastic.4 Over time fascia will however, lay new fibres to rebind. This is what western, or modern, cupping aims to facilitate This is called myofascial release. Myofascial release can be achieved manually, with a slow, deliberate massage technique, heat and compression but the suction of the cups lifts and separates the muscle fibres and surrounding connective tissue in a way that cannot be achieved manually. It also increases the blood flow around the restricted muscle to help restore its function.

Australian TCM practitioner and modern cupping pioneer, Bruce Bentley says “Judging from what we can see and feel, we can suppose that the various layers of the skin and the fat beneath are drawn inside the cup, together with a positive tension exerted on the underlying fascia”. He goes on to say “we can presume therefore that the suction effect and the drawing out and elevation of these tissues facilitates an increase of local blood supply to the immediate area, which in turn implies an enhanced metabolic uptake of oxygen and feed of nutrients to those parts. It therefore relaxes and reduces pain [caused by] congestion and contracture”.5

Cupping works fast, with minimal pain to re-knit the connective tissues with a ‘trickle down’ effect to underlying muscle tissues, circulatory and nervous systems and perhaps even organs.

But what are those ‘bruises’?
Bruce Bentley maintains that a cupping mark is not bruising but the physical outcome of pathogens, toxins, blockages and impurities (waste products) that are an undesirable presence in the body.6

MediNet defines a bruise as an injury of the soft tissues that results in breakage of the local capillaries and leakage of red blood cells. In the skin it can be seen as a reddish-purple discoloration that does not blanch when pressed. When a bruise fades, it becomes green and brown, as the body metabolizes the blood cells in the skin. It is best treated with local application of a cold pack immediately after injury.7

However, when tested, the composition of the dark pigmentation left from cupping was found to be ‘old blood’, stagnant blood in the tight muscle fibres.8 Blood that is not moving, the more it thickens, congeals and darkens. TCM also recognises the different colours, shape, temperature and texture of the marks as a diagnostic tool to signify varying pathogens or deficiencies within the body.

Rest assured the marks left by cups are painless, they do not feel like bruising and fade within a few days to a few weeks, depending on how dark they are. I also have observed that clients who have regular cupping tend to mark less and less.

What is the difference between the different types of cups?

L to R: plastic pump cups, silicone cups, glass cups with aspirator suction pump, plastic suction pump with magnets, glass

There are many and varied types of cups. Glass, plastic suction pump, rubber, silicone, glass with a vacuum pump, plastic with a vacuum pump and magnets. The most common used by physical therapists are the glass, plastic suction pump or the silicone cups.

The glass cups are considered the traditional cups, largely used by TCM practitioners. They are used by some physical therapists too. The vacuum is created by placing a fueled flame, usually a cotton wool ball doused in methylated spirits, into the cup for a second or two. The flame is removed and the cup is quickly placed on the oiled skin. The heated air in the cup then cools to create the suction, the oil on the skin acts as the seal to the vacuum.

Flame to create vacuum in cup

It does not feel hot on the skin. Often clients expect it to feel warm and are surprised that the glass is cool. The wide lips on the glass cups feel smooth on the skin. Depending on how much suction is created, the cup can be left where it’s placed, or moved around to massage with. The suction with the glass cups is often strong and tends to leave strong marks, like the ones you might have seen on Michael Phelps at the Olympics.

There is no exact way of measuring the suction on these cups and it takes some experience before a practitioner can judge the amount of suction the flame will create.

Plastic pump cups are often used by myotherapists and some massage therapists. They are fast and easy to use as there is no need for a flame and the amount of suction is easily controlled via the pump. They can be used static or moved to massage with also. They tend not to mark as much as the glass cups but can leave a slight pinkish circle where the cup is placed or a strip where the cup is moved.

Silicone cups are becoming more and more popular among massage therapists and other physical therapists due to their ease of use, durability and gentleness on the client. Suction is created by squeezing the cup and placed on the skin. Suction can be created without oil but seals better with a little bit of lubricant and the cups can be massaged with. This technique is especially good for myofascial release. These cups are not as strong as the glass or plastic pump cups, and therefore leave very little marking on the skin.

What are the contraindications of cupping?
The cupping contraindications are similar to that of massage. Cupping cannot be performed on skin that is broken, has acne, rash or other contagious skin disease. Cupping on pregnant women should be considered with caution, not to the soft tissue areas of the abdomen or lower back. Although I have seen good results on the sore hips of pregnant clients. Cupping shouldn’t be performed on existing bruising as it can be uncomfortable, although I have experimented on myself with the silicone cups to see if it move the bruising out quicker, which it did quite successfully I might say.

Are there other types of cupping?
Facial cupping for skin rejuvenation, headache, sinus and TMJ disorder relief; cupping to reduce stretch marks, scarring and cellulite all exist.

Wet cupping or Hijama, is an Arabic tradition. It is where an incision is made on the skin and the cup is placed over the incision to draw the blood out for therapeutic purposes. This practice is not used by physical therapists and has a risk of infection.

If you are considering myotherapy or massage for a chronic injury or muscular tension, consider trying some cupping with your physical therapy. It is a fast and effective way to mend soft tissue and alleviate muscular pain.

 


  1. Bently, B., Cupping, viewed 11th of August, 2016 <http://www.healthtraditions.com.au/course-details/cupping.htm>
  2. Myers, T 2014, Anatomy Trains – Myofascial Meridians for Manual & Movement Therapists, Elsevier Health Sciences, London
  3. Myers, T 2014, Anatomy Trains – Myofascial Meridians for Manual & Movement Therapists, Elsevier Health Sciences, London
  4. Myers, T 2014, Anatomy Trains – Myofascial Meridians for Manual & Movement Therapists, Elsevier Health Sciences, London
  5. Bentley, B., ‘Modern Cupping’, The Lantern Vol 10-3, pp.15
  6. Bentley, B., ‘A Cupping Mark is Not a Bruise’, The Lantern Vol 12-2, pp.16
  7.  Definition of a Bruise, viewed 11th of August, 2016 <http://www.medicinenet.com/script/main/art.asp?articlekey=2541>
  8. Bentley, B., ‘A Cupping Mark is Not a Bruise’, The Lantern Vol 12-2, pp.16

When is a bruise not a bruise? When it’s a cupping mark.

Cupping, in Chinese medicine, is a therapy in which glass cups are applied to the skin
along the meridians of the body, creating suction as a way of stimulating the flow of energy.

It is also a modality of deep tissue, myofascial release that I perform as part of my remedial massage treatment. Using suction to create vacuum pressure, cupping is used to soften tight muscles and tone attachments of muscle to bone, loosen adhesions within the muscle and lift connective tissue, bring hydration and blood flow to body tissues, move deep inflammation to the skin surface for release, and drain excess fluids and toxins by opening lymphatic pathways.

It works by suctioning a glass cup to the skin. A vacuum is created when a flame briefly inserted into the cup heating the air, the cup is then placed onto the oiled skin to seal the vacuum. The air in the cup cools and the skin, fascia and muscle tissues underneath, stretch up into the cup.

As a result blood and fluids are drawn out of the muscle beneath and towards the skin. This leaves the appearance of a bruise where the cup was placed.

Typically a bruise is caused by tears to the muscle fibres after an impact to the area. Blood pools and clots in the area to aid healing to the muscle tissues. The cups do not cause tearing, but rather suction and stretching.

Also, a bruise is generally painful to the touch due to inflammation of the injury. A cupping mark is not.

There has been little scientific research into the marks left by cupping but their continued use throughout history indicates a popularity in traditional and alternative medicine practice. The only research known into the marks was performed at the Australian Institute of Sport where cupping tissue samples were observed under microscope. The finding was “old blood”.1

In Chinese medicine the cupping marks are used a diagnostic tool. An indicator to the level of ‘stagnation’ of energy in the area. I would say, in my practice, I have observed that the greater the area of tension is, the deeper the colour of the mark. Some people however, do not mark at all.

Most people are alarmed by the sight of cupping marks, as there is nothing in our frame of reference in modern medicine that indicates a mark as a safe or healthy response to treatment. However, in my experience as both a therapist and an avid receiver of cupping I can comfortably say that the marks are usually forgotten once the muscle tension has been relieved.

 


  1. http://www.healthtraditions.com.au/uploads/212-cupping-proof.pdf

 

Overuse Syndrome – What is it? How do I avoid it? How can I help it?

What is Overuse Syndrome?
Overuse syndrome is a disorder where a certain part of the body is damaged by repeatedly overusing it or subjecting it to too much stress.

For example, if you rely on your hands for your work, you are more prone to overuse injury of the arms.

Typists are prone to overuse injury of the wrists

What are the signs and symptoms?
Initially the area affected may feel fatigued, ache or tension; swelling, heat or redness in the area can also occur. If this fatigue is not resolved prior to your return to the activity, micro-trauma may occur, building up over time more serious syndromes can develop.

Weakness, numbness and or tingling in the extremities can occur as well as general aching or shooting pain.

Some common examples of overuse syndromes are:
Tendonitis
Bursitis
Carpal Tunnel Syndrome
Patellofemoral Pain
IT Band Syndrome
Plantar Fasciitis

ITB irritation is a type of overuse injury

Who gets over use syndrome?
Those who are prone to overuse syndrome are usually those involved in occupations that rely heavily on the use of hands or arms. Trades such as builders and electricians; check out or line production workers; typists. Some athletes may be prone to overuse syndrome in other areas of the body, and those with hobbies that require lots of ‘hand heavy’ work, such as knitting or crocheting,

How is it treated?
Most start with conservative treatments such as massage, physiotherapy and some stretching and strengthening exercises such as yoga or prescribed pilates.
At home treatments such as heat and cold therapies, rest, and the use of compression bandages can also help.
If conservative treatments are unsuccessful cortisone injections or surgery may be suggested.
Ideally, the best way to treat an overuse injury is to rest the affected area, and to discontinue the activity that is causing the injury. For some this may be impossible due to their work. The employment of an occupation therapist can be useful to help you change the way you operate and keep you working without pain or further injury.

Are there any complications?
It is always best to seek treatment as early as possible for an overuse injury. The longer an injury of this type goes on, the harder and longer it will take to heal. On-going injury can lead to tendon damage, calcification and spur build up, or cartilage damage, for example, all of which will require surgery to rectify.

How can I avoid getting over use syndrome?
Warming up and stretching before use. Before exercise and even before work, take some gentle exercise and stretching of the area.
Negotiating with your employer to change your routine work throughout the day. The less you repeat the same action, the less you are likely to cause injury.
Resting at the end of the day, to ensure any micro injuries heal before you next return to the activity.
Ensuring you are doing your activity with the best ergonomics possible. For example, ensuring your desk is set up for you.

Correct posture can help to avoid overuse injury

How can remedial massage help?
Remedial massage will use various soft tissue manipulation techniques to relieve any muscle tension build up that could cause further complications from overuse.
Deep tissue massage improves circulation around micro-trauma in the muscle to speed up recovery. It also breaks down calcification build up that leads to spur development.
Cupping stretches the connective tissue surrounding the muscles, allowing for release of compartment tension and greater movement of muscles.
Dry needling alleviates trigger points in the muscles and referred pain that may have built up with overuse.

Stretches for arm overuse syndrome from “Stretching” by Bob and Jean Anderson

Stretches Screen Shot 2015-05-11 at 3.33.54 pm

 

How Myofascial Dry Needling and Cupping Works

In the past couple months I have added myofascial dry needling and cupping to my services.  I offer it in my remedial treatments, if I think that a client is suitable to the therapeutic benefits these two modalities can offer.

What is myofascial release?

Fascia under chicken skin, for example

Fascia under chicken skin, for example

Fascia is a connective tissue that covers all our organs and muscles and groups of muscles. When we stretch we are stretching the facia as well as the muscle. The fascia is connected to everything and so releasing tension in one area can also help ease pain in other areas of the body. There are many myofascial release techniques including massage, stretching, compression, skin rolling, foam rolling, and strain-counterstrain techniques. Cupping works in a similar way to deep tissue massage or skin rolling to release myofascial tension.

Gwyneth Paltrow (Photo by Jim Spellman/WireImage)

Gwyneth Paltrow with cupping marks

What is Cupping?

Cupping is a therapy in which a jar is attached to the skin via suction. It is an ancient practice found in Chinese, Hindu and Egyptian scriptures. Cupping fell out of favour in western regions the early 20th Century with the favour of chemical drugs but recently there has been a resurgence of interest with physical therapists using it for myofascial release. It is very effective for musculoskeletal pain, headaches and migraines, sporting injuries, asthma, chronic cough and gastrointestinal disorders.

Cupping Therapy

Cupping

It is generally safe and the only side effect are the purple ‘bruising’ marks that are left on the skin. Cupping cannot be applied to open wounds, dermatological problems such as acne, or sunburn.

A flame is inserted into the jar to remove the oxygen and allow the cup to suction. The flame and treatment of cupping can look daunting but it is relatively pain free, most clients describe it as a ‘pinching’ feeling. It works fast to reduce muscle and fascia tension.

What is dry needling?

Dry needling is similar to acupuncture, in that they both use fine, solid needles, inserted into certain points in the muscle. From there, the two practices diverge. Acupuncture works on a Chinese philosophy that pressure points along energy channels running throughout the body can be pin-pointed to treat all of the bodies systems.

Doctor uses needles for treatment of the patient

Dry needling

Dry needling is a Western based philosophy, pioneered by Janet Travell, MD, where the needles are inserted into the trigger point or ‘knot’ in the muscle to treat musculoskeletal pain. Although, there is a high degree of similarity between the locations of trigger points and acupuncture pressure points for pain relief. Dry needling is performed throughout much of the western world by myotherapists, and is becoming increasingly popular in Australia by various physical therapists, who are seeing the physical benefits of myofascial release.

Dry needling of a trigger point will elicit an involuntary reflex in the muscle fibers, blood, oxygen and inflammation will be forced into the muscle and the nerve endings in the muscle will be stimulated, all resulting in a reduction in pain and release of tension in the muscle. The same response as with non-invasive trigger point therapy and deep tissue massage. There are a number of different techniques used by various practitioners to date from injecting the muscles to just piercing the skin with the needle like acupuncture.

Many studies have concluded various reasons as to why dry needling and acupuncture reduce pain including; stimulation of the spinal reflex arc; eliciting a local twitch response during the application of any needling technique; change in neuropathic condition and a histamine release that causes local irritation and relaxation of the muscle; mechanically breaking up the nodularity of the tissue; decrease in stiffness of the muscle through an electrical event; bleeding causing release of so called platelet derived growth factors, which aids in the healing of the muscle; normalization of the pH and of several biochemicals and neurotransmitters that are involved in regulation of pain.

Unfortunately however, no scientific study to date has reported the reliability of trigger point diagnosis.

Dry-Needling-PicWhat side effects are there?

Mild muscle soreness or ache is a common side effect after the procedure, bruising is also common. Typically, the soreness lasts between a few hours to a few days. Recovery from dry needling can be aided by the same techniques as deep tissue massage like drinking water, resting, mineral salt baths, gentle stretching, and ice or heat over the effected area.

Complications

Like any medical procedure, there are possible complications. While these complications are uncommon, they do sometimes occur and must be considered prior to giving consent to the procedure.

  • Any time a needle is used there is a risk of infection. However, using new, disposable and sterile needles, along with sterilising the skin, infections are extremely rare.
  • A needle may be placed inadvertently in an artery or vein. If an artery or vein is punctured with the needle, a hematoma (or bruise) will develop. Usually the needles used are too fine to puncture the wall of an artery and bend around to avoid it. If any bleeding from a vein occurs, it is no larger than a pin-prick bleed.
  • If a nerve is touched, it may cause paresthesia (a pins and needles sensation) which is usually brief, but it may continue for a couple of days. It is theorised that this can help the function of the muscle and in some practices encouraged.
  • When a needle is placed close to the chest wall, there is a rare possibility of a pneumothorax (air in the chest cavity). If you experience pain in the chest, pain on exertion, shortness of breath, dry cough or decreased breath sounds during auscultation up to half an hour after treatment, you should seek medical attention.

Contraindications and precautions for dry needling

You should not receive needling if you are suffering from blood disorders such as Hemophilia or VonWillebrands disease. Those with blood borne diseases need to disclose their condition to their therapist. Patients on Warfarin, Plavix may not be able to have needling, all medications should be disclosed to the therapist before treatment. Infants cannot have needling and children need parental consent. Those with cancer should seek advice from their practising physician before needling treatment. Patients with sensitivity or allergy to nickel or chrome may react to materials in the needles. Epileptic patients also need special attention and strong stimulation is forbidden in treatment. Those with heart disease or recent cardiac surgery also cannot have needling.

Should I have cupping or dry needling?

Ultimately your physical therapist will advise you if they think you can benefit from either modality. Either are rarely a treatment in itself and is usually done in conjunction with other manual and physical therapy treatments, such as massage and stretching.

myofascial_releaseThere is no specific, predetermined number of treatments for patients with myofascial pain. Chronic conditions will require more treatments than acute conditions. In addition, the amount of treatments will also depend on concurrent other medical conditions, your compliance with any at home treatment, your age and physical condition. If your therapist does recommend it, then don’t be afraid to try the treatment and make a decision yourself about how you like the results.