After the nearly 3 month COVID lockdown, we're very happy to say that Myotherapy and Remedial Massage are back from Wednesday 28th October!

We've moved a few things around in the clinic, and we can't wait to welcome you back and resume your treatment plan.

We've given the first choice of appointments to those of you we know have been waiting patiently for this day, but we'll have our full online booking system up and running again very soon.

Thanks for your support throughout this year!

Dry Needling is a manual therapy technique used by Myotherapists to help reduce pain and tension in muscles.
We've previously discussed the similarities and differences between Dry Needling and Acupuncture, but you may still be wondering - how does Dry Needling actually work?

The "Dry" Needle
The reason they are called "dry" needles is to differentiate them from hollow needles like the ones used for blood tests or vaccinations. A dry needle can't inject or withdraw fluids from your body.
The needles themselves are ultra thin and flexible. They come with a guide tube to allow us to place them with care and precision.
All needles used for dry needling are single use only.

Where We Apply It
Myotherapists use dry needling in painful, tight or restricted muscle groups. You may have heard about Trigger Points - those painful, tight bands that can form within a muscle over time, with repeated use or from injury. Dry needling is a technique that helps address these trigger point areas in a very specific and precise way.
We assess the areas through watching you move and through palpating the muscles to find the best spots within the muscle to position the needle to relieve the trigger point. We also assess the surrounding joints and muscles, for example for hip pain we may find that dry needling in your lower back or in your thigh can help relieve pain and strain from your hip.

What Happens When We Needle A Trigger Point?
When we first insert the needle to the muscle, it can be felt as a little pinprick sensation on the skin. We then guide the tip of the needle into the right angle and depth of the muscle to directly stimulate the trigger point. This takes some skill and the ability to visualise in 3D the target muscle and the surrounding tissue like nerves, veins, arteries, bones and ligaments.
By applying the needle into that trigger point, it causes a combination of chemical and electrical responses by the muscle. The micro damage causes by inserting the needle sends chemical messengers to the brain to get a healing response to occur. It can also cause a nerve impulse to occur, making the muscle twitch and release.

To Stimulate or Not To Stimulate
Because our aim in using dry needling is to get a change in the muscle tension, we often can stimulate the needle. This means we might gently move the needle in a pulsing in/out movement to repeatedly stimulate the trigger point, or we might twist the needle in a particular direction or in a series of back and forward movements.
Stimulation of the needle can lead to more twitching, what we call Local Twitch Response. Dry needling can be effective even without the involuntary muscle twitch response.
Some practitioners prefer a more intensive stimulation of the needles, however we prefer a gentle and slow approach.

Does Dry Needling Hurt?
In most cases, not really. Which is often surprising! The most common sensations you'll feel are the pinprick of the needle being positioned, a dull aching or tightening sensation around the needle, and the quick twitching response of the muscles releasing. The twitching can sometimes feel intense, but only lasts a very short time.
After needling, some people can experience a little localised soreness at the sites of the needles, but most people just feel relief from tension and pain in those areas.

Is Dry Needling Safe?
In the hands of a trained practitioner, dry needling is a safe and effective technique.
Myotherapists undergo many months of training and assessment in the skillful use of dry needling, however not all practitioners who offer dry needling are Myotherapists. Remedial Massage Therapists, Chiropractors, Physiotherapists, and other skilled practitioners can opt to undertake short courses in dry needling.
Here in the Simple Wellness Myotherapy clinic, we only allow our Myotherapists to use dry needling on our patients, and we strongly believe that a weekend short course is not enough time to develop the skills needed to use dry needling safely and effectively.

What Sort Of Pain Can Dry Needling Help Treat?
Dry needling is great for releasing tight trigger point areas all throughout the body. It can be effective in treating headaches, neck and shoulder pain, back pain, bursitis, pain from disc injuries, sports injuries, plantar fasciitis - so many things!

Want to try dry needling for your muscle pain? Book an appointment with one of our Myotherapists.

Many people are familiar with the term "bulging disc" in regards to lower back pain. It can feel like an intense, sharp, stabbing sensation that can often travel down your leg through your hips and bum, sometimes as far as your feet.

This is a common diagnosis when you start to develop back pain. You get a scan which shows changes in the disc, and the pain matches the effected nerve area. It can be a scary diagnosis.

But you may be surprised to know that a lot of people who don't have pain have also been found to have changes in their discs. I find this study to be really encouraging, because it shows that people who have significant changes to their disc structure can still live a painfree life. It suggests that the disc changes may have already been there for some time before any painful symptoms even began, and gives hope that even if the structure doesn't change, that the pain can change.

Lets have a look at this interesting literature review, particularly in regards to the findings around disc degeneration, disc bulges and disc protrusions.

This is a literature review of 33 separate studies that investigated the imaging of spinal degeneration in painfree people ranging from their 20's to their 80's. It was published in the American Journal of Neuroradiology in 2014.

In total, the review takes into account MRI and CT scan imaging on 3110 individuals with no painful symptoms.

As you would likely predict, the number of findings increased with the participants age group, showing age-related degeneration occurs even in people who aren't experiencing pain.

Lets have a look at the imaging results for the disc degeneration, bulge and protrusion categories:

Disc degeneration - changes to the disc and surrounding vertebrae that result in loss of cushioning and support, may include signs of osteoarthritis at the joint.

The Results:
Disc degeneration in painfree participants was identified in:

• 37% of 20-29 year olds
• 52% of 30-39 year olds
• 68% of 40-49 year olds
• 80% of 50-59 year olds
• 88% of 60-69 year olds
• 93% of 70-79 year olds
• 96% of 80+ year olds

Disc bulge - changes that alter the shape of the disc and can make portions of it "bulge" out of place, which can apply pressure to nearby nerves.

The Results:
Disc bulge in painfree participants was identified in:

• 30% of 20-29 year olds
• 40% of 30-39 year olds
• 50% of 40-49 year olds
• 60% of 50-59 year olds
• 69% of 60-69 year olds
• 77% of 70-79 year olds
• 84% of 80+ year olds

Disc protrusion - changes to the annular membranes around the disc allows the disc nucleus to protrude and apply pressure to the nerves.

The Results:
Disc protrusion in painfree participants was identified in:

• 29% of 20-29 year olds
• 31% of 30-39 year olds
• 33% of 40-49 year olds
• 36% of 50-59 year olds
• 38% of 60-69 year olds
• 40% of 70-79 year olds
• 43% of 80+ year olds

What does this mean for your bulging disc?
It means that theres a good chance that your structural changes were already present before your back became painful. The area may be irritated or flared up right now, but these findings are a good indication that even if your scans don't change, your back pain still can settle down.
It means that a scan showing disc changes doesn't have to be a life sentence of pain.

Does this mean bulging discs DON'T cause pain, then?
Don't get me wrong, bulging discs can be painful, and for some people it can be severe. This study just helps to show us that theres more to back pain that what shows up on MRI or CT scans. Structural changes are just one layer in the complex onion that is back pain.

We can help!
There are lots of ways we can change your experience of back pain through massage and myotherapy techniques like dry needling, taping and support, strengthening the surrounding muscles with exercises that are appropriate for you, and supporting your understanding of how your back functions.
Book a time to come see us to talk about your back pain and creating a treatment plan to reduce it.

Plantar Fasciitis is a very painful condition that affects your heel and the sole of your foot. Often the mornings are the worst pain, people often explain they feel like they have to hobble about for the first few minutes of their day.

Usually it affects one foot or the other - some very unfortunate people can get both feet affected at the same time.

Symptoms include heel pain; arch pain; altered walking patterns; cramps or spasms in the sole of the foot. Usually the pain reduces after getting moving, but those first few steps can be uncomfortable through to excruciatingly painful.

What kinds of treatments work best for Plantar Fasciitis?
The techniques I've found that work the best for people with Plantar Fasciitis are:

• Myofascial Release of the lower leg muscles that lead into the plantar fascia
• Cupping for the heel and soles of the feet
• Muscle Energy Technique stretching for the sole of the foot and the back of the calf
• Taping the sole of the foot and the lower leg
• Dry needling the calf

The hands on treatment sessions are only part of the recovery plan though. Like with most pains or injuries, looking at the way you move and stretch outside of your time in the clinic is important to helping you feel better, quicker. Our therapists will show you some simple but effective movements that help you to stretch your foot and leg to reduce the pain. We can also offer you some temporary pain relief suggestions like ice bottle rolling and using spiky physio balls.

Ready to look at a plan for kicking Plantar Fasciitis?
Book a 60 Minute Initial Consultation with us. We'll assess your movement and muscle balance, give you a feel-good hands on treatment, and walk you step by step through your treatment plan.

You’ve been told you have Tennis Elbow, but you don’t even play tennis?
The pain can catch you off guard, and make normally simple tasks feel really difficult - opening jars, turning door handles, shaking someones hand, maintaining your grip on something.
This type of pain can feel like a deep muscle aching, a stretch in the muscle, sharpness when you move, or a combination of these feelings.

Our Myotherapists and Remedial Massage Therapists can help by creating a treatment plan for you that relieves the pain and gives you back your strength and ability to turn, twist and grip again.

Tennis Elbow is a painful condition of irritation and inflammation of the tendons around the outer side of your elbow. Its normal to feel the dull, constant ache throughout the day, and have the pain turn into sudden, sharp or shooting pain when you move your elbow or wrist, or try to grip something or twist a lid or door handle.

It can happen if you spend a lot of time doing repetitive wrist movements like typing, using tools, carrying something heavy for a long period of time. We see it with people who play musical instruments too, or video gamers who get so into the game they forget to take a break for hours on end.

Our typical treatments for this kind of pain will look at assessing your movement and strength first so we can plan out some short and long term goals. Our short term goals are usually the ones you want the most - to get rid of this awful pain!! But its also important to plan for the long term goals of recovering the strength in the area so that this feeling doesn't come back.

A series of hands on treatments can help to reduce the pain and sensitivity in the area, and we'll give you a few movements that help that you can focus on between treatments. This is a pain that tends to respond well to doing some stretch and strengthening movements each day, starting with small easy movements, working up to more challenging or weight resisted ones.

The hands on part of your treatment may include some remedial massage, cupping, active release techniques, dry needling, and trigger point therapy. Afterwards we can support your elbow with kinesiotaping to reduce pressure over the joint and tendons.

Do you need help with elbow pain?
Our therapists are ready to help assess your pain and work with you to create a treatment plan to reduce the irritation and restore your movement and strength.
Book your first consultation with us now!

Most people have heard of the Rotator Cuff being a big culprit of shoulder pain, but do you know what it is and how to get help?
Our Myotherapists and Remedial Massage Therapists help a lot of people with Rotator Cuff pain - its one of our most commonly treated pains!

The Rotator Cuff is a group of 4 muscles that all work together, and they have different actions. So when you come in with a Rotator Cuff injury, the first thing we’ll work out for you is which muscle is causing you to feel the pain.

The job of the Rotator Cuff group is to move and stabilise your shoulder, and it does that by making what I like to light heartedly call the Shoulderblade Sandwich. Imagine your shoulderblade bone (scapula) as the filling of the sandwich, and the Rotator Cuff muscles are the bread on either side. The muscles on the outer side work to lift your arm and rotate it outwards away from your body, and the inner muscles rotate your arm inwards.
The most common issues we see with Rotator Cuff complaints is tight muscles referring pain, or muscle tears.

Rotator Cuff referral pains can be felt locally around the shoulder, as well as further down your arm, elbow, wrist and hand.

If you've got a Rotator Cuff tear or a partial Rotator Cuff tear, you'll likely notice pain and difficulty on raising or rotating your arm.

Muscle tears can be identified on an ultrasound. If you’ve already had the ultrasound and been given the report that you have a tear, the next step for you is to rehabilitate that muscle, and we can help!

Pain from shoulder and Rotator Cuff injuries usually respond well to hands on treatments like massage, cupping, or dry needling. We also like to help stabilise your shoulder using kinesiotaping.


So how do you get help if you think you might have a Rotator Cuff problem?
Firstly, book a time to come see us so we can help you find which of those 4 muscles is acting up. We’ll do some muscle testing and make a plan for reducing your pain and getting you strong again.

If we think you may need an ultrasound to check for possible muscle tears, we can refer you to Dr Waj Dib here at Together Medical Family Practice in Knoxfield. Dr Dib is a fully bulk billed GP who can send you for scans if you need them.

The Similarities
First, let’s look at the common ground between the two forms of treatment.
 
The needles
Both use needles as the tool of treatment. These needles can come in various lengths and thicknesses depending on what they are used for. Needles should always be sterilised and single-use.
 
The training
Qualified practitioners have to be trained extensively in how to correctly needle a client. Learning where, when and how to use a needle on a human body is a bit intimidating, but it is essential for safety reasons. Whether you get acupuncture from a Traditional Chinese Medicine practitioner or dry needling from your Myotherapist, you can rest easy knowing there has been months or even years spent on training.
 
However, dry needling courses can also be offered as short weekend courses for practitioners like remedial massage therapists, physiotherapists, chiropractors, etc. If I'm honest, I don't think these courses are long enough, in depth enough, and with enough assessment and examination of each participant. Acupuncturists and Myotherapists train for a long period of time, need to pass both written and practical exams, and complete student clinic treatments under supervision to build their needling competency.
 
The Differences
Now we get to the differences between the two forms of treatment.
 
Why it’s done & what it treats
Acupuncture is a Traditional Chinese Medicine practice, with thousands of years of use. It is used as one treatment form to bring the body back into balance according to TCM treatment protocols, the most familiar of these being the system of meridians, or energy points throughout the body.
 
Acupuncture can be used to balance hormones, optimise digestion, reduce stress and treat a lot of conditions, including musculoskeletal issues.
I'm always very honest with people when I say that I don’t understand the theory or application well because I’m not a trained acupuncturist, and I refer any more specific acupuncture questions to Amanda Cox-Edwards at Upwey Acupuncture.
 
Dry needling is a modern physical therapy. It is used to correct imbalances in musculoskeletal health. The goal is to release tension in a muscle, returning it to its natural, neutral tone. Dry needling is used specifically for muscle and joint complaints, as a comparison to acupuncture which has more system wide applications.
 
Where it is used
Acupuncture can be used directly over an area of concern. But it can also be used distally – that is, a distant point on the body that is related to the area of concern according to the meridians. Certain points on the bodies surface relate to other areas, including internally. Of course, your acupuncturist won't needle directly into your kidneys to treat a kidney issue or into your intestines to treat a digestive issue, they will use the TCM protocols to stimulate points throughout the muscles and skin of your body that relate to the kidneys or digestive system.
 
On the other hand, dry needling is used directly on the affected muscles. We find the muscle that is tight, spasming or needs to be released, and then locate the spots of most tension within that muscle and that becomes our needling target zone.
 
How the needle is used
The final major difference is how the needle itself is used as a tool. In acupuncture, the practitioner will insert the needle in the specific spot and depth and generally leave it to do its job while the client relaxes. This can be for up to 45 minutes, depending on what they are treating.
 
Dry needling is not left alone. Instead, the practitioner will often try to stimulate the muscle fibres by moving the needle, helping to release the tension. The most commonly used stimulation techniques include an up-down motion to repeatedly hit the target within the muscle; a twisting action to wind and release the tissue; and in-out motions on an angle to release broader areas of tension. Some therapists take an aggressive approach to dry needling, and it can be uncomfortable or even painful to receive needling from this type of therapist. By now, you probably know that I'm your gentle Myotherapist, so in typical gentle fashion I use very slow, deliberate stimulation techniques where needed. I also like to let my needles rest then re-stimulate it a few minutes later, rather than continuous stimulation.

Dry needling is just one tool out of a big, broad toolbox that Myotherapists have to use. Scared of needles? We have plenty of other ways to gently encourage your muscles to relax and release without needing to use needles on you.
 
Does dry needling sound like something you want to try? The good news is that myotherapists have extensive and ongoing training in dry needling. So book yourself in a session to try it today.