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.
We took the last 10 days to take a slow and cautious approach to completing our risk assessment with the rolled back Stage 3 Restrictions here in Victoria.
I've just listened to Dan Andrews' update for Sunday 19/07/20, and after reviewing all the data of the last 10 days since the Stage 3 Restrictions were re-announced, I have some updates on our risk assessment.
And its good news!
Our local council area, Knox Council, has stayed a relatively low risk zone. Knox has remained one of the least effected regions of Metro Melbourne throughout the pandemic. As of 19/07/20, there are only 9 active cases of COVID19 in the Knox region, and the data shows good statistics on very low new cases occurring in our area, and good rates of recovery.
The Department of Health has advised that Myotherapy and Remedial Massage appointments are still allowed under the current Stage 3 Restrictions.
This means that you are currently allowed to continue getting treatment for chronic pain conditions, injuries, or pain from your new work from home set up!
We can help you with headaches, back pain, sciatica, shoulder pain, fibromyalgia pain, RSI, nerve symptoms like pins & needles and shooting pains, and these sorts of specific pains or injuries.
From Monday 20th July, we will be open these hours:
Monday, Tuesday & Friday 9am-7pm
Wednesday & Thursday 9am-4pm
Dan Andrews has announced today that from midnight on Wednesday this week, it is mandatory to wear protective face masks outside of your home. This is to protect you, your family and your community. We know this may not feel comfortable during your treatment, but we will ask that you keep your mask on during your appointment.
Help us to keep COVID19 out of our clinic:
What about Stage 4 Restrictions?
Theres a lot of talk going around about Stage 4 Restrictions, but Dan Andrews has not announced any plans to move to this level of restriction at this time.
If any further tightening of restrictions is announced, we will keep you informed with how that impacts your treatment plan.
To make a booking, go to our online booking page to see our current availabilities.
Here in Melbourne, we're back in Stage 3 Restrictions.
That means that most of our favourite ways to move, stretch and exercise may not be available to us right now, including gyms, yoga studios, pilates classes, martial arts, personal training, and lots more.
So what are your options from home to keep moving, stretching and feeling physically well? Here are some of our favourite at home, online accessible resources.
Erica Webb Yoga & Pilates Virtual Studio - Erica has an amazing and gentle approach to movement as medicine. Shes fun, insightful, and her classes are suitable for people of all ages and abilities. Erica is a local yoga teacher from Croydon. Her membership subscription costs less than a single traditional yoga class per month.
Nate Bower Fitness - you don't need a boxing bag to be able to follow along with these boxing drills. Guaranteed to get your heart rate up, and lots of beginner friendly classes. This YouTube channel provides free 20-30 minute boxing class videos.
Couch To 5K App - Want to start running? This app helps you go from dusting off your old runners, to running a full 5km. Starting with very small bursts of running with big walk intervals, and as your fitness improves the interval timing changes, until you can make it through your full 5km run. I've used this app myself in the past and found it really useful and encouraging. You can use the official C25K app on Apple or Android, or there are plenty of similar versions for free (maybe with a few ads!)
Mountain Pilates - Jeanette Tatton is a local pilates instructor in the Hills, and is running Zoom pilates classes each week. Pilates is a great full body workout that is gentle but effective at strengthening your body.
Alpha Health - Our good friend Ash and her partner Paul are amazing personal trainers offering online coaching to keep you fit and moving throughout isolation. When Anytime Fitness in Ferntree Gully is open, Ash offers training there, too.
What are your favourite online resources to stay inspired and healthy during lockdown? Let us know on our social media channels on Facebook and Instagram!
Unless you've been hiding under a rock, if you live in Melbourne then you'll be aware that our local new COVID19 cases have been dramatically increasing, and that in response to the rapid rise of infection numbers, Premier Dan Andrews has rolled Metro Melbourne back into Stage 3 Restrictions.
What does this mean for your treatment plan with your Myotherapist or Remedial Massage Therapist?
The good news is that Myotherapy and Remedial Massage have been given the OK by the Health Department, and getting a treatment is included in the four reasons to leave your home under the Seeking Medical Care category.
However, we're taking a cautious approach.
We are planning a short closure from Thursday 9th July to Sunday 19th July, and aim to reopen from Monday 20th July.
Why are we closing if the Health Department have not forced us to close?
In short, we want time to gather more data about these spikes in infection to inform our risk assessment.
We closed for 9 weeks when the pandemic was first announced. At that time, most infections in Melbourne were coming from international travelers and people returning home from overseas. Health experts were unsure how the numbers would play out, and we followed the advice from the Association of Massage Therapists to close our doors for safety. The strict stay at home orders during March through til June appeared to keep our infection numbers low in Victoria, and these numbers have started rising quickly in the weeks since restrictions have been eased.
The situation now feels closer to home and even more serious than back in March. The infections Melbourne is experiencing right now are a high number of community transmissions.
Our choice to close for a short time is more of an ethical choice than a legal choice. Legally, we are allowed to remain open throughout the 6 week Stage 3 rollback. However, we always want to put patient health and safety first, and after a 9 week closure earlier this year we feel it would be irresponsible to ignore the very real risks that are present now.
Our current risk assessment
Thankfully, our clinic is in a location that has very few local cases. Knox has 2 active cases as of 9/7/2020, and has had less than 30 confirmed cases total throughout the pandemic, according to the Victorian Government website.
The majority of our patients live in Knox, Yarra Ranges, Casey, Maroondah and Monash council areas. Many of you are now working from home, but some are still traveling for work or have family living in other regions.
We know that some COVID19 test results are taking up to 5 days to process, which means the daily new case figures may be reflecting the test results of up to 5 days ago.
We have also seen many of our high risk patients choosing to stay home in isolation a little longer, including people with compromised immune systems, elderly or caring for elderly, or people with pre-existing respiratory conditions.
We currently expect that our risk level is relatively low due to our location, screening procedures, sanitisation and cleaning procedures.
However, we acknowledge that it would only take one infected person to potentially risk others.
What do we expect to learn by closing temporarily?
In the safety of closing for this short period, we expect to gain more insight on infection numbers close by to our clinic, and in Metro Melbourne as a whole.
We do expect numbers will continue to rise because of the delays between testing and results. We hope by taking an extra 10 days to wait on the numbers we will get a better understanding of the situation so we can modify our COVID19 Plan if we need to.
We hope to see the Knox and surrounding areas new case figures to stay low and stable.
Will we definitely reopen on Monday July 20th?
At this stage, that is our goal date. If our risk assessment findings start to indicate a higher level of risk, we will potentially extend the closure for safety of patients, our practitioners, and the doctor and staff of Together Medical Family Practice who we share facilities with.
What will happen when we reopen?
We'll continue to use our COVID19 Procedures that we created to maintain a clean and hygienic treatment environment. This includes continuing screening every person at every appointment they attend, and the longer periods between each appointment for ventilation and thorough sanitisation.
Our practitioners will be wearing masks, we'll be smiling underneath even though you can't see it!
The Together Medical Family Practice has also arranged a hygiene station at the front door for anyone who enters to use hand sanitiser and take a face mask.
Our waiting area has been rearranged to distance the chairs, and we are recommending that everyone waits in their car until we call you in to avoid the need to sit in the communal waiting room.
Who should you see if you urgently need an appointment while we are closed?
Our good friends at Tecoma Myotherapy are remaining open throughout the restrictions. Mat Richardson and his team are exceptionally caring and friendly therapists, offering Myotherapy and Remedial Massage. Let them know that we've asked them to take care of you while we are closed, we know you'll be in good hands.
Our Myotherapists help a lot of people with scoliosis of varying degrees, from very mild curves to more exaggerated curves that permanently alter posture.
Myotherapy is not a cure for scoliosis, but ask any of our patients and they'll agree that managing the pain and muscle fatigue is much easier with a regular treatment to help manually decrease the load and pressure on their spine.
What is Scoliosis?
Scoliosis is a curvature of the spine to the right or left, creating a C or S shaped spine. It usually begins at puberty during growth spurts. Most people with scoliosis will have mild symptoms that can be managed by staying active and using therapies and tools that manage muscle tension and discomfort.
What do Myotherapists do to help someone with scoliosis?
As always, we start with an assessment. We'll look at your back, and how you move and check where you feel pain during your movement. You'll probably notice you have regular patterns that your scoliosis follows - like one hip or shoulder sitting higher than the other, one shoulder that rolls forward or backward more, or a particular painful spot that gets really tight or feels like it builds up pressure.
Hands on massage treatment is always a favourite with our patients. Why? It feels good! And it helps to stimulate the over-tired muscles supporting the spine. This can help reduce the muscle tension and fatigue, and let those high-pressure areas feel some relief.
Cupping is a technique that works particularly well for a lot of our scoliosis patients. We use cupping to help get a quick change in muscle tightness and reduce trigger point areas, while also bringing lots of new, fresh blood to the muscles to help them heal and release. The cups have a pressure valve and a pump that we use to create the gentle suction effect, which stretches the muscles and connective tissue under and around each cup, and stimulates increased bloodflow to that area. They can feel a little pinchy at first especially over tight areas, but after a few minutes that feeling usually goes away, and when the suction is broken the pressure releases and leaves the muscles feeling warm, stretched and more mobile.
The relief that comes after a treatment can be extended by using taping to help support your spine, hips and shoulders. Did you know you can keep the tape on for up to a week?
How often do I need to see a Myotherapist?
When you first come in, we like to see you again within 1-2 weeks to see how your first treatment settles in. From there we can work out the best schedule for you to keep painful flare ups at bay. This is really different person to person, but the average is about every 2-4 weeks - for some people we spend a little longer doing weekly treatments until it starts lasting longer, and for some people we can move to a 6-8 week schedule.
If you experience a pain flare up, come in for an appointment so we can settle the flare as quickly as possible and get you back to your normal maintenance routine.
How do I get an appointment?
Appointments can be made online or you can phone Mel on 0401212934.
Does this sound familiar?
These can be signs of hip bursitis, which is an inflammatory condition that can be a very common cause of hip pain.
What is Bursitis?
Bursitis is the name of a condition where the bursa in your joints become inflamed. Bursa are the fluid-filled sacs that help cushion joints and reduce friction as the joint moves. Healthy bursa are important in pain free movement.
When the bursa becomes inflamed it swells and becomes highly sensitive. The joint doesn't move easily, and the muscles surrounding it can become painful and tight trying to protect the joint.
Bursitis can cause acute pain that increases with physical activity. If the inflammation remains active for a long time, the pain can progress to a chronic state.
What causes hip bursitis?
The most common causes of bursitis are things like overuse or strain on the hip joint. This can happen through a high level of exercise or activity, or through repetitive unbalanced activities like holding a baby on one hip, or leaning your weight to one side to avoid pain in other areas like your lower back, knee or ankle.
Other causes can be less common things like infection or gout within the joint. People with autoimmune conditions like rheumatoid arthritis can be more vulnerable to developing this inflammatory condition.
How can we help?
Remedial massage and myotherapy can help relieve painful symptoms of hip bursitis. We can reduce muscle tension around the hip joint, and assess the other areas above and below the painful hip so that we can address any issues that are contributing to your bursa becoming irritated. Taping for stability and support can be very useful, and can help relieve pain for longer. We can give you a program of exercises to gradually strengthen your hip without increasing the irritation.
Book a time with us to get the ball rolling.
Should I see a doctor?
If your hip pain has been ongoing for quite some time, it can be a good idea to check in with your doctor.
Your GP can advise you if a course of anti inflammatory medication will be helpful for you, or you can ask your pharmacist for an over the counter recommendation for symptom relief.
We're lucky to be located inside Together Medical Family Practice in Knoxfield, where you can get access to a fully Bulk Billed GP in the clinic with us and an understanding pharmacy team downstairs.
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.
Disc degeneration in painfree participants was identified in:
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.
Disc bulge in painfree participants was identified in:
Disc protrusion - changes to the annular membranes around the disc allows the disc nucleus to protrude and apply pressure to the nerves.
Disc protrusion in painfree participants was identified in:
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.
We're pleased to say that after weeks of being closed due to COVID19, we're very close to reopening! We're sure you're as excited as Emily and I both are to get back into our treatment room for the myotherapy and remedial massage therapy treatments you've been missing!
We've been given the OK to reopen 4 days a week by our medical professional landlords, Dr Wajib Dib the GP we share our clinic with at Together Medical, and Amer Dib the pharmacist who owns and runs Knoxfield Pharmacy downstairs from us. They've been happy with the policies and procedures we've put in place for sanitisation and screening, and are welcoming us back from the start of June.
Needless to say, due to COVID19 we’ve needed to optimise the cleanliness of our space and put in place procedures to maintain social distancing outside of your treatment.
These are the changes we’ve made to ensure your health and safety during your appointment:
What else is new?
We've broken up Myotherapy and Remedial Massage into 2 categories. We hope this will make it easier for you to know what type of treatment you want to book.
If you have an injury to be assessed, a chronic condition needing expert maintenance, or want more advanced treatment techniques like dry needling, cupping, mobilisation, taping, or a tailored exercise plan, you can book a Myotherapy appointment.
We've also removed the need to book an Initial or a Return session for Myotherapy treatments, you can now just choose the appointment length you need.
This means if you would prefer "just a massage" to address your aches and pains, you can book for a Remedial Massage and get what you're expecting - feel good, hands on massage! Perfect for muscle soreness and general preventative care!
Appointment Length and Fees
From June 1st, we'll be offering the following appointment types:
Myotherapy - 30 mins ($79), 50 mins ($99), 80 mins ($134)
Remedial Massage - 30 mins ($70), 60 mins ($100), 90 mins ($130)
Ready to book in? Pick a time from our online booking page for when we return in June!
Anyone with long term pain will likely relate with this statement my sister recently made about her chronic back pain and exercise:
"Yeah, the pain flare ups seem to be less frequent with exercise. But also feels hard to convince myself to exercise, because if I stretch too far it hurts real bad, too??"
This situation is so common with people I see every day in the clinic. The pain has been there for a long time, but thinking on times that they've been most physically active, that tends to be the times that the pain has been its least intense, frequent and invasive.
So if we know that staying active can change the intensity, frequency and overall impact pain has on our lives, why is it so hard to convince ourselves to do the exercises? Its an internal fight that a lot of people have with themselves.
In practitioner language we call it Fear-Avoidance Behaviours, which basically means not doing the beneficial thing because of the fear of causing pain even if you know long term the beneficial thing reduces the pain intensity and/or frequency. It’s one of the biggest struggles for people with chronic pain.
I think a lot of the solution to it is finding a really enjoyable activity. In my sisters situation, she started taking MMA classes last year. A weird choice for someone who is already in pain, right? But even though shes learning some serious fighting moves and coming away with some proper bruises, her long term back pain has been more under control than it had been in ages.
I explained it to her like this.
"You’re not there to slug away at a pointless activity that you don’t enjoy. You have fun, you learn, it’s interactive, the people are nice and supportive, it’s social, it’s not 100% competitive, you get to do it as a family activity with Matt and the kids. So it’s probably so much more appealing than going for a run or going to lift weights at a gym by yourself for an hour a few days a week."
And I think she got it!
"Absolutely! Ohh that all makes so much sense... it's so true though. Going to the regular gym or even working out at home is like... ugh. No thanks. But going to MMA is so easy?! Because it's just fun... I mean, it's actually a really complicated work out, and some of it SUCKS... but is somehow so damn fun?!"
While she's having all this fun kicking and punching, she'll definitely be using a lot of back muscles to coordinate and control the movements, and core muscles, hip stabilisers, all the areas that single exercise prescription focuses on. The difference is instead of doing separate specific exercises for each muscle group, it’s all just rolled into a sequence of movements and blows and dodges, mixed in with an instructor that makes her laugh and being able to spar with her partner. This is way more enjoyable for her than doing strict sets and reps of isolated exercises.
Some people love doing the specific exercises, and guess what, thats awesome too because if you love it and enjoy it, you're more likely to do it!
Lets talk neuroscience
We already know that almost any kind of exercise produces endorphins, which are these wonderful little brain chemicals (neurotransmitters) that are natural pain and stress relievers.
Endorphins act a little differently on the Peripheral Nervous System (all the nerves in your body that aren't part of your brain or spinal cord) and the Central Nervous System (the brain and spinal cord)
They work by binding to opioid receptors in the Peripheral Nervous System. Its like your own personal stash of codeine, and your body makes it in response to exercise! They also work by reducing the amount of inflammatory chemicals that the nerve produces.
In the Central Nervous System, endorphins also bind to the opioid receptors. Here their effect is to reduce another neurotransmitter called GABA. With GABA reduced, your brain is able to produce more dopamine - the pleasure neurotransmitter! Interestingly, these opioid receptors in the brain are most abundant in regions of the brain that control pain regulation.
So how is it more helpful to have a fun active hobby?
Researchers found that endorphin release varies depending on the intensity of the activity, suggesting that higher physical intensity leads to increased endorphins compared to more moderate activity.
But is the endorphin rush better from a fun activity vs an activity that you find boring or tedious?
I'm honestly not sure, but what I do believe with certainty is that most people are way more likely to actually DO the exercise if its something they find fun and enjoyable and actually have a desire to do it.
Realistically, it probably doesn't matter WHAT you do, more that you just DO IT!
Yesterday, Premier Dan Andrews announced an update regarding COVID-19, and extended the State of Emergency til May 31st.
Some positive changes and updates were announced.
From tomorrow onwards, people can start to visit their loved ones, and have up to 5 guests in their homes.
The testing results from over 140,000 tests in Victoria identified 30 new cases, which is about 0.018% of all the tested individuals.
The numbers of infections and hospitalisations here in Victoria are relievingly low, compared to other similar sized cities across the world.
However, the Premier has encouraged people that if they can work from home, they must continue to work from home. The 1.5m social distancing requirements are still in place. There are now 5 reasons allowable to leave your home - seeking medical care, going to work, doing essential shopping, exercising, and now to visit family or friends.
We will remain closed a little longer, but we feel like things are starting to shift and we hope to bring better news of reopening soon!
Meet Our Team
We have a team of great practitioners available 7 days a week at our Knoxfield clinic.