Dry needling or Intramuscular stimulation (IMS) is a technique developed by Dr. Chan Gunn (www.istop.org) and is extremely effective for releasing hypertonic muscles which contain trigger points. The treatment involves dry needling of the trigger points in the hypertonic muscles without injecting any substance.
(Image from istop.org)
The needle sites can be at the epicenter of taut, tender muscle bands, or they can be near the spine where the nerve root may have become irritated and supersensitive. Penetration of a normal muscle is painless; however, a shortened, supersensitive muscle will 'grasp' the needle in what can be described as a cramping sensation. The result is a stimulation of the stretch receptor in the muscle (muscle spindle), producing a reflex relaxation or lengthening response.
(Image from istop.org)
According to Dr. Gunn, 'Shortening in muscles acting across a joint increases joint pressure, upsets alignment, and can precipitate pain in the joint, i.e. arthralgia.' Dry needling of the 'shortened' muscle band causes an immediate relaxation which is palpable. A sense of release and increased range of motion is often experienced by the patient.
When used in conjunction with motor control training (see Prescriptive Exercise Instruction) and postural and movement training (see Postural & Movement Training), the release obtained from dry/needling IMS can be long lasting.
Some of the physiotherapists at Diane Lee & Associates - Consultants in Physiotherapy are certified to use this technique and integrate dry needling/IMS into their treatment plans. Further information on IMS can be found at the website www.istop.org for the Institute for the Study and Treatment of Pain.
At Diane Lee & Associates we use dry needling to release trigger points in muscles which you feel as tight bands. This is often necessary before you can connect to the deep core muscles. If you are familiar with looking at ultrasound images and you know what an isolated transversus abdominis contraction looks like, the video clip on this page will be of interest to you.
If you haven't had the opportunity to see your own transversus abdominis in action, go to Clinical Services/Rehabilitative ultrasound imaging page of this website for a quick instruction on how to interpret images and come back to watch this one.
Essentially, this individual is trying to perform an isolated contraction of transversus abdominis and the overlying internal oblique muscle is hypertonic (not tight, but rather its tone is increased - remember this is driven by the nervous system) and preventing transversus abdominis from contracting on its own. It doesn't matter whether she tries to connect through her pelvic floor (which should contract with the transversus abdominis) or through her low abdomen (ASIS cue) no connection cue produces the desired effect.
The trigger point in the internal oblique is then released with a dry needling technique and immediately after you can see on the ultrasound that the performance of transversus abdominis has improved. The long fibers of multifidus (back muscle) are then released with dry needling and the isolated TrA contraction is immediately restored.
So, sometimes getting your core going properly is less about what you need to do and more about what you need to stop doing i.e. what needs to be released.
We recommend that you read about core muscle training vs core muscle strengthening for more information on ways to get your core going. The same principles hold true for muscle imbalances around your neck, shoulder, hip or knee, the combination of dry needling with motor control training and THEN strengthening through postural and movement training is our preferred approach.
