Whether you are an athlete, enjoy working out, or a desk jockey, the likeliness is you’ve experienced pain or discomfort at one point or another in your life. In many cases, these injuries will come and go in a relatively short time period and you don’t require treatment. But what about the injuries/pain that come and never fully recover or that keep coming back? This is where the skill of a physical therapist can come into play. Unfortunately, I think some people have misconceptions about what physical therapy is. Either they have had a negative experience in the past or feel “I don’t have time for therapy” as they think you need to devote multiple appointments a week for several weeks to treatment. I compare a physical therapist to a good lawyer. There are times where you might be in major trouble/conflict and need multiple visits to work something out, but other times you just need consultation and direction from time to time (or a tune-up). Also, just as all cars aren’t the same, all physical therapists aren’t the same. Unfortunately, there are still therapists out there using the “throw the kitchen sink at the patient and hope something works” technique.
So where am I going here and how does this relate to functional movement assessment?
A functional movement assessment has a patient perform multiple movements to systemically find the source of their dysfunction. This increases efficiency and effectiveness of treatment and there is a direct cause and effect relationship seen with activities/exercises! You see, I’m an impatient person, early in my career I never was really comfortable with the throw and wait technique. Just as you as a patient want to feel better, I as a therapist want more of an immediate result that I’m helping you. That’s why I get so excited about functional movement, dry needling, and cupping because when used together it can produce some of the quickest results I’ve seen as a therapist. Most of my patients need to see me 1-3 times to see major changes in their symptoms. The “homework” that you perform between visits work on exercises that are helping to build better movement patterns. As you get better with the movements, the stress on the injured area improves and your body has the ability to recover.
Take the squat for example.
Picture from www.thefitnesstraineracademy.org
If you perform a squat and there is a flaw, this occurs for a reason and is likely putting extra stress on parts of your body. This can lead to INJURY and PAIN! These flaws may be the result of an injury or the cause of an injury. Just because you feel better after an injury doesn't mean all the effects of the injury are gone, hence why some people never feel "back to normal" after an injury. A functional movement assessment will break down the squat to determine why you are moving incorrectly and give you exercises that are components leading towards correcting these flaw(s). As your exercises progresses, your ability to perform a proper squat should also progress. Moving better means less stress on your body and your body is better at working as a machine. You should see a noticeable change not only in your ability to squat, but if addressing the appropriate mechanisms, YOUR SYMPTOMS! The original source of dysfunction, when optimized, becomes the exercise you need to build on to continue improving/maintaining the change. It’s the ultimate cause and effect relationship.
Contact me to discuss your personal functional movement assessment!
Maybe you have back pain and are considering a technique called dry needling, but you’re not really sure what that means or what a treatment might entail. All you’ve heard was a co-worker raving about the relief they obtained after a treatment and that made you interested. You have tried other treatments….rest, medication, imaging, possibly physical therapy, or the dreaded I’m going to fix myself looking up things on the internet… (sticking with the OH MY theme on the blog), but your symptoms are still there. Let’s discuss more about dry needling.
Dry needling is a technique which uses solid filiform needles, which are often called acupuncture needles. This needle is designed for one time use and is usually a very thin stainless steel. Confusion usually creeps in over the fact that dry needling uses acupuncture needles. It’s important to point out acupuncture and dry needling are completely different, they both use the same needles but the location and purpose is vastly different. Acupuncture is generally based on qi, an energy form that travels in the body along meridians and treatment is attempting to rebalance this energy. Dry needling is based on scientific knowledge and anatomy which attempts to treat pain and trigger points by releasing the body’s natural hormones and chemicals. The term “dry” comes from the fact that the needle does not contain medication. Dry needling treatments vary depending on the desired effect, but may vary from a quick in and out of the needle to leaving multiple needles in up to 30 minutes. Electrical stimulation can be used to enhance the effect in many cases. I know, hooking up electricity via alligator clips to needles stuck in my body!?! WHOA, I don’t know if I signed up for this right? Most people have had electrical stimulation or even TENS treatments if you’ve experienced pain in the past. When receiving these treatments, you are using the same electrical current, but instead of needles you are using a sticky electrode that goes on the surface of the body. Where higher levels of electricity are needed to get through the layers of tissue when using an electrode, the electricity needed to stimulate a needle is MUCH less because it’s located directly in the effected structure. It’s the equivalent of watering the entire yard with a sprinkler hoping to hit the flower bed, when you can take a watering can and directly water the flowers. Much better results in less time! Treatments can result in significant pain relief and muscle relaxation, which when combined with the proper exercise can yield large gains. Large gains allow you to return quicker to THE THINGS YOU WANT TO DO! Do I have you excited yet?
Dry Needling - My Experience
When I mention Dry Needling to most, the look of shock and horror usually fills their face. Maybe it's because I use the term needles, yes plural, which is a new concept to most. Here's how I got to my first experience... It was Sunday September 27, 2015, I was playing in my rec league hockey game. As I skated toward the center of the ice, a player heading full speed hit me head on. The collision was hard, happening so quickly I couldn’t even attempt to protect myself. I ended up leveled on the ice, with a concussion and the worst neck pain I’ve ever experienced. Six months off the ice dealing with concussion symptoms: nausea, headaches, visual problems, and head pressure combined with continued neck pain. My treatment path included visits to the doctor, manipulations to my neck, vestibular-orthopedic physical therapy, and neurological eye exam/treatments. Stretching, massage, ultrasound, strengthening, and vision exercises that you perform until you are nauseous. NO FUN! While the concussion symptoms gradually improved, the neck pain did not, while frustration continued to grow. In April 2016, I took Sue Falsone’s Dry Needling and Cupping training. For those that don’t know, when Physical Therapists go through training, this means you are basically a human guinea pig practicing every technique on each other throughout training. She asked for a volunteer to demonstrate techniques on the neck, this was my chance. My neck pain had increased from sitting in class and changing into so many different positions. Ten needles in the back of my neck and head and my pain was gone, the pain I had been experiencing for months, it was gone! And there it was, I was hooked and wanted to bring this powerful tool to others.
So the big question... was it horrible to get stuck with needles? Not at all! Most of the needles I had no idea if they were in or out. Were a couple of needles sore going in, sure, but compared to the pain I was experiencing, this was nothing!
Do I have you excited? Contact me to schedule an assessment!
Ryan Goodman is owner of Goodman Performance Therapy LLC and the Team Physical Therapist for the Columbus Blue Jackets with experience in Orthopedic and Sports Medicine Injuries.