Inside DM

Dry Needling

Why dancers are having their trigger points released with a needle

We are all looking for a little magic when it comes to injury prevention and recovery. So it’s no surprise that dancers, always on top of new health trends, have recently started getting into dry needling. The treatment promises instant relief to some of dance’s most nagging injuries by releasing trigger points in the muscles with a needle. But it also has medical professionals buzzing with controversy. When your physical therapist pulls out a needle, should you question whether it’s safe for you?

What Is It?

Dry needling uses filiform needles—the same kind as traditional acupuncture. But although the tool is the same, the approach is different. Based in ancient Chinese medicine, acupuncture seeks to balance the flow of energy along pathways in the body called meridians. Dry needling, on the other hand, arose out of Western medicine in the 1940s: Dr. Janet Travell, a specialist in pain referral patterns, identified trigger points in the body that would relieve pain by releasing tension in the associated muscles. Initially she injected the trigger points with fluids such as saline. The term “dry needling” originated when she discovered that the technique had the same effect without the injection.

How It Helps

The practitioner inserts the needle using a technique that elicits a “twitch response,” an involuntary reaction in the muscle that enables it to release tension. The immediate elongation of the muscle fibers allows the muscle to relax. “When the needle taps the tight tissue, it creates a micro-trauma which brings a lot of blood to the area,” says Bianca Beldini, a licensed acupuncturist and physical therapist at Sundala Center for Wellness in New York City. “Immediately when you take the needles out, the patient’s range of motion improves and their pain decreases.” Acupuncture techniques vary, and this twitch response is not something that acupuncturists would normally go for, unless they use the trigger-point dry needling technique.

The Effects

Many dancers find that the muscle release dry needling provides has dramatic results. “I have needled dancers the same day as an injury and they are able to return to rehearsal after treatment,” says Erika Johnson, director of dance medicine at Marathon Physical Therapy and Sports Medicine in Massachusetts. “This is obviously case dependent, but it’s exciting to see this trend.” While it can’t help every injury, Johnson has used dry needling on muscle strains and spasms, tendonitis, sprained ankles and many of dance’s other most common injuries.

For New York City Ballet principal Sara Mearns, who has been treated by Beldini since she first joined the company in 2003, the approach combining dry needling technique with more traditional acupuncture has helped her heal faster and feel better. “If I have a strained calf, she is able to fix it within two sessions probably,” Mearns says. She admits that she was nervous about the needles at first. “But the needles are so tiny and the release that I get from them is deeper than any other therapy.”

The Timing

The first time a dancer experiences this type of needling, Beldini often encourages them not to dance for the next 24 hours. This gives them a chance to find out how long they will experience soreness. “The twitch response can release a fair amount of lactic acid, so the dancer is typically quite sore after,” explains Beldini. A good practitioner will be able to perform the technique gently and minimize this soreness as they get to know your body better. Mearns can be needled by Beldini and dance pain-free the next day. In fact, during performance seasons she sees Beldini every Monday even if she’s not injured because the treatment has become so therapeutic. “It’s a process,” says Mearns, “but once you get to that place where you can really handle that deep release in your muscles, your body will be completely different.” 


Why the Controversy?

Few dispute the effectiveness of dry needling. But controversy circles around who is qualified to do it. Many acupuncturists argue weekend courses aren’t enough to qualify physical therapists to needle people. “Acupuncturists aren’t just throwing a needle into one muscle to get a twitch response, but we’re needling into a bunch of different things,” says acupuncturist/physical therapist Bianca Beldini. In fact, several states have ruled that dry needling is outside the scope of practice for a physical therapist because it involves puncturing the skin.

Yet some in the physical therapy community feel they are qualified, since they are myofascial and biomechanical specialists. “Physical therapists have been treating trigger points and myofascial restrictions with their hands for decades, and the filiform needle is simply an extension of this,” argues dance medicine specialist Erika Johnson. In fact, Johnson feels that becoming a practitioner of dry needling has helped her develop a greater appreciation for when acupuncture is a better treatment, and regularly refers dancers to acupuncturists.

In a perfect world, every dry needling specialist would have training in both practices, but this is a rare combination because both specialties require extensive training. Make sure that anyone treating you with a needle has been trained to use it and has experience with physically active clients like athletes and dancers.

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