Otherwise known as intramuscular stimulation (IMS) or trigger point dry needling, dry needling is a skilled intervention that helps relieve neuromuscular pain and increase muscular function. This practice should not be confused with acupuncture, which is based in the traditions of ancient Chinese medicine; dry needling is unique to western medicine.
When executing this technique, the therapist will use a very thin needle to penetrate the skin and stimulate myofascial trigger points. These trigger points are also referred to as muscle knots, or a motor point (the most excitable area of a muscle). The needle stays below the skins surface throughout treatment, threading in and out of the muscle knot. When the needle is inserted into the trigger point it aids in the release of the shortened muscle, allowing it to relax through a twitch response or ‘reflexive spasm’.
While receiving this treatment; clients can expect to feel a dull to moderate aching sensation referred to as “deqi”. Effective dry needling requires the client to experience “deqi” as well as a local twitch response. Physiotherapists use dry needling to release trigger points, restore efficient muscle contraction (decrease muscle tension), increase range of motion, and decrease pain by releasing opioids (the body’s natural pain killers).
Dry needling has been proven to be a widely effective choice of treatment for many clients, particularly for low back pain, neck pain, shoulder pain, knee osteoarthritis (OA), hip OA, as well as headaches, piriformis syndrome, and whiplash.
All of our physiotherapists at Maximum perform both dry needling and acupuncture.
Acoustic Wave Therapy (AWT) is an innovative treatment for musculoskeletal conditions. AWT is a series of high-energy percussions or radial pressure waves to the affected area using a transmitter head on the skin. The mechanical pressure of the acoustic waves provokes a response in the tissue that stimulates the formation of new blood vessels. This increase in blood supply/circulation accelerates the healing process. The radial pressure waves also stimulate the body’s natural self-healing processes by promoting a positive inflammatory response at the site, then assisting with regeneration and repair. AWT appears to be able to reset the healing process especially in stubborn chronic injuries where other conventional treatment and modalities have not been successful. The evidence for the use of AWT is overwhelming! In the last 10 years, over 300 articles and abstracts have been published regarding the efficacy of AWT. Of special note, many randomized controlled trials showed that AWT is safe and effective for treating plantar fasciitis (Gerdesmeyer et al. 2008) hamstring tendinitis (Cacchio et al. 2010), Achilles tendinopathy and jumper’s knee (Rompe et al. 2007), and calcific shoulder tendinitis (Bannuru et al, 2014). There has also been exponential growth in AWT use for trigger point therapy.
The most striking aspect of AWT is that it has a 75-85 percent success rate when combined with exercise.
For many injuries, AWT is a great non-invasive alternative to surgical procedures. For best results it is recommended that treatment be performed at one week intervals for a minimum of three treatments.
“regular exercise is really important to me and I have had a chronic high hamstring injury that was not improving with routine stretching, strengthening, and acupuncture! I took the plunge, trying Acoustic Wave Therapy and was surprised to see that after 7 treatments (with my home stretching and strengthening program), I am finding significant improvement. I am able to walk (even run!) up stairs without difficulty, bend forward on one foot, and have resumed jogging and biking.” Dr. Jennifer Young
Sue Underhill is a Registered Physiotherapist at Maximum Physiotherapy, and is trained in administering Acoustic Wave Therapy. Give us a call (705)444-3600 to find how Acoustic Wave Therapy can help you.
Today, many of us sit in front of the computer working all day, chasing that next promotion. You may find yourself in back-to-back meetings — or at your desk — straight through lunch hour. When was the last time you really paid attention to your posture? How is your lower back? How is your neck feeling?
According to the National Institutes of Health, back pain affects eight out of ten people. Our bodies were designed for walking and other movements throughout the day. We were not designed to sit in chairs for long periods of time with little movement. All that sitting puts our bodies at risk of having bad posture.
Bad posture can:
Cause some muscles to work harder than others, creating muscular imbalances.
Decrease the range of motion in your joints.
Interfere with breathing and damage your heart and lungs (due to a bent spine restricting the expansion of the rib cage).
Leave you tired (due to muscles working extra hard just to hold you up).
Lead to rounded shoulders, headaches, back pain, and all kinds of body aches.
Good posture means the muscles in your body align properly. That allows you to move efficiently in your daily activities. Does good posture seem out of your reach? Try these four easy steps:
1. Strengthen your core muscles.
Plank hold (15-30 seconds)
Partial crunches (8-12 times)
Side planks (15-30 seconds on each side)
Floor back extensions (8-12 times)
2. Strengthen and stretch your upper body to fix rounded shoulders.
Reverse dumbbell flies (8-12 times)
Rows with dumbbell (8-12 times)
Chest stretch (hold 10-15 seconds)
Upper back stretch (hold 10-15 seconds)
3. Strengthen and stretch your neck muscles.
Chin tuck (8-12 times)
Isometric holds from the left, right, front, and back of the head (15-30 seconds)
Chin to chest stretch (10-15 seconds)
Ear to shoulder stretch (10-15 seconds)
4. Strengthen and stretch your hip joints.
Bridges (8-12 times)
Laying side leg raises (8-12 times)
Standing quad stretch (10-15 times)
Laying hamstring stretch (10-15 times)
Perform these exercises two to three times a week, depending on your fitness level. Also, you can start with just one set of each exercise. As you get stronger, you’ll be able to add more sets without compromising form. It’s a good idea to check with your doctor before starting any new fitness routine.
Kinesiology tape is uniquely designed elastic tape constructed of cotton and elastic fibers. It is breathable and has the same approximate thickness as our skin which makes it more comfortable than most other types of tape. The tape’s elasticity is 40-60% of its resting length and stretches along it long axis only. The adhesive part of it is medical grade and heat activated. There is no medicine in the tape, it is hypoallergenic and it is latex free!
The elasticity of the tape can help to either stimulate or detonify a muscle, and provide proprioceptive feedback to the sensory nerves on the skin.
It can enhance the function and positively influence muscle, fascia, tendon, ligament, circulation, and pathological movement patterns. It is used to treat clients with muscle imbalance, postural issues, ligament, tendon and joint injuries, and so much more! Kinesiology tape can be combined with any other therapeutic modality (heat, manual therapy, electrostimulation, acupuncture etc. It can be worn for 3-5 days with continued therapeutic benefit. Kinesiology tape is appropriate for any stage of your injury or treatment plan – from acute to chronic. Although millions of athletes have benefitted from the application of kinesiology tape, most of the applications are for non-athletes. There are many brand names of kinesiology tape which vary in quality – usually elasticity and durability. We have tried many brands and have decided that Kinesio Tex Gold is superior.
We also use zinc-oxide athletic tape, whose primary purpose is for support and not rehabilitation, and has limited wear time.
Leukotape is used in our clinic, mostly for McConnell knee taping.
Osteoarthritis? Physiotherapy can help! Osteoarthritis (OA) causes degeneration of the cartilage in joints and is present in more than 50% of people older than 60 years of age. The knee joint is commonly affected by OA, causing pain, stiffness, decreased activity and lost time at work.
Current research shows that physiotherapy can significantly reduce these symptoms. A recent study looked at the benefit of physiotherapy in patients diagnosed with moderate-to-severe knee OA. Outcomes were compared between a group of patients who had arthroscopic knee surgery followed by physiotherapy and a group who had physiotherapy only. After two years, there were no differences between those who had surgery and those who had physiotherapy alone with respect to pain, stiffness and physical function.
Another recent study compared the potential benefits of a home-based exercise program to a clinically-based physiotherapy program for patients with knee OA. After 4 weeks, those in the clinical physiotherapy group had an improvement of 52% in physical function compared to 26% in the home-exercise group. What does physiotherapy treatment consist of for knee OA? The physiotherapist will develop an individualized program depending on the patient’s current pain, physical function and goals. Treatment may consist of a stretching and strengthening program, manual therapy, education regarding the patient’s condition, ultrasound, laser and acupuncture.