From 21st Medical Group
PETERSON AIR FORCE BASE, Colo. — In March, Maj. (Dr.) Ryan Girrbach, 21st Medical Group Physical Therapy clinic, traveled to Denver to become certified in therapeutic dry needling. TDN is an exciting new procedure intended to reduce pain by treating “trigger points” in chronically tight muscles.
The certification was attained through an intensive three-day, 27-hour course, with mostly hands-on instruction and laboratory practice. Less than 1 percent of all PTs in the country are certified in TDN.
TDN, also known as Intramuscular Manual Therapy, is a technique employed by physical therapists to treat the neuromusculoskeletal system based on muscular dysfunction, pain patterns, and other orthopaedic signs and symptoms. It relies upon a detailed physical examination and assessment to guide treatment. The physical therapist must have extensive education and knowledge of the nervous, muscular and vascular systems as well as orthopaedics in general to apply for training. TDN differs from acupuncture in that the latter is based on Eastern medical diagnosis, requiring training in traditional Chinese medicine. Ultimately, TDN is used as an additional option to traditional PT treatment centered on strength, flexibility and conditioning.
“Trigger points” are hyperirritable spots found within a taut band of skeletal muscle or in the muscle’s fascia (connective tissue attachments). Trigger points, typically associated with chronic pain, are painful upon compression, and can give rise to characteristic pain, referred tenderness, motor dysfunction, and other autonomic nervous system phenomena. Trigger points can also refer pain to other regions that are assessed by the PT.
The primary goal of TDN is to desensitize and/or “release” trigger points, restore normal muscle function, and to possibly induce healing in the target tissue. This is achieved by introducing sterile needles, ranging in length from 30-100 mm, into varying depths of muscle with a goal of obtaining a local muscle twitch response. The muscle contraction releases the shortened muscle, essentially “resetting” it to a normal state. Needling is also thought to produce local inflammation that is necessary for healing, and to provide electrophysiological and neurophysiological effects at the chemical and cellular levels consistent with muscle function restoration.
For more information on dry needling, go to http://www.kinetacore.com/, or call the 21st MDG Physical Therapy Clinic at 556-1075. A referral from your primary care physician or orthopaedist is required in order to be evaluated for TDN services. Currently, due to high demand, only active duty members are eligible for care at the Peterson PT clinic.