DRY NEEDLING…..What it is & how it could help your injury & pain

DRY NEEDLING…..What it is & how it could help your injury & pain

WHAT IS DN & HOW IS IT DIFFERENT TO ACUPUNTURE?

A thin filiform needle is inserted into a trigger point , connective tissue or fascia and is used alongside other forms of physiotherapy to promote pain relief, reduce stiffness and facilitate range of movement and function. It’s has been use since the 1980’s but recently become very popular.

ACUPUNTURE is a similar concept of needling but can be seen as more holistic, looking at the body’s state of energy flow and meridians.  Acupuncture focuses on fixed points where as DN targets more specific muscle pain points. The therpapist will palate and find these pain / tight spots.

The areas of muscle pain are known as myofascial trigger points. Muscles can have one or several points.  They are seen as hyper irritable spots in skeletal muscle that are associated with hypersensitive palpable nodules in taut bands…. That knot you feel in your upper shoulders most of you will be familiar with?!

Often these trigger points will REFER PAIN , so we may put needles in quite far away from where you will be perceiveing your pain.  BACK & SCIATIC pain would be a good example of this…… Often needling would be used around the back for pain that is felt down into the leg.

Studies have shown 30-85% of people presenting to a clinic are found to have myofascial trigger points to be the cause of their pain!

 

WHAT ARE THE EFFECTS?

By inserting a needle into these taut bands / trigger points we are aiming to re set the muscle and help reduce the referred pain. A local response of redness , swelling , heat and pain such as seen in an inflammatory reaction will be elicited – briefly this will stimulate the good chemicals to be released and  begin to reverse the ischemic (or toxic like) effects which commonly occur with injury. This may help REDUCE PAIN, INCREASE ROM, MOBILITY and FUNCTION

 

WHY SHOULD YOU TRY IT?

For all the reasons listed above!  It is another modality that can be used alone or in conjunction with other physio techniques which may help facilitate your healing, or better allow you to access a movement pattern/range of movement you have been struggling with.  Also the many ways needling can act on the body in terms of pain relief, it may benefit you where perhaps other treatments no longer have such a desired effect.  It can also be a very quick procedure so ideal in sports settings.

 

WHAT WILL YOU FEEL?

there are various sizes of needles and the therapist will choose one depending on the muscle and each individual . Treatment is often pain free but it is common to feel a ‘twitch response’ . The needle can be manipulated to further stimulate the fascia and muscle tissue to produce a local stretch response. Keeping it brief needling works on pain at different levels within the body ( locally, within the spinal cord and the higher ‘brain centers’ ) but overall has been seen to facilitate opioid release and pain modulate.

Everybody’s experience is different but often when needling the lower limb patients report a feeling of lightness.  It’s also quite common to feel a dull ache following treatment

Below is a nice example of how fine the needles are – nothing to be afraid of!:

Image result for dry needling
example of how small the needles are in DN & acupuncture

 

DEEP (trigger points) VERSUS SUPERFICIAL (pain relief)NEEDLING:

superficial needling uses needles that are much smaller and don’t penetrate more than 1cm, but are often left in for up to 15 mins.  Where as deep needling uses needles up to 125mm treatment normally lasts for a couple of mins.

superficial DN:

– reduced local & referred pain ( activates mechanorecptors coupled to C fibers)

– increased ROM ( stretching in fibroblasts within connective tissue/ fascia)

– if stimulating skin according to hiltons law you the same nerve will innervate the muscle directly below, so potentially have an overall greater effect

deep DN:

– local twitch response ( targeted at specific muscle )

– reduction of noxious inflammatory immune related chemicals

– resetting and reduction of pain within a muscle

– overall increased ROM, decreased pain and increased function

 

If you would like to know if needling can help you with an injury be sure to get in touch!

BACK CARE for skiers and snowboarders

This is not in any way prescriptive but something to help you look after your back, and hopefully avoid flare ups.  I’ve summarised some of the key things which I think will be helpful, after seeing a huge number of high level skiers and ski instructors this year with back pain.  I think the main problem arises from:

  1. being in a slightly forward flexed position, which isn’t great for your posture, and also jeopardises the discs if they are prone to irritation and compression
  2. carrying a ABS/back pack adds more load to that position
  3. varying conditions, race training or travelling at high speeds, often winding the body into deep positions where the body has huge forces to deal with
  4. park – something has to absorb those landings, there is no doubt that this over time will take its toll, but being in balance and having your core to support your spine will significantly help

 

I’ve split this into 3 key things to work at – even if you can just pick one thing from each of 1) stretches 2) self massage release 3) core to do every day that would be a awesome start!  A lot of the stretches you will have seen before, but it’s the small micro adjustments you can make to really target a muscle group and benefit from the stretch.  Without a one to one session it’s hard to explain, but I’ve tried to give some key pointers.

STRETCHES: hold each for a good 30secs, repeated x3

 

GLUT STRETCH 1: cross ankle over knee & push knee away from you. The more you lift up through your chest the more you will feel the stretch. Making small left to right movements with the legs will target the different gluts

 

GLUT STRETCH 2: cross 1 leg over the outside of the opposite knee.  Try anchor your hip to the ground & twist/bind into the pose

 

 

HIP FLEXOR : square off your pelvis so its facing forwards. Tuck your tail bone under (posterior pelvic tilt) then slightly arch your back and lean away from your back leg

 

DOWNWARD DOG: be especially careful in this pose if your disc is irritated. Aim to push shoulders back and heels down – good stretch for the hams and calves

 

Q/L STRETCH 1: this muscle is needed a lot for lateral separation in skiing and good mobility/stability in snowboarding. Slide one foot over to the side & then look to that foot.

 

Q/L STRETCH 2: hands planted twist & drop one hip bone down towards the floor. Repeat other side

 

Q/L & HAMSTRINGS: make an ‘L’ shape with your legs (this will also open up that hip), then reach forwards & to the outside of your foot – the stretch should be in the hams & your side.  Think to look under your armpit

 

 

HAMSTRING WALL SIT: Try sit here for a longer duration (i.e 5mins) while reading a book/watching TV etc. Try and get your butt right up against the wall and keep the knees straight. Progress to leaning forwards

 

SELF MASSAGE RELEASE: spikey massage ball & foam roller

 

HIP FLEXOR BALL RELEASE: place ball just below & down form the front of the pelvis. Allow your body weight to pressure the ball. Hold for at least 30secs & move down the top 1/3rd of the thigh

 

HIP FLEXOR BALL RELEASE OPTION 2: as above, but allow the knee to slowly bend up & down

 

 

GLUT RELEASE: start with the ball on the outside of the hip. Make small rotations in/out with the knee. Repeat with the ball more in the centre of the butt & your back against the wall!

 

 

PARAVERTEBRAL & Q/L RLEASE: Place the ball in near to the spine in the muscles either side. Pressure & wriggle the ball side-side, or flex the spine up &down

 

FOAM ROLLER QUADS: a) roll from top of hip to knee & back b)hold roller still then straighten/bed knees up & down

 

CORE:  This is a very brief intro into getting your deep core muscles activating.  This is hugely important in stabilising your spine – no matter how strong or ‘ripped’ you are, you need your deep core to ‘have your back’!!!  Often the more traditional sit up actions can be counterproductive if not done correctly, and you will 100% benefit more from an ABs workout if you deep core is working

 

TRANSVERSUS ABDOMINUS (Trans abs): tilt & tuck your pelvis several times until you find a neutral spine. Keep the shoulders relaxed. think to draw the LOWER stomach in (as though tightening to tuck your shirt into your jeans), or think of stopping mid pee. Placing your fingers 2 cm in from your pelvis you should feel a discreet tightening of this muscle. Hold between 5-30secs. You know you are cheating you are holding your breath!

 

SCISSORS: activate your trans abs as above. Keep the rib cage pressed against the mat, then lift one hip & knee to 90 degrees. Breathe out as you slowly lower & repeat. To progress take arms over head as raising a leg.

 

This is designed only to be an aid to helping your back.  It is always best to get a tailored programme from a professional to suit your needs.  Get in touch if any questions or comments 🙂

HITT cardio ski/snowboard workout

This can be done on its on in the suggested format: 4 minutes work, followed by 1 minute rest.  Repeated 3 -5 times.  8 exercises consisting on 30secs high intensity/30 secs of ‘active recovery’.  This is designed to mimic the intensity of an average ski run.

Alternately this cardio set can replace the previous cardio set in the last 3 phase workout.  Preparation is key!

Post-holiday, pre-ski Cardio HIIT workout

Feeling a bit sluggish after too much turkey and Christmas cheer over the holidays? Need to get in shape for skiing? Well, you're in luck amigos – our friend and your favourite Jo Pollard – Physio is back with a high-intensity cardio workout designed to put the pep back in your step. This workout can be done on it's own, or as the cardio section of a three-phase mountain workout by adding core and balance sections as seen in Jo's last workout video.Once your HIIT game is on point, head over to SkiBro to find your ideal ski instructor, school or guide and book online in just a few clicks.

Gepostet von SkiBro am Montag, 7. Januar 2019

3 PHASE MOUNTAIN WORKOUT

 

Want to be in best shape as you can be this winter? Try this sequence of CARDIO FITNESS, BALANCE/PROPRIOCEPTION and CORE to not only prepare you for winter, but keep you on top of your game 💪👊

This is sequence works on the fundamental elements to get you in shape and keep you on form for this winters riding.  The cardio section is designed to mimic the intensity of an average ski run, where your heart can pick up, followed by active recovery phase.  Next is a core section, which well help your stability and overall performance.  Saved until the last, is the balance and proprioception section – this is ideally done at the end when your fatigued, challenging your neuromuscular system, helping you develop balance reactions and better movement control when you start to fatigue, and may help with injury prevention.

Nov 27, 2018

Want to reduce falling over and risk of knee injuries while skiing and snowboarding?

Then take a look at these 5 exercises and reasons why to add hamstring strengthening to your fitness programme

#ski fit #injury prevention #biomechanics #stronger #train smart

REASON 1: INJURY PREVENTION #ACL

Many of us (and rightly so) focus on exercises to our quads, as this is where we feel the burn when riding, especially in the pow right?  While this is correct and it is important to train these muscles, it’s also important to exercise the counteracting muscles; the hamstrings.  If our quads are too strong, or our hamstrings too weak, there is an imbalance.  This combined with fact that the hamy’s act like a brake system which means that if we fall, twist or land awkwardly, we are more likely to cause injury to our knee if the hamstrings can’t counteract this quad contraction or adequately play it’s stability role.  This is of huge importance in avoiding ACL injury and important to include in any programme post *ACL surgery/injury (*always seek physio advice for a specific plan)

REASON 2: BE MORE DYNAMIC AND EFFICIENT.

Our hamstrings contribute to stability, shock absorption and
better movement patterns. Connecting our hips and knee joints, they provide efficient
load absorption and power to be transmitted in our sports.  Our hamstrings and gluts work together to
provide strength and explosive movements, but also support what is known as our
posterior chain.  In skiing and
snowboarding this would relate to us being able to maintain good posture,
resist falling over and keeping up right in bumpy or unpredictable terrain.

REASON 3: WANT TO AVOID FALLING OVER AS MUCH?

Our hamstrings often work eccentrically, meaning they are
lengthening whilst also contracting. 
This is especially important whilst running or kicking, or in the skiing
environment to help control our movements, especially if we feel we are going
over the ‘handle bars’ – are hamstrings act like decelerators.

REASON 4: BE BALANCED – STRENGTH THROUGH RANGE

As well as being strong, our hamstrings need good length in
them to optimally provide the qualities discussed.  If the hamstrings are tight, they can pull on
your pelvis and cause biomechanical imbalances. 
You are at risk of this if you ski or snowboard for long periods, as you
are nearly always working with a bent knee and therefore at risk of the hamstrings
tightening and potentially straining.

REASON 5: BIOMECHANICS

Sorry ladies but this is aimed at us!  Women are more likely to have valgus collapse in their knees -meaning our physiology generally means our knee drops into adduction and internal rotation more easily (i.e. collapses in).  While skiing or snowboarding with our knees in a bent position our inside knee ligament (MCL) is not so effective at supporting our knees – our hamstrings (as well as other muscles of the knee), play a huge support and protection role to the knee ligaments.

There are of course many exercises, but give these 5 a go to get your hamstrings and gluts firing up…..

BRIDGE; start – spine neutral, core activated

BRIDGE; finish:  squeeze through your gluts to form a stable platform.  Rest on the heels for increased hamstring bias

ADVANCED OPTIONS; single leg +/- weight

RUSSIAN DEADLIFT; keep the knees relatively straight, but soft.  Hinge from the hips with chosen weight (barbell, kettle bell or a backpack filled up!).  Squeeze through the gluts and core to stand back upright

GYM BALL HAMSTRING CURLS; start-core engaged, hips off the floor maintaining a neutral pelvis, feet resting on the ball 

GYM BALL HAMSTRING CURLS; finish – maintaining the neutral pelvis use your feet to slide the ball away.  Repeat

REVERSE GLIDERS; start – find a slidy surface and place a tissue or towel under 1 foot

REVERSE GLIDERS; finish – slide the tissue backwards into a lunge.  Keep hips forwards and ensure front knee doesn’t go over front ankle (NB focus on feeling the hamstrings firing in the front stable leg)

RUNNERS REACH; start – core engaged standing tall on one foot, the other leg at 90 edgrees

RUNNERS REACH; finish – reach forwards and out, keeping front knee soft and pelvis aligned towards the floor.  Drive through the gluts and hamstrings back to the start position

LANDING CONTROL; start on a step (stairs or the yellow pages)!

LANDING CONTROL; finish – drop and stick.  Try and land soft.  The aim is to control your knee – do not let it track inwards!
For power this exercise it can be progressed by landing and exploding straight up into a single leg hop

Start with low reps and sets i.e 4-6 reps x 3 sets, and build up as you gain strength and confidence.  As with any exercise it is important to fully warm up and seek further advice if you are unsure of any of the exercises.  Feel free to get in touch for advice and more ways you can prepare yourself for your sport or post injury programmes 🙂 

MOUNTAIN READY WORK OUT – cardio full body set

I’ve teamed up with SkiBro to provide the first in a series of exercises, which can easily be done in the comfort of your own home, just click on the link above to see episode 1.

This workout is designed to take no longer than 30 mins, so there is no excuses not to fit it in!  It designed to get your heart rate up and work all the major muscle groups used in skiing/snowboarding.  Try and complete the whole set and repeat it continuously 4-6 times.  If you are not sure of fitness levels, or need to work up allow a 30 second rest between each set, and start off with 2 or 3 rounds until you can complete 6.  The exercises here are all round great for all types of sport and general fitness, so get involved!

Getting yourself ready and in shape for your ski holiday means you can not only enjoy your skiing more, but also get less fatigued, help reduce likelihood of injury, and all in all stay out on the slopes longer!

Get ready to get started, get sweaty and get strong!!

Jo Pollard Physio

Hello! I would like to introduce myself and my new website.  I am Jo, and have been working for various companies over the last few years, but am setting up independently for my 7th season in Val D’lsere!  I am fully registered as a physio in France and the Uk.  I can also accept clients that can benefit from free, or greatly reduced physio with their Carte Vitale.

This summer I have had a great summer working in Chamonix, working with all kinds of athletes and tourists.  Its been great to see a variation of hiking, running, biking and climbing injuries!

I’ve been a physio for nearly 12 years now and have worked in many areas of physio, but mostly with the sporting population.  I have also been working with the para GB ski and snowboard teams and was lucky travel to all parts of the world.  I am a passionate skier and snowboarder, and combined with my experience am confident to get people back to where they want to be.  See my ‘about’ bio for more info!  Don’t hesitate to get in touch for any preseason injury queries or find out how pilates could benefit you!  Bring on the snow 🙂 

One of my favorite lines touring last year – lets hope for more powpow this year 🙂