By: Judy Gelber PT, DPT, OCS, CFL2
"I’m the last person anyone would expect to have started dry needling."
Reasons why I didn’t need it
1. I had a perfectly established and effective practice without it.
2. I was indoctrinated to think that if you focus on prevention and the reasons behind a pain problem (teach a man to fish), you will make more change than directly addressing the tissue (give a man a fish). Just to be clear, I still believe in that doctrine.
3. It costs money to get trained (I’m…frugal let’s call it) and seemed like a risk I did not want to take on as a practitioner.
4. My perception was that the real reason someone would needle was to make money, and I always felt it was more a gimmick than true therapy.
5. It seemed like less thought process (stick a needle in it) and not as hard of work as understanding anatomy and kinesiology.
6. I do pride myself in being open-minded. I tried being needled. Three times for three different things by three different practitioners. Two of those experiences were underwhelming and the third (and final) was negative – negative in that the clinician couldn’t adequately educate me on what she was doing, and her technique was not effective in helping my symptoms.
Why I started researching
Honestly, the initial jump start was business-oriented. My people wanted it and therefore I needed to at least look into it. There has to be SOME reason why it is so popular. Maybe my experiences were the exception (they were) and not the rule.
I reached out on a social media networking group (Physios in CrossFit) and started asking for suggestions. OVERWHELMING support to get trained. The suggested company was KinetaCore (who I am in no way affiliated with, for the record).
I started researching the course and it felt like serendipity that KinetaCore was hosting a course not even 6 weeks later in my city. It’s not like I’m in Phoenix or Denver or Boston.
It must be a sign.
Suffice it to say, now I perform dry needling. And, surprise, I really like it. So let’s go back to my first list and add my own retorts from the believer’s side.
1. Even though my practice was established and effective, I couldn’t reach all patients. And I had limited (although growing) resources to help someone in the moment, when they really needed help. It’s always a struggle to help educate an athlete to see long-term, overarching goals and not just the immediate injury, but if I can get them in the door during the immediate injury, I have a better chance.
2. It’s okay to feed a man a fish at the same time as you teach him how. He might trust you more.
3. The cost I spent on the course was worth it. If nothing else, it was the most enjoyable continuing education I had taken in 12 years. More than that, it’s nowhere near as risky as I imagined in my head. The same ignorance our patients have about dry needling, our clinicians do as well. (Note to self to write just a basic educational post for therapists like me.)
4. This one is key. Needling truly bothered me from an ethical sense. The thing is, I still think SOME clinicians needle with the number one goal of ease, financial gains, and to not have to work as hard (see #6, the negative experience). And this is where I see opportunity – the chance to be a good role model and raise the standard, because it can be a very skilled set that is part of an even bigger skill set.
5. To my notion that less thought went into needling, it’s quite the opposite. I think I am lucky - years of teaching palpation and surface anatomy to entry-level DPT students gave me quite a leg up when it came time to learn palpation and techniques for needling. Beyond that, I was surprised to experience that needling:
a. Actually IMPROVES my anatomy knowledge, especially when I use stim. "That bulge right there? It’s pronator teres. See how your arm moves?"
b. Also advances my understanding of the patient presentation. "Hip hurts? Find the band and needle it – oh hey, it’s your rectus femoris that’s talking, not psoas like someone told you."
6. The negative experience: I don’t need to go into details. She was safe, clean, and needled I am guessing the way she was trained. I think you learn something from every experience. What I took from that one is that I’m glad to be trained in more than just trigger point needling. My brain can’t help but think of things in a more global sense (what’s going on right there but then how does that connect up and down the chain and what else might have an impact to that particular pain problem). And I also took away that it is good to share with my patients the rationale for why I needle what I do. In order for them to recognize how hard I think about them, I have to be able to share that thought process on a level that matters to them (which varies from person to person). That has helped me a ton from the customer service standpoint and so I thank my bad experience for helping me do things differently.