Tag Archive for: dry needling

Three Reasons Your Physical Therapy Didn’t Work

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Have you been to physical therapy once, twice, maybe even three times for the same thing… and now you’re left wondering why it didn’t work?

Or perhaps you went to physical therapy and it “worked,” but you have to do about 10 exercises per day that if you miss… even once… the pain comes right back. (hint – that means it didn’t actually work.)

This is sadly an all too common occurrence in this profession. However, if you’ve already had the chance to work with us, then you know we are a specialty practice.

But here are three reasons why your treatment in a regular physical therapy clinic might not have worked for you…

For physical therapy to be successful – it MUST start with a full and thorough musculoskeletal examination. But for varying reasons, this isn’t always possible.

The problem in most traditional physical therapy settings is that physical therapists are sometimes restricted with what they can and can’t do. Sometimes the restriction comes from an insurance company, and sometimes they are simply overworked.

If a doctor sends you for knee pain, your PT may only be able to look at and treat your knee. They are “administratively” prevented from giving you the full and thorough examination that you need.

I can’t tell you how many times I’ve seen knee pain being caused by someone’s spine. If I wasn’t able to look at and treat that area, I’d have missed it!

Other times PT’s have too many patients at once, and are forced to take short cuts. This could cause them to miss important details. I’ve been at this for 20 years, and in my opinion, the perfect physical therapy evaluation should consist of three major components: the interview, the examination, and the plan.

Your therapist should be asking you a lot of questions to find out how your pain is impacting you. They should do a lot of movement testing (not just poke you) to confirm why you’re having pain. And lastly, they should clearly explain to you why your pain is behaving the way it is and have a solid plan to solve it – one that is NOT dictated by your insurance company.

If your PT evaluation didn’t look like this, or your therapist was rushed, chances are something got missed.

The second reason I see physical therapy not working for people is because your PT used too many passive modalities.

This includes everything from electrical stimulation, ultrasound, dry needling, Graston technique, traction, laser therapy, and even manual therapy. We call these treatments “passive” because they are done to you.

There is a time and place for these things. But generally speaking, they should only be used to address very specific pain and impairments that are preventing you from moving in a way that is going to produce the real healing.

For example… let’s say you’ve got a tight knot in your upper trap that is giving you neck pain. There are some fabulous modalities like dry needling and massage that will quickly get rid of your pain, but a few days later, the pain will come back…

That’s because the tight knot is the symptom.

The underlying cause of this recurring tight knot is what’s essential to figure out and address.

If all your therapist does is treat the symptom with passive modalities that feel good, your therapy isn’t going to work and you’ll continue to suffer.

The last reason I see physical therapy not working is because there are just too many different exercises being assigned.

Physical therapists LOVE to give homework, but sometimes that homework can turn into two or three pages of exercises.

This is rarely necessary. And the chances of anyone doing all of these exercises every day is highly unlikely.

My firm belief is that your physical therapist should be working on highly specific problems with highly specific exercises. I refer to these as corrective exercises. You typically should only have 3-5 to do at any given time. These corrective exercises should compliment what you are doing in your session, and be designed to specifically address pain, and/or a very specific impairment or weakness.

They should NOT be generalized or cookie cutter – and you should absolutely have a very good understanding of why you are doing them and what they are designed to accomplish.

Ok… so now that you know what quality physical therapy should look like…

If you’re NOT getting it… it might explain why it “didn’t work”.

Sadly, insurance puts a lot of limitations on what physical therapists can and can’t do, which is why a lot of people are starting to move away from using their insurance all together. They know they can get better quality care, and have their problem resolved completely, by paying out of pocket to an office that isn’t tied behind red tape.

Plus, while it might seem cost prohibitive at first, it’s A LOT better than the costly alternative of unnecessary surgery or injections.

Remember that physical therapists are movement experts.

If you’re only doing cookie cutter exercises, riding the bike for 10 min, or just lying on the table every session – you’re not spending adequate time restoring full mobility and quality of movement.

Your physical therapy probably won’t work, and it certainly won’t give you the lasting results you’re looking for.

If this experience is sounding all too familiar – consider working with a practice like ours. We’re not restricted by the red tape and we care about doing things the right way, even if that means more work on our end.

Curious? Talk to one of our specialists for free!

You can do that by Requesting a Free Discovery Session right HERE!

What is Dry Needling?

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At CJ Physical Therapy and Pilates, our goal is to help you live a pain-free life without pain pills or invasive procedures.

Trigger Point Dry Needling is one of several strategies we use to treat muscles that are extremely tense and in spasm. The spasm causes the muscle to be in constant tension which reduces blood flow, decreases oxygen, and can produce fibrotic unhealthy tissue over time (scarring). When a physical therapist inserts the very thin acupuncture needle (dry needle) into a knotted up muscle, it creates a local twitch reflex. Research shows that this not only relaxes the muscle, it breaks up the pain cycle by improving blood flow and oxygen to the muscle. This whole process helps to reduce and normalize inflammation in the area to promote healing. However, dry needling is not necessary for everyone, so it’s important that you know what it is and when it can be used to improve your health! Here’s our advice when it comes to pursuing dry needling treatment.

Work with a physical therapist to use dry needling in conjunction with movement based rehabilitation.

Dry needling can work wonders to relax your muscles. However, they’re just going to get tense and damaged again if you don’t learn how to use them properly and address any movement dysfunction that may be occurring. You don’t want to think of it as a quick fix! Dry needling is just the first step for some individuals who aren’t able to begin a physical therapy or movement regimen without first breaking up the pain cycles in the muscles that are prohibiting healthy movement. Dry needling serves as a “helper” to relax those muscles – and should be integrated with physical therapy treatment and strengthening activities such as Pilates.

Don’t be afraid of trying dry needling!

It can be uncomfortable for some people, but others say they feel no pain at all. It’s not dangerous and has lasting positive effects when used in conjunction with hands-on physical therapy under the direction of a specialist. Furthermore, our clients love it:

“After two back surgeries in my 20s and a new hip at 58, I figured I was lucky just to be walking. Dry needling has transformed the way I move. I’m more flexible. My walking stride has more length and I can stand longer.” – John

Do you have questions about dry needling? Want to see what a specialty physical therapy practice can do for you? We offer FREE Discovery Sessions right here in Portsmouth that give you the opportunity to ask any questions you may have! It’s a completely free, no-obligation appointment that will give you all the information you need to make the BEST decision for YOUR health. All you have to do is fill out this quick form, and we’ll be in touch!