Stick it to your tendon pain with Dry Needling
How many people have dealt with musculoskeletal pain and don’t know where to go to get help? “According to a report from the National Center for Finland Statistics in 1998, 46% of all diseases are related to musculoskeletal disorders, which occur in various areas of the body such as the neck, shoulder, elbow, hand, low back and hip joints” (MohammadBahger, et. al., 2020). What this means is that there is a large portion of the population is afflicted by pain of their musculoskeletal system and learning how to diagnose and treat effectively. Historically, clinicians have treated tendinopathies with the R.I.C.E. (rest, ice, compression, elevation) method. After learning from a former colleague (and following up on my own research as well) Michael Stella, ATC I have learned that ice is not the best first course of treatment for tendon conditions.
The first line of treatment, as presented by Uygur, et. al. (2017) is considered to consist of oral and topical anti-inflammatory drugs, ice, and bracing. The second line (if the first fails) includes therapeutic injections of saline, corticosteroids, and platelet-rich plasma (PRP). Little is known of dry-needling as a viable treatment option. As an objective measure, researchers compared pain and functional capabilities of patients at baseline, 3 weeks post-treatment and a 6-month follow up survey. They found that, when compared to first-line treatment options, dry-needling was effective at reducing symptoms at 3 weeks and then more so than convention first-line treatments at the 6-month follow up. Therefore, dry needling is a low risk, low cost, and highly effective treatment option for lateral epicondylitis (Tennis Elbow). This viability of treatment for this condition can be extrapolated into the treatment of other tendinopathies.
There are many other tendinopathy conditions that people are commonly afflicted by: rotator cuff, patella, and Achilles tendinitis. The majority of overuse tendinopathies in athletes are actually tendinosis, or a physiological change of tissue properties of the tendon during athletic activities. Stoychev, et. al. (2020) reviewed dry needling as a treatment option for tendinopathies and wrote that the prevailing idea that tendinitis is caused by overloading of the tissue but they wrote that the repetitive microtrauma causes physiological changes in cellular matrix and subsequent symptoms. Proper application, from a trained professional, of dry needling as a treatment technique helps to promote healing by disrupting the chronic degenerative process as well as promoting local fibroblastic activity (i.e., promote localized healing to occur). If inflammation is not the direct cause of tendinopathies, as once thought to be the leading cause, then it leads to the questioning of NSAID’s (Non-Steroidal Anti-Inflammatory Drugs) as the prevailing first-treatment option by many clinicians. Why not seek out a trained professional for a dry-needling consultation?
Golf is a highly athletic sport (more so than people think) and requires a high-velocity movement when hitting the golf ball. The combination of this velocity with the volume of swings, from practice and competition, leads to many injuries. In fact, elbow pain is the second more common injury suffered by golfers (low back pain is the most common). Being able to safely diagnose and treat effectively so that golfers can return promptly to being out on the course, with their friends enjoying their lives, is the most important factor when considering the most effective treatment option for your clients. Before you resort to the temporary relief of a prescription drug (rabbit hole of treatments), consider dry needling as a quick, low risk, effective treatment to helping you return to your sport.
Blanchard, Dr. Jeff. “The Anatomy of a Golf Injury.” The Physician's Golf Injury Desk Reference, Jones and Bartlett Publishers, 2007, pp. 9–11.
Stoychev, Vladimir, et al. “Dry Needling as a Treatment Modality for Tendinopathy: A Narrative Review.” Current Review in Musculoskeletal Medicine, vol. 13, 15 Jan. 2020, pp. 133–140.
Unverzagt, Casey, et al. “Dry Needling for Myofascial Trigger Point Pain: A Clinical Commentary.” The International Journal of Sports Physical Therapy, vol. 10, no. 3, June 2015, pp. 402–418.
Uygur, Esat, et al. “Dry Needling in Lateral Epicondylitis: A Prospective Controlled Study.” International Orthopaedics, vol. 41, 2017, pp. 2321–2325.