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Dry Needling SIG

JOSPT article June discussion

This topic contains 0 replies, has 1 voice, and was last updated by  JACQUELINE DOIDGE 3 months ago.

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    Let’s discuss the June article in JOSPT ‘Effectiveness of Inclusion of Dry Needling in a Multimodal Therapy Program for Patellofemoral Pain: A Randomized Parallel-Group Trial.’
    The results show no significant difference between the Man Ther/Exercise and the Man Ther/Exercise/DN group at 3 and 6 months.
    In our courses, we talk about the importance of addressing the agonist/antagonist muscles and identifying the culprit muscle, and not just the victim. Especially in Patello-femoral syndrome, we so often find that the quads are often the victims of deficits in rotation control around the hip. We also find that patients often struggle to effectively recruit the hip rotators which are causing the deficit.
    In your evaluation of these patients, I always ‘finesse’ my MMT to also test Glut Med and Min in inner range, where the weakness can be profound, and the presence of painful trigger points found. These may be active or latent; especially the Glut Min, which can refer into the leg and lead to satellites in the V. Lat or overload the quads to cause TrP’s also. This is often when I will first needle the hip, and retrain the muscle, before picking on the quads.
    I’d love to hear your comments on these ideas and thoughts on the article.

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  • I appreciate the above analysis and support the use of the term “doctor” while differentiating what that specifically means. While I am cautious to avoid contradicting an orthopedic surgeon to a patient, I also resent the idea that physical therapists specifically should not refer to themselves as doctor. This was the opinion of one ortho surgeon with whom I shared a patient in the past year. His initial statement was that only a “doctor” (MD or DO) should refer to themselves as doctor when dealing with healthcare, but it turns out he did not agree with his own statement once challenged on the subject. He did not want the physical therapists to call themselves doctors, to avoid “confusing the patient.” When asked, however, he seemed to have no problem with an optometrist, podiatrist, psychologist, or any number of other providers referring to themselves as doctor. I believe the problem arises from the fact that Physical Therapy as a profession is in a transition, and we must understand that some time must be given to allow for acceptance of this transition.

  • One of the take home messages for me is ‘never give up!’, treat what you know, and don’t let the imaging keep you from being confident in well rounded conservative care.

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