Sunshine on my Shoulders

 Shoulder Pain

What You May Have Done For It:

Taken ibuprofen, acetaminophen, and naproxen sodium

Rested it

Stretched it

Exercised it

Ignored it

Asked a friend for advice

Asked Facebook for advice

Asked Google for advice

Iced it

Heated it

Wore a sling

Not slept on it

Not slept well in a long time

Saw your doctor

Saw your chiropractor

Saw your physical therapist

Saw your potential surgeon

Taken pain medications

Gotten injections

Gotten a massage

Had X-Rays and/or MRI

Thinking about or have had surgery

And………You still have shoulder pain!

As a physical therapist of over 20 years and a dry needler for 10+ years, if you consulted with me, I would certainly ask you if you have tried dry needling. I would explain to you why and how it might help, whether it’s appropriate to try it on you, and find out if you are willing to try it since you have “tried everything.”  I’d be educating you about your rotator cuff, scapular, neck, thoracic, and arm nerves and muscles. Dry needling is not a miracle or cure-all. It may or may not help you. It may take a few or many follow-up sessions and a combination of all of the other things you have been doing for it. Dry needling may very likely speed up the healing process and decrease the pain. It may also have you rethinking surgical options, which should always be a last-case scenario. Just my 2 cents.

Brief Anatomy and Possible Key Players:

Muscles: supraspinatus, infraspinatus, subscapularis, teres minor, upper trapezius, levator scapulae, rhomboids, teres major, latissimus dorsi, serratus anterior, pectoral major and minor, deltoid, biceps, triceps, coracobrachialis, cervical and thoracic multifidus

Nerves: Cervical and Thoracic nerves originating at C5, C6, C7, C8, T1, T2, T3, T4

Common diagnoses: Rotator cuff injury/tear, thoracic outlet syndrome, cervical radiculopathy, labral tear, subluxation, dislocation, rotator cuff repair, neck pain, shoulder pain/strain

Dry Needling For You, St. Pete!

Provider: Julie Schumann, PT

Location: Valverde Chiropractic, 5203 Central Avenue, St. Petersburg, Fl  33710

Limited appointment times: Monday, Tuesday, and Friday

Email for an appointment or to discuss whether this type of treatment might help.

Website: www.dryneedlingforyou.com

Who Am I?

 

(Image from Treasure Island Kite Festival, 2023)

Thanks For Asking!!!

At this stage of life’s game, I am a wanderer, a skeptic, an introvert, a half-glass-full type, a realist, a problem solver, a mom, an ex, an optimist, a friend, a dance-like-nobody-is-watching type, an every-moment-is-precious type, a listener and a sounding board, a live-in-the-present type because your past can clog you up and your future is unknown.

How Did I End Up In St. Pete?

I have lived in New York, Australia (briefly), and Colorado for 97% of my life. A whirlwind of a love story gone bad and having to pick up the pieces quickly brought me to Florida. I’ve traveled thousands of miles on my own through a personal journey taking me from emotionally heartbroken to emotionally heart-centered. I may tell you about it someday when I get to know you.

What Do I Love About St. Pete?

The beauty, the climate, the diversity, the hustle, the quiet, the laughter, the music, the tides, the dolphins, the manatee, the pelicans, the sunrises, the sunsets, the ingenuity, the trees, the brick streets, the ‘happiness’ signs, the independence of small business, the artistry, the creativity, the murals, the music (oops, I said that again), the curiosity, the sense of community, the connections, the passion.

(A night at The Blueberry Patch, Gulfport, Fl)

(A Gulfport sunset)

(A mural and a ride on PedalPub St. Pete)

Why Do I Practice and Promote Dry Needling?

Dry needling is a technical offshoot of my career foundation as a licensed physical therapist. It is what I do to help people. It is a technique for pain relief and functional recovery. Stand-alone, it is nothing. Combined with the medical thought process, anatomical knowledge, questioning, realistic expectations, time for the client, listening to the client, and the coaching client to pursue their goals (standing, walking, running, sports, working, lifting, caring for others, caring for self, etc.) dry needling then becomes a dynamic and personal part of healthcare. I enjoy being a dynamic and personal part of healthcare.

What Will You Get From Me?

My attention.

A face-to-face discussion of your history, limitations, and goals.

Medically and anatomically based decision making.

Experienced dry needling care. I’ve been doing this for over 10 years.

Realistic expectations.

Honesty. If I don’t think I can help, I will tell you so.

Hopefully, some humor and laughter.

You may learn about my life’s journey and possibly I will learn about yours!

A brief history of my dry needling education and experience:

In 2009 I took my first dry needling class and was interested but a bit too nervous to use the technique on clients consistently, so I stopped. In 2012, I decided to take the beginner class again. This time I followed through and started ‘needling’ people. I completed my certification with intermediate and advanced dry needling classes. I began to love performing dry needling about a decade ago and have continued to use it on my clients whenever possible. As described in my blogs, dry needling has been a helpful tool for the treatment of many neuromuscular conditions such as sciatica, sprains, strains, low back pain, neck pain, shoulder pain, TMJ pain, headaches, bursitis, tendinitis, plantar fasciitis, whiplash, subluxations, rotator cuff injuries, thoracic outlet syndromes, stenosis, and degenerative disc diseases.

Currently, I practice in St. Petersburg, FL. I see a limited number of patients per week so that I can give each patient the attention to pathology and treatment techniques needed. 

Office location: Valverde Chiropractic, 5203 Central Avenue, St. Petersburg, FL  33710

Availability: Monday, Tuesday, and Friday

Website: www.dryneedlingforyou.com

To schedule an appointment please email me or call or text at (813) 922-8757 and I will get back to you as soon as I can.

She Blinded Me With Science

Could There Really Be A Therapeutic Effect?

So, your friend told you to try dry needling for your shoulder pain. Now what? Search Google for dry needling to see what it is and how it might help. Here is a brief synopsis of what might be taking place when a thin needle is inserted into muscles and tendons. If you checked out of high school science and are currently being guided by your emotions, you can skip this. You can check out my earlier blogs about dry needling: What’s the Point and Should I Stay or Should I Go Now.

The goal of incorporating dry needling into the therapeutic plan is to desensitize supersensitive structures (trigger points), calm the nervous system, improve/restore range of motion and function, and possibly create a healing response in tissues such as muscle, tendon, and nerve. My brain certainly does not hold onto the names of chemicals, nerve and muscle fibers, pathways, or chemistry so these are basic summaries of what I’ve learned in the past. If you seek more thorough microscopic descriptions I can likely (possibly) point you in the direction of sources or links.

There is still uncertainty about the actual mechanisms of healing, but these are the theories:

1. Chemical Effects: Normalizing the chemical components (bradykinin, CGRP, Substance P) of painful trigger points. Needle insertion will cause micro-trauma, micro-bleeding which encourages platelet-derived growth factor into the local tissues, causing an inflammatory and healing response.

2. Mechanical Effects: Trigger point dry needling may mechanically disrupt the dysfunctional chemical synapses at the motor end plate. This may be attributable to needle techniques such as spinning or pistoning which often cause LTRs (Local Twitch Responses) which in return may improve muscle fiber length or inhibit antagonistic muscles.

3. Neurophysiological Effects: Some hypotheses suggest dry needling may cause ascending and descending nerve conduction pathway changes at the spinal cord level that lead to decreased pain.

4. Electrophysiological Effects: There is also the possibility that eliciting a local twitch response may use excessive acetylcholine (ACh) that was causing spontaneous electrical activity (SEA) in the pain region. The metal needle may have an influence on decreasing SEA.

So, whatever is happening with needle insertion, it seems to offer benefits. I have been a proponent, clinician, and client of dry needling services for the past 10+ years. It is the one tool that I have used in my 22+ year physical therapy career that consistently offers clients at least a fairly rapid change in their symptoms. Honestly, when I get injured or have pain that I can’t shake, it is the help of a dry needling provider that I seek first and foremost. ***This is my personal experience, preference, and knowledge base. This is not a substitute for you seeking your own medical advice.

If you are interested in reading about who should and should not try needling due to absolute contraindications, and relative contraindications please read the blog here.

___________________________________________________________________________

Dry Needling For You, St. Pete!

Provider: Julie Schumann, PT

Location: Valverde Chiropractic, 5203 Central Avenue, St. Petersburg, Fl  33710

Limited appointment times: Monday, Tuesday, and Friday

Email for an appointment or to discuss whether this type of treatment might help.

Website: www.dryneedlingforyou.com

Should I Stay Or Should I Go Now?

Can I Have Dry Needling Performed On Me?

Photo by Tonik on Unsplash

You have some type of pain and are curious whether dry needling might be an effective treatment for you. It is not for everybody. There are some absolute contraindications and other relative (cautious) contraindications.

Absolutely Nope!

1. Needle phobia - you are just too scared of needles!

2. You don’t want to. Simple. Done.

3. Unable to give consent - potentially due to communication, cognitive, or age-related factors.

4. You are having a medical emergency.

5. May not be advised if you are undergoing current cancer treatments. Discuss with your MD.

6. Over areas of lymphedema due to increased risk of infection/cellulitis.

7. Open category of inappropriate for any other reason.

8. Recent surgery - best to wait 6 - 12 weeks after any surgery. Discuss with needling provider.

Maybe, Let’s Talk About It.

1. Abnormal bleeding tendency. Bleeding and bruising are common side effects of needling therapy.

2. Vascular disease. How are your blood vessels working? 

3. Compromised immune system may lead you to be at greater risk of infection. Talk to your MD.

4. Diabetes - poor tissue healing, sensory deficits, poor circulation.

5. Pregnancy - nope, not in the first trimester.

6. Children - usually not done on those younger than 13 years old. Depends on maturity and willingness.

7. Sick or frail patients - just may not tolerate the dry needling procedure.

8. Patients with epilepsy - caution, due to sensory experiences.

9. Psychological status - anxiety or emotional distress? It just may not be the right treatment. Discuss.

10. Patient allergies - typical needles have 8-10% nickel & 11% chromium. Needle allergy is rare.

11. Medications - immune suppressive drugs, psychotropic or mood-altering, blood thinning. Discuss.

12. Implanted devices such as catheters, drug delivery systems, implants, wires, electric devices. Discuss.

What Could Go Wrong?

1. Painful treatment. Post-needling soreness is common for 1-2 days post-treatment.

2. Bruising and bleeding. Common.

3. Fainting, dizziness, sweating, light-headedness. Rest and delay driving until feeling well.

4. Bending or breaking of the needle. Rare. Discuss with your needling provider.

5. Infection - pain, swelling, redness, fever, malaise. Seek medical assessment.

6. Fatigue - don’t drive until feeling well.

7. Pneumothorax. Rare but serious complication. Symptoms may include: shortness of breath, chest pain, coughing, and decreased breath sounds. Seek emergency medical attention.

***Your dry needling provider will be weighing the pros and cons of this type of treatment. Have an open dialogue. Remember, there is no such thing as a magical treatment and your symptoms more than likely will not be cured in one session of dry needling, or anything else for that matter.

Disclosure: I have been a proponent, clinician, and client of dry needling services for the past 10+ years. It is the one tool that I have used in my 22+ year physical therapy career that consistently offers clients at least a fairly rapid change in their symptoms. Honestly, when I get injured or have pain that I can’t shake, it is the help of a dry needling provider that I seek first and foremost. ***This is my personal experience, preference, and knowledge base. This is not a substitute for you seeking your own medical advice.

___________________________________________________________________________

Dry Needling For You, St. Pete!

Provider: Julie Schumann, PT

Location: Valverde Chiropractic, 5203 Central Avenue, St. Petersburg, Fl  33710

Limited appointment times: Monday, Tuesday, and Friday

Email for an appointment or to discuss whether this type of treatment might help.

Website: www.dryneedlingforyou.com

If you are a provider of dry needling services (yes, all provider types, not just PTs) and you would like to be included in my provider referral list, please email me. I will not entertain debates between professionals or inter professionally. Been there, done that. Niceness and respect wins.

Dry Needling, What’s the Point?

What is Dry Needling?

The use of very thin, solid needles inserted into the skin and underlying structures like muscles, trigger points, tendons, and scar tissue for the purpose of decreasing pain (joint pain, back pain), improving range of motion, decreasing radiating symptoms (pain, numbness, tingling), reducing muscle spasm, decreasing headaches and jaw pain, and improving your physical mobility and function. Typically, when used as part of a physical therapy treatment, other aspects of care will include stretching, manual therapy, exercises, modalities, and balance training as appropriate. For a quick demonstration and discussion of what dry needling is watch this YouTube video. Warning, yes it shows needles being placed into the skin.

Who Performs Dry Needling?

Trained physical therapists, chiropractors, acupuncturists, MDs, DO’s. Ask your medical team for a referral to a dry needling provider if you think you’d like to try it. Search the internet for providers in your area.

Why is Dry Needling an Important Piece of the Puzzle when Dealing with Pain? 

Truthfully, it may or may not be. What we know about life, there is never such thing as a sure thing. What we treat as therapeutic clinicians is the arthro-neuro-muscular system. Yes, joints, nerves, and muscles! An anatomical system. Physician care is fragmented. Typically, you may start out seeing your general practitioner who then will refer you in many different directions: neuro, ortho, podiatrist, rheumatologist, the hip guy, the spine guy, the shoulder guy. There are plenty of options for taking medications, having injections, having surgery, and taking over-the-counter pain relievers. But should these be the first line of defense?

The medical system historically has undertreated the neuromuscular system. Listen up. The nerves control everything. We have about 45 miles of nerves in our bodies. One MRI of the spine will not tell you what you need to know about the pain in your hip, knee, or foot. Irritations of nerves can happen anywhere in your body. The nerve pathways (peripherally and centrally) are what signal to the brain that something is wrong. When nerve supplies are cut, compressed, or compromised we run into issues ranging from numbness, tingling, paralysis, pain, tightness, looseness, radiating, burning, limping, immobility, and throbbing. Remember the nerves run the show. They connect with all systems in your body: organs, muscles, bones, and vessels. 

An ankle sprain is a nerve injury. A shoulder strain is a nerve injury. Whiplash is a nerve injury. Headaches may in fact be a nerve injury. Elbow pain may be a nerve injury. Carpal tunnel syndrome is a nerve injury. Sciatica is a nerve injury. Could your bursitis be a nerve injury?

Things we know about nerves: They need blood flow, space, and movement! 

What theories tell us about dry needling: The technique may increase local circulation, may change the faulty chemical compositions at neuromuscular junctions, and can alter pain signals to and from the brain.

The takeaway: Whether you choose the path of dry needling or not, checking in with a physical therapist, chiropractor, massage therapist, acupuncturist, or other trained bodyworker should get you on a better path to healing your injury. We treat neuromuscular symptoms. Find your partner in health first, before you are walking the line toward medication prescriptions or surgeries.

Disclosure: I have been a proponent, clinician, and client of dry needling services for the past 10+ years. It is the one tool that I have used in my 22+ year physical therapy career that consistently offers clients at least a fairly rapid change in their symptoms. Honestly, when I get injured or have pain that I can’t shake, it is the help of a dry needling provider that I seek first and foremost. ***This is my personal experience, preference, and knowledge base. This is not a substitute for you seeking your own medical advice.

If you are interested in reading about who should and should not try needling due to absolute contraindications, and relative contraindications please read the blog here.

___________________________________________________________________________

Dry Needling For You, St. Pete!

Provider: Julie Schumann, PT

Location: Valverde Chiropractic, 5203 Central Avenue, St. Petersburg, Fl  33710

Limited appointment times: Monday, Tuesday, and Friday

Email for an appointment or to discuss whether this type of treatment might help.

Website: www.dryneedlingforyou.com

If you are a provider of dry needling services (yes, all provider types, not just PTs) and you would like to be included in my provider referral list, please reach out in the comments or email me. I will not entertain debates between professionals or inter professionally. Been there, done that. Niceness and respect wins.