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Integrative Dry Needling

Kerry Brecht

The history of Dry Needling dates back to the 1940’s with Dr. Janet Travell who identified that muscular trigger points and referred pain patterns were helped with wet needling (with fluid injected). She later discovered similar results with the use of dry needling (needle only). Muscular trigger points are hyper irritable areas in the muscle and fascia that have shortened fibers. These areas can be palpated to produce a twitch response, or a localized contraction. Typically there is decreased blood flow to the center of these restrictions which can lead to further irritation, restriction and the pain cycle continues.

Dry needling has been reinstated in the state of Tennessee for Physical Therapists to provide this procedure to our patients. Dry needling uses a fine filament needle that is inserted into the trigger point or restricted tissue to help release the tension. Dry needling is based on neuro-anatomy and modern scientific study of the musculoskeletal and neuromuscular systems. Dry needling works by causing a micro lesion within the restricted tissue thus breaking up shortened tissues, helps to normalize the inflammatory response, and centrally mediates the pain helping to break the pain cycle.

Many conditions can benefit from dry needling such as neck pain, back pain, restricted joint motion, shoulder and knee pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow), headache including tension type and migraine, jaw pain and limited opening, buttock pain, leg pain (sciatica, adductor/groin strains, hamstring strains, calf tightness), plantar fasciitis, fibromyalgia. Only physical therapists who have completed state approved certification can perform dry needling.

We are excited to offer this as another treatment option at Kerry Becht Physical Therapy and Massage, Inc. 1409 W. Baddour Parkway, Suite A, Lebanon, TN 37087 . Call us for an appointment (615) 444-1408. View for additional information and research articles It will be used in conjunction with our current pain treatment programs which include myofascial release, spinal and joint mobilization, manual therapy, therapeutic and stability based exercises, modalities, craniosacral therapy, and trigger point release therapy. Please see our website for additional treatment programs www.kerrybechtphysicaltherapy.com

Not all Physical Therapists are the same…

Kerry Brecht

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Not all physical therapists are the same. Sure we all have our basic skills when we graduate from college, but what truly sets a therapist apart is their desire to learn and enhance their skills through continuing education and developing their intuition. I believe having a work setting that is a learning environment, mentorship to each other, and time to use more advanced skills are crucial for developing skilled clinicians. My name is Kerry Becht and I have been a physical therapist since 1994. I opened my private practice, Kerry Becht Physical Therapy and Massage, Inc., in Lebanon, TN in 2006. In the past 10 years we have grown to have 4 PTs, 1 PTA, 2 Licensed Massage Therapists, and an Office Manager.

Since I opened, we have always had extended treatment times and one on one individual time with our patients. Time is valuable to ensure proper diagnosis, that treatment is effectively executed, and our patients are educated on how to help themselves when not in therapy. We assess and treat the whole person because sometimes the source of the pain can be originating at an area away from the pain. For example, pelvic alignment issues can contribute to headaches, so we would need to treat the pelvic alignment as well as the head and neck. An ankle or foot issue can cause compensation at the knee, hip and lower back.

We treat ALL the same types of patients all other clinics treat, but our APPROACH is very different. Manual therapy techniques such as myofascial release (www.myofascialrelease.com), craniosacral therapy (www.upledger.com), spinal and joint mobilization, muscle energy techniques, and soft tissue mobilization take time to administer and be effective. Manual therapy is the core of our treatment with progressive functional based exercises and stretches. If you can eliminate the structural tightness, soft tissue restrictions, and stiffness, the movement of the area being treated will have better biomechanics, thus the exercises will be more effective. Just doing exercises and stretches alone will not correct structural restrictions in the spine, joints, muscles, or fascia (connective tissue). As the pain and structural limitations improve, core stability and functionally based exercises can focus on specific needs to restore strength, endurance, and balance.

In addition to orthopedic, post-op, and spinal issues that we treat, we also have therapists with specialized treatment in the following areas:

Certified Lymphedema Therapist, 2 Pelvic health and Women’s Health therapists, 3 PTs that treat vertigo, TMJ and headache treatment, pre and post-partum therapy, 2 certified Rock Tape Therapists, and we will offer DRY NEEDLING once approved by the state of Tennessee in May 2016. Our 2 massage therapists are also trained in myofascial release, trigger point release, essential oils (Raindrop Technique), and often see our PT patients once discharged to maintain their progress with the soft tissue improvement.

Give us a call at 615 444-1408 if you would like to schedule an appointment or have any questions. Or visit our website at www.kerrybechtphysicaltherapy.com

Do you have headaches? What is a “normal” headache? Where is the pain?

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It is not “normal” to have headaches but it is common. Most of the time due to our reliance on electronics and our jobs on the computer, we tend to do more sitting and then become more sedentary thus developing poor posture. This can lead to restricted muscles, poor strength and endurance of the postural muscles. Joints can become restricted and the end result often are headaches. A cervicogenic headache is where the primary contributing source is the neck and perceived in one or more regions of the head and/or face as stated by the International Headache Society. Patients typically complain of pain in the back of their eyeball, forehead pain, pain at the base of their skull, or even a headband shaped pain. The joints at the base of the skull contribute to almost 50% of the motion of the cervical spine. When these become limited and tight, they become strained and guarded and painful. Other contributing factors are most commonly seen to be due to motor vehicle accidents, poor posture, fatigue, and stress as well.

If you have never been treated for chronic headaches, you might have more benefit from physical therapy than medicine alone. We can assess manually and determine what joints and muscles in the neck or back are tight or restricted. We can address postural dysfunctions and weakness that are not addressed often at the gym independently. When muscles are tight or the spine is stiff, those muscles are not able to perform their job because pain is causing spasm often, inhibiting their function. Research supports exercise and manual physical therapy being the best treatment for this condition. In fact, even at a year after manual therapy and appropriate exercise one specific research study reported reduced frequency, intensity in headaches and reduced neck pain (Jull et all 2002).

Please call us if you feel you fall into this category for an initial evaluation to see if therapy is appropriate for you! How can we help you today?

*Kelly Ehlert, PT, DPT, OCS, COMT

Plantar fasciitis

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Plantar fasciitis is an irritation of the plantar fascia of the foot. The plantar fascia is the thick band of connective tissue in the arch from the heel to the toes. Its job is to assist the muscles of the foot to support the arch. Pain frequently starts due to a change in activity level, increased standing, or a change in footwear predisposing people to increased pressure on the bottom of the foot or arch. Most people try to reduce it by calf stretches, sleeping with special socks to reduce the shortening of the soft tissue in the foot, or even having surgery. When this doesn’t work what should you do?

Physical therapy should be considered as an excellent, first treatment option for this pain! If you are not able to reduce the pain within a couple weeks what ends up happening is the development of micro tears in the fascia that can eventually lead to more problems. This begins to create restrictions in the tissue, pulling on the heel bone, or the calcaneus, and can also contort the bony arch of the midfoot. The calf begins to tighten if it’s not already tight begin with and people usually begin to change their walking pattern, possibly now causing low back or hip pain! According to “The Diagnosis and Treatment of Heel Pain: A clinical Practice Guideline – Revision 2010” in the Journal of Foot and Ankle Surgery, stretches, strapping with special tape and PT are the top level suggestions for patients with foot pain. They suggest at least 6 months of independent and PT assistance until surgery or more invasive treatment is considered.

Let us reduce your pain and return you to work and your recreational activities!! Call us for your initial evaluation to get started with treatment and enjoy life again!

 

*Kelly Ehlert, PT, DPT, OCS, COMT

Prep for Running with a Physical Therapy Analysis

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Now that the weather is warming up, runners are hitting the streets, training for races, long and short. You may be looking to prepare for a marathon, or perhaps just wanting to stay healthy with a mile or two of cardio in the fresh air. Whatever your reason for running, the stresses can be a little much for your body to tolerate. This is certainly no reason to steer clear of your outside exercise. A physical therapy analysis from a physical therapist early into your training can save your body from excess strain, which could enable you to reach your fitness goals with fewer injuries.

Why Analysis is Important

No two people are built the same. This means mechanically everyone moves differently. Activities that may be pain-free for one person may be uncomfortable to someone else. Though a person may know what movement causes their pain, it’s difficult for an untrained eye to understand why. A physical therapist can examine the muscles, both large and small, that are used during activity to determine what imbalances, weaknesses, or restrictions could be causing the issue. Often times, the true cause of the pain is located in an area far away from where it is actually being felt. This makes self-diagnosis tricky.

Additionally, an assessment before your training begins can reveal potential dysfunctional movements and preventative measures can then be taken.

How We Help

After analyzing your pattern of movement from top to bottom while you walk and run, we can make suggestions to correct problems that may potentially lead to pain. Our findings may lead to a recommendation for a different type of shoe, or advice on areas to strengthen and stretch. If your running issues stem from old injuries, we can address those also. Whatever your needs, our goal is to help you run this spring without aggravating old injuries or causing new ones.

Before you lace up those shoes, contact us to discuss healthy running! We’re here to help. Call (615) 444-1408 to schedule your assessment.