Life After Trigger Point Dry Needling… it STILL isn’t legal in Tennessee?

Trigger point dry needling (TDN) is an extremely effective way to treat pain caused by muscular tension and spasm. Understandably, many patients were upset by the June 2014 decision that TDN did not fall under the scope of practice of a physical therapist in Tennessee. A bill adding this treatment back into our scope of practice has passed; it is likely that TDN will be offered again in the spring of 2016 by physical therapists who have been appropriately trained in the technique.

In the meantime, do not despair! Physical therapists have returned patients to pain free, active lifestyles for decades. While TDN is efficient and effective, it is only one tool in our tool case. Joint mobilization, soft tissue mobilization, ASTYM, selective stretching, progressive exercise, running form assessment, and postural education are only a few treatment techniques that we use on a day-to-day basis. Allow me to take a step back…

Trigger points or “knots” are typically a symptom of a greater overlying problem. Although they can be a significant generator of pain, treating an isolated area of muscle tension and only treating that is like putting a band-aid over a leak in a water hose. You will slow the flow of water but…you understand what I’m getting at here.  I do not want to overlook the importance of short term pain relief, however,  I do want to highlight the importance of a long term solution. No one likes a high water bill.

Today, physical therapists undergo approximately 7 years of higher education to earn their Doctorate of Physical Therapy. That’s a lot of school! Only a small minority of that time is dedicated to dominating intramural sports, performing awkward icebreakers with classmates, and checking social media. The rest is focused on becoming proficient in the most evidence based treatment, diagnosis, and evaluation of bodily impairment.

It is important to realize that injuries, especially overuse injuries, very rarely happen in isolation. We must always ask why one side hurts more than another and why an specific area becomes painful. Our bodies are an entire system, not a collection of isolated parts. As a system the body prefers symmetry and positions which keep the joints in “neutral”. This minimizes the force that is applied by gravity or the ground and minimizes the stress exerted on muscles, tendons and ligaments. Deficits in strength, flexibility or movement quality cause injury…not visa versa!

Am I very excited to re-introduce trigger point dry needling to my practice next spring? Yes. Can I help you return to running/biking/triathlons/world domination without it? You betcha.


Questions about how your running form, movement quality, or posture relates to your performance and/or pain? Contact your friendly physical therapist for a consult.


Happy Holidays, my friends.