Many people who work while sitting at a desk eight or more hours a day complain of neck, shoulder and mid-back pain after a long day at work. Aches and pains through these regions tend to arise due to poor posture while sitting at our desks. The muscles through our neck and back of our shoulders become fatigued from trying to keep you upright against gravity while you sit for a long duration typing away at your computer. Stretching the muscles through these regions can be simple and efficient during the workday and can also give your body much-needed movement after you have been sitting at your desk for a long period of time. If your poor posture while sitting goes unaddressed, these aches and pains can lead to chronic pain which can affect your overall neck and shoulder mobility during daily activities.

To help prevent this from happening, here are three stretches to help you stretch your tired muscles so that you can reset and begin to sit with better posture.

Seated Upper Trap Stretch

Start in a seated position sitting nice and tall for good posture. Bring your hand on the side you wish to stretch behind your back.  Place your other hand on top of your head and gently pull your head to the side away from the hand that is behind your back. You should feel the stretch through your neck through the upper trap region. Hold this for 30 seconds on both sides.

Pectoralis Doorway Stretch

Begin by standing in a doorway with the arm to be stretched raised above your head and placed against the side of the doorframe.  Gently lean forward through the doorway and slightly rotate your body away from the raised arm. The stretch should be felt through the front of your chest. Hold this for 30 seconds for both arms.

Seated Thoracic (Mid-back) Extension Stretch

Sit in a firm low back chair with the back of the chair sitting underneath your shoulder blades. Cross your hands and place them on top of the opposite shoulder. Lean back over the chair allowing shoulders to extend back over the edge of the chair to feel the stretch through your mid-back. Repeat up to 10 times moving further into the motion each time if comfortable.

The stretches described above should not cause pain but should help stretch tight muscles through the neck, mid-back and shoulder region to help with promoting proper posture. These stretches can help keep your neck from becoming painful while at work and can also help with preventing neck and shoulder pain.

If you already have neck, mid-back or shoulder pain and these stretches are not enough to help with decreasing the pain then there may be more of an underlying issue at hand. You may benefit from seeing a physical therapist. Find a location nearest you to #GetYourMoveBack!

If you are on the fence about having trigger point dry needling(TDN) performed, here’s a brief “what to expect” blog article to help you make your decision.

When you arrive for your appointment at one of our physical therapy clinics, your physical therapist will assess your condition and pathology to determine if TDN is right for you.

Trigger point dry needling treat a multitude of conditions because it addresses myofascial restrictions. These myofascial restrictions are a significant component to movement pathologies, pain, and dysfunctions throughout the body. Typically, the therapist will determine certain movements or positions that reproduce pain so they can single out which muscles and structures would benefit from a dry needling treatment.

Following the assessment, and if TDN is recommended, your therapist will review the risk factors. Trigger point dry needling is a relatively safe technique and is very safe when performed by a trained clinician. Risk factors include bleeding, bruising, muscle soreness, infection, and a pneumothorax. Infection and a pneumothorax are by far the most serious risk factors, however, they rarely occur.

A risk of infection happens anytime the skin’s surface is disrupted by a cut, scrape, or needle. Sterile needles and use of a sanitary technique are always used at Foothills Sports Medicine Physical Therapy to minimize this risk. A pneumothorax is a medical term for a punctured lung. This occurs if the needle enters the lung field and disrupts the tissue. The risk for a pneumothorax is generally applicable when needling anywhere in the chest, thorax, and upper abdominal region.

TDN has multiple treatment procedures. Most patients describe symptoms during treatment as an ache or slight cramping feeling in the muscle. This can vary greatly based on the treatment techniques utilized. Here are some popular techniques and their descriptions:

  1. Pistoning technique, in which the needle is moved up and down at different angles of the muscle belly causing a “twitch” or trigger point release.
  2. Static technique, in which the needles are left in the muscle for a prolonged period (typically 5-10 minutes) to release muscle tension or trigger points.
  3. Static technique with electrical stimulation, in which the needle is placed in the muscle and an electric current is applied through the needle to stimulate the muscle. During a treatment with this technique, repetitive contractions at regular intervals occur in the muscle.

Whichever technique is right for you will be determined by your physical therapist and based on your condition and tolerance to the treatment.

Following your dry needling treatment, many therapists will reassess movements and positions that were determined painful at the beginning of the session. In many cases, following TDN, these symptoms are lessened or completely gone. Other responses to treatment include soreness in the muscles that were treated. This soreness is typically described as feeling as if you worked out this muscle. Also, this soreness is different from the pain that brought a patient into treatment and the intensity greatly varies from person to person.

Additional physical therapy treatments including stretching, soft tissue massage, heat, and exercises can assist in alleviating this soreness as well as train the body to utilize and sustain the changes made during TDN treatment. If you’re interested in finding out if dry needling can help you, contact us.

When searching for a solution to overcome an injury or chronic pain, surgery should be only considered as the final option. Physical therapy at Foothills Sports Medicine can truly work miracles in most situations as a safer, less expensive, and less invasive alternative.

Many times, physical therapy is necessary in order to proceed through the medical continuum of care. Physical therapy is now widely accepted by insurance agencies that offer direct access in many states. Many states, including Arizona, now offer direct access to physical therapy; meaning a doctors referral is not required to receive physical therapy. At Foothills, we pride ourselves on scheduling patients within 24-48 hours, which means we can help you on your road to recovery even faster. If a therapist believes physical therapy isn’t the best solution, they often can refer patients to the correct specialist that can assist them with a full recovery.

Surgeries come with great risk, and not every surgery outcome is without fault. Many surgeries alter the biomechanics of the affected area by changing the way joints or muscles naturally move. Physical therapy comes in by teaching that joint how to move again through a full range of motion.

Another complexity of surgery is left over scar tissue. Anytime muscle is incised during surgery, scar tissue will be left behind. The difficulty with scar tissue is that it can potentially cause major problems with soft tissue mobility and joint mobility.

If a patient undergoes rotator cuff repair, the torn tendon will need to be reattached to the humeral head. For a surgeon to do this, they have to make incisions to access the tendon, pull the tendon back to the attachment site, and anchor it down. In this case, scar tissue forms during healing if tendon isn’t laid down correctly, which can limit tissue mobility. If there is less tissue mobility, then there could be a narrower potential range of motion, which can impede a patient’s quality of life in the long run.

In most cases, it’s imperative to have physical therapy prior to a surgery so that joint strength can be built. The stronger you go into surgery, the stronger you will come out. Putting this work in ahead of time will improve the benefits of rehab following surgery. Schedule an appointment or visit the team at Foothills Sports Medicine who are here to help you build strength before so that you can be pain-free after.

Foothills Sports Medicine Physical Therapy is a leader in Arizona physical therapy because of its commitment to high quality, individualized treatments and cutting edge techniques like Trigger Point Dry Needling. Foothills Sports Medicine also offers a free assessment of your needs, which you can schedule online here. For more information about Arizona physical therapy, visit our blog.

Stacy Scherzer obtained her masters in physical therapy from Mizzou and has a Certification in Orthopedic Manual Therapy. She is here to explain what Trigger Point Dry Needling is, and how it can be used to effectively treat pain.

What is TDN?

Trigger point dry needling (TDN) is a technique that aims to improve muscle or soft tissue’s mobility and length through myofascial release. Other forms of myofascial release you might be more familiar with include massage, cupping, and foam rolling. These therapeutic techniques can help to release tension and decrease pain.

Trigger point dry needling is unique because it requires a certified physical therapist’s in-depth knowledge of anatomy. It involves inserting a monofilament needle into a “trigger point,” or a tense area in the muscle, which elicits a twitch response. This twitch response decreases muscle restriction, which effectively lengthens the muscle to a small degree. This slight increase in length releases tension at each end of the muscle where it attaches to the bone. The resolution of a trigger point also allows the muscle to contract more effectively and efficiently, improving its function.

What can conditions can be treated with TDN?

TDN treatment technique is highly effective in treating musculoskeletal conditions, which includes pain or injury in joints, tendons, ligaments, nerves, and muscles. Myofascial pain comes from irritation in the muscles, and its contribution to musculoskeletal conditions is substantial. Pain in the body causes muscles to become automatically tight as a protective response. This causes further pain as portions of the muscle become restricted, leading to accumulation of waste products and reduced blood flow. This process becomes a vicious cycle and worsens without skilled intervention.

Low back pain is a common condition that could be treated with TDN. There are many causes of low back pain, including injury from heavy lifting, poor body mechanics, or even inactivity. The pain can cause the muscles in the spine to tighten and become restricted, compressing the vertebrae and increasing pressure on the discs. All of these factors contribute to back pain and can lead to limited motion and altered body mechanics, or movement patterns. While some myofascial release techniques, such as soft tissue massage, can alleviate some pain, TDN is able to reach the deep stabilizing muscles (called multifidi). These are too deep to address with massage alone, and release through TDN allows for more rapid recovery and pain reduction.

Muscle restrictions can occur in all parts of the body. These restrictions increase tension and pressure not only on the muscles, but on the tendons, joints, and other tissues as well. Without treatment early on this pressure could develop into tendonitis, causing conditions such as tennis elbow, plantar fasciitis, and rotator cuff tendonitis. Trigger point dry needling can be used on nearly every muscle in the body to prevent further injury and resolve pain more effectively and rapidly than any other myofascial release technique.

Foothills Sports Medicine Physical Therapy is a group of locally-owned AZ physical therapy clinics. We provide the latest physical therapy techniques to patients all over the Valley, and we believe in a hands-on and individualized approach to patient care. You can go online today to schedule a free assessment with one of our expert staff, by simply clicking here. If you want to read more about physical therapy techniques and tips, follow our blog!

Stacey Scherzer is an AZ physical therapy expert who works at our Arrowhead location. As a physical therapist (PT) and Certified Orthopedic Manual Therapist (COMT), she has years of experience in out-patient orthopedics and has treated a wide variety of diagnoses. She is here today to explain how having a Foothills physical therapist will benefit you.

Physical therapists offer many benefits to patients, in both their approach to treatment, and their accessibility. PTs can treat a wide array of musculoskeletal diagnoses and neuromuscular problems — meaning we can fix the way your entire body moves, and even change the way your brain thinks about this process. Our staff is full of experts in sports medicine and we can offer training for functional movement, sports, gait, balance, and any other concerns or issues that a patient may be experiencing. PTs have a wide variety of manual, hands-on techniques to serve their patients, including: trigger point dry needling, manipulation, mobilization, STM, and stretching techniques. We will teach you corrective exercises to accomplish your therapy goals, and to remain healthy and pain-free in the future!

When patients feel like they have a connection to someone within the medical community, a so-called “friend in the business,” it puts them at an advantage. You have a person who can help navigate the medical system, direct you where you may need to go, educate you on the causes of your problem, recommend treatments, and explain complicated medical terminology.

There are many benefits of working with a physical therapist here at Foothills Sports Medicine Physical Therapy. First, we can typically get a patient in for a free consultation much faster than other medical providers. From there, we can begin an intervention. Arizona is a direct access state, which means you do not need a referral from a physician to see a PT. Many insurance companies do not require this either, so you can save time and money by not having to see your doctor first. Treatment and symptom management can begin very quickly, which is paramount in a quick recovery process.

If physical therapy is not an appropriate route for treatment, your physical therapist can refer you to a doctor that can deal with the condition best. Foothills Sports Medicine has many great contacts with physicians that can assist this process, and can often expedite the time it takes to secure an appointment. We see a multitude of patients from various doctors, so we know which doctors typically produce the best results and outcomes, and can find the best fit for a patient’s particular needs.

Finally, your physical therapist can be used as an invaluable resource for information. Physical therapists are great educators and experts in anatomy and physiology, so they can teach patients about their diagnosis and the reasons for their pain. They can assist patients with understanding their imaging reports, and they can provide activity modifications and recommendations to begin the healing process.

Injuries, chronic pain, limited mobility, decreased strength, and functional deficits can all be sources of frustration for individuals. Furthermore, trying to navigate the medical field can be trying, confusing, and full of medical terms that often don’t make sense to patients. Let the AZ physical therapy experts at Foothills help you by making your recovery process as stress-free as possible. We will work with you to walk you through each step, making sure that you feel comfortable and confident along the way.