Stick It To Pain

Dry needling, a new service of Mary Greeley Rehab & Wellness, relieves pain for athletes and others.

By Steve Sullivan

After suffering an injury, Amber VanLoo feared she would have to give up her passion for running.

Then she discovered the needle.

Emily Paulson was starting a new job that would require her to be on her feet a lot. She was worried that she wouldn’t be able to do it because of her intense knee pain.

Then she discovered the needle.

Amber and Emily are just two people finding much sought-after pain relief from dry needling, a new treatment offered by Mary Greeley Rehab & Wellness. (See below for Amber's and Emily’s stories.)

Not a Shot
Anne Hilleman, a physical therapist in Mary Greeley’s Rehab & Wellness, performs a dry needling procedure on Amber VanLoo.

Anne Hilleman, a physical therapist
in Mary Greeley’s Rehab & Wellness,
performs a dry needling procedure
on Amber VanLoo.

Dry needling isn’t a shot. Nothing is being injected. The procedure involves a thin filiform needle to treat myofascial pain and dysfunction. Myofascial pain is a clinical term for muscle pain. The needle penetrates the skin and enters the areas of muscle and connective tissue where trigger points for the pain exist.

Physical therapist Crystal Savage has been certified in dry needling since 2015 and has performed dry needling on hundreds of patients, including Olympic athletes. Her Rehab & Wellness colleague, Anne Hilleman was certified in 2019. People who seek help from Savage and Hilleman are suffering from pain in their hips, knees, joints, and other areas.

“Dry needling interrupts the incorrect messages that a part of the body is getting from the brain,” said Savage. “It retrains the muscle, or resets things, loosening up a restriction that could be affecting proper function of the muscle.”

Think of it as when your computer freezes, so you do a restart.

Mary Greeley offers drying needling as part of a physical rehab treatment program. While a treatment program is generally covered, at least in part, by insurance, dry needling is not. Rehab & Wellness charges $25 per treatment.

Triggered

Dry needling will not work for everyone. A therapist will first determine if a patient is a viable candidate for dry needling. Some conditions, such as a pregnancy or the severity of the pain, may prohibit use of treatment.

An evaluation is done to determine a patient’s pain pattern and assess where the trigger points are.

“We’re considering a lot of factors. We’re looking for tightness and tenderness, for lack of strength and lack of range of motion. Assessment is an important part of the success of the treatment,” said Savage. “You have to identify the area to needle to get the result you want. There’s a precision to this.”

Some people are initially skeptical of the treatment, while others jump at the opportunity. Savage and Hilleman have performed the procedures on their respective spouses. It turned them from skeptics to fans.

“Some people are gung-ho and want to go ahead and do it,” said Hilleman. “Others think about it a little bit, do a bit of their own research.”

Procedure

During a dry needling procedure, a therapist may place one or more needles in the identified area. Let’s take hamstrings, which is a group of muscles and tendons at the rear of the upper leg. To treat pain in this region, Hilleman may start with four to six needles. Those needles would remain there for 10 minutes or so. During this time, Hilleman may gently manipulate the needles, which, in turn, stimulates the tissues into which they are inserted. Depending on the patient’s trigger points and pain levels, Hilleman may remove the first set of needles and insert new ones in a different section of the area.

Another approach is to use fewer needles and electrical stimulation. Savage, for example, might treat knee pain by inserting a needle into a trigger point in the back, hip, or thigh. She would then touch the needle with a device that sends a slight electrical stimulation through the needle. This method only takes a minute or two, depending on how the muscle responds to the electrical stimulation.

The treatment can bring immediate relief or require repeated treatments to completely ease the pain. (Writer’s note: I was suffering severe knee pain that caused me to limp. I did one dry needling treatment with the electrical stimulus. The pain and limping were completely gone the next day and as of publication had not reoccurred.)

The therapist will review procedure benefits and risks with the patient. The procedure is only done with the patient’s expressed approval. The trigger point areas have already been determined through an examination of the area where the pain is located. The therapist will wear gloves, and clean the area to be needled with isopropyl alcohol.

The insertion of the needle only takes a second. Some people might feel mild pain. There is sometimes some minor bleeding when the needle is removed.

Dry needling can work on almost any area of the body, including legs, back, hips, and shoulders. It can also be used on the face for the treatment of TMJ (temporomandibular joint), headaches, or sinus problems.

“People want whatever it will take to get better,” said Savage.

Popular with athletes

Hilleman is wired into the athletic community and knew a lot of peers who were getting dry needling treatments at other clinics. She wanted them to be able to get it at Mary Greeley. She gets a lot of inquiries from people she competes with.

“I knew people in the running and triathlete communities who were going elsewhere for needling. I was seeing positive results and wanted to be able to do it here,” said Hilleman. “I get asked about it a lot by my patients and by people I do races with.”

Amber VanLoo runs with her dog, Bow. An injury sidelined her running passion, but physical therapy and dry needling have helped get her back on the road. (inset) VanLoo is treated with several needles, which Hilleman moves slightly to provide stimulation to trigger points.

Amber VanLoo: Hamstrung

An injury derails a passion for running. A needle gets it back on track

“I’ve always been a runner. I ran in high school and then started running marathons after high school averaging a marathon a year,” said Amber VanLoo., an athletic mother of five from Huxley. “Running is my quiet time, my destresser. I love running.”

That love led to VanLoo turning in such a strong performance in the 2016 Des Moines Marathon that she qualified for the 2018 Boston Marathon. Unfortunately, an injury derailed that dream.

She had been doing trail marathons, and after running a 26-mile event, her hamstrings felt “super tight.” Soon, she was in excruciating pain. She did physical therapy for several months with no relief. She was diagnosed with a stress fracture in the pelvic area and ordered to rest and essentially do nothing. In other words,
no running.

Months went by without much relief. She got another opinion from a doctor in Iowa City who specialized in running. She was diagnosed with hamstring tendinopathy, which can cause deep pain. It was a particularly disturbing diagnosis for VanLoo, who is a hamstring dominate runner. Intense physical therapy was recommended. Dry needling was also suggested.

She was already working with Anne Hilleman, a physical therapist at Mary Greeley Rehab & Wellness. Hilleman herself is a triathlete and a certified triathlon coach. She’s also trained in dry needling.

“I was getting really cranky. I was doing yoga, which was the only thing gentle enough,” VanLoo said. “I thought I was never going to run again. I was getting older and I would have to give it up. Anne was like, 'Nope, you are going to run again.' She’s good at encouraging you. She gets it.”

VanLoo has been doing dry needling for a few months now as part of her on-going program with Hilleman. The program also involves the Alter-G, which is an anti-gravity treadmill that helps people recover mobility and enhance their physical performance.

“She puts the needles in, leaves them for 10 minutes, and then stimulates them, moves them around a bit,” VanLoo said. “I can feel it when she’s hitting the spot where the pain is, but right now I’m to the point where I don’t have daily pain anymore. I had stabbing pain all day a dull ache all the time. I don’t have it anymore.”

Her tight hamstring began to loosen up over time, and she experienced less and less pain. After a month of dry needling treatment, VanLoo decided to try running again, and she has been gradually increasing her distance and how often she runs. She hopes to be able to do marathons again in the future.

No surprise she’s now a big proponent of dry needling.

“I definitely promote it,” VanLoo said. “I’m a runner and everyone who knows me knows that I was injured. They are now seeing me running again and asking me what I did. After listening to doctors and resting and everything suggested, Anne is the one who fixed me.”

Emily Paulson: Instride

Dry needling cures a high schooler’s ‘weird’ walk.

Emily Paulson, an Ogden high school student, has patellar tendonitis, which is caused by inflammation of the tendon that connects the kneecap to the shinbone. Pain can be mild or, as in Emily’s case, severe. The pain had already caused her to give up high school track.

“I was a runner and think that's where all my pain was starting to come from,” she said. “It was preventing me from running like I normally would.”

Walking was also painful, so much so that Paulson altered her stride to compensate for the discomfort.

“I walked on it wrong for so long,” she said. “I just got used to walking weird.”

Her doctor referred Paulson to Mary Greeley Rehab & Wellness for physical therapy, where she met physical therapist Crystal Savage.

“She could tell right away how much pain I was in,” Paulson said. “She explained that the condition of my knee was causing me to lose some muscle mass, which could cause me to not walk as well.”

During a therapy session, Savage talked about dry needling.

Paulson admitted to being a little “iffy” about the procedure at first. After Savage showed her the equipment used, and after doing some of her own research, Emily decided, “let’s give it a shot.” She was motivated to try anything for relief since her new job was going to require a lot of moving around.

She didn’t want her knee troubles to disrupt her performance.

Savage dry needled a few trigger points in her knee, using electrical stimulus. Paulson said she was a little sore afterwards and “the next day I felt great walking, nothing hurt. I was walking perfect and doing everything I wanted to do.”

She has done a few other treatments, with Savage doing dry needling on her hip and back.

Paulson reports that the new job is going great and she’s hoping to do high school track again.