IMS, also known as intramuscular stimulation or Trigger Point Dry Needling (TPND), is a form of passive treatment aimed at modifying pain and improving available range of motion during times of injury. It involves the use of an acupuncture needle or ‘dry needle’ placed into a muscle group with the intention of triggering a reactive event. This event can be felt as a modest ache or a reflexive twitch around the needle, not too dissimilar to getting hit in the knee with a reflex hammer. Once achieved the needle is promptly removed and the desired effect has either been achieved or subsequent points are selected and needled at the discretion of your therapist to achieve the desired outcome. The total timeline of treatment may vary depending on how many needles are required to achieve results.
Is IMS safe?
The short answer is yes. Having said that there are certain points on the body that do carry some measure of risk. They are generally located over the mid back and neck. It is the responsibility of your therapist to inform you of any relevant risks during your treatment and give you the opportunity to accept or deny these risks. Your therapist has undergone significant training in order to minimize risk of injury and it is our job to keep you safe while on the path to recovery.
Why does IMS work?
The truth is we’re not quite sure yet. There are a lot of studies available comparing IMS/TPDN to other forms of therapy as well as comparing it to exercise alone. All show positive outcomes from the use of this treatment. There are some theories that it may, in effect, reset the nervous system either through the introduction of novel stimuli or electrical discharge due to the metallic nature of the needle. Other theories include the release of healing cells known as substance P as a result of the procedure. The exact mechanisms remains a point of targeted research but what we do know is that for the right person IMS works fast and profoundly.
Do the effects of IMS last?
The answer to this question is complicated because pain is complicated. With that in mind, if the injury is physical in nature then it is unlikely. When tissue gets disrupted then mechanical stress in the form of targeted exercise is a requisite for durable recovery. If the injury is largely sensational, meaning no significant tissue disruption but a profound pain experience, then possibly. For further insight into how pain functions as an experience visit our previous post “the painful truth” for more information.
Are there any side effects of IMS/TPDN?
Some people may experience mild side effects from their treatment. As the needle does create some micro-trauma this can lead to a sense of fatigue or mild ache in the area. This is typically resolved with heat as needed and appropriate hydration. These symptoms can last as little as 20 minutes to as long as 2 days. Other mild side effects can include bruising post session. There are no firm activity restrictions required post treatment unless the patient wishes to do so. Before your session, your therapist will have a detailed conversation with you regarding treatment planning, potential risks, and what to expect.
When will I notice the benefits of IMS?
Following a detailed assessment, your therapist will recommend a treatment plan based on the nature of your condition and their findings. For most people the mobility benefits resulting from IMS are immediate and profound. However, those suffering from chronic or persistent conditions might require a series of treatments to disrupt established patterns of pain, spasm, or dysfunction.
How do I book IMS?
The Physiotherapists at South Island Physiotherapy have the experience and knowledge to help you navigate pain and injury. If you’re interested in IMS you can book with one of our physiotherapists HERE
Shockwave Therapy (SWT) is a non-invasive, non-surgical form of treatment that can accelerate healing and improve tissue health. Shockwave therapy involves the introduction of strong energy pulses to an affected area or injury site for a period of 2-5 minutes. Doing so has been shown to stimulate cellular metabolism, enhance blood circulation, and regenerate damaged tissue(s).
How do I know if my condition is appropriate for SWT?
The Physiotherapists at South Island Physiotherapy have the experience and knowledge to determine if your condition will improve through the use of SWT. After assessing your condition, and screening for medical conditions, should you be a good candidate for SWT – your physiotherapist will develop a unique rehabilitation protocol that’s appropriate for your degree of injury and stage of healing.
Who’s a good candidate for SWT?
Many factors influence who might be a good candidate for SWT. For example, is your condition new or old? Is it reoccurring? Is it prone to swelling? What is the quality of pain? How painful can it become? How long does it take for your pain to reduce from its highest point to its lowest. In general, we find that older conditions that have struggled to heal respond best to a course of SWT.
What should I expect during treatment?
During SWT, an acoustic pressure wave is transmitted from the treatment probe to the affected area or injury site. This wave has the ability to penetrate deep into tissues that are struggling to heal. The treatment process is short (2-5 minutes), but it can be moderately uncomfortable. However, following treatment patients often experience a reduction in pain as well as improved mobility.
What does a course of SWT look like?
Though every patient and their condition are unique, we recommend 5-8 sessions of SWT at an interval of once per week. It’s important to stimulate cellular metabolism and circulation early and often when attempting to regenerate tissue. The Physiotherapists at South Island Physiotherapy will parallel your course of SWT with progressive exercises so that new tissue becomes more resilient and less susceptible to future injury.
Are there any side effects to SWT?
Not only is SWT a non-invasive, non-surgical method for regenerating tissue, but it’s also incredibly safe. The most common side effect is a degree of post-treatment soreness. If it occurs, don’t worry! It typically resolves within 24 hours.
How do I book for SWT?
If you’re interested in SWT you can book with one of our Physiotherapists HERE
Pain is often the reason people seek medical care but it is often a highly misunderstood sensation. Traditional western medicine has made leaps and bounds in our efforts to preserve life but has missed the mark on improving the quality of it. Now this may be a point of contention as modern pharmaceutical practices have allowed for people to pursue their hopes and dreams through medication that may have been previously unavailable to them. I am not going to dispute that modern medicine has saved lives and improved them for many people with significant diseases. The population I am speaking of are the “medically well.” These are the people who could change certain behaviours and ultimately not require pharmaceutical support. These patients are not at imminent risk of decline or death but still very much present with a body system that is taxed and unsustainable. This article is to help those in this category understand what they’re feeling. Often, in order to receive a medical diagnosis for one’s problems there is a battery of tests performed. They check all of your vital organs and systemic functions, monitor blood work and endocrine function in an effort to tell you what is ‘wrong’ with you. That process is valid but what about if you’re in pain and there is nothing ‘wrong’ with you? When this occurs the primary mandate of any practitioner should be to improve a patient’s experience with their body rather than try, through passive treatments, to correct any perceived anatomical variance (which evidence suggests that our ability to do so is dubious at best). In short we are trying to give some one a better experience within themselves and we must shift our attention away from fixing a problem to creating a new experience. So if we can, for the sake of argument, agree that the dominant focus for the medically well is to resolve pain and improve quality of life then it would seem important to understand the nature of the symptom we are trying to affect. Pain is a complicated sensation that is highly variable but I will try and simplify it as best I can in the following observations.
Pain is a language. More specifically it is a language of safety. In its more rudimentary form it is designed to keep you alive in the presence of a perceived threat. The key word there is perceived. This does not imply real versus unreal, it merely implies that should an individual in any capacity assume their experience is threatening to their physical or emotional well-being, then it stands to reason that that individual should feel pain in an attempt to re-direct behaviour in retreat of this threat. The nature of their experience (intensity of pain or quality) is merely determined by the urgency through which that individual should adjust course in order to best preserve their life. For example, breaking your leg sure feels worse than cutting your leg as one could lead to a more significant loss of function or potential mortality.
Pain is a multi-factorial experience. More specifically pain is three things at the same time. It is sensational (what you feel), emotional (how you feel) and behaviour changing (what the body wants you to do about it). The sensational aspect of pain is what most are familiar with. It is the discomfort that drives people to seek care. The emotional is the non-physical expression of pain. As an example, the feelings of grief due to the loss of a loved one. We use the word pain to articulate this experience as well. Finally, pain is a behaviour changer. Similar to hunger, it is meant to direct behaviour in order to satisfy a condition of the body so that it can return to balance. The solution to any pain experience is found in a deep dive of all three aspects of a pain experience.
Threat only exists in 4 aspects of our experience: physical, mental, sleep and diet. If any of these pillars of experience are under threat (injury, stress, non-restful sleep or dietary intolerance) then the potential for pain is heightened. All 4 pillars influence each other in various ways and in the case of persistent atypical pain must be considered in order to allow the well-being to exist in the body.
To sum up the preceding observations, pain is complicated and the source of it can sometimes be hard to pin down. Having said that treatment doesn’t have to be. We find often the simplest solution is generally the right one and we at South Island Physiotherapy are dedicated to exploring both your pain and your future success with you.
When you think of physiotherapy, what comes to mind? If you could describe what physiotherapy is to a friend, would you be able to? It may surprise you to know that very few people can actually articulate our service. Which is odd when you think about it; would you ever buy a television or a car without knowing exactly what it does? Of course not, so why would you invest your time, money, and energy into a service in which you don’t fully and comprehensively understand? It is because of this that we’d like to take a moment to outline the top 3 ways that physical therapy should work for you:
1. Physical therapy is not and should not exclusively be about pain relief. Pain is the obvious reason people book an appointment with their trusted therapist but there are a lot of more convenient and cost effective ways to change pain. Physical Therapy is about rising above injury. It is an opportunity to discover how robust the body is and how capable you are in realizing your desires. In doing so pain is eliminated as a consequence. People deal with pain all the time; some every day but the only reason you’ll make the time and effort to come see a therapist is when it affects your joy or threatens your identity.
2. Physical Therapy is a process. More specifically, It is a process in recovery, a process in self-efficacy, and most importantly in self-discovery. When a patient truly walks across the finish line of an injury there is a transition from “I can’t” to “I can.” That, simply put, is the magic of Physical Therapy. This process is broken down into 3 stages. Stage 1 is symptom management and can account for 80% of the perceived improvement. Stage 2 is physical adaptation. In this stage heavy training is required to encourage the body to increase its supply to meet the desired demands. Stage 3 is functional revelation. In other words, it’s taking all of your hard work and putting it to use. In this stage the focus is to test the limits of your new found ability and/or capacity with the goal of forgetting that the injury ever happened.
3. Physical Therapy should be solutions focused not symptom focused. The aspect of Physical Therapy that people are most familiar with is passive care. That is the element of your session in which something is done to you. There are a variety of passive treatments available, including: soft tissue techniques, intramuscular stimulation, dry needling, shockwave therapy, spinal manipulation, spinal decompression, etc. These treatments are important but do best when paralleled with progressive exercise appropriate for your stage of healing. In isolation, passive treatments can result in durable symptom resolution. However, specific exercise(s) can help stimulate adaption and lead to a more resilient, capable body. In many ways, the job of a Physiotherapist is to a) select an appropriate treatment that will manage your symptoms and b) integrate appropriate exercise to stimulate adaption so that you can become more resilient, overcome injury, and achieve your goals. This process requires for us to focus on solutions related to your concern and adapt in order to overcome.
If you’re ready to make your move you can book with one of our Physical Therapists HERE
