Physical Therapy has emerged as the go-to approach for shoulder problems like adhesive capsulitis (frozen shoulder), bursitis, and issues associated with the rotator cuff.
Clinicians and researchers alike, are quite rightly reconsidering some long-held beliefs about what causes shoulder dysfunction (anatomy vs the lived experience), how we should label shoulder problems (impingements vs subacromial pain syndrome), and how best to support sufferers.
Academic debates, that cite peer-reviewed research and clinical experience, provide compelling reading into the subject. And although these debates can often leave the reader with a lot of head-scratching questions (‘So, what is going on? What do I call it? What do I do?’), it is exciting that physiotherapists, sports therapists & sports rehabilitators, osteopaths, and chiropractors are the ones who are leading the debate and will ultimately drive change for the better.
The Role of Exercise in Shoulder Pain Rehabilitation
The role of exercise in shoulder pain rehab is an area of general consensus. Of course, the activities which come under the exercise umbrella are many and diverse, so it is not enough to say ‘let’s exercise the shoulder’. But it is safe to assume that no matter what we label the issue or consider to be the cause of it, we will very likely prescribe exercise as the first step towards shoulder pain rehabilitation. But when exercise hits a plateau or is off the table due to pain or apprehension, we must turn to alternative methods like acupuncture.
The Role of Acupuncture/Dry Needling in Shoulder Pain Rehabilitation
Dry needling as a stand-alone intervention is not advocated for in any seminal traditional Chinese medicine (TCM) text, nor is it supported in any of Breeze Academy’s Masterclasses (which lean towards a western philosophy). Whilst dry needling can provide huge benefits, it does not replicate the physiological benefits achieved through exercise (for the medium to long term). In fact, no approach to shoulder rehabilitation should be uni-dimensional.
The Benefits of acupuncture in Shoulder Pain Rehabilitation
Not everyone responds positively to exercise (or even the thought of movement), and quite often, clients are unable to progress towards their therapy goals because of this. In these cases, introducing dry needling with the purpose of enabling the initiation or progression of shoulder exercise, can be an invaluable tool.
When to Introduce Acupuncture/Dry Needling in Rehabilitation
If pain release happens after one session, or even within the first session, then mission accomplished, we may never need to reintroduce acupuncture again. On the other hand, one session may not be enough, as recipients of acupuncture often gain pain relief at different time points within their rehab journey.
Acupuncture and dry needling can always be reintroduced later within the rehab cycle if progress plateaus. That is to say, we are not fixed to ‘a course’ of acupuncture – we may provide needling to open a window of opportunity at any point in the rehab journey, to raise pain thresholds and soothe movement anxieties. Subsequently, we use this window to progress exercise.
A confident dry needler will introduce acupuncture alongside exercise and manual therapy, within the same session. Taking advantage of segmental acupuncture theory, needling the non-effected limb / strong distal points, leaves the affected limb needle-free, allowing for targeted rehab.
##How Often Can Acupuncture /Dry Needling Be Performed?
Although there is no ceiling to how many times we perform dry needling on someone (especially if they are progressing towards their rehab goals), it would be unusual to go beyond 4 sessions of acupuncture if your client had not experienced any benefit.
In summary, although acupuncture and dry needling are not adequate replacements for high-quality rehab that includes exercise and advice, needling can be an extremely beneficial path of treatment in cases where exercise is hampered by pain and movement anxiety.
Learn more about Acupuncture for Shoulder Pain & Injury
If you would like to learn more about Acupuncture and Dry Needling for Shoulder Pain or Injury, Breeze Academy offers an online course that provides detailed dry needling techniques specifically targeting acupuncture for the upper limbs.