Dry Needling is a specialized service offered by Sapphire Physical Therapy. I am often asked how dry needling works and how it differs from acupuncture treatment. Due to the success I have personally had with both patients and in treating my own running-related overuse issues, I will explain what dry needling is and how it complements our fundamental physical therapy treatment methods. ~John Fiore, Sapphire PTimage


Dry needling is an effective soft tissue and musculoskeletal treatment technique to reduce pain associated with running-related injuries. Dry needling has been offered by Sapphire Physical Therapy for nearly three years. Licensed physical therapists with additional, specialized dry needling training are now incorporating dry needling into physical therapy treatment plans with impressive results. All dry needling treatment approaches and methods, however, are not alike. Understanding the science behind dry needling and an extensive knowledge of human neuromuscular anatomy is vital to successful dry needling treatment. Dry needling utilizes acupuncture needles as treatment tools, but should not be equated with acupuncture. Acupuncture has been practiced for thousands of years and is a systemic (whole body) treatment approach. Acupuncture is based on the Yellow Emperor’s Canon of Internal Medicine which was written between 206 BC and 220 AD. The Canon integrated various channel theories into one system based upon the limited neuroanatomical knowledge of the time.i Yun-tao Ma, PhD (who trained me in 2013-2014 and who founded the American Dry Needling Institute) has bridged the gap between ancient Chinese acupuncture philosophies and the neuroanatomical knowledge of western medicine to create the integrative dry needling treatment approach. Based on the cellular biology of tissue healing and its relationship with the peripheral and central nervous systems of the body, Dr. Ma has facilitated safe, effective dry needling techniques to reduce pain and stimulate tissue healing in the physical therapy outpatient setting. I was fortunate to receive my dry needling training from Dr. Ma and I now utilize integrative dry needling in my physical therapy practice. If you have struggled with a persistent running injury, suffer from acute or chronic musculoskeletal pain, experience frequent headaches, back or neck pain and are otherwise in good health, dry needling is an effective, virtually pain-free treatment used in conjunction with physical therapy therapeutic exercise and manual therapy techniques.


Various theories have existed for thousands of years for the presence of tender points or trigger points in predictable locations throughout the body. Treating such tender points (acupressure points) released tension and eased pain. What ancient practitioners did not realize, however, is the fact that pressure through a sensitive acupressure point stimulates a sensory nerve ending. The sensitized sensory nerve relays a message to the spinal cord where the central nervous system transmits the information to the brain. Sensory input is processed in the brain and a range of neurobiological events are set into action depending on how the stimulus is perceived. Dry needling, therefore, activates the body’s natural healing potential by specifically targeting and balancing the sympathetic and parasympathetic nervous systems to facilitate healing on a cellular level (at the site of the needle insertion or the injured body area). Dry needling also stimulates parts of the brain (via the hypothalamus) which activate the principle survival mechanisms (the nervous, endocrine, immune, and cardiovascular systems) and normalize the physiological activities of the whole body.ii iii


Dry needling treatment utilizing the Integrated Neuromuscular Acupoint System is painless approximately 80% of the time. While some practitioners “manipulate” the needle upon insertion, pain-free insertion of the needle alone initiates the self-healing process without the unnecessary pain to the patient which occurs during needle manipulation. Integrative dry needling results in complete resolution of symptoms in 28% of cases, resolution of symptoms for six-months or more in 64% of cases, and marginal results in just 8% of cases.iv Dry needling treatment begins with a Quantitative Evaluation to determine the distribution of acupoint sensitivity in two key body areas (lateral forearm H1point & lateral lower leg H4 point). The distribution of sensitive acupoints effectively predicts the number of recommended treatments. Running injuries (acute and chronic in nature), musculoskeletal pain, tendonitis, tendinosis, joint pain, back and neck pain, muscular guarding, delayed onset muscle soreness, cumulative stress (overuse injuries) injuries, and joint stiffness all respond remarkably well to dry needling treatment. Dry needling indirectly improves the effectiveness of running-specific weight bearing strengthening exercise and manual therapy techniques by reducing chronic compensatory movement patterns resulting from stiffness, tightness, and pain.


Following a comprehensive medical history screen and physical therapy objective evaluation (functional testing, range of motion testing, strength testing, video running gait analysis), dry needling may be determined to be an effective component of your treatment. In addition to treating restricted, painful, or injured areas, a sequential series of key body locations (homeostatic points) may be included in the dry needling treatment. Treating of the body’s 24 homeostatic points restores homeostasis in the body and boosts our healing capacity.v When homeostasis declines, homeostatic acupoints are gradually transformed from a latent phase (non-sensitive) to passive or active phase (sensitive with or without palpation). The positive systemic response to dry needling the 24 homeostatic points makes it possible not only to treat the localized injury, but also to prevent running injuries by boosting the healing and recovery response of the body. Treatment frequency varies based upon the degree of restriction or injury and overall health (self-healing potential determinant). Dry needling may be incorporated into your physical therapy exercise and manual therapy treatment to bring about more timely results and functional improvement in running performance. Call or email John Fiore at Sapphire Physical Therapy to learn more about dry needling. Feel free to call and schedule an appointment to see how dry needling can be an effective, efficient addition to your running injury prevention and treatment plan.
John Fiore, PT
Sapphire Physical Therapy

i Ma YT: Biomedical acupuncture for pain management: an integrative approach. Philadelphia, PA. Elsevier Churchill Livingstone. 2005. ii Tracey KJ: The inflammatory reflex, Nature 420:853-859, 2002. iii Wang H, it al: Nicotine acetylcholine receptor alpha7 sub-unit is an essential regulator of inflammation, Nature 420:384-388, 2003. iv Ma YT: Biomedical acupuncture for pain management: an Integrative approach. Philadelphia, PA. Elsevier Churchill Livingstone. 2005. v Dung HC: Anatomical acupuncture, San Antonio, TX, 1997, Antarctic Press.