VOLUME 1 ISSUE 3
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MAXimize Motion
PerforMAX Physical Therapy
May/June 2010
Father’s Day
SPECIALS!
----------------------------
ONE-HOUR MASSAGE
Give Dad the gift of relaxation
this Father’s Day with a
one-hour massage
for only $50!
----------------------------
“YOUR PERFECT SWING”
GOLF CONDITIONING
Help Dad improve his golf
game with a:

Comprehensive golf fitness
evaluation

Sports massage or
stretching session

Instructive program to
address strength, flexibility, and
improve golf performance
total program only $140!
------------------------------------
Both specials must be
purchased before 6/18/10
Call
303-932-2500
to make your appointment
with
wi th
Focus On . . .
Trigger Point Dry Needling
Trigger point dry needling (or TPDN, also referred to as intramuscular stimulation [IMS]), is a
treatment for muscular tightness and spasms that can be performed by a physical therapist
using acupuncture needles. The needle is inserted into the muscle, targeting a myofascial
trigger point. Needling of the trigger point will cause a local twitch response, which is an
involuntary spinal cord reflex where the fibers in the tight band of muscle contract.
Myofascial trigger points are defined as hyperirritable spots in skeletal muscle that are
associated with a hypersensitive palpable nodule in a taut band of tissue surrounding the
muscle. These localized areas of deep tenderness within the tight muscle band often refer
pain, cause muscle shortening and limited range of motion, and compress and irritate
nerves. When the nerves are irritated, they cause a protective spasm of all the muscles to
which they are connected.
Trigger points develop in the muscle secondary to various stresses, (i.e. postural, repetitive motion,
psychological, emotional etc.), and are more likely to develop in tissue that has neurological
dysfunction, likely caused by compression, disc dysfunction, facet joint dysfunction, vascular
compression, metabolic stress, biomechanical stress, postural stress, etc.
(2010 GEMt - Global Education of Manual Therapists. http://www.gemtinfo.com/physical-
therapy/Trigger-Point-Dry-Needling-- Oerview/page34.html)
What is the Goal of Trigger Point Dry Needling?
The goal of trigger point dry needling is to release the tight areas in the muscle, allowing
the muscle to lengthen, remove the source of nerve irritation, promote healing by creating
a local inflammation which is necessary to produce healing, and decrease spontaneous
electrical activity in the muscle.
Physical therapists are using TPDN around the world to effectively treat acute and chronic
orthopedic and musculoskeletal conditions, and peripheral diagnosis such as:

carpel tunnel
limited mobility or range of motion

tendonitis
chronic pain

osteoarthritis
spinal dysfunction (acute and chronic)
Trigger Point Dry Needling IS NOT Acupuncture.
Acupuncture is based on Eastern metaphysical concepts and attempts to control the flow
and balance of energy in the body. Trigger point dry needling, while using acupuncture
needles, is based on scientific neurophysiciological and biomechanical principles.
Upon evaluation, a physical therapist trained in trigger point dry needling can determine if
a client’s condition would benefit from this treatment method.
Clinical Studies:Several clinical outcome studies, case reports, review articles, and research
studies have demonstrated the effectiveness of TPDN, such as:
Lewit found that dry needling of MTrPs [myofacial trigger points] caused immediate analgesia
[absence of sense of pain] in nearly 87% of needle sites. In over 31% of cases, the analgesia was
permanent, while 20% had several months of pain relief, 22% several weeks, and 11% several
days; 14% had no relief at all.
(Lewit K. The needle effect in the relief of myofascial pain. Pain 1979;6:83-90)
An Australian study on the effects of latent MTrPs [myofacial trigger points] on muscle activation
patterns in the shoulder region, found that patients assigned TPDN and passive stretching returned
to normal muscle activation patterns, whereas subjects with placebo treatment did not change.
(Lucas KR, Polus BI, Rich PS. Latent myofascial trigger points: Their effect on muscle
activation and movement efficiency. J Bodywork Mov Ther 2004;8:160-155.)
Ingber documented successful TPDN of 3 patients diagnosed with chronic shoulder impingement
syndrome. Patients needed 6, 11, and one treatment, respectively, before returning to playing
racquetball. Two of these patients had failed previous physical therapy treatments.
(Ingber R.S. Iliopsoas myofascial dysfunction: A treatable cause of “failed” low back
syndrom. Arch Phys Med Rehabil 1989; 70:382-386.)
PAGE 2 MAXIMIZE
MAXIMIZE MOTION

Meet Your Therapist

Focus on . . . Jenny Cannon, MPT
Jenny has been with the Performax at the Littleton clinic since January 2007. Leanna Leder talked to Jenny
about how she became interested in physical therapy, her practice of trigger point dry needling, and her
treatment philosophy.
Q. Where did you go to College and what did you major in?
A. Texas Tech University. I majored in Zoology and then attended the University of Texas Medical Branch,
Galveston, TX for Physical Therapy school.
Q. How did you become interested in Physical Therapy?
A. I was in a lot of sports growing up and in college. I first became interested in athletic training with sports
and then found out about PT. As I learned more about the differences, PT seemed like a better fit and career.
Q. Did you become interested in Physical Therapy while you played softball?
A. I played organized softball starting at age eight and played through college. I went to Bradley University my freshman year of college
and then transferred to Texas Tech with my coach my sophomore year. I had a couple of minor injuries during college and at the end of high
school that introduced me to athletic training and then to physical therapy. I also did volunteer work in a nursing home PT department during
one of my breaks, then worked there as an aide the following summer. During that time, I realized I really liked PT, but not necessarily that
setting. I also did some job shadowing with a PT clinic similar to Performax that really got me more interested in pursuing outpatient
orthopedics. During PT school, orthopedics came more easily to me than some of the other areas due to the sports and exercise background.
Q. How did you get involved in dry needling and why do you think it is important for therapy?
A. I first learned about dry needling through a friend who is also a PT. She had taken the classes and then did some needling on me. I saw
the benefits of it and how it can be a good adjunct to manual therapy. It’s just another tool that can help patients’ progress faster, improve
their mobility, and decrease pain.
Q. What types of injuries do you use dry needling for and what kind of results do you typically see?
A. I use dry needling for a variety of patients. I use it a lot with chronically stiff spine patients. It’s great for getting improved joint and soft
tissue mobility. I also see that not only does the muscle release better, but also there is improved muscle control and activation that carries
over to improved strength. I've also had really good results with herniated discs. Patients with knee problems benefit with improved ITB,
hamstring, and quadricep mobility and flexibility. Shoulder and elbow tendonitis patients also benefit with improved soft tissue tone that leads
to improved range of motion and then strength.
Q What is your general philosophy of patient care?
A. My philosophy is more manual therapy based with getting the joints and soft tissue moving better and improved balance throughout. I
also like to look at the big picture to see what all is contributing to the pain, especially in spine patients. For example, a lot of cervical pain
may stem from problems in the low back that is causing compensation all the way up the chain. As mobility improves, of course
strengthening and flexibility exercise is important to stabilize the patient.
Q What part of therapy interests you the most?
A. Spine patients are always challenging and interesting, to put all the pieces together finding out what is contributing to their pain. I also
enjoy high level athletes because you can do more challenging, creative and sport specific exercise with them.
Q What advice do you give patients for after-therapy care or preventative measures?
A. Be aware of body mechanics and posture. Listen to your body and try to find exercise that you enjoy. If you enjoy a particular exercise
you're more likely to do it regularly and stay more fit.

Safety Tips for Spring Gardening

Summer is approaching, which means it’s time to start gardening again! But this year you can take preventative
steps to ensure personal safety when taking on the task of working in the garden. With such heavy tools and
strenuous work comes the risk of injury. Some ways to avoid those injuries include:
 Use aids when carrying or lifting heavy materials. The use of dollies or wheelbarrows can be helpful when lifting
soil bags or large amounts of plants.
 Avoid carrying awkward shaped materials.
 Bend at the waist when carrying heavy materials.
 Bend at the hips and knees and lift up with the legs when lifting heavy materials. This method
can also be helpful when shoveling.
 Do not turn your back while carrying the heavy materials.
 When picking out gardening tools, lightweight and easy to maneuver equipment will help
gardeners be more comfortable.
 Keep your worktables and materials at an elevated level to avoid bending over.
 Use a mat to kneel on when planting to ease the pressure and possible pain on knees.
Taking the proper precautions can help keep your green thumb safe from injuries this summer! By Leanna Leder

Performax Physical Therapy Park Meadows Physical Therapy

Pilates & Aquatic Center Denver Tech Center Lone Tree
5920 S. Estes St. #100 8200 E. Belleview Ave., #505E 8671 S. Quebec, #130
Littleton, CO 80123 Greenwood Village, CO 80111 Highlands Ranch, CO 80130
303-932-2500 303-741-0235 720-344-7034
www.performaxpt.com