Prehabilitation or (pre-hab) is defined as “a process of improving the functional capability of a patient prior to a surgical procedure so the patient can withstand any postoperative inactivity and associated decline.” In terms of outcomes, studies have shown that patients who are to undergo knee and hip replacements and perform 6-weeks of land and water-based PT decreased their odds of needing in-patient rehab by up to 73%. This basically demonstrates the stronger and more flexible you go into the procedure, the better and quicker outcomes you’ll have afterwards. Some exercises that will be beneficial prior to a knee or hip replacement would be lower extremity stretching, glute and quad strengthening, as well as cycling for continuous non weight bearing motion. Ask your physical therapist for prescribed therapeutic exercises to create a mobility and strengthening program to perform prior  to your upcoming procedure.


Arthritis Foundation | Symptoms Treatments | Prevention Tips | Pain Relief Advice

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Understanding and Treating Vertigo and BPPV

Disturbances in the inner ear can cause Vertigo which is a type of dizziness. A common symptom is the feeling of spinning in your head or the world around you is spinning or moving. It can last several seconds or minutes.

Benign Paroxysmal Positional Vertigo is a specific type of vertigo and usually presents as a feeling of spinning with head motions such as turning over in bed, looking up or looking down, sitting up, turning your head to look at your surroundings. It consists of brief episodes of mild to severe symptoms and can include nausea. It can result to gait and balance problems.

Crystals in your ear being in the wrong place in the inner canals can cause BPPV. These crystals in your ear can be dislodged from their normal position as you change your head position. If you experience dizziness due to BPPV, consulting a physical therapist can help treat BPPV and dizziness by restoring the normal function of the inner ear through positional treatments and exercises. A physical therapist can also help if you have gait and balance problems associated with BPPV.

One of the common treatments for vertigo caused by BPPV is Epley maneuver. It consists of turning the head towards the affected ear followed by a series of head and body movements to help move the ear crystals from the semi circular canals to reduce or eliminate vertigo.

Here are some tips to manage Dizziness caused by BPPV

  1. Avoid tilting or moving your head quickly
  2. Sit for a few minutes at the side of your bed before getting up
  3. Try some deep breathing exercises to help you relax
  4. Focus your eyes on a stationary object while waiting for the dizziness to subside
  5. Elevate your head while lying on your back by using several pillows

What is Dry Needling and How Can It Help My Pain?

What is Dry Needling?

Dry needling is a manual treatment method that healthcare providers use for management of pain and issues with movement quality that stem from musculoskeletal conditions. With this method, the provider inserts a thin needle into or near the area of pain, trigger points, or related symptoms. A common method of dry needling is called Trigger Point Dry Needling that focuses on targeting myofascial trigger points in the muscles. Trigger points occur when the muscle is overused which can cause an energy crisis resulting in muscle fibers not receiving adequate blood supply. When this happens, the muscles aren’t getting the oxygen and nutrients that it needs to return to a resting state causing pain and increased sensitivity. Trigger Point Dry Needling stimulates these areas to help bring back normal blood supply to clear built up acidity and release tension. With this method, people will often feel muscles contract or twitch as the muscle relaxes and resets. Another method of dry needling is called Neurologic Dry Needling which evolved from Trigger Point Dry Needling with greater focus on needling the system versus the points in order to treat all types of neuromusculoskeletal conditions. This method is based on peripheral and central neurologic principles and works to deliver treatment locally, segmentally, and systemically. The goal is to improve inflammatory responses, improve blood flow, and reduce muscle guarding. Ultimately, both dry needling techniques help to  relieve pain, increase blood flow, and improve mobility for most people.


What Type of Pain Does Dry Needling Treat?

Dry needling can be used to treat a multitude of musculoskeletal conditions to address pain and mobility restrictions that can occur from scar tissue, myofascial tension, trigger points, and other connective tissue issues. Some conditions include:

  • Lower back pain
  • Neck pain
  • Headaches/Migraines
  • Shoulder Pain
  • Muscle Strains
  • Osteoarthritis
  • Overuse Injuries
  • Post-Surgical Recovery
  • Generalized Muscle Tension
  • Range of Motion Restrictions
  • Joint Issues
  • Tendinitis
  • TMJ Pain/Dysfunction
  • Pelvic Pain

What to Expect During and After Dry Needling Treatment?

Each time you receive dry needling, your licensed physical therapist will assess each treatment area via palpation (use of hands to feel the muscle tissue). Following the assessment, your provider will use a sterilized needle to work on the treatment area. The needles are always single-use and disposed of immediately in a sharps container. The needle is surrounded by a plastic tube that helps to guide with placement of the needle in the appropriate treatment. Some people fear that the needles will be extremely painful, but because of how thin the needles are along with technique, needles are able to penetrate the skin with little to no sensation. Once the needle is in place, your tissue can response with reduction in tension or an involuntary muscle contraction when a trigger point is released, which can feel uncomfortable, but this sensation is short-lived and people often times feel immediate changes.

It is common to experience soreness in the area following dry needling for 24-48 hours, but it will resolve on its own. It is a similar feeling to the soreness that one would feel after strength training or a hard workout. Soreness can be managed with ice, heat, and gentle stretching. Other recommendations to further assist the healing process include:

  • Drinking Plenty of Water: Hydration can help to avoid or reduce sore muscles by helping to flush out toxins, transport nutrients into cells, and regulate body temperature and pH balance.
  • Exercising: As long as your pain doesn’t return, it is helpful to stretch, work your muscles, and continue your daily activities. Movement helps to improve mobility and blood flow.
  • Massaging Your Muscles: Massaging helps to further relax muscles and stimulate tissues to improve blood flow and encourage reduction in tension and soreness.

Who Can Perform Dry Needling?

Dry needling is regulated differently from state to state on which healthcare professionals can perform dry needling. Healthcare providers that can generally perform dry needling consist of physical therapist, chiropractors, and athletic trainers. Regulations and requirements vary from state to state. In the state of Maryland, athletic trainers are not permitted to use dry needling as a course of practice. Maryland law requires that licensed physical therapist undergo 80 hours of training prior to eligibility to practice dry needling, therefore are highly trained compared to other requirements in other practicing states.

Acupuncture vs. Dry Needling

Although acupuncture and dry needling both use the same type of myofilament needles for treatment, the two methodology and theories are very different. Acupuncture is a treatment developed with theories centered in Eastern Medicine beliefs with the idea that illness and pain occurs when the body’s vital energy doesn’t flow freely. Acupuncture is guided by needle placement along meridians that can help to restore physical, mental, and emotional equilibrium. Dry needling on the other hand was a development of Western Medicine beliefs are targets the source of pain from a musculoskeletal or neuromusculoskeletal approach. Although clients may see the similarities on the surface, the function of the two professional approaches are very different.


Dry needling is a very helpful technique in the rehabilitation process, but it is simply another tool in the toolbox for physical therapy treatment. Dry needling is best when paired with other treatment approaches to help relieve pain and improve function. The best way to know what will work for you to relieve your pain and improve your function and quality of life is to schedule an appointment with a physical therapist to diagnosis your pain, create an individualized plan of care, and help you get back to feeling better. Here at Red Canyon, we are ready and excited to be able to help you! Schedule today!