Shoulder pain is one of the most common musculoskeletal complaints, affecting athletes, desk workers, and anyone in between. Two prevalent causes of shoulder discomfort are shoulder impingement syndrome and rotator cuff-related pain. These conditions can be debilitating, limiting daily activities, exercise routines, and overall quality of life. Among the various treatment options available, dry needling has emerged as a powerful and effective technique for alleviating shoulder pain and restoring function.
Understanding Shoulder Impingement Syndrome and Rotator Cuff Pain
Shoulder Impingement Syndrome occurs when the long head of the biceps tendon or the tendons of the rotator cuff become compressed between the bones of the shoulder joint during movement. This is most common in the subacromial space (between the top of the humeral head and below the the acromion process at the tip of the shoulder). This compression repetitively will beat up the tendons that run through the space resulting in inflammation, pain, and reduced range of motion. Common symptoms include discomfort when reaching overhead, pain at night, and weakness in the shoulder.
Symptoms of shoulder impingement may include:
Pain when extending or lifting the arm overhead
Discomfort when lifting or lowering the arm
Pain with bringing the arm out to the side and then into external rotation (like throwing a ball)
Pain with bringing the arm behind the back
Pain with bringing the arm across the front of the body
Pain when lying on the affected side
Nighttime pain reducing sleep quality
Rotator Cuff Related Pain often stems from overuse, injury, or degeneration of the tendons that make up the rotator cuff. There are four muscles that make up the rotator cuff, but the one that tends to get irritated or injured with impingement syndrome is the supraspinatus tendon. The rotator cuff muscles and tendons are crucial for stabilizing the shoulder joint and enabling a wide range of movements by pulling the humeral head onto the glenoid fossa of the shoulder blade (imagine the head of the humerus as a golf ball sitting on the glenoid fossa like it's a tee). The rotator cuff pulls the humeral head onto the shoulder blade through ranges of motion while other larger and more powerful muscles take the shoulder through ranges of motion, When the rotator cuff gets injured, symptoms may include a dull ache deep in the shoulder, difficulty lifting the arm, and sharp pain during specific activities such as throwing or lifting. There can also be popping and clicking, which is usually painful. There can also be weakness as a result of sharp pain. Rotator cuff pain can result from various factors, including tendinitis, tears, or overuse injuries.
What is Dry Needling?
Dry needling is a minimally invasive technique that involves inserting thin, filiform needles into trigger points, tendons. tight bands of muscle, or other dysfunctional tissue. Unlike acupuncture, which is based on Traditional Chinese Medicine, dry needling is rooted in modern anatomy, neurophysiology, and evidence-based practice. By targeting specific areas of dysfunction, dry needling can:
Release muscle tension and knots or myofascial trigger points
Improve blood flow to the affected area
Reduce and improve inflammation
Modulate pain signals
Facilitate the body’s natural healing processes
Reduce the chance of requiring surgery
Reduce injury recovery time
How Dry Needling Helps with Shoulder Impingement Syndrome and Rotator Cuff Pain
Dry needling offers several benefits for individuals suffering from shoulder impingement and rotator cuff pain:
Release Myofascial Trigger Points
Myofascial trigger points —hyperirritable spots in skeletal muscle— are common in shoulder pain syndromes. These are typically major pain generators ad develop in tight muscle tissue bands to protect an area from being injured or develop due to repetitive stress and strain through an area. By targeting these points, dry needling can relieve pain immediately, referred pain and restore normal muscle function.
Reduce Muscle Tension
Muscle tightness can contribute to impingement by altering shoulder movement mechanics and increasing tendon compression of the long head of the biceps tendon or supraspinatus tendon. Dry needling helps to relax overactive muscles which improves those movement patterns which reduces pain.
Improve Range of Motion
Restricted range of motion is a hallmark of both shoulder impingement and rotator cuff dysfunction. By alleviating tension and promoting tissue healing, dry needling can enhance flexibility and mobility in the shoulder.
Promote Healing
The supraspinatus tendon and the long head of the biceps tendon tend to develop tendonitis and struggle to recover when there is inflammation because they do not have the greatest blood supply. The needle insertion stimulates a localized healing response due to placing the needles directly into the tendons and creating small amounts of targeted microtrauma and bleeding for more effective healing. This response includes increased blood flow and the release of growth factors, which support tissue repair.
Pain Modulation
Dry needling can influence the nervous system to modulate pain. By disrupting pain signals and releasing endorphins, it can provide immediate and long-lasting relief for shoulder discomfort.
Athletes Most Affected by Shoulder Impingement
Athletes who frequently perform overhead or repetitive shoulder movements are most at risk for shoulder impingement. These include:
Swimmers: The repetitive arm movements, especially in strokes like freestyle or butterfly, put significant stress on the shoulder joint.
Baseball and Softball Players: Throwing motions, especially for pitchers, can lead to overuse injuries and impingement.
Tennis Players: The serve and overhead shots involve repetitive shoulder motion, increasing the risk of impingement.
Weightlifters: Exercises like shoulder presses or snatches can exacerbate impingement if done with poor mechanics or excessive load.
Volleyball Players: The spiking and serving motions involve high stress on the shoulder joint.
Gymnasts: The demands of routines often place extreme forces on the shoulder, increasing the risk of impingement.
What to Expect During a Dry Needling Session
If you’re considering dry needling for shoulder pain, here’s what you can expect:
Assessment
A trained practitioner will evaluate your shoulder to identify the sources of pain and dysfunction. This assessment will guide the needling process.
Procedure
During the session, the practitioner will insert sterile, single-use needles into the targeted areas. You may feel a slight prick or a muscle twitch, which is a normal and often therapeutic response. The therapist may gently manipulate the needles to elicit a local twitch response in the muscle.
Duration
A typical session can last anywhere from 10 to 30 minutes, depending on the severity of your condition and the number of trigger points being treated.
Post-Treatment Sensations
After the session, you might experience mild soreness, similar to that of a deep tissue massage. This soreness typically subsides within 24-48 hours.
Complementary Techniques
Dry needling is often combined with other treatments, such as corrective exercises, manual therapy, or kinesiology taping, to enhance its effectiveness.
Targeting Key Muscles
Dry needling for shoulder pain typically focuses on three key muscles:
Anterior deltoid
Infraspinatus
Subscapularis
By targeting these muscles, dry needling can address the root causes of shoulder pain and dysfunction.
Mechanism of Action
When the thin needle is inserted into a trigger point, it creates a micro-trauma in the muscle tissue. This action triggers several beneficial responses:
Local Twitch Response (LTR): The muscle experiences a slight convulsion, allowing for a release of pressure.
Anti-inflammatory response: The needle insertion stimulates an anti-inflammatory reaction in the affected area.
Improved blood circulation: The treatment enhances blood flow to the previously swollen or restricted areas, bringing essential nutrients and healing proteins.
Muscle relaxation: Dry needling helps release tension in tight muscles, addressing imbalances that may contribute to shoulder pain.
Effectiveness and Safety
Research has shown that dry needling can be an effective treatment for shoulder impingement and rotator cuff pain. A systematic review of studies on dry needling for subacromial syndrome (which includes conditions like rotator cuff tendinopathy and shoulder impingement) found that the technique can reduce pain within four weeks, with some patients experiencing benefits after just a single session.
It's important to note that while dry needling is generally considered safe when performed by a trained professional, some individuals may experience minor side effects such as temporary soreness or bruising at the needle insertion sites.
Is Dry Needling Right for You?
Dry needling is generally safe when performed by a licensed and trained professional. It can be an excellent option for individuals experiencing persistent shoulder pain due to impingement or rotator cuff issues. However, it’s important to consult with your healthcare provider to determine if dry needling is appropriate for your specific condition.
Final Thoughts
Shoulder impingement and rotator cuff-related pain don’t have to sideline you from the activities you love. Dry needling offers a targeted, effective, and non-invasive way to address the root causes of your pain and support your recovery. By incorporating this technique into your treatment plan, you can move toward a stronger, pain-free shoulder—and a better quality of life.
If you’re ready to explore dry needling for your shoulder pain, reach out to a qualified professional today. At Elevation Spine and Sports, we specialize in personalized care to help you achieve your goals. Schedule a consultation and take the first step toward relief and recovery.
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