The Number 1 Risk Factor For Developing Knee Arthritis

A new study has shown there is likely to be a 276 per cent rise in knee replacement procedures from 2013 to 2030 (based on data from Australia's joint replacement registry).

Pretty staggering ! 😱

The biggest risk factor for knee arthritis leading to a total knee replacement is being overweight, which overtime stresses the knee joints (70% of Aussies are overweight).

This article talks about your options, especially if you want to avoid surgery.

Main points 💥

✅ Gradually increase your activity levels and incorporate targeted strengthening exercises to build the muscles around the knees.

✅ This can make them stronger, help to maintain appropriate co-ordination and reduce pain.

✅ Don't be fearful of exercise and movement, even if you do feel some pain. Pain doesn't equal damage.

✅ Running 💯% does not cause knee arthritis. On the contrary, runners have less chance of developing arthritis because they generally not overweight.

✅ Consult with your GP and Physiotherapist who can develop a customised plan to get you moving well again.

✅ Individual movement assessment can help you identify your weak links and help get you on the fast track.

✅ For more info about how Physio can help with your knee pain and get you moving well again 👇

Knee Osteoarthritis (OA) Part 2 - What Is The Best Type Of Exercise?

Exercise therapy: the treatment of choice

This months blog has a focus on exercise for knee osteo-arthritis (OA), an issue that I’ve had a passion for treating for many years.

It’s predicted that arthritis will soon impact over 3 million Australians.

Thankfully, there has been some very positive research showing the benefits of combining a tailored Physiotherapy program with an exercise program to build your bodies capacity, with significant benefits in the short term (six weeks) and long-term (one year).

I hope you will find some useful information and if you know anyone suffering with knee pain from OA, it would be great if you could please share it with them.

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Current guidelines recommend exercise for everyone with knee osteoarthritis, irrespective of radiographic disease severity.

Evidence shows a personalised exercise program, gives the best long term outcomes. 

These exercise programs consist of:

  • specific neuro-muscular exercises to help align the knee joint

  • cardiovascular aerobic fitness

  • strength training

Ideally this exercise program is set up by a Physiotherapist after a comprehensive assessment. 

Is exercise and movement safe for people with knee OA?

It is a common misconception that exercise causes arthritis.

Research shows that the main risk factors for knee OA are:

  • excess body weight

  • reduced muscle strength

  • knee mis-alignment

  • history of a prior traumatic knee injury

An important point to make here is that (except for traumatic injury) all of these factors are modifiable, meaning we have control over them.

This can be quite an empowering feeling, when you contrast this with someone who is told by a specialist, after viewing their scans, that nothing can be done, apart from surgery.

The risk of pain and injury are greatest when your physical capacity is low, as it sets you up for constant overload and damage.    It's important to note that    regular moderate       exercise       strengthens joints    and can decrease the risk of osteoarthritis.    Moderate activity levels provide the ‘sweet spot’ for physical health and acts like a vaccine against injury.

The risk of pain and injury are greatest when your physical capacity is low, as it sets you up for constant overload and damage.

It's important to note that regular moderate exercise strengthens joints and can decrease the risk of osteoarthritis.

Moderate activity levels provide the ‘sweet spot’ for physical health and acts like a vaccine against injury.

Getting past the fear of movement in OA

APA physiotherapist Dr Christian Barton, an OA researcher at LaTrobe University, says:

“One of the biggest problems we have to address is that many people are told to rest when they have pain, rather than stay active. As a result they often become quite sedentary, which can lead to depression, weight gain and an increased risk of other chronic diseases.

Proper exercises, regular physical activity and good health education are essential for OA management, all of which can be delivered by exercise specialists like physios. The missing link is the funding to provide patients the opportunity to do this.”

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You Have Two Options:

  1. OA Diagnosis —> Fear of doing more damage —> rest/avoid activity —> deconditioning —> depression —> weight gain —> increase load on knee —> downward spiral —> general health declines

  2. OA Diagnosis —> Consult with Physiotherapist (with a special interest in knee OA) —> personal assessment —> address fear of movement —> set up with graduated exercise program —> Physiotherapy manual techniques to decrease pain, improve joint alignment —> re-build capacity —> maintain happy and healthy life

What is the point in doing exercise and rehab if I’m eventually going to need surgery?

The first thing to keep in mind is that not everyone with OA will progress to a point where they need a joint replacement.

In fact only about 30% in those are diagnosed with OA subsequently go onto require a total knee replacement.

We know that ‘prehab’ gives significantly better outcomes if you do eventually need to go for surgery, so by getting your knee stronger and more robust will have direct benefits. You

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A Few Notes On Pain

As you start to move more, you most likely feel some knee pain.

It's critical though you understand one key fact: "Pain does not equal tissue damage".

The truth is pain is related to the threat of tissue damage, not actual tissue damage.

There is a whole field of pain neuroscience research now showing that the pain you feel is not correlated with how much tissue damage there is.

This is relevant to know for people with knee OA, as many people have severe joint degeneration on x-rays, yet have absolutely no pain.

Rather pain is a 'request for change' and in chronic knee pain may be more related to ongoing weakness and stiffness in the knee.

A sure sign that movement is needed to get the muscles stronger and protect the knee joint.

It’s OK for exercise to be painful (especially as you warm-up at the beginning), but try and keep it to an acceptable level (e.g. < 5/10). Also, monitor the response in the following 24 hours after you exercise.

Patience is key.

As you build your capacity over time, you will get less intense and frequent pain flare-ups.

Credit: Christian Barton Presentation

Credit: Christian Barton Presentation

Three Components To An Effective Exercise Program:

  1. Neuro-muscular control

One important risk factor that can lead to progression of knee OA is the mis-alignment of your knee (in particular the kneecap).

Many people with knee pain who get motivated to exercise may end of causing a flare-up if there knee is out of alignment.

Some signs you may have a knee alignment issue:

  • general ache/pain in the front of the knee

  • pain aggravated activity involving a bent knee and body weight on the leg (e.g. walking up and down stairs, squatting, kneeling, jumping or hopping)

  • pain aggravated by sitting for prolonged periods e.g. driving or sitting in a movie theatre (eg, jumping, hopping, running, going up or down stairs, or squatting).

  • some people also hear and feel a grinding / clicking around the knee with mild swelling


A number of factors can alter the mechanics of the patellofemoral joint and increase joint stress, leading to OA.

This is where an detailed Movement Assessment with an experienced Physiotherapist can really pay dividends.

We can quickly see which parts of your body are moving efficiently and which are not and then take the time to out together a customised plan of attack for you and this can have the capacity to not only reduce symptoms but have the potential to slow disease progression.

Manual therapy, dry needling, exercise and taping can all greatly assist with re-aligning your knee joint.

Pilates can also very beneficial it helping to build the neural pathways for efficient movement.

2. Aerobic fitness

Aerobic exercise has many benefits for people with arthritis that include:

  • stimulating natural endorphins that can help decrease pain as much as taking medications (without the side effects)

  • builds your physical capacity and increases muscle strength to help protect the joint

  • helps in managing your weight (there is a large body of evidence that identifies obesity as a risk factor for developing OA of the knee, particularly in women)

  • improves mental health and lowers the risk of depression and anxiety

  • getting you out of the house and away from sedentary behaviours

  • strengthens social connections

What exactly is aerobic exercise?

Aerobic exercise can be defined by light to moderate intensity, and is characterised by our ability to maintain it for a prolonged duration (many minutes to several hours). You should be able to maintain a conversation as you move.

Capacity vs Demand

We know that your symptoms are likely to flare-up when you get fatigued. It is important to build your cardio-vascular capacity so you can comfortably perform your everyday activities with ease and comfort.


When you’re had a flare-up and are in pain, your activity levels tend to drop off. This has in impact on your bodies capacity, and your ability to deal with demand and loads will be temporarily reduced, until you can build it back up again.

Pacing yourself with a graded exercise program is the best way to re-build capacity. Monitoring your time, distance and pace can be extremely beneficial with a GPS watch or app in your phone.

How much aerobic exercise should I aim for?

Current guidelines recommend aerobic exercise be performed ideally on most, and preferably all, days of the week, for a minimum of 30-60 minutes a day.

This 30-minute total can be performed in one go, or be made up of 3 x 10-minute sessions, if that’s more convenient for your lifestyle.

How do you choose what sort of cardiovascular exercise to do?

“The best exercise is the one you’ll commit to doing”

Factors to consider:

  • What do you enjoy doing and what you will commit to?

  • How much time do you have to fit into the day?

  • Do you have any social support that would increase adherence?


Before you begin

As you begin an exercise program, you may need to allow a period of 'body tuning' i.e. using manual therapy, massage, dry needling and specific exercises to improve tissue quality and joint alignment.

Similar to playing an instrument, tuning up before hand makes things perform much better and reduces the wear and tear.


Gradually increasing the amount you walk would be an excellent way to start building your aerobic fitness.

Don’t forget to invest in some good quality shoes that are replaced every 3-6 months, depending on how active you are.


While cycling can be good for the health of the knee joint, unfortunately it can contribute to muscle imbalances.

Specifically cycling inhibits the glutes and makes the hip flexors and hamstrings tighten up. This can have consequences when walking and standing for long periods, as the knee joint is likely to experience increased load and strain.

If you really enjoy cycling, that’s cool, but you may need to spend some extra time working on correcting your muscle imbalances.

For many years it was thought running ‘caused bad knees’ and it was best to avoid if you have knee pain.

However, much research has come out recently with some surprising findings - runners are at a reduced risk of developing knee arthritis.

The exact mechanisms for this are still unclear, but may be related to runners maintaining a healthier weight level, with stronger muscles and more resilient joints.

BENEFITS OF RECREATIONAL RUNNING - Recreational running is not only good for your overall health, but also benefits your knees and hips—just 3.5% of these runners develop hip or knee arthritis. A sedentary lifestyle—not running—or competing as an elite runner increases the risk of hip or knee arthritis by 10.2% and 13.3%, respectively.   Source: Journal of Orthopeadic Sports Physical Therapy

BENEFITS OF RECREATIONAL RUNNING - Recreational running is not only good for your overall health, but also benefits your knees and hips—just 3.5% of these runners develop hip or knee arthritis. A sedentary lifestyle—not running—or competing as an elite runner increases the risk of hip or knee arthritis by 10.2% and 13.3%, respectively.

Source: Journal of Orthopeadic Sports Physical Therapy

Bottom line: there are certain strategies for helping offload the knee when running (such as increasing your cadence 5-10%) to keep you from aggravating your knee pain. Please contact us to find out more.


Getting in the water regularly would be one of the best things you could do for knee OA. The buoyancy of the water helps decompress the joints and allows you to move freely with minimal pain. Swimming, water aerobics or even just walking in the water can be very healing for the knee joints.

Just ensure you are still getting enough weight bearing exercise to stimulate your muscle and bone growth.

3. Strengthening

National guidelines recommend x 2 strengthening sessions per week.

This doesn’t mean you you need to necessarily go to the gym, (but it may be helpful if you have a small weights at home) to gradually progress your strength capacity.

Your Physio will be able to guide and progress your strength program.

Major muscle groups that should be targeted include the quads, glutes, hamstrings and calves.


Dealing with flare-ups

  • flare-ups are a natural part of the OA presentation and should be expected

  • the main thing is to listen to your body and temporarily reduce any load and strain for a few days

  • focus on non-weight bearing exercise such as pool and pilates exercises to help keep strength in glutes and core

  • take panadol as needed

  • use ice or heat packs

  • keeping an activity log to monitor how your body responds to your exercise can help identify triggers

  • If your symptoms persist for more than a few days, make an appointment to see your Physio.

How can a Physiotherapist assist someone with knee OA?

1.  Assessment and Diagnosis

A modest investment in a Physio Assessment early on  in your journey pays big dividends in terms of identifying relevant contributing factors and helping you get on the fast track to healing. 

We spend a lot of time in the beginning educating you so you know what to expect in terms of recovery and what you need to do, to manage your recovery successfully.

"Give me six hours to chop down a tree and I will spend the first four sharpening the axe." - Abraham Lincoln

2.  Dry Needling / Massage and Taping

Often 4-6 sessions of manual therapy will help minimize pain, re-set your tissues and get you into a position where you can confidently self-manage. 

Muscles that are commonly tight and affecting your knee include the

  • ITB

  • TFL

  • hamstrings,

  • quads and calves

Foam rolling and spiky ball massage are effective at maintaining flexibility, but dry needling has the ability to get to the deeper part of the muscle and get a more effective release. 

Find out more about dry needling here.

We can also show you how to tape your knee to provide relief in the short-term.


3.  Guidance on load management

We will give you advice on how to gradually re-load your tissues to safely protect your knee from future flare-ups.  We work with your coach or trainer to manage your return to doing what you love. 

4.  Building a personalised home exercise program

You are the most important part of the healing process and what you do is the most important part getting you better. 

We use the convenient Physitrack App to build your personalised home program with videos delivered to your smart phone.

5.  Movement Re-Training

Once your pain is under control we then watch how you move and optimise your movement patterning to decrease the chances of the knee pain returning.

Pilates can be a very effective way to maintain efficient movement patterns.

Is Knee Pain or Injury keeping you from being as active and healthy as you want?


I hope this post has given you some valuable guidance in planning your exercise to help your knee. It is very general information, so please consult your Physiotherapist for advice specific for you.

There is a lot of positive research now that shows taking a proactive approach to your health can have a very successful outcome for your knee pain.

If you have knee issues and like some more personalised guidance, it would be a pleasure to help you (we can help in person or via our online tele-health portal).

Please take a moment to fill out the form below and we’ll get back to you as soon as possible.

Name *

Knee OA - Part 2 - Exercise

1. Do you think exercise is a beneficial intervention for knee OA patients. If so why?

Yes exercise is very beneficial for knee OA.

2. How often do you prescribe exercises for knee OA patients?

Doing some form o

3. What are the most effective exercises for your pt groups.

For knee pa

4. Do you often see changes in patient function and pain after an exercises prescription? If so what sort of changes do you often observe?

5. How many days a week should OA patients exercise?

6. How many repetitions and sets do you often prescribe patients with mild, mod and severe knee OA

7. How many times a week do you often prescribe such exercises?

8. What sorts of lower limb exercises do you prescribe patients with knee OA and why?


Knee Osteoarthritis - Part 1 Your Options

Osteoarthritis (OA) is the most prevalent joint disease and a leading source of chronic pain and disability worldwide.

There is a common perception among people with knee arthritis that nothing can really be done, (outside of taking medications or having knee replacement surgery).

This study by Mitchell and Hurley (2008) showed that many people were unaware of the options available to them, despite consulting with their general practitioner.

Research indicates less than 4% of people attending a GP clinic with knee osteoarhritis are referred to a Physiotherapist.

The intention behind this blog post is to inform you of some of your options, so you can make an educated decision about what is best for your situation.

Knee OA…what options do you have?

1. Ignore the pain

This can be an effective strategy in the beginning. Ignoring the pain and getting on with things can be actually be quite helpful.

This usually works particularly well when you are young and resilient.

Our bodies are masters at compensating and this means you can still do what you want in the short-term as your body may be able to transfer load from the knee into the hip or lower back.

As you get older though (around the age of 30+), this strategy has less effect as the compensatory patterns have a limited capacity.

As your body runs out of options and strategies, you will eventually find yourself not recovering like you did before and the stiffness and pain starts to get stronger.

2. Rest the knee and avoid using it

Advice to rest and avoid pain is commonly provided to people with knee and other joint pains - advice that is often wrong, and harmful.

Unfortunately the majority of people with knee OA reduce moving due to fear they will wear the knees out and make things worse.

This leads to a downward spiral of pain, weakness and a loss of confidence.

Interestingly, we know that weak thigh muscles are one of the biggest risk factors for ongoing knee pain. When you stop moving and become inactive, muscle loss accelerates significantly.



At some point in your 30's you naturally start to lose muscle mass and function.

Physically inactive people lose an average 3-5% of their muscle loss per decade after the age 30. The technical name for this is sarcopenia.

The picture above demonstrates the dramatic consequences of an inactive lifestyle and severe muscle wasting.

Adipose tissue refers to the fat layer around the muscles.

Clearly, avoiding movement is not going to be your best solution.

What about running, won’t that lead to increased OA?

Interestingly, recreational runners (3.5% risk) had a lower occurrence of developing knee OA compared with non-runners (10.2%).

One of the main ways running protects you from arthritis is by maintaining you at a healthy weight. This leads us to our next point.

3. Weight Loss

Obesity is a strong risk factor for knee pain and increases the risk of symptomatic knee osteoarthritis.

Women who are overweight are four times more likely to develop knee OA than women who are a healthy weight. And men who are overweight are five times more likely to develop OA than men who are a healthy weight.


But losing even a small amount of weight can be beneficial. For people who are overweight, every 5 kg of weight loss can reduce the risk of knee OA by more than 50 percent.

4. Medication

Medications such as panadol and anti-inflammatories have their place when you have an acute flare-up of knee pain.

But they are not designed for long-term use, due to their side effects on the liver and gastro-intestinal system.

5. Arthroscopic Surgery

Traditionally, arthroscopic surgery has been performed for chronic knee pain. Over the past few years however the research has indicated that for people with degenerative knee pain (including meniscal lesions), performing arthroscopic surgery does not improve outcomes.

The evidence refuting arthroscopy to treat meniscal degeneration and knee osteoarthritis (OA) is now clear and compelling. In Australia, the number of arthroscopies for degenerative knee pain has halved since 2011.

If the knee pain and degeneration is severe, conservative measures have been tried and you are having difficulty functioning day to day, then a Total Knee Replacement would be a logical thing to consider in consultation with your doctor.

However, the point being made here is that arthroscopic surgery is not required for degenerative knees.

Of course with any surgery there is the risk of infection and blood clots forming in the leg, as well as post-op recovery and rehabilitation for a few months afterwards.

6. Exercise therapy: the treatment of choice for Knee OA

Exercise therapy has the best evidence providing both short and long term benefits to people with knee OA.

High-quality evidence suggest that land-based therapeutic exercise provides benefits in terms of reduced knee pain and improved quality of life (Bennell et al 2015). This benefit can be sustained for 2-6 months after cessation of formal treatment.

Exercise therapy involves a combination of supervised sessions with a health professional to target:

  • strength

  • cardiovascular fitness

  • flexibility

  • neuro-muscular retraining

Getting all the pieces of the puzzle to get you back to doing what you love.

Getting all the pieces of the puzzle to get you back to doing what you love.

As you begin an exercise program, you may need to allow a period of 'body tuning' i.e. using manual therapy, taping, massage and dry needling to improve tissue quality and joint alignment.

Similar to playing an instrument, tuning up before hand makes things perform much better and reduces pain and tightness.

This is where are a good Physio comes in, who has a deep understanding of knee pain and a passion for helping people overcome it.

We do that everyday of the week and you can find out more about us here.


We know that movement and exercise can be what truly helps knee pain.

The evidence is compelling.

It addresses all of the modifiable factors that can get you out of reactive mode, and into building your foundation.

But what type of exercise specifically helps?


If you have any questions in the meantime, please feel free to contact us.

If you'd like to see how we can help set you up with a plan of attack to overcome your knee pain, please use our easy online booking system to schedule an initial appointment.


Mitchell HL, Hurley MV. Management of chronic knee pain: a survey of patient preferences and treatment received. BMC Musculoskelet Disord. 2008 Sep 18;9:123

Exercise for osteoarthritis of the knee: a Cochrane systematic review.

Fransen M, McConnell S, Harmer AR, Van der Esch M, Simic M, Bennell KL.

Br J Sports Med. 2015 Dec;49(24):1554-7

The Association of Recreational and Competitive Running With Hip and Knee Osteoarthritis: A Systematic Review and Meta-analysis.

Alentorn-Geli E, Samuelsson K, Musahl V, Green CL, Bhandari M, Karlsson J.

J Orthop Sports Phys Ther. 2017 Jun;47(6):373-390.

"Surgery versus Physical Therapy for a Meniscal Tear and Osteoarthritis, The New England Journal of Medicine, 2013"

An Exercise For Tight Hip Flexors That Works Better Than Stretching

It's 'Global Running Day'... One of my fav exercises for runners, especially those with issues with their hips.

This drill will build capacity in the hip flexors (TFL, rectus femoris and iliopsoas), an important group of muscles for running. 

Like the hamstrings, the hip flexors often end up in constant 'protective mode' due to weakness and lack of strength.  Sitting all day tends to make them tight as hell.

This exercise will help get to the root cause of your tight hip flexors and also help to switch on your glutes.

Stand with theraloop around the middle part of your feet.
Drive one knee up so your thigh is parallel to the ground while also activating your core.

Important ➡️The weight bearing leg drives down⬇️ to the ground, strongly activating the gluteals. ✅This will help improve your running efficiency and gluteal activation on push off.

Happy Running!

#globalrunningday #runnersbody #runnersworld #runnersofinstagram #running #runningcommunity #resilientrunner #runforlife #runningtherapy #runninginspiration

Top 10 Muscles That Respond To Dry Needling

Top 10 Muscles That Respond To Dry Needling

One of the benefits of dry needling is it's a very precise way of releasing a muscle. 

Compared to massage, getting a twitch response out of a muscle gives a very predictable and effective release, deep from within the muscle belly.

In this post, I wanted to give you some insight into some of the best responding muscles that dry needling can help with.

If you want to learn more about exactly how dry needling works, please read more here.

Of course dry needling can be done to any muscle.   The following post is to give you some insight into some commonly treated muscles that give especially good 'bang for your buck'.

*Please also see some important notes at the end of the post.

1.  Deltoids


In terms of shoulder pain, the deltoid is a very under-rated muscle.

The deltoids include three sections (anterior, middle and posterior) that sit superficially around the shoulder.  The deltoid is involved in almost all shoulder movement.

The way the it wraps around the shoulder makes it a very difficult muscle to stretch and it is prone to building up tension.

Trigger points and knots often develop in the deltoid that can give rise to shoulder pain (see pic above). 

This pain can be quite severe and unrelenting and stubborn to usual treatment.

A common history is over-doing some push-ups and waking up the next day with pain in the front of the shoulder. 

Or someone who has done a lot of heavy over-head weights (Cross fitters...!) over the years and doesn't do much stretching. 

Sometimes it's the last small movement and final straw the breaks the camels back so to speak.

Dry needling the deltoid often gets some powerful twitch responses. 

Expect soreness and a dead arm feeling for a few days before things settle down.

2. Latissimus Dorsi


The latissimus dorsi is a fascinating muscle. 

It has attachments to the hip, shoulder, upper back, lower back and rib cage - and that makes it the largest muscle in the upper body.

Tightness in the latissimus dorsi has been shown to be an important cause of chronic shoulder pain and chronic back (especially upper back) pain.

Because of its extensive attachments, it can be another difficult muscle to stretch effectively. 

Dry needling gets in there and gets the job done.

If your lats are tight, you will need to add in some regular childs pose and over-head stretching, in addition to foam rolling your upper back.

3. TFL / ITB


The fastest way to release your ITB

Release the under-rated small muscle that attaches to it, called the Tensor Fascia Latae (TFL).

The TFL is a small but powerful hip flexor and usually tight from excessively sitting, walking, running and cycling.

When overly tight, can contribute to knee pain by causing mis-tracking of the kneecap. 

Combine dry needling with some specific gluteal activation and you will be well and truly on the way to saying goodbye to your ITB pain and tightness. 

If you look after your TFL well, there's a good chance that excruiating ITB foam rolling will not be required.  Happy days :-)

4. Glutes

Gluteus Medius_0.jpg

One of the cool things about dry needling is that we can access deep points in a muscle that you would otherwise be unable to access.  

The gluteus medius is an interesting muscle that can be dysfunctional in chronic lower back pain, hip pain and knee pain.  

Dry needling can immediately 're-set' the glutes and allow for a graduated re-loading program. 

Long-term, a well functioning gluteus medius will protect your hips, knees, ankles and lower back. 

5. Calf - Gastrocnemius & Soleus


Calf muscle tension and limited flexibility is especially common in the modern age. 

When tight, the calf muscles are prone to cramping and eventually tearing.

Deep tissue massage can be effective, but can be very painful, bordering on intolerable.

Dry needling to the calf muscles, whilst intense, is quicker and more effective in its release. 

Expect some treatment soreness for 1-2 days post-needling.

And don't forget to re-build your calf capacity with an appropriate strengthening program.

6. Upper Trapezius


Much like the calf above, the upper traps can be loaded with tightness. 

Causes can include poor posture, lack of physical activity and prolonged stress. 

Heavy handed massage can stir up more irritation in the muscle.

Dry needling is more like using a sniper approach - with a few direct releases, you can release the traps and get the blood flowing much more effectively and deeply. 

This study recommended dry needling for immediate pain reduction in upper body myofascial trigger point dysfunction.

Using heat on the traps via a wheat pack is really helpful, especially in the evening before bed.

Also make sure you are getting enough down time as chronic upper traps tension is a sign of sympathetic over-activity.

7. Infraspinatus


The infraspinatus is a sneaky little muscle that sits behind your shoulder blade. 

It is often weak and gets overloaded when using your arm and shoulder.  

When the infraspinatus gets tight, you'll often feel pain in the front and deep part of your shoulder.

Dry needling de-activates the trigger points quickly, but be prepared for a dead arm for a few hours.

Don't forget to re-build with some simple strengthening exercises with a thera-band.


8. Wrist Extensors


Tennis elbow is a very common condition that primarily affects the extensor tendons on the outside of the forearm. 

The pain often drags on for months and years due to a very poor blood supply in the elbow tendons.

The research shows that dry needling releases a very specific chemical, known as Platelet-Derived Growth Factor (PDGF), that produces a strong increase in blood flow into the muscle.

In effect, blood is a healing agent, bringing oxygen and critical healing chemicals to the damaged cells.

No other technique that I know of is capable of doing this.

9. Biceps


When was the last time you stretched your bicep muscle?  

Another muscle that gets used a lot, and builds up a great deal of tension. 

You'd be surprised how that niggling pain in the front of your shoulder improves after your biceps is released through dry needling.

10. Hamstrings

Biceps Femoris, Semitendinosus, Semimembranosus.png

Tight hamstrings are pretty common. 

Stretching them normally does more harm than good (see here).  

Dry needling produces a quick and effective release.

Specific strengthening exercises that lengthen the muscle gives the best long term solution. 


Dry needling certainly isn't for everyone, but it can be a very effective and powerful treatment in the right context. 

Two quick notes:

1.  There are different types of dry needling and this blog refers to the type that activates a local twitch response. 

This is very different to acupuncture and dry needling where the needles are inserted superficially and left in for 20 minutes as the practitioner leaves the room. 

2.  Dry needling is always used as part of comprehensive treatment approach

This includes assessing your thoughts and beliefs about your injury, movement patterning and general health considerations. 

Specific exercises targeted towards your individual needs will help give you the best long-term outcome.

If you have any questions about dry needling - please feel free to give us a call 1300 657 813.

If you'd like to schedule a dry needling session and start feeling better straight away, please book online below: