Detailed course outline

Lesson NumberLesson NameDescriptionDuration
1Online Course IntroductionLets all get on the same page with an overview of what the course and the Integrated Dry Needling process involves. Be sure to print your self some copies of the Integrated Global Assessment Form for use in your practical sessions and the course notes Range of Motion Technique Reference to ensure you have permanent copies.0:15:27
2Practitioner BackgroundHere's where you let me know who you are, your background as a practitioner and as a dry needling or acupuncture practitioner. This helps me greatly in tailoring course material and in my interactions with you. This section also contains questions to ensure our expectations of the online learning process are aligned.0:03:00
3Assumptions of the Integrated Dry Needling treatment paradigmMechanical pain is the result of inefficient movement leading to specific tissue overload,resulting in the production of abnormal impulses which may arise from several areas but mayresult in pain sensitivity or pathology in only one. Reducing abnormal impulse production by resolving movement dysfunction through the use of dry needling is an effective means of addressing mechanical pain. This is one of a number principal assumptions of the Integrated Dry Needling model that appears to be common sense and well reasoned but which is difficult to support with current literature. This and several other assumptions are discussed in this presentation.0:04:11
4The Integrated Assessment ProcessThe Integrated assessment is the process by which we define the movement dysfunctions and all the active sources of abnormal neurophysiological drive present, and by which we determine the appropriate combination and locations of the techniques that required. It is also the way we determine the extent to which they have been effective, predict prognosis and track the progress of, not only the abnormal neurophysiological drive reduction, but the entire rehabilitation process.0:20:10
5Engaged assessment and interpreting assessment findingsIn order to achieve an efficient ,successful ,Integrated Dry Needling intervention that does not rely on a provocative examination requires a different type of therapist engagement to the more conventional provocative assessment. This presentation discusses some of the process as well as how to use the information gleaned from the movement analysis, global screening and palpation profile.0:18:02
6Assimilating Integrated Dry Needling into your current practiceAs therapists we all come from a range of backgrounds and experience and meet under the common banner of Integrated Dry Needling. This presentation offers some ideas of how to expand or perhaps "shuffle" your current treatment paradigm to make the Integrated approach at home in your clinic.0:10:13
7Forensic NeedlingForensic needling, where the treatment forms a valuable part of the assessment, is a more complex paradigm of using needles in your test retest process to gain insight and certainty about the role of different possible sources of abnormal neurophysiological drive in any given clinical situation you find yourself presented with.0:23:18
8Pointers for General PracticePun intended....This is the odds and ends presentation. There is chat about needles and equipment and some of the points that tend to be covered in one way or another in basic training but which may differ significantly across various dry needling approaches.0:32:30
9Integrated Dry Needling Techniques OverviewThis is a short presentation about some of the characteristics of the overall Integrated Dry Needling treatment process and how the different needling techniques relate to each other which provides the context for us to go into each of the techniques in more detail in the presentations that follow.0:10:40
10Integrated Insertion TechniqueThere are many aspects of needle insertion to consider and it is important to be aware of the reasons for each of them as all are important for either safety, accuracy, comfort, therapist ergonomics and effectiveness or a combination of several of these factors.0:13:19
11Structural TechniqueStructural techniques don't comprise a large percentage of your needles but are the neurological depth charges of our Integrated Dry Needling techniques and done well, vastly reduce the amount of other needling your will need to do to resolve your screening and profile findings.0:14:11
12Peristructural TechniquePeristructural techniques are the those that let us selectively "down regulate " tissue and neural irritability and are those with which we achieve the disinhibition that allows such rapid and large scale resolution of so much movement dysfunction.0:17:02
13Reactive TechniqueReactive techniques are an amazingly direct, yet completely comfortable tool for modulating inflammatory processes and ramping down tissue sensitivity and in conjunction with the other techniques provide a way to address the pain and sensitivity of acute soft tissue injuries, allowing early return to therapeutic , normal movement patterns which in turn addresses swelling and muscle inhibition ( yes prepare to watch many of those simple acute lateral ankle sprains walk out limp free....there's no other technique, brace or therapy that achieves anything similar.)0:06:55
14Autonomic TechniqueAutonomic techniques are often forgotten about practitioners who have learned some of the more commonly used and perhaps more dramatic of the Integrated Dry Needling techniques but if you have been left wondering by people who don't seem to respond or who seem to be stirred up by the lightest needling or manual therapy treatments embrace these techniques and prepare to be able to address a who patient populations tissue irritability that eludes most dry needling practitioners.0:12:59
15Technique Variations and In BetweensOnce you have learned and are practicing the Integrated Dry Needling techniques you will quickly find, as your confidence and needling sensitivity grows , that you are working in the "grey zone" between the specified techniques. This is not only acceptable, but , is expected and it is nice to be aware of it as it happens and some of the applications you are most likely to first be aware of it.0:06:58
16Occipital techniqueOccipital techniques, practiced well, achieve many of the same effects on upper cervical spine movement as many manual therapy and manipulative techniques. The are extrmely safe and are indipensible in the treatment of cervical spine, temporomandibular joint and any other upper quadrant presentation.0:03:24
17Cervical Spine Facet TechniquesUsed in conjunction with the anterior techniques, theses techniques both mobilise and reduce irritability and sensitivity of the cervical spine facet joint capsule0:03:27
18Thoracic cage techniques: rib angle, rib neck and interspinous needlingIts hard to choose a “most valuable” technique but the the rib angle techniques would be contenders. These are the simplest and easiest to practice of the thoracic techniques and at the same time are the most used each day in in the clinic due to the common thoracic spine range restrictions seen in both upper and lower quadrant presentations. The other techniques included in this section are no longer taught in live classes but have been included here because, they are less intimidating to the experienced dry needling practitioner and though not applicable in every situation, definitely have their place.
19Lumbar Spine and Sacral TechniquesConnective tissue remodelling, sacro-iliac joint irritation modulation, lumbar spine mobilisation.In isolation, no dry needling techniques are particularly impressive but used within the Integrated quadrant approach these techniques do all this and more.0:07:19
20Scalp and Face TechniquesThese techniques have their place where indicated to resolve movement barriers in the upper cervical spine, scalp and cranial sutures.0:04:57
21Anterior Cervical TechniqueThe "golden triangle " of the upper quadrant. So many practitioners don't treat the spine anteriorly at all let alone needle it. You will hear several times during the course that if forced to choose between treating anteriorly or posteriorly there is no competition. Once these techniques are learned you will find nothing else impacts cervical spine, shoulder girdle and thoracic spine range and neural irritability like anterior cervical techniques. Definitely a top 3 technique.0:03:52
22Inguinal Region/ Anterior Lumbar Spine TechniqueYou will see multi-region neurological, performance and mechanical changes and thats before you add in any other techniques. If you were only permitted to needle one region for all lower limb and lumbar spine pain presentations (not to mention the effect it will have on the thoracic spine and cervical spine mechanics in some individuals)-this is it! No-one likes to be needled here but performed well it can be achieved with relative comfort. Don’t leave home without this technique and be prepared to have your whole model of back pain and movement revolutionised by this anterior technique.0:09:07
23Knee Techniques: Tibio-femoral, Meniscus, Lateral Retinaculum, Medial Collateral LigamentReduce tibiofemoral joint irritability and inflammation, become the ultimate manager of optimal scar formation following knee ligament injuries and harness the dynamite connective tissue remodelling power of these techniques and watch your management of traumatic and degenerative presentations escalate 0:11:49
24Leg and Foot Techniques: Interosseous,Heel, Inter-metatarsal, Syndesmosis and Ankle These techniques will catch the attention of the podiatrists but , like us all, they need to address the whole quadrant thoroughly in the assessment and treatment process. Only by doing this can we fully understand the neurophysiological drive contributing to, and see what these great techniques have to offer in heel pain, lateral compartment syndrome, plantar fascia presentations as well as reahabilitation and mobilisation post lower limb trauma or surgery0:20:08
25Forearm and Hand Techniques:
Interosseous Forearm, Inter-metacarpal
First Carpo-metacarpal Joint
These techniques will catch the attention of the hand therapists but , like us all, they need to address the whole quadrant thoroughly in the assessment and treatment process. Only by doing this can we fully understand the neurophysiological drive contributing to, and see what these great techniques have to offer in upper limb and hand pain presentations as well as rehabilitation and mobilisation post upper limb trauma or surgery0:20:10
26Axilla-Posterior Glenohumeral TechniqueSo you've been thinking that you need to needle pectorals and latissimus to effectively change gleno-humeral joint internal rotation and external may have to think again about how things work when you pair these techniques with the anterior cervical spine techniques. Every day in the clinic I see these ranges change and never needle pecs or lats.....Must have techniques for the hand therapists as they will change everything distally as well.0:08:41
27Greater Trochantur and Ischium TechniqueWhen practitioners are very muscle belly focussed with their dry needling they do not often explore other (more effective) options available that do not result in temporary increases in tissue irritability and reduced range of motion. You cant use what you don't know but thats all behind us now...0:08:28
28Integrated Global Screening Single leg stability This series of short video demonstrations looks at one example of the way we remove our focus from pain provocation to searching for movement dysfunction,identifying, on initial assessment, what it is not moving that is leading to other structures moving too much or in a way there were not meant to and eventually becoming irritated and pain sensitive. This is the challenge faced by many experienced Integrated Dry Needling practitioners and is essential to achieving outstanding results with the Integrated Dry Needling techniques0:02:12
29 Integrated Global Screening Lumbar Spine0:03:57
30Integrated Global Screening Cervical and Thoracic Spine
31Integrated Global Screening Upper limb0:05:19
32Integrated Global Screening Lower limb 0:11:35
33Palpation Profile Anterior Upper QuadrantPalpating and identifying irritated or upregulated or structurally adapted tissue is vital to practicing skilled dry needling but the most fun for the practitioner of Integrated Dry Needling is watching most of the palpation profile change without directly applying dry needling to the tissue that is changing. The palpation profile and Integrated Global Screening must both change as a result of needling for us to be certain that there will be a meaningful change in a patients movement and tissue loading as a result of our treatment. This is also a fantastic tool to assess the status of our progressive loading and movement retraining programmes we give our patients.0:04:25
34Palpation Profile Posterior Upper Quadrant0:01:23
35Palpation Profile Anterior Lower Quadrant0:14:56
36Palpation Profile Posterior Lower Quadrant0:09:23
37Needling demonstration Anterior Upper QuadrantThis series of demonstrations takes us through the whole process of addressing our screening findings and applying the global treatment-all our Integrated Dry Needling techniques in action, working together to achieve the outcomes we will see in the reassessment series.0:7:40
38Needling Demonstration Posterior Upper Quadrant0:05:23
39Needling Demonstration Anterior Lower Quadrant0:21:02
40Needling demonstration Posterior Lower Quadrant0:12:33
41Reassessment Lumbar SpineHave we been effective? How changeable,what rate of change and what degree of change can we expect from the neuro-mechanical system we have just treated? All of this information and more lies at our finger tips in the re-examination. If we are treating the source of mechanical pain,it is not what the patient tells us post treatment that provides evidence of treatment effect but whether or not they move differently. 0:02:09
42Reassessment Cervical and Thoracic spine0:04:09
43Reassessment Upper Limb0:01:46
44Reassessment Lower Limb0:04:15
45Reassessment Single Leg Stability 0:02:39
46Sports and Clinical Applications Overuse Injuries The rationale for using Integrated Dry Needling in the management of all stages of overuse injuries from resolution of initial screening findings to maintaining an optimal integrated screening throughout the stages of retraining and progressive loading and return to competition. The Integrated screening quickly tells us if the patient is training past loss of form or has insufficient control or awareness for the chosen level of activity allowing sensitive readjustment of the programme without exacerbation of symptoms.0:11:18
47Sports and Clinical Applications Unresolved AcuteIntegrated Dry Needling and the Integrated global screening is the perfect tool to identify and address the reasons why that acute injury has been slow to, or has not responded to conventional treatment at all. You wont be left wondering with this structured approach to addressing what others find difficult to treat.0:13:24
48Sports and Clinical Applications AcuteWhy wait until that apparently simple, acute presentation, becomes complex or non responsive. Early identification of potential barriers to improvement will avoid this undesirable outcome but will more importantly allow rapid modulation of the inflammatory processes and tissue irritability associated with acute presentations giving your patients quick and dramatic results. It really is too easy.0:19:47
49Challenging Needle AnglesIf you always think that the only way to change shoulder rotation is to release pecs, lats and subscapularis and you never try any other way, you are not giving yourself the opportunity to explore any new , perhaps advantageous, possibilities. Letting go of some old ideas may be necessary to allow progress. Find out in this presentation.0:11:56
50The WrapWell its been challenging and fun I hope. I know both you and your patients will benefit greatly from you having more technique options and by having a more global integrated treatment approach. 0:08:16
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