Before we get to talking about IMS Dry Needling for Tennis Elbow — does this sound a bit familiar? The story usually goes something like this: a while ago I was doing a lot of typing and I started to notice a sense of stiffness my forearm. Then I noticed it was also happening during exercise like deadlifting. Next it seemed to be happening all the time like when I picked up a bag of groceries even just tried to turn the door knob to open the door. I don’t remember doing anything in particular, but the pain has been getting worse slowly and now I’m starting to feel weaker on this side than my other side when I do gripping activities.
Ok, so What is Tennis Elbow?
Tennis elbow, or lateral epicondylitis, is a condition that causes pain on the lateral aspect of your elbow. This is where the muscles and tendons of the forearm responsible for extending your wrist and fingers attach. Tennis elbow is an overuse injury that progresses over time with repetitive motions, and can last for quite a long time – months to years in many cases. We want to help you overcome it, as quickly as possible, so you can get back to doing all the things you love at 100%.
What is IMS Dry Needling, you ask?
IMS dry needling It’s a treatment technique we use to stimulate the muscle (thus the name intra-muscular stimulation aka IMS), in a way that we can’t quite do using our hands or other means externally.
You can see this as a “reset” for your muscle, just like other forms of manual therapy such as massage, joint mobilizations or manipulations provide a novel stimulus to the body and help to wake things up, relax things and facilitate better movement.
It involves inserting an acupuncture-type needle (thus “dry needling”, as opposed to “wet” needling such as injecting lidocaine, saline or other substances). The needle taps into the skin, then into the muscle, and can be back out all within 3 seconds (if the goal is to be as quick and comfortable as possible).
How Can IMS Dry Needling Help Reduce Tennis Elbow Pain?
As you probably already know, tennis elbow feels like a pain in the muscles/tendon at the side of the elbow. If we palpate (touch) these muscles deeply, or exert (by gripping, lifting or resisting movement), we can often reproduce pain.
While you may find relief simply by inserting and removing the needle, the most effective points will be those points that stimulate a twitch in the muscle, upon insertion. Sometimes it takes a bit of work to find these exact points.
Twitchy muscles are generally the most dysfunctional, or unhealthy bands of muscle. What’s more, if we insert the needle and there’s no twitch, it suggests your muscles are relatively healthy. In this way, IMS can sometimes provide some “diagnostic value” as well. An experienced clinician will be able to tell you if the level of twitch you’re experiencing is unusual for the muscle in question, and thus, sometimes we can interpret whether we really need to be concerned about the muscles as your pain generator, or look elsewhere for the cause of your problem.
Test-retest: the immediate way to know if IMS Dry Needling helped your Tennis Elbow pain.
In most cases with a client who has symptomatic tennis elbow, we can reproduce the pain through clinical tests such as gripping, or resisting specific movements such as extending the fingers or wrist. If we can quantify the pain with a certain test, provide the treatment, and re-test afterwards, you’ll have an immediate sense whether this is helping you or not. In some cases, we’ll use grip throughout the treatment after doing each point, and a client can literally point to where they feel the pain, at which time we can palpate for a taut band in that muscle, and continue. In other words, sequentially taking down the pain in a series of muscles, using the client’s feedback throughout the process.
What else should you know about IMS Dry Needling for Tennis Elbow Pain?
Mainly that it’s not going to be the ONLY part of your treatment. In most cases, we’ll assess and treat at/near your elbow, as well as at/near your shoulder and neck (where the nerves that go to the elbow come from). Clinical experience suggests that working exclusively at the elbow tends to be less successful than treating at both the elbow and neck.
Next, we need to balance our work between passive treatments and active treatments such as strength exercise and stretching.
Further, in a given physiotherapy session, we’ll probably also incorporate some massage techniques, and perhaps joint mobilizations.
So the point is, IMS is part of the treatment process, but it’s not everything. Ask your physiotherapist if massage therapy or chiropractic may be helpful in your situation as well.