Course Review: Functional Dry Needling Level 1 | Modern Manual Therapy Blog

Course Review: Functional Dry Needling Level 1

I had the opportunity to take Functional Dry Needling over this past weekend in Kinetacore's home base of Brighton, CO. In short, an amazing course that I would recommend to anyone interested in a very powerful reset.




Course highlights:
  • review of the history of dry needling which goes back some 100 years
  • reviews of the research behind the effects of DN
  • the potential complications and occurrence of problems
    • they do a really good job of respecting the nervous system, overall health, patient want/need, placebo, nocebo
  • research review on the effects of DN
    • increased blood flow
    • decrease banding
    • decrease spontaneous electrical activity
    • biochem changes
      • decr substance P, CGRP
      • incr B endorphin levels
    • CNS changes (PPT) - in local Tx area plus other areas suggesting changes in descending pain pathways
    • not solely acting on local structures
The background of FDN really resonated with my approach as they go over pathoanatomy versus functional (movement based) approach. They also review current pain definitions from the IASP and peripheral and central sensitization. The SFMA Top Tier is instructed and used as pre-test and post-test after any area is treated. It's emphasized to review the entire SFMA as changes may happen distally to a treated area.



gratuitous website placement and filipino ass shot

Shout out to my lab partner, Candace Good, the first person I ever needled! Edo attempted photobomb - fail!
Day 1 - Fumble Fest

Even though it was a larger course, we were fortunate to have 3 lead instructors, and at least 4 more assistant instructors. We broke up into small groups for practice and demonstration. Naturally, I volunteered as much as possible. For gluteus medius, and minimus, I had some very painful twitch responses, that made me break out into a sweat. They were S bomb bad, but not quite F bomb bad. My posterior hip was sore for maybe 1-2 hours but my movement was significantly improved.

For my right VMO, I had such a large twitch response, that my hand started shaking, I felt faint and started sweating in my palms and feet. By the time they finished with my pulse-ox measurements and BP, I felt much better. Considering during the first lab, a participant passed out after needling his own right common wrist extensors, I was careful not to get up quickly.

The instructors are quick to point out this happens at least every other seminar and it gives course participants a healthy respect for the power of DN to effect changes in the sympathetic nervous system.

It's amazing learning a new psychomotor skill that is so foreign. You forget as a manual therapist of 16 years what it's like to be uncoordinated and inept at something. At the end of Day 1, I thought, the evolution of my approach in the past 4 years has made nearly every single one of my Tx to be pain free. Will I be able to do this? 



Yeah, it happens... not tender at all
Day 2 - Getting There

By the mid point of day 2, we got to lumbar spine and cervical spine; it was much more comfortable, especially with the e-stim to the needles to get a much more comfortable twitch, that did not occur with the twitch responses from pistoning technique. It really was amazing by the end of Day 2, how much more confident you get by continuous practice of handling needles, working on different partners and getting checked off by various faculty.

Unlike other manual therapy courses, where you are left alone, practice for a few minute, then chit chat or get on your cell phone to check your facebook, you are constantly practicing. Most participants even stayed 45 minutes after the class or longer. Maybe it had something to do with that Cert Exam on Day 3.

Yay for towels, that really makes me not exposed, getting ready for lumbar multifidus!
afterward, MSE was much better than the normal DP, went to a much more movement DN
By the end of Day 2, I definitely felt confident with handling the needles, the quick tap to place them, and both threading and direct techniques, plus using e-stim. I also did not pass out, and even though I had several uncomfortable twitches responses, they were very transient, and movement was improved in most areas. I was barely sore from any of the treatments.

Day 3 - Testing Day

What's this? There's a test you say? Now I remember what being in PT school is like when you get asked practical questions. Since I do not focus on anatomy, innervations, etc... for The Eclectic Approach and just tissue and movement patterns, this was a BIG review for me. Like any other organization, KinetaCore only puts its stamp of approval if you can pass a didactic and practical exam. Ok, I'll finish this post later, I have to study for this 7 am test.

Whew, I passed! The instructors state their goal is to make you a safe and competent practitioner. The practicals are like 1:1 sessions with feedback and constructive criticism. You get to choose which muscle you needle and I chose Glut Min, the one I was worst at. No point in choosing one you're really comfortable with, how would you improve? Day 3 finished up with the lower leg and arm, and everyone continued to practice as much as possible. Unlike traditional OMPT Courses, where most participants think, "I'll just practice this one later," all of the participants continued to take up the entire allotted practice time.

As a bonus, Edo Zylstra, KinetaCore founder gave me some time at the end of the course to demo the EDGE Tool and surprisingly about 3/4 of the class stayed! Thank you if any of you are reading this.

Why You Should Take FDN Level 1
  • TDN is a growing and EB practice (certainly more than IASTM)
  • the founders of KinetaCore are staunch supporters of the APTA, and travel around to all states to protect our practice act where it needs defended, and improve it where it is unclear or not allowed - NY Boo!!
  • student to faculty ratio is excellent, even in larger classes, plenty of time for hands on with lead and assistant instructors providing great feedback
  • the 3 lead instructors (Edo, Nelson, and Keri) are all amazing presenters, each with their own style, but are very easy to follow, charismatic and have great senses of humor
  • TDN presented functionally with the SFMA as test-retest
    • instructions not to chase the pain, but to find a possible cause
  • TDN is an extremely powerful reset that belongs in any manual therapists's toolbox, many of us (including myself) had changes in our Top Tier movement patterns, tone, and function immediately
Nelson Min (main presenter for the course) had to take an early flight, I'll catch him during Functional Therapeutics 
Despite my early reservations due to some very painful twitch responses on Day 1, after Day 2 and Day 3, I can without a doubt give FDN Level 1 my highest recommendation. It will join my Top 5 Recommended Courses, next time I write that list. It is everything a modern course should be, mindful of the research, supporting like minded companies (SFMA, FMS), and is up to date on modern Pain Science. Take it, you will not be disappointed.

Keeping it Eclectic....

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