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Sabre Foundation

Disease is a drama in two acts. The first one happens in the gloomy silence of the tissues, with the stage lights off. The pain or other symptoms only arrive in Act Two. ~R. Leriche, MD, French surgeon and author of La Phylosophie de ¡a Chirurgie (1 955)

For Mila, Katrine, and Anton. With love, Yun-tao Ma

Finally! A definitive text on dry needling in the sports environment has arrived. Until now I have found no meaningful information in print or on the Internet that deals exclusively with the use of dry needling in the treatment and management of athletes.

The use of dry needling in sporting clubs is not new. However, it has been my experience and observation that needling is used simply as an adjunct to traditional treatment techniques and is therefore restricted to the release of trigger points.

Working with elite athletes on a daily basis I am constantly looking for techniques that will give us an advantage in reducing recovery time and returning the athlete to competition. We are under pressure to return athletes to competition as soon as possible. While I was achieving good results incorporating dry needling with the management of injuries, it was not until I had contact with Dr. Ma, and started using the correct techniques, that I noted the recovery time for contusions, strains, and sprains was nothing less than amazing.

This book presents information that will aid in the prevention of injury by detailing needling techniques to facilitate maximal recovery from training and competition, delayed onset muscle soreness and overtraining syndrome. Prevention is always far better then cure, but traditionally we have looked to our strength and conditioning and skills coaches to build "bullet proof" athletes.

By providing regular de-stressing treatments as detailed in this book you can substantially improve physical performance and give your athletes the edge over their competitors.

This is a truly exciting text and a must-have for anyone working with athletes and sporting teams.

Tim Cooper

Physical therapist for the Australian Rules football teams and other elite athletes Queensland, Australia

Dr. Ma, after 40 years of clinical experience and extensive research in the fields of neuroscience and pain at National Institute of Health (NIH), University of Maryland, and the University of Iowa, has formulated a unique approach that addresses both local and systemic effects of dry needling for normalizing myofascial and soft tissue function, regulating body homeostasis, preventing injuries, treating movement dysfunctions, and enhancing athletic performance beyond conventional methods.

Integrative systemic dry needling (ISDN) is an indispensible modality that is easy to learn and can be effectively applied by many clinical practitioners involved in preventing and treating sport injuries, chronic pain, and movement dysfunctions with predictable prognosis in athletes, military personnel and individuals involved in heavy labor work.

Dr. Ma defines a new meaning for dry needling and provides a simple but comprehensive and thorough rationale and explanation of the mechanism of effects of integrative systemic dry needling on psychological, behavioral and physical aspects of the athlete's performance. He provides ample functional and practical implications for using ISDN in any clinical setting.

M. Reza Nourbakhsh, PT, PhD, OCS

Professor, Department of Physical Therapy North Georgia College and State University Dahlonega, Georgia

Dr. Ma takes our understanding of dry needling to a new level by explaining the comprehensive biological and physiological processes involved with using needles.

Dry needling research has traditionally focused on treating local pathology and the local effects. Advancing the use of dry needling from a focus on local responses allows the practitioner to apply this intervention with a better understanding of all of the potential systemic effects including those on the central nervous system.

Biomedical acupuncture combines the research on dry needling with the worldwide research that explains the effects of this intervention from a modern scientific perspective, giving us a more comprehensive understanding of its effects.

Using the research foundation compiled in this book and the clinical insights in treating patients and athletes, the use of needles as a treatment modality can be studied with a solid scientific foundation, enhancing our understanding of this valuable intervention.

In our physical therapy clinics, many athletes request a comprehensive dry needling intervention as developed by Dr. Ma and presented in this book, noting improvement in flexibility and faster recovery. For the athlete, dry needling may be considered a "total body" intervention to enhance performance and maintain function after training and competition.

Herbert L. Silver, PT, ECS, OCS

Senior Clinician and President Velocity Spine and Sports Physical Therapy Atlanta, Georgia


Dry needling acupuncture is a new medical modality for treating patients with soft tissue pain and sports injuries.

Sports are specialized, skilled activities requiring actions that are highly coordinated among different body systems. The nerves, muscles, and skeletal system must cooperate in elaborate patterns of activity according to a precise timing sequence. If a muscle cannot conform to the current timing and pattern, the coordination is broken and the speed and precision of the performance will be impaired, possibly resulting in injury.

In clinical terms, optimal performance is dynamic and needs continuous maintenance. Many factors, especially overtraining, can obstruct the achievement of optimal performance. Sports scientists, doctors, coaches, and athletes are always seeking more effective procedures for treating intrinsic muscular fatigue and other problems, and now dry needling acupuncture offers a solution.

The use of needling to improve performance in sport and to treat related problems and injuries is not new. In ancient China, all Kung Fu masters were also masters of acupuncture. Today, although clinical successes in treating athletes with needling therapy are reported from time to time, the full potential of dry needling in sports medicine has not been recognized for at least three reasons.

First, the majority of practitioners do not understand the physiological mechanisms of dry needling, and so their practice is mostly empirical, based on their personal clinical experience.

Second, although empirical practice can produce good results—sometimes even apparent miracles—in most cases the results are not as good as they could be. For example delayed onset muscle soreness (DOMS) and insufficient recovery between training sessions and competition are common problems in most active athletes, and many athletes never take the time for complete regeneration and repair. This makes them prone to injury, impairs their performance, and may ultimately shorten their sports career. It is my belief that dry needling is the most effective therapy yet discovered for helping athletes to recover completely from those conditions, as long as the practitioners know the underlying mechanisms of needling and understand how to use the needles correctly. This especially true in athletes who do not show any physical signs of pathology, but are affected by deep physiological stress which can lead to future injury or premature tissue degeneration.

Finally, many practitioners only concentrate on needling trigger points, when research tells us there are at least three other types of myofascial conditions affecting athletes, each requiring a different needling technique.

This book provides a thorough and complete explanation of how to treat soft tissue dysfunction and prevent the development of chronic injuries in sports training and exercise, and it includes specific needling procedures for achieving maximal recovery from training and competition, DOMS, and overtraining syndrome. Athletes can substantially improve their physical performance through regular use of the de-stressing therapy introduced in this book, and they can also achieve complete recovery from intrinsic fatigue, overtraining, and musculo-skeletal stress, while increasing the integration of all their physiological systems.

It should be emphasized that the modern modality known as dry needling acupuncture does not share any common foundation with traditional Chinese acupuncture, which is based on ancient Chinese philosophical and cultural concepts. The term acupuncture is used here in the sense of its original Latin roots: acus (needle) and punctura (puncture or piercing).

In recent years the unique efficacy of dry needling therapy has been recognized by an increasing number of medical doctors, physical therapists, chiropractors, occupational therapists, and others, who have appreciated its value and incorporated it into their clinical practices. "Dry" as opposed to "wet" needling is defined by Drs. Janet G. Travell and David G. Simons as "needling the soft tissue without injection of any liquid substance to treat human pathology" in their classic text, Myofascial Pain and Dysfunction: The Trigger Point Manual.

They also state: "In comparative studies, dry needling was found to be as effective as injecting an anesthetic solution such as procaine or lido-caine in terms of immediate inactivation of the trigger point".1 Their ground-breaking work and other innovative needling methods such as the approach of Dr. C. Chan Gunn, which is known as Intramuscular Stimulation (IMS), have laid the foundation of what is now known as the new modality of dry needling acupuncture.

Clinically, soft tissue pain is an aspect of soft tissue dysfunction and may include myofascial pain, other musculoskeletal pain, fibromyalgia, and other soft tissue pathology. Soft tissue injury is present in most types of sports injury. Dry needling acupuncture is a very effective modality for treating acute and chronic soft tissue damage. An additional clinical benefit of dry needling is that it is effective in preventing the chronic injuries which result from repetitive overuse of muscles as is commonly seen in sports and physical exercise.

Dry needling acupuncture is a unified system which successfully combines both systemic and analytical approaches. Practitioners should not treat local symptoms only, but also need to restore the systemic homeostasis of their patients.

In contrast to wet needling, the clinical procedure of dry needling acupuncture emphasizes more tissue healing than pain relief, a more systemic approach than treatment of local pathology, and both postinjury treatment and pre-injury prevention.

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Essentials of Human Physiology

Essentials of Human Physiology

This ebook provides an introductory explanation of the workings of the human body, with an effort to draw connections between the body systems and explain their interdependencies. A framework for the book is homeostasis and how the body maintains balance within each system. This is intended as a first introduction to physiology for a college-level course.

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