Download CPD Health Courses - Dry Needling Courses

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This Dry Needling Course has been endorsed by the following bodies:
Australian Physiotherapy Association
Osteopathy Australia
Chiropractors' Association of Australia
Australian Association of Massage Therapists
Institute of Registered Myotherapists of Australia
Radial Nerve
Lateral antecutaneous brachial nerve
Radial Nerve
The radial nerve enters the forearm from the cubital fossa deep and lies
medial to the brachioradialis. It divides into superficial (sensory) & deep
(motor) branches.
The superficial branch lies deep to brachioradialis, it courses backwards
over the radius & emerges under the brachioradialis tendon. It passes
over the tendons of EPB/EPL at the lower third of the radial shaft. It
supplies the back of the hand (index & 2nd fingers) & radial web region
(thumb & index finger).
The deep (motor) branch or posterior interosseous nerve passes
through supinator and emerges under the extensor digitorum mid-way
along the radial side of the forearm.
Lateral Antebrachial Cutaneous Nerve
The Lateral Antebrachial Cutaneous Nerve or Lateral Cutaneous Nerve
of the forearm is a branch of the Musculocutaneous nerve.
It appears at the anterior surface of the cubital fossa, where it divides
into Volar & dorsal branches. These branches supply the anterior &
posterior radial side of the forearm respectively.
(
) identification, location,
discussion Needling Demonstration & Practice
Brachioradialis & 4 Extensors of the wrist & fingers
Common origin from the lateral epicondyle & supracondylar ridge
TOP
TEST
BRACHIORADIALIS
FLEXION
ECRB
RADIAL
DEVIATION
ECRL
RADIAL
DEVIATION
ED
WRIGGLE
ECU
ULNAR
DEVIATION
SHAFT OF ULNA
PALPATE
BOTTOM
TEST
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Brachioradialis
Anatomy
Origin:
Proximal ⅔ of the lateral supracondylar
ridge of the humerus, and lateral intermuscular septum.
Insertion:
Lateral side of the base of the styloid
process of the radius.
Action:
Flexes the elbow joint, and assists in
pronating and supinating the forearm when
these movements are resisted.
*Originally name Supinator Longus.
Duchenne demonstrated that it clearly
flexes the elbow and restores a neutral
forearm from either supination or pronation.
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Brachioradialis
Surface Anatomy
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Flexion of the elbow.
Place the forearm neutral between
pronation and supination.
Flex the elbow.
Seen as a tube like prominence on the
radial side of the forearm.
Brachioradialis together with the shaft of
the ulna provide a clear division between
the flexors & extensors of the forearm.
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Brachioradialis
Caution
Radial Nerve & Lateral Antebrachial
Cutaneous Nerve of the forearm
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Brachioradialis
Needle Selection
Size: 0.25 x 30-50mm
Direction: Perpendicular & pincer grip
Depth : 20-25mm
Suggested patient position: Elbow flexed
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Brachioradialis
TrZs are usually found only in the deep
part of the brachioradialis muscle.
Compression of these active TrZs
often evokes their characteristic
referred pain pattern, primarily to the
dorsal web between the thumb and
index finger.
Referral can also be felt into the lateral
elbow and the radial side of the forearm.
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The kidneys lie paraspinally between the levels of T12 L3. The right kidney may extend down to the level of L3
spinous process. Deep needling in this region may injure
the kidneys.
Needling in the region of the lower back is limited to
between the levels of L4 - S2 for Dry Needling
Introductory Course.
The Spinal Canal lies between 20 - 40 mm below the
skin in this region.
Lower Back
(
) identification, location,
discussion Needling Demonstration & Practice
S-Spinalis
L-Longissimus thoracis
I-Iliocostalis Lumborum
>%V%-
Multifidi – deep to erector spinae
Rotatores – deep to Multifidi
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Multifidi & Rotatores
Anatomy
Origin:
Deep to the erector spinae these short
muscles run from the transverse processes
L5 to C2 & sacrum. Every 2-4 vertebrae
Insertion:
Spinous processes of Sacrum, all lumbar,
thoracic & cervical vertebrae.
Action:
Rotation of the spine (unilaterally).
Extension of the spine (bilaterally).
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Multifidi & Rotatores
Surface Anatomy
Ask your patient to lie in a prone position.
With your palpating fingers feel along the
paravertebral region in the lumbar spine as
the patient is asked to lift the ipsi-lateral leg
with a extended knee.
Locating L4 spinous process:
Locate the highest points of the iliac crests
with one hand on each side of the pelvis.
Connect a line across the spine from these
two landmarks. This is the lower border of
L4 spinous process.
As a group, the tick Multifidi fibres are the
only ones running transversely across the
paravertebral area & can be easily felt along
the lamina groove of the thoracic and lumbar
vertebrae.
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Multifidi & Rotatores
Caution
The kidneys lie paraspinally from the level of
T12 to L2.
The right kidney may extend down to the level
of the spinous process of L3.
Deep needling in this region may lead to injury
of the kidneys.
Needling of Iliocostalis Lumborum in Dry
Needling Techniques is limited to needling
at the levels of L4-S2.
The spinal canal lies between 20-40mm
deep to the skin surface.
Deep needling should not be carried out in
patients with a significant scoliosis.
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Multifidi & Rotatores
Dry Needling Techniques
demonstrates needling to
Iliocostalis Lumborum between
L4-S2 ONLY.
TrZs in the Iliocostalis Lumborum refer
into the ipsilateral lower back & sacrum
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