My encounter with Dry Needling in KL,Malaysia

In 2016 April i started one on one gym training with Luke Lango in Honey Badgers Crossfit, it was the first time i was introduced to compound movement such as back squat, front squat, deadlift, bench press and military press. Since i was a total beginner, my typical routine would involve 3 combination of compound movement plus 1 accessory exercise each session . On a weekly basis i would try to lift heavier weight. One day after a heavy set of bench press, few hours my hand and fingers starts to get numb and tingling sensation. I remember waking up middle of the night unable to feel my fingers and got panicked. After all is my first sports related injury and many to come later on.

Next day i went to see a chiropractor about it but the tingling sensation still persists, instead of tingling at the last two finger it went to first two finger and thumb. I went online to research and found out it was ulnar nerve impingement as the sensation started from the arms down to last 2 fingers. Then came my first encounter with a physiotherapist who had practice dry needling for a year Frederick Khoo who now works with Precise Rehab (galleria Hartamas). He was one of the pioneer who practice dry needling in Malaysia at the time. It took me x2 1hour session a week apart to get better. Dry needling has few methods, he practice the more i called it aggressive version or deeper needle insertion by inserting the dry needle to the affected tight muscle and do hooking/hunting and look for local muscle twitch. It means that he will push needle in and out couple of time at the same spot but at different angle to target the surrounding muscle until an involuntary muscle contraction happen. Due to its aggressiveness in engaging the muscle to twitch you will feel very sore afterwards and i remember i couldn't even lift my arm to push the glass door or use it to drive home. The other more gentle or i called it superficial dry needling technique. With this technique you don't hook/hunt for local twiches. The needle is inserted to the tight muscle around the trigger point and leave the needle in for few minutes and let it 'marinates' like beef in juice. With hooking technique, usually you only look/hunt for 1 or 2 local twitches in a muscle example upper trapezius.. On the other hand, gentler version uses more needle maybe 3-5 needle and insert along the trigger point at upper trapezius at let it rest.  I personally think that hooking technique excites/engage the muscle causing inflammation to the area and initiate healing. While the gentler technique causes a response or disrupt the muscle tissue environment and desensitization or healing occur. Anyway both of the method are effective in releasing muscle tightness effectively. So much more than stretching and massage. You could say deep dry needling is directed towards trigger point and used more effective for nerve compression problem due to muscle shortening, whereas superficial dry needling is directed towards areas near the trigger point desensitising the area so is a more relaxing method compare to former engaging method.

After 2 months of training in honey badger, i move on to Axiom performance. In this gym i was treated by Aldrin Ho from singapore who specialise in ART and dry needling as well. As my workout regimen got more intense (lifting to failure), my body starts feeling the toll, i feel fatigue and tired everyday. I feel so depleted after training and i couldn't do another light session in the evening, i find myself sleeping most of the time to rest. Aldrin uses a more gentle approach and my muscle doesn't feel that sore. I could get back to workout after a day rest but needed 2-3 days rest with Federick's treatment. My treatment with Aldrin is mainly to release muscle tightness in places like quads, forearm as well as some acupuncture meridian to allow my body to relax.

In 2017 i have a grade 1 tear of teres minor or teres major after doing pull up. I was having one to two twice session gym a day per week at this period of time. I have difficulty lifting my arm and rotating it. This time i went to see Lip Qin colleague of Federick to get some dry needling done. Basically he release the tightness of the surrounding muscle to allow healing to take place. It took me a week to two to have complete movement/range of motion back. I also had my triceps done after two weeks as i felt uncomfortable at my elbow during skull crusher movement. I tried chiropractor with adjustment done at forearm near elbow but doesn't work at all just felt longer hand as if my joint is pulled longer. I spent another few more session with Lip Qin releasing my rotator cuff muscle, lats chest and quads. Each visit usually took about 20-40mins and involve around 5-7 needle/insertion point.

I like dry needling alot because of its effectiveness in releasing my muscle tightness in a deeper manner. And i get it muscle tightness quite often due to my trainer always pushing my limit. In order to coop, i usually have 1 session of massage and 1 session of infrared sauna and 1 day of self foam rolling each week. After around 1 year or so only i realise i've been training too much as a beginner and my recovery period too short and i've been getting injury too often like every month or two i will get an injury. (I would think maybe i'm in my 30s my testosterone and human growth factor isnt firing wild anymore so i need a longer recovery period or it might be i have posture problems and muscle imbalance and weight training expose all my weakness). So from 5-6 times a week of training plus yoga/pilate, swimming, cardio, chiro, massage, infrared sauna haven been reduce to as of now august 2017 3times training per week + 1pilate +1 manual therapy.

Later on i found Dr shane a chiropractor who also did dry needling at axis chiropractic(bandar utama) and have around 8 session with him. His dry needling technique is the same as Lip Qin and Federick but less aggressive , slower hooking (inserting and pulling out needle) movement.

ps. dry needling on quads is painful and after about +16 session of dry needling sometimes you get needle/pain phobia, the twitching response you get might not be comfortable for everyone. At one point while driving for a session my mind goes.... oh boyyy... here we go again... can i not do it, sometimes i dislike the twitching response.

Dry needling is a powerful tool but with my experience the practitioner is more important because is not just about palpitating finding tight muscle/trigger point and release it.... one need to know the anatomy and physiology very well to know which muscle to target, a weak muscle can be tight and if you release a weak muscle which is tight and not strengthening it.... your in trouble. Finding the root problems is also important for example there is one occasion i feel the problem lies in my triceps as its tender when i touch, but i just have my triceps release 2 weeks ago, so i ask for another triceps release, but instead he work on my back muscle somewhere around teres minor/major or it could be head of triceps.

In Malaysia we lack integrated fitness center or multidisciplinary clinic. Dry needling is only part of a solution to your sport injuries you need much much more than that, i know it cause i've been there. Dry needling to me is effective in solving nerve impingement. It is only a tool, because dry needling doesn't solve my shoulder imbalance issue, i find myself getting my upper traps release consecutively for 5 session in 5 weeks and the problem still exists. The tightness keeps coming back, is only when i went to see a physiotherapist that specialise in manual therapy that i found out the involvement of other muscles.