Thoughts from Align 2018

By: Jeremy Snyder

I led a break out session at the Align Conference in Denver, Colorado, with Edo Zylstra and Paul Killoren entitled, “Neuropathy in Sports Medicine:  Functional Dry Needling® (FDN),” and the main take away from the session was that most (if not all) orthopedic injuries have a neurologic component.

Presentations about research and theory are sometimes not as popular as technique focused courses.  I brought up during our talk that the theory behind our Physical Therapy techniques is important because it drives our intention.  We might use a tool like FDN, manipulation or an instrument as an input, but the way we apply that tool might look very different based on the intent of that treatment.  I think, in Physical Medicine, we can argue a lot about the tools we use but for the most part we agree on the underlying theories.  The current theories explaining mechanisms of almost any manual therapy are very different than the ones I was taught in school, which does change how I apply that modality.  It is humbling to think that much of what we accept as evidence based treatment really is still poorly understood in terms of exact mechanisms.  As Michael Shacklock said during his opening session, “Do you realize that gravity is just a theory?  But we ignore it at our own risk!”

It was interesting to see how much overlap there was between speakers (literally, from  around the globe).  A common theme of the weekend presented by multiple speakers was the idea that healthy nerves need three main things:  Space, Blood, and Movement.  It struck me that Functional Dry Needling (FDN) is a beautiful tool that can address all three categories!  If I can change the tone of a muscle that may be the source of compression at a nerve, I can give that nerve much needed space.  Edo Zylstra presented research indicating increased blood flow following FDN.  Ultimately, the reason we apply FDN is to get improved movement, and it is imperative that we get our patients to follow up that treatment with improved quality and quantity of movement.

The hardest thing about a conference like this is integration.  There was so much great information shared that it is easy to forget and go back to familiar practice patterns.  I have really tried this past month to put new concepts into practice and actually went back to the handouts of many speakers, multiple times.  I have already started to change my language and techniques for neurodynamic tests to be more systematic in my approach.

When you get hundreds of PT’s together in a room, the passion and excitement for what we do becomes infectious.  We work in an industry that is notorious for burn out, it is so easy to get frustrated with the daily grind of patient care.  A conference like this is just the thing that I needed to remind me of why what we do is so important…and how we can do it better!