Cupping is not for athletes only!

Since the Olympics began last Friday, we've seen a lot of circular bruise marks on the athletes. These bruises are coming from a technique called cupping. This technique has been practiced in Chinese medicine for many many years.

In the Olympics cupping is being used in different areas of the body to improve circulation and loosen up the muscle and fascia or connective tissue that underlies that area.


Not only athletes benefit from cupping.  Many of our patients have increased muscle tone and tightness of their tissue in their areas of pain, specifically neck and back pain.  Cupping over these areas and sliding the cup helps to release some of that tightness in the tissue.

Let us know if you have any questions about cupping and if you think it would benefit you!!


July 7, 2016


What is Functional Dry Needling (FDN) or Trigger Point Dry Needling and why does my physical therapist keep asking me if I want to try it? Is it like acupuncture?

These are excellent questions! Let’s sort out what FDN is and isn’t.

FDN is not acupuncture.  The similarities begin and end with the type of needle used in both treatments. In both FDN and acupuncture, a solid filament needle is used, versus a hollow needle, which is used in injections. However, physical therapists do not practice acupuncture. Acupuncture uses Traditional Chinese Medicine (TCM) to evaluate chi flow in a person’s body. The practitioner assesses the patient’s tongue, their pulse and evaluates meridians in their body to determine needle placement.

In contrast, a physical therapist who performs FDN utilizes the subjective information that the patient tells him or her about their pain/loss of function. He or she also uses examination tools such as range of motion and strength testing to assess where there may be muscle dysfunction. The needle is inserted into muscle tissue that is overly tight to restore function and decrease pain in that area. The patient is then typically educated in a more effective movement pattern now that he or she is able to function more freely.

Studies show that FDN can decrease inflammatory chemicals in your body!  In fact, in a study by Shah et al, people with active trigger points (hyperirritable spots in muscles that produce pain and refer tenderness in a predictable pattern) were found to have increased inflammatory markers in their muscle tissue both at the painful muscle (in this case the upper trapezius muscle in your shoulder area) AND at muscles far away from the painful muscle (like the gastrocnemius, a calf muscle)[i].  Furthermore, these inflammatory markers decreased in both the upper trapezius muscle AND the calf muscle (gastrocnemius) after FDN was performed!

Evidence is incredibly important in quality physical therapy treatment but at the end of the day what really matters is if patients are feeling better and able to get back to doing what’s meaningful for them.

Recently a patient came into our clinic who had been waking up with severe headaches every day.  After FDN to her suboccipital muscles, she was able to wake up for the first time in three months without a headache! And, she was educated in stabilization of her cervical spine after the FDN was performed to teach her a more ideal movement pattern so the benefits of her needling treatment would last.

Is there an area of your body that is chronically tight or always limiting function? Does massage to this area feel good but the pain returns after a few days? Or did you slip and fall and now your leg is really sore? These issues all could be indications for FDN. It is up to your physical therapist and you to decide if this treatment could be helpful. You, of course, are the most important person in this process!

This is just a taste of the benefits of FDN. If you would like to learn more or have additional questions, please contact us at: 303-740-2026 or email us at:

We look forward to working with you!


[i] Shah JP, Danoff JV, Desai MJ, Parikh S, Nakamura LY, Phillips TM, Gerber LH.  Biochemicals associated with pain and inflammation are elevated in sites near to and remote from active myofascial trigger points.  Arch Phys Med Rehabil 2008;89:16-23.

July 1, 2016


Where are you right now? What are you using to read this: a laptop, tablet or phone? Are you leaning forward with your head down? How are your head, neck and jaw feeling right now?

Yes! Posture matters!

We all sit in front of devices more and more with the prominent role computers and the internet play in our lives. And, as we get more engrossed in our work, we tend to lean forward, rounding our shoulders and sticking our head and neck out. However, none of us were designed to be in this posture for long periods of time.

When we sit all day with our head forward and our shoulders rounded we decrease our ability to take deep breaths and we create muscle imbalances in our neck and shoulders which can lead to pain and dysfunction.

In fact, 15% of all soft tissue complaints to primary care doctors are about neck pain.[i] We tend to use our large muscles which attach to our neck to stabilize our cervical spine. However, with physical therapy treatment which includes: postural education, soft tissue mobilization, functional dry needling and training of your deep neck stabilizing muscles, you can greatly reduce your pain!

We just had a patient come into the clinic with incredibly high levels of neck pain which were affecting her ability to work. She was educated to modify her posture in sitting by doing a small chin nod, (bringing her chin slightly down towards her chest) and sitting up tall as if there was a string pulling her up towards the ceiling. She was also educated to bring her shoulder blades down and back on her spine slightly squeezing them together. Finally, the patient was asked to set an alarm on her phone to remind herself to get up and move every hour or so throughout the day. In just 2-3 sessions her pain was a 1/10 or less! Her experience is backed by the evidence as well! Training your deep neck muscles with a knowledgeable physical therapist decreases forward head posture and neck pain.[ii]

So, try these tips of chin nods, shoulder blade squeezes and lifting your spine up towards the ceiling and see how these change your pain. Click here,, to see how improving your posture will improve your overall sense of well-being and mood too!

Also, remember to get up and move around every hour or so to avoid prolonged sitting. If you continue to have pain or would like more helpful tips, please feel free to contact us for more information at 303-740-2026 or email us at

We look forward to working with you!


[i] Gupta BD, Aggarwal S, Gupta B, Gupta M, Gupta N. Effect of Deep Cervical Flexor Training vs. Conventional Isometric Training on Forward Head Posture, Pain, Neck Disability Index In Dentists Suffering from Chronic Neck Pain.Journal of Clinical and Diagnostic Research : JCDR. 2013;7(10):2261-2264. doi:10.7860/JCDR/2013/6072.3487.

[ii] Falla, D., Jull, G., Russell, T., Vicenzino, B., & Hodges, P. (2007). Effect of Neck Exercise on Sitting Posture in Patients With Chronic Neck Pain. Physical Therapy, 87(4), 408-417. Accessed June 29, 2016.

How are TMJ disorders treated?

JUNE 29, 2016

Because more studies are needed on the safety and effectiveness of most treatments for jaw joint and muscle disorders, experts strongly recommend using the most conservative, reversible treatments possible. Conservative treatments do not invade the tissues of the face, jaw, or joint, or involve surgery. Reversible treatments do not cause permanent changes in the structure or position of the jaw or teeth. Even when TMJ disorders have become persistent, most patients still do not need aggressive types of treatment.

Conservative Treatments

Because the most common jaw joint and muscle problems are temporary and do not get worse, simple treatment may be all that is necessary to relieve discomfort.

Self-Care Practices

There are steps you can take that may be helpful in easing symptoms, such as:

  • eating soft foods,
  • applying ice packs,
  • avoiding extreme jaw movements (such as wide yawning, loud singing, and gum chewing),
  • learning techniques for relaxing and reducing stress,
  • practicing gentle jaw stretching and relaxing exercises that may help increase jaw movement. Your health care provider or a physical therapist can recommend exercises if appropriate for your particular condition.

Pain Medications

For many people with TMJ disorders, short-term use of over-the-counter pain medicines or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, may provide temporary relief from jaw discomfort. When necessary, your dentist or physician can prescribe stronger pain or anti-inflammatory medications, muscle relaxants, or anti-depressants to help ease symptoms.

Stabilization Splints

Your physician or dentist may recommend an oral appliance, also called a stabilization splint or bite guard, which is a plastic guard that fits over the upper or lower teeth. Stabilization splints are the most widely used treatments for TMJ disorders. Studies of their effectiveness in providing pain relief, however, have been inconclusive. If a stabilization splint is recommended, it should be used only for a short time and should not cause permanent changes in the bite. If a splint causes or increases pain, or affects your bite, stop using it and see your health care provider.

The conservative, reversible treatments described are useful for temporary relief of pain – they are not cures for TMJ disorders. If symptoms continue over time, come back often, or worsen, tell your doctor.


Botox® (botulinum toxin type A) is a drug made from the same bacterium that causes food poisoning.  Used in small doses, Botox injections can actually help alleviate some health problems and have been approved by the Food and Drug Administration (FDA) for certain disorders.  However, Botox is currently not approved by the FDA for use in TMJ disorders.

Results from recent clinical studies are inconclusive regarding the effectiveness of Botox for treatment of chronic TMJ disorders. Additional research is under way to learn how Botox specifically affects jaw muscles and their nerves.  The findings will help determine if this drug may be useful in treating TMJ disorders.

Irreversible Treatments

Irreversible treatments that have not been proven to be effective – and may make the problem worse – include orthodontics to change the bite; crown and bridge work to balance the bite; grinding down teeth to bring the bite into balance, called “occlusal adjustment"; and repositioning splints, also called orthotics, which permanently alter the bite.


Other types of treatments, such as surgical procedures, invade the tissues. Surgical treatments are controversial, often irreversible, and should be avoided where possible. There have been no long-term clinical trials to study the safety and effectiveness of surgical treatments for TMJ disorders. Nor are there standards to identify people who would most likely benefit from surgery. Failure to respond to conservative treatments, for example, does not automatically mean that surgery is necessary. If surgery is recommended, be sure to have the doctor explain to you, in words you can understand, the reason for the treatment, the risks involved, and other types of treatment that may be available.


Surgical replacement of jaw joints with artificial implants may cause severe pain and permanent jaw damage. Some of these devices may fail to function properly or may break apart in the jaw over time. If you have already had temporomandibular joint surgery, be very cautious about considering additional operations. Persons undergoing multiple surgeries on the jaw joint generally have a poor outlook for normal, pain-free joint function. Before undergoing any surgery on the jaw joint, it is extremely important to get other independent opinions and to fully understand the risks.

The U.S. Food and Drug Administration (FDA) monitors the safety and effectiveness of medical devices implanted in the body, including artificial jaw joint implants. Patients and their health care providers can report serious problems with TMJ implants to the FDA through MedWatch at or telephone toll-free at 1-800-332-1088.

Temporal Mandibular Dysfunction (TMD)

JUNE 1, 2016

TMJ By Mayo Clinic Staff

The temporomandibular (tem-puh-roe-mun-DIB-u-lur) joint (TMJ) acts like a sliding hinge, connecting your jawbone to your skull. You have one joint on each side of your jaw. TMJ disorders — a type of temporomandibular disorder or TMD — can cause pain in your jaw joint and in the muscles that control jaw movement.

The exact cause of a person's TMJ disorder is often difficult to determine. Your pain may be due to a combination of factors, such as genetics, arthritis or jaw injury. Some people who have jaw pain also tend to clench or grind their teeth, although many people habitually clench or grind their teeth and never develop TMJ disorders.

In most cases, the pain and discomfort associated with TMJ disorders is temporary and can be relieved with self-managed care or nonsurgical treatments. Surgery is typically a last resort after conservative measures have failed, but some people with TMJ disorders may benefit from surgical treatments.