If you’re looking for a way to relieve muscle pain and improve overall performance, you might consider physical therapy dry needling. This treatment method is becoming increasingly popular among physical therapists as an effective way to treat a variety of musculoskeletal conditions, from neck and shoulder pain to tennis elbow. In this blog post, we’ll discuss the basics of physical therapy dry needling and how it can help you.


is a technique used to treat muscle pain and improve performance. It involves inserting tiny, thin needles into trigger points, or areas of muscle tension, to stimulate and release muscle tension. This can help improve range of motion, reduce pain, and improve overall mobility.

Types of Needles

The needles used in physical therapy dry needling are typically sterile, disposable needles that are inserted into the skin. The needles are inserted to a depth that is specific to the patient’s condition, and the area is then manipulated to stimulate the muscles. This can help to relieve pain and improve range of motion.


The dry needling treatment is typically done in a series of sessions that last anywhere from 10 minutes to an hour. During each session, the physical therapist will assess the patient’s condition and response to the treatment before moving forward. The number of sessions depends on the individual patient and the condition being treated.


Physical therapy dry needling can be beneficial for a variety of conditions and injuries, such as tmj/tmd, neck and shoulder pain, tennis elbow, low back pain, and carpal tunnel syndrome. It can also help improve athletic performance by releasing tension in tight muscles and increasing range of motion. If you’re looking for a way to reduce muscle pain and improve performance, physical therapy dry needling may be an option for you. Talk to your physical therapist to find out if this treatment is right for you.

Marathon Training, Part 2

The miles are building! In a good marathon training plan, there should be four focus items for endurance running – we call this Endurance Periodization. Each period has a specific goal and targets a different need for long-term running success. The four periods are BASE, BUILD, PEAK, and TAPER. I built my training plan based on these periods, and my next several blog posts will discuss them and their purpose.

The BASE period in marathon training is where the emphasis is on increasing your volume of running and building anaerobic capacity. This should be your marathon training plan's first several weeks to months based on the goal distance. Most of the running of this phase (about 80% of total mileage) is "easy running" or zone 2 if using heart rate variability.

10% of the mileage is done at the threshold "tempo pace" or zone 3, and the final 10% is done above the threshold "sprint pace" or zone 4. So what is easy running? This run can maintain a zone 2 heart rate and is considered a conversational pace. Breathing should be relatively normal. This type of running strengthens the heart muscle tremendously. It improves the heart's stroke volume (the amount of blood pumped with one beat or contraction of the heart). It allows for improvement without overstressing the system. Easy running also improves muscle fibers. They are shown to have an increase in number and size. The mitochondria (power powerhouse of the cell) move to the periphery of the cell, which is closer to the oxygen supply that comes into the cell. This helps the body exchange fuel for energy and complete oxygen exchange more effectively. These changes in our cardiovascular system and muscle fibers occur with time spent running in this space. Not speed.

We must remember that success with marathon training occurs with consistency - not speed or pace. As my mileage increases, I am cautious about monitoring my heart rate and how I feel. Items such as stress, sleep deprivation, water intake, and dietary changes all impact our heart rate variability and rate of perceived exertion. Now that you are familiar with heart rate variability attempt to monitor your "easy long runs" maintaining zone 2 measures. Check in for the next marathon training post to discuss threshold and above-threshold training changes.

If you missed my first post on max heart rate and tracking exertion.

Part. 1 Marathon Training

Today begins the first week of my marathon training. I am reminded the number one factor for running success is consistency. We measure consistency with the volume or duration of running. Often, the intensity of the running ( pace or speed) becomes the primary focus erroneously. Grossly 60% of running-related injuries are due to this.

Understanding the difference between volume and intensity is essential to maintain running consistency and decreasing injury risk. The volume of running is our total time or mileage. Intensity is effort. We measure this effort through heart rate variability and perceived exertion (RPE) rate. Heart rate is the measure of how HARD we are ACTUALLY working. RPE is self-feedback about how HARD we FEEL we are working. RPE is rated on a 1-10 scale. See the chart for examples.

Using our max heart rate, we can place ourselves into one of five zones that correlate with heart rate variability. The easiest way to find your max heart rate is by subtracting your age from 220. Each zone correlates to a percentage of the max heart rate. 75% of our total running volume should only be in zone 2 or 3. Use the chart below to determine your heart rate and RPE in each zone.

In the next few posts, we’ll talk about each of these zones in relation to running and what kind of cross-training is good to do during these times. Look at your training plan to determine which zone you spend most of your running time in. Are you at risk for overtraining? Or, if you need to recover now, learn more about running injuries here

What’s your running persona?  Are you participating in a Couch to 5K program, training for 10K fun race or are you a regular marathon participant?  Or perhaps you enjoy cross country trail running.  Regardless, physical therapy should be a big part of your training.
 “In running, it doesn’t matter whether you come in first, in the middle of the pack, or last. You can say, ‘I have finished.’ There is a lot of satisfaction in that.” — Fred Lebow, New York City Marathon co-founder

And here are some additional inspirations running quotes

Physical therapy for runners is a special and specific practice.  At The Therapy Network, our therapy specialists offer a full range of therapy options.

Running Facts for Everyone

Running can be part of a healthy lifestyle.  If you are considering participating and starting a running program, there are many smartphone apps, programs and local groups to support your start.  If you are a seasoned runner, you already know many of the benefits.  Here are a few benefits worth reviewing:

  1. Running cuts your risk of heart disease and possibly cancer.

  2. Do you want to burn up to 100 calories per mile?

  3. Running strengthens joints and bones

  4. Relieve stress with running

  5. When running outdoors, you get a healthy dose of fresh air

  6. The cost to start running for exercise and health is minimal compared to other sports.

  7. Running is part of a healthy lifestyle plan when you follow safe running guidance.

Why You Should Make Physical Therapy Part of Your Plan

With all the positive attributes of running, you may be wondering why you should include “physical therapy for runners” in your plan.  With any sport or physical activity, you must ensure that you are following the guidance to prevent injury.

If you are embarking on a running program, or if you are an experienced runner, it is time to consider booking an appointment with a running therapy specialist.

Over 60% of avid runners experience an injury each year.  That’s an injury for every 100 hours of running.  Many of the injuries can be remedied with a few days of rest, but some will need medical attention.  One way to avoid injury while enjoying running is to meet with a running therapy specialist.

Do You Have the Proper Running Gait and Shoes?

A top way to ensure that you run injury-free is to review your running gait and the fit of your shoes with arunner tying shoes specialist.  This tip is for those that are starting a couch to 5K training program and for anyone embracing running.  Even if you have been running for years, it is not too late to evaluate your gate and your favorite shoe choice.

Many running injuries are from overuse and are prevented in the future by following the guidance of a sports physical therapist.  At The Therapy Network, we offer tools for both novice and experienced runners to include:

  1. Video Analysis: A video gate analysis seeks to identify the root of an injury or a bad habit that may lead to a future injury. At TTN, we can correct any form or gait issues before they lead to an over-use injury.

  2. Running Shoes and Orthotics: A Therapy Network specialist can advise you on the best running shoe to fit your needs and if orthotics are needed. The Therapy Network is a resource for custom orthotics in Tidewater, Virginia.

Injury Recovery with Physical Therapy

If you are a runner that has experienced a recent injury or if you are prone to over-use injuries, it is time to schedule an appointment with a specialist.  You may find that a slight modification to your running plan will solve many issues.

  1. Sports Therapy Taping: Would you benefit from Kinesiology Taping? After an evaluation by a Therapy Network specialist, they may recommend taping as a training solution. Taping reduces pain while also improving performance.

  2. Shin Splints and Foot or Ankle Conditions: If you are a runner diagnosed with shin splits or a foot and ankle condition, a sports physical therapist at The Therapy Network will create a custom recovery plan.

If you have been trying to self-treat a running injury, it is time to see a specialist.  Not only can a  running therapy specialist shorten your down-time, but they can also provide injury prevention education.  Education is the key to running injury free.  Yes, you can download a running app to your smartphone, but a one-on-one review with a specialist will ensure a positive running experience and future.

You Do Not Need a Physician’s Referral in Virginia

Raise your hand if you would like to receive guidance from a running specialist but are dreading the physician’s referral process!  Well, the good news is that you do not need a physicians’ referral to visit The Therapy Network in Virginia.

If you just started a running program or if you are training for a marathon, you can see a therapist specialist this week.

Life in coastal Virginia affords us mild temperatures, even in the winter months.  Our communities offer many places to run, including park trails.  Don’t delay in scheduling an appointment for a review with a specialist.  A TTN team member can provide education and keep you running throughout the year.

Appointments Available in Coastal Virginia

If you live or work in Norfolk, Virginia Beach or Chesapeake, Virginia, there is a Therapy Network near your neighborhood or office.  With six locations in Tidewater, Virginia, there is TTN near you now.  We also have appointments available this week with a running therapy specialist.

When thinking of physical therapy for runners, think of The Therapy Network.