Fifth installment of our "No Mess Up Mondays" series on Facebook. You can check it out here or (facebook.com/msdryneedling). Remember, one of the best ways to stay safe and smart when you are performing dry needling is knowing exactly what lies under the surface of the skin before you insert a needle! That is why choosing the right dry needling training course is so important. It is easy for us to remember the femoral artery when we are anywhere near the femoral triangle. During our dry needling courses, we identify the femoral triangle (sartorius is lateral border, adductor longus is medial border, and inguinal ligament is superior border) and we palpate the femoral artery. Then, we put a large mark there so we won't stab the patient in the femoral artery! However, I think sometimes folks forget, or maybe they never learned, about the adductor canal during their dry needling training course.
Below, you'll find a deeper look at the adductor canal. Remember, the contents include the femoral artery, femoral vein, and saphenous nerve. This area is especially concerning when needling the vastus medialis or the gracilis. It is always a good idea to have the patient perform a quad set and mark the bottom of the vastus medialis. Have them do that quad set before you insert a needle. Contracting the quad with a needle in the quad is a good way to make your patient dislike you!
Identify the "no-go" zone
As you can see from the pictures below of needling the gracilis and the VMO, it is a good idea to identify the area to avoid. For the gracilis, we avoid the distal third of the muscle and we ensure the needle depth is not deep enough to penetrate the back side of the gracilis and enter the adductor canal. With the VMO, just stay above the line you marked, and you'll have a nice bony backdrop.
Want to kick things up a notch? There is a huge patient population in need of pelvic floor physical therapy. It's not just for the ladies either. Tons of men have fits with pelvic floor pain, myofascial dysfunction, chronic prostatitis, and rectal pain syndromes. I've seen it frequently on this deployment. Consider expanding your knowledge with some pelvic floor training, then we can teach you how to add some needles to it in our Pelvic Floor Dry Needling Course! I'll have course dates posted by the end of the year. It is only a one day course. It'll be a lot of fun..I mean, who wouldn't want to experience dry needling in their pelvic floor..??