That knot has been sitting in the same spot for months, and stretching it, rolling it and leaning on it has changed nothing.

Dry needling is the use of a thin, solid filament needle placed directly into a taut band of muscle or a trigger point. The needle is dry, meaning nothing is injected. What treats you is the mechanical effect of the needle in the tissue. A trigger point is a small contracted section of muscle that will not let go on its own. It refers pain to somewhere else, restricts the range of the joint it crosses, and sits far too deep for fingers or a foam roller to reach with any precision. The needle reaches it directly. As it enters the band, the muscle often produces a brief involuntary twitch, and that twitch is associated with the contracted fibers releasing, local blood flow changing, and the pain coming from that point settling down. Despite the shared tool, this is not acupuncture. The reasoning is anatomical and built on your physical examination, not on meridians. Dry needling requires specific certification to perform, and Dr. Tochi Egbuzie, PT, DPT, FAAOMPT holds it, alongside an AAOMPT fellowship in orthopedic manual physical therapy.
Needling is a way in, not a plan. Releasing a trigger point creates range and comfort that only lasts if the movement pattern that built the trigger point gets corrected in the same visit. Every appointment runs 45 to 60 minutes, one on one with your DPT, and the same person who examined you is the person holding the needle. Most patients feel a change after the first session, and typical plans run two to three visits a week for four to six weeks. Fittees is in-network with Blue Cross Blue Shield, UnitedHealthcare, Cigna and Medicare, and for other insurance we provide a detailed superbill so you can file for out-of-network reimbursement. No referral is needed, because Texas is a direct access state.
Dry needling is for muscle pain that has not moved with rest, stretching or pressure. These are the cases where the needle is usually the shortest route to a change.
A trigger point in the upper trap that shows up as a headache behind the eye. One in the glute that sends an ache down the leg. One near the shoulder blade that you feel in your arm. When the sore spot and the source sit in different places, treating where it hurts goes nowhere. Needling treats the source instead.
You cannot turn your head far enough to reverse the car, or lift your arm past shoulder height, and the block feels muscular rather than bony. Guarded muscle will not stretch its way out of that. Releasing the taut band first usually returns enough range that the strengthening work becomes possible in the same visit.
Months of massage, rolling, heat and stretching, with the same knot sitting in the same place each time. That pattern usually means the fibers are not being reached, not that you have not tried hard enough. A needle works at a depth and a precision hands cannot match, which is why it often changes a picture nothing else has.
Nobody should be surprised by a needle. Here is exactly how a dry needling session runs at Fittees.
Dr. Egbuzie examines how you move, then works through the muscle by hand until she finds the taut band that reproduces your symptoms. She positions you so the muscle is relaxed and supported, and tells you what you are about to feel. Nothing happens until you say you are ready, and you can stop it at any point.
A thin needle goes into the trigger point. Most people barely feel it enter. What you may feel is a deep ache, a brief cramp, or a quick involuntary twitch as the band lets go, and that lasts a moment. The needle stays in for a short time depending on the muscle. Sharp or electric pain is not expected, so speak up immediately.
The needle comes out and you get up and move. Range of motion first, then the loading that teaches the muscle to work at its new length. This is the part that stops the trigger point rebuilding by next week. You leave with a short home program and a clear idea of what to do over the following two days.
The needle is far thinner than one used for an injection, and most people describe insertion as a light prick or nothing at all. A deep ache or a brief twitch during treatment is normal and expected. Afterwards, muscle soreness like the day after a hard workout is common for a day or two, and a small bruise or a spot of bleeding at the site happens occasionally. Tell Dr. Egbuzie before your appointment if you are pregnant, take blood thinners, have a bleeding disorder, a compromised immune system, lymphedema in that limb, a pacemaker, a metal allergy, or a strong fear of needles. Most of these do not rule treatment out, they change where and how it is done, and needle phobia is usually handled with a conversation, a different position and a slower start. Needles are single use and sterile, and they go straight into a sharps container afterwards. Keep moving gently and drink water for the rest of the day.
A trigger point is not tightness you can stretch out. It is a contracted band that has to be reached directly, and then given a reason to stay released.

Skilled hands-on joint and soft tissue work that gives you the range you then learn to own.

A precise, high-velocity thrust that restores segmental motion and turns pain down immediately.

Return to sport is a standard you meet, not a date on a calendar. We test it before you go back.