Dry Needling

Dry Needling & Trigger Point Manual

Dry Needling courses are designed for healthcare professionals such as physiotherapists, doctors, chiropractors and osteopaths. Since 1995, the David G. Simons Academy has been offering internationally recognized training programs, built on a teaching method developed in the early 1990s. This approach has been continuously refined to ensure the best results. Our practice-oriented courses provide step-by-step guidance for the correct and safe use of various Dry Needling techniques.

DGSA training programs follow international standards, such as Swiss Guidelines for Safe Dry Needling, published by the Swiss Dry Needling Association (DVS). Participants practice three-dimensional topographic anatomy, focusing on anatomical landmarks, identifying risk areas and appropriate needle selection to ensure the safety of the technique. The practice is closely monitored by experienced trainers.

The theoretical part includes notions of pathophysiology, causes and risk factors, its diagnosis and differentiation, the treatment of myofascial trigger points and myofascial pain, as well as safety rules, indications, contraindications and hygiene norms for Dry Needling. Participants also gain an insight into evidence-based practices in this field.

The courses are internationally recognized and meet the highest standards of quality, safety and professionalism.

Is Dry Needling a legal practice in physiotherapy?

In most countries, yes. The Dry Needling technique is widely used by physiotherapists around the world. In many countries, this method has been part of professional practice for decades. However, in some countries there are additional requirements for physiotherapists, such as specific training proven by a diploma – as is required, for example, in Switzerland, and in Romania, this treatment method is not yet regulated.

Although each course operates as a stand-alone unit, we recommend completing the entire training program. Obtaining the Dry Needling Therapist Diploma issued by DGSA provides full certification, while practicing in an organized setting (study groups or quality circles) during the training period is beneficial for progress.
Because regulations differ from country to country, it is important to check the legal requirements applicable in your field.

Top 30 DN Course

Prerequisites

This course is intended for physical therapists (PT), physicians (MD), nurses, chiropractors (DC) and osteopaths (DO) or final year students of related faculties.

Course content

This three-day introductory course covers the basics of dry needling, myofascial pain syndrome, trigger points and the main clinical aspects of dry needling. The course is practice-oriented, and participants practice applying the dry needling technique to the Top 30 muscles, under constant supervision.

Course duration

22.5 hours

Course objectives

Upon completion of the course, participants will:
  • Understand the scientific foundations of myofascial pain syndrome and trigger points.
  • Be able to identify the Top 30 muscles by surface anatomy, palpation, and function. They will also understand their clinical symptoms and perpetuating factors.
  • Recognize the characteristics of trigger points through physical examination and apply this knowledge to the Top 30 muscles.
  • Understand the specific indications and contraindications for dry needling.
  • Apply safety rules for the dry needling technique.
  • Perform dry needling technique on Top 30 muscles.
  • Understand the possible side effects and complications of dry needling and react accordingly.

Advanced Dry Needling Course - Upper Body

Prerequisites

  • Top 30 DN course or
  • Top 30 Combi Course or
  • Equivalent courses offered by other providers, individually verified.

Course content

In this two-day advanced course, participants will learn the diagnosis, physical examination, and application of dry needling techniques for the most common muscles of the upper body. This course is practice-oriented, and participants will practice dry needling techniques under constant supervision.
Note: Recognition of the dry needling technique depends on the regulations of the country in which it is practiced, and graduates are responsible for complying with these local regulations.

Course duration

15 hours

Course objectives

Upon completion of the course, participants will:
  • Fi capabili să identifice cei mai comuni mușchi ai jumătății superioare a corpului prin anatomie de suprafață, palpare și funcție, și vor înțelege simptomele clinice ale acestora și factorii perpetuanți.
  • Recognize the characteristics of trigger points through physical examination and apply this knowledge to the specific muscles in this region.
  • Perform the dry needling technique for the most common muscles of the upper half of the body.
  • Update your knowledge about research in the field of myofascial pain syndrome and trigger points.

DN Exam Preparation Course

Prerequisites

  • Top 30 DN Course and Advanced Dry Needling Courses – Upper and Lower Body or
  • Top 30 Combi Course and Advanced Dry Needling Courses – Upper and Lower Body
  • Equivalent courses: we will check comparability individually.

Course content

The DN Professional Course is a one-day program. It is designed as a review course and is a prerequisite for the dry needling exam.

Course duration

8 hours

Dry Needling Exam

The dry needling exam is the completion of dry needling education (diploma). Successful completion of formal dry needling training is required by regulatory authorities in some countries, such as Switzerland. The dry needling training offered by the DGSA meets the requirements of the Swiss Dry Needling Association (DVS) and the French Dry Needling Society (SFDN).
In Switzerland, the exam is organized by DVS. In France, the exam is organized by SFDN. In other countries, the exam is offered by DGSA, for example in Romania and the Republic of Moldova through the examination board consisting of DGSA Instructor Alexandru Mǎzǎreanu and Diego Leoni.
The three exam diplomas are equivalent.

Note: Recognition of the dry needling technique depends on the regulations of the country in which it is practiced, and graduates are responsible for complying with these local regulations.

Manual Trigger Point Therapy

Manual trigger point therapy is a manual technique used to treat trigger points, which are a major cause of muscle pain. This technique involves the application of strong manual pressure, which can be uncomfortable or even mildly painful for the patient. However, like dry needling, this pain is often perceived as a “good pain” that brings relief. There are four main techniques. A distinction is made between manual techniques that directly treat the trigger point (techniques I and II) and fascial techniques (techniques III and IV). The choice of the appropriate treatment, whether dry needling, manual trigger point therapy or a combination of the two, is made in collaboration between the therapist and the patient. Relevant contraindications must be excluded and patients must be informed about possible side effects.

The Four Techniques of Manual Trigger Point Therapy

Technique I

Technique I consists of local compression of a trigger point. This is also known as ischemic compression. The goals of this technique are to increase local blood flow, as a result of ischemic compression, and to stretch the trigger point area. Technique I can be combined with passive or active movements to optimize the effect. The more precisely the trigger point is treated, the less pressure is required.
Technique I and II of the gastrocnemius muscle. (© Copyright 2022 – David G. Simons Academy, DGSAⓇ)

Technique II

Technique II involves local manual stretching along the tensioned band. The pressure applied is similar to that in Technique I, but the stretching effect is stronger. The goals of this technique are similar to those of Technique I: increasing local blood flow and stretching the trigger point area. This technique is very effective, and the precision of the treatment reduces the need for high pressure.
Technique I and II of the gastrocnemius muscle. (© Copyright 2022 – David G. Simons Academy, DGSAⓇ)

Technique III

Technique III is applied over a large area, for example, using the palm of the hand. It should not be painful. The goal of this technique is to improve the mobility of the fascia and all connective tissue, which is essential for intramuscular mobility.
Technique III of the latissimus dorsi muscle. (© Copyright 2022 – David G. Simons Academy, DGSAⓇ)

Technique IV

Similar to technique III, technique IV focuses on improving mobility between adjacent muscles, i.e. intermuscular mobility. This technique can be slightly painful.
Technique IV of the biceps femoris caput breve muscle. (© Copyright 2022 – David G. Simons Academy, DGSAⓇ)

The History of Manual Trigger Point Therapy

The concept of myofascial trigger points was introduced by Janet Travell in the 1940s. Since then, various manual therapy methods have been developed to treat them, such as ischemic compression, myofascial release, and post-isometric relaxation. Even classical massage has treated trigger points, but without the use of specific nomenclature and, perhaps, less systematically. Documents attesting to the use of these techniques date back to the 15th century.
Dr. Ida Rolf (1896-1979) was among the first scientists to study the characteristics of human connective tissue and developed the Rolfing technique, which became the basis of manual trigger point therapy.
The manual trigger point therapy that we teach was developed in the 1980s by Swiss physician Dr. Beat Dejung. Inspired by the work of Ida Rolf and the trigger point therapy concept developed by Simons and Travell, Dr. Dejung created, together with a group of physiotherapists, a systematic manual trigger point therapy. This is also known as the “Swiss Approach to Trigger Point Therapy” and treats trigger points, connective tissue and fascia.

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