Our Services

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Sessions are one-on-one, so just you and Dr. Joshua Pniewski every time.  Physician referrals are accepted but not necessary.  Dr. Pniewski uses a variety of techniques and approaches in a concise treatment plan tailored to each patient.  Your treatment will depend on your specific problem, goals from therapy, and which approach may best fit your needs. 

When you or your athlete runs into a problem, having expedited access to consultation and treatment can mean the difference  between sitting out 5 days versus 5 months.  

We are well connected with many athletic trainers and sports medicine surgeons in the area.  There sometimes can be a missing link in the communication.  This is were we come in!  Is it just a bump or bruise?  Or... is this a major concern?  This can be a difficult decision on the weekends for many parents and coaches in our community.  By having direct walk in access, we can help determine the best path for your young athlete.  Our number one priority is keep our athletes playing in a safe manner for the longevity of their athletic careers.  

There is a growing need to keep our body performing at its most efficient level possible.  If you are a weekend warrior or a high school pitcher trying to maintain a healthy shoulder there are options to keep you healthy and keep the statistical likelihood of injury as low as possible.  

Stretching and mobility programming coupled with existing practice regimens can be helpful in staying in peak performance.  Also, manual therapy and/or spinal adjustments can help reduce painful movements to further reach your movement goals.

What is Trigger Point Dry Needling (TDN)?

Dry needling is an effective physical therapy treatment that involved inserting a very fine filament needle through the skin, into the muscles, and the surrounding tissue. It is an effective treatment for a multitude of musculoskeletal and neuromuscular conditions.

A small needle is placed into the targeted problematic tissue. By doing this, the goal is to normalize the physiology of the tissue and restore homeostasis. In other words, it aims to return tender, painful, inflamed, or irritated tissue back to an optimal, non-painful and stable state. It is an excellent complement to a regular exercise, stretching, or mobility program.

Injections into myofascial trigger points (hyperirritable spots in muscle) were first proposed by Medical Doctors Janet Travell and David Simons in the early 1940’s. These physicians injected various substances including corticosteroids, analgesics, saline, etc. into trigger points. The wider use of “Dry” Needling started after a study in 1979 by a Czech physician, Karel Lewit, where it was emphasized that the “needling effect” is distinct from that of the injected substance (dry vs. wet needling). Since then, numerous medical studies have found no difference between injections of different substances and Dry Needling in the treatment of musculoskeletal pain.

Is dry needling the same as acupuncture?

Acupuncture is a form of traditional Chinese medicine that has been practiced for centuries. It is based on the theory that energy, called chi, flows through and around your body along pathways called meridians. Acupuncturists believe that illness occurs when something blocks or unbalances your chi. Acupuncture is a way to unblock or influence chi and help it flow back into balance. Qi energy flows through a meridian or energy highway, accessing all parts of the body. Meridians can be mapped throughout the body; they flow within the body and not on the surface, meridians exist in corresponding pairs and each meridian has many acupuncture points along its path. Research has repeatedly shown that any association between a trigger point and an acupoint or meridian is a chance association.

What is the difference between acupuncture and dry needling?

The practice of acupuncture by acupuncturists and the performance of dry needling by physical therapists differ in terms of historical, philosophical, indicative, and practical context. The performance of modern dry needling by physical therapists is based on western neuroanatomy and modern scientific study of the musculoskeletal and nervous system. Physical therapists that perform dry needling do not use traditional acupuncture theories or acupuncture terminology.

What are the Risks of Dry Needling and is it safe?

Drowsiness, tiredness or dizziness occurs after treatment in a small number of patients (1-3%) and if affected, you’re advised not to drive. Minor bleeding or bruising occurs after dry needling in 15-20% of treatments and is considered normal. Temporary pain during dry needling occurs in 60-70% of treatments. Existing symptoms can get worse after treatment (less than 3% of patients); however, this is not necessarily a “bad” sign. Fainting can occur in certain patients (0.3%), particularly at the first treatment session when needling the head or neck regions. Dry needling is very safe; however serious side effects can occur in 0.01% of people. The most common serious side effect from dry needling is pneumothorax (lung collapse due to air inside the chest wall). The symptoms of dry needling induced pneumothorax commonly do not occur until after the treatment session, sometimes taking several hours to develop. The signs and symptoms of a pneumothorax may include shortness of breath on exertion, an increase in breathing rate, chest pain, a dry cough, bluish discoloration of the skin, or excessive sweating. If such signs and/or symptoms occur, you should immediately contact your physical therapist or physician. Nerves or blood vessels may be damaged from dry needling which can result in pain, numbness or tingling; however, this is a very rare event and is usually temporary. Damage to internal organs has been reported in the medical literature following needling; however, these are extremely rare events (1 in 200,000).