Course Content Dry Needling – Intramuscular Stimulation

Theory and practice of medical acupuncture, based on the teachings of Dr. Travell and Simon (the inventors of the trigger point concept). There are numerous approaches to needling patients, many of which are incorrect and some of which are unsafe. This course is aimed at absolute beginners as well as those who already have experience with medical acupuncture (dry needling).

Simeon Niel-Asher tells you why you should definitely attend this course:

Safety: is our most important concern. We take plenty of time to discuss the neuroscience and neurovascular anatomy and demonstrate the safety precautions and safest techniques for each muscle. We also treat the complications of needling, including bleeding, infection and pneumothorax (in the chest area).

Duration of the course: Dry needling is based on anatomy and osteopaths/physiotherapists/chiropractors have completed hundreds of hours of anatomy training, the technique itself is very easy to learn. The key lies in understanding the anatomy and in particular the fiber direction. We cover the anatomy of each muscle in great depth, both in theory and in practice.

We are committed to safe and effective techniques and establishing a gold standard for needling.

Triggerpoints3d: One of the main problems after a course is that students often go out and forget how to perform the correct techniques. Asher and Gerwin have solved this problem by developing an app that contains over 400 4k videos by Professor Gerwin demonstrating the gold standard of needling.

 

ADVANCED Course Content

DAY 1 – HEAD, FACE, THORAX AND NERVE ENTRAPMENT SYNDROMES

Day 2 – MORNING

TMD & orofacial pain

(Temporalis, lateral and medial pterygoid muscles, masseter, facial expression muscles: procerus, buccinator, corrugator, platysma)

1. Clinical overview

Why TMD and facial pain are often misdiagnosed:

• “Tooth pain” that is actually muscular
• Continuum of headache, jaw and neck
• How occlusion and posture interact with craniofacial trigger points
• Sensitization of trigeminal pathways → widespread symptoms
• Why imaging rarely helps

2. Case 1 – Unilateral jaw pain + joint noises (“Classic but misleading TMD”)

Common misdiagnoses:

• Degenerative joint disease
• “Disc Dislocation”
• Malocclusion

Trigger points:

• Lateral pterygoid (intra-articular pain, reproduction of joint noise)
• Medial pterygoid (sore throat, deep jaw pain)
• Masseter (“tooth pain”)

Possible muscular factors:

• Corrugator (forehead/eye pain)
• Procerus (pressure on the forehead)
• Buccinator (cheek symptoms → tooth symptoms)
• Platysma (front of throat, jaw symptoms)

Day 1 – AFTERNOON

Chest pain and nerve entrapment syndromes

(Pectoralis minor, Pectoralis major, Serratus anterior · Pronator teres · “Double Crush Concepts”)

1. Clinical overview

Why 30% of “chest pain” is musculoskeletal in nature:

• Anxiety and breathing mechanics
• Referred pain from pectoralis minor to the chest wall and scapula
• Serratus anterior rib/side pain misinterpreted as visceral

Orthopedic diagnosis of exclusion:

• Red flags (cardiac, costochondritis, pulmonary)
• Simple rib springing tests

2. Case 1 – Chest tightness, anxiety, paresthesia in the arm

Common misdiagnoses:

• Costochondritis
• Cardiac workup with negative findings

Key muscles:

• Pectoralis minor (primary)
• Serratus anterior
• Pectoralis major (sternal and clavicular portions)

3. Case 2 – Median nerve entrapment (pronator teres syndrome vs. carpal tunnel)

DAY 2 – PELVIS, ABDOMEN, VISCERAL REFERRED PAIN, FOREARM AND HAND

Day 2 – MORNING

Pelvic pain (including gynecological contexts) + abdominal and viscerosomatic pain

(Adductors, GiGO complex, obturator internus; external oblique, rectus abdominis, psoas major)

1. Clinical overview

Understanding the pelvis as a neuromyofascial hub:

• Pelvic floor – hip rotator – abdominal muscle chain
• Viscerosomatic referral (colon, bladder, uterus, ovaries)
• How trigger points mimic visceral pain
• Why chronic pelvic pain is rarely caused “only by the pelvic floor”

2. Case 1 – Gynecological pain (but musculoskeletal origin)

Presenting symptoms:

• Pain during intercourse
• Deep pelvic pain
• Groin pain with hip rotation

Muscles:

• Obturator internus
• GiGO complex
• Adductors

3. Case 2 – Abdominal pain: visceral vs. myofascial

Symptoms:

• “Stabbing” in the external oblique and rectus abdominis
• Pseudo-appendicitis symptoms
• Testicular pain and PID pain
• Gynecological pain

Muscles:

• External oblique
• Rectus abdominis
• Psoas major

Neurological focus:

Viscerosomatic pathways:

• How organ irritation sensitizes the corresponding spinal segments
• Trigger points as amplification zones of the spinal cord

4. Synthesis:

The pelvis–abdomen algorithm

• Primary pelvic factors
• Abdominal factors
• Visceral mimicry
• How to sequence IMS for chronic, unresolved pelvic pain

Day 2 – AFTERNOON

Upper-extremity flexor systems and intrinsic muscles of the hands and feet

(Flexor carpi radialis, palmaris longus, flexor digitorum superficialis and profundus, hand interossei; intrinsic foot muscles)

1. Clinical overview

Why forearm flexor groups cause persistent hand symptoms:

• Grip load + repetitive strain
• Contributions from the cervical spine
• Why treating the wrist alone fails
• Hand–forearm–shoulder chain

2. Case 1 – Medial forearm pain + weak grip

Often misdiagnosed as:

• “Golfer’s elbow”
• Carpal tunnel
• Tendinopathy

Involved muscles:

• Flexor carpi radialis
• Palmaris longus
• Flexor digitorum superficialis and profundus

3. Intrinsic hands and feet (mini-module)

Applications:

• RSI syndrome (repetitive strain injury)
• Metatarsalgia
• Plantar heel pain

Muscles:

• Quadratus plantae
• Lumbricals
• Interossei
• Abductor hallucis
• Flexor hallucis brevis
• Foot interossei