Needling technique Flashcards
position, grip/technique, needle
Infraspinatus
s/l or prone
flat - down to scapula
40-50 size
deltoid
prone, supine, or s/l
flat (but don’t go too medially)
40-50mm
Biceps
supine
pincer - and needle lateral to medial
40-50mm
brachialis
supine
Flat - lateral to medial (Do not pass mid line)
40-50mm
Triceps
prone, can do s/l or supine too
Pincer - lat/long head
flat - Medial head (lat to med direction)
40-50mm
Upper Trap
prone, sidelying, or supine
pincer grip
30-40mm
SCM
upper - prone
Most of it - supine
Upper - toward occiput in btwn mastoid and occiput
OR – small window in s/l off mastoid process
Supine - with pincer with findings vessels
Needle 30mm
Lat
Prone for trunk portion
Supine, s/l, prone for axillary
Trunk = rib lock
Axillary - Pincer
Trunk 40mm
Pec Major
Supine
Clavicular - flat lateral clavicle create window and tangential parallel with clavicle
Axillary - pincer
Sternal - rib block with whole hand flat
Subscapularis
Axillary - Supine
Medial - prone
Axillary 90deg abd ER and go perp into scapular
Medial - hammerlock position with shelf mm and go into scapular area. Do not use support in front of shoulder**
Medial 50mm needle
Wrist extensors
Supine in slight flex
Flat - tangential tech
Pincer - Extensor longus/brevis
Flat - digitorum/ulnaris
For ulnaris come from the side to stay more horizontal
Needle 30mm
Brachioradialis
supine with slight flexion
Pincer grip
Needle 30-50mm
Supinator
Supine
Flat -start at radius and only fan inf/sup direction. needle radius towards ulna
Go off radius and below radial head towards ulna
Needle 40mm
Anconeus
Prone - forearm flexed ~45deg
Flat (thin muscle so insert just prox to TrP and hit bone)
Needle 30mm
QL
sidelying / prone
Flat - need to open up QL (Pillow under, arm overhead), find mid line and go just posterior to mid line.
Posterior approach - L3 middle, up and over past p/s and slight ankle to belly button.
Psoas major
side lying, supine, prone
Flat palpation -
Lateral approach - like QL but 10-30deg ant to belly button. (Avoid abdominal cavity)
Posterior - same as QL but deeper
Supine - Iliopsoas approach - lateral to femoral canal (flat)
75mm
50mm if anterior?
Glute max
prone or s/l
flat
60-75mm
Glute med
sidelying
flat
50-60mm
Glute min
prone or s/l
flat
50-60mm
Adductor longus/brevis
Gracilis
Adductor magnus
supine :
with leg out to the side in ER - pincer/OK grip
Magnus - flat palpation (if you needle magnus you typically go through gracilis)
sidelying - pincer (longus/brevis)
*stay away from big groove (adductor canal)
Needle - 50-60mm
Pectineus
supine - slight ER
Flat -Femoral Triangle (inguinal ligament, sartorius, adductor longus) locate artery. Middle finger on it. Other rest down for nerve (lateral), vein Medial). Needle AP only
Needle 50-60mm. Only down about an inch.
Rectus femoris
supine
Flat
40mm fine. Longer for deeper quad.