2024 Alabama Dry Needling Statute (Click Here)Concussions are just one of the many impairments that resolve faster and more completely upon the thoughtful implementation of dry needling with direct focus on regulating autonomic nervous system homeostasis.

As of 2024, Physical Therapy Assistants (PTA’s) are now able to perform dry needling under the supervision of their overseeing Physical Therapist.

Here is a brief example of the power Physical Therapy Assistants (PTA’s) now have at their disposal, in the form of dry needling, to specifically induce autonomic nervous system homeostasis, the key to health.

Concussions lead to an overall decrease in blood perfusion and impaired neuronal function in the brain. Some neurons become hyperactive, others become hypoactive, resulting in autonomic nervous system dysregulation tilted toward sympathetic dominance. The same thing typically happens to tissues outside the brain when they get disgruntled.

Two of the most objective facts we know about the effects of thoughtful dry needling are it induces increased blood flow and improved neurophysiologic function, both in soft tissues outside the brain, and in the brain itself. On a base level, this occurs by stimulating the body in a direct, specific-enough manner to restore normal communication between brain regions and the corresponding affected structures or processes. It restores the normal balance to both the sympathetic and parasympathetic sides of the autonomic nervous systems. Autonomic nervous system homeostasis is the key to healing and maintaining mental and physical health. It allows the brain and body to use their full armory of their innate defenses, without inhibition, to fight off and resist pathology.

Nothing in our body changes on its own without the brain telling it to. In the absence of continued insult or structural damage, the brain and body know how to heal themselves and function properly. The issue is, they get inhibited from using their awesome, innate healing powers, secondary to factors stimulating the autonomic nervous system into a chronic state of sympathetic hyperactivity. Without autonomic nervous system homeostasis, our brain and body lose access to their superpowers. This is bad.

Dry needling and joint manipulation both induce some level of direct mechanical alteration of tissue. However, the underlying reason they both work so well when mindfully performed is neurologic, secondary to the mechanical stress. We are using tissue in the body as a means of access to stimulate homeostasis in the brain. This enables proper regulatory communication between various brain regions and corresponding locations in the body, resulting in homeostasis of both the brain and the body.

Remember, the typical human reaction to mental or physical stress, strain, pain, or trauma, is to elevate the sympathetic autonomic nervous system. The overwhelming majority of people in the US are living with chronic sympathetic autonomic nervous system hyperactivity. This means the overwhelming majority of people are living their day-to-day lives feeling like hot garbage, whether they are consciously aware of it or not. The human mind and body have amazing adaptive abilities, even if the adaptation is detrimental to overall wellbeing. This is unfortunate, but don’t lose hope! There are simple tools available to dramatically and naturally improve your mental and physical health, like dry needling!

Throughout our courses, we demonstrate and discuss our unique needling system focused on depressing sympathetic activity, elevating parasympathetic activity, and achieving autonomic nervous system homeostasis. You will walk away with a deep understanding of our needling methodology and how to help any impairment with dry needling, including why electric auricular vagus nerve needling is a key to success.

The gut-brain axis and the hypothalamic-pituitary-adrenal axis, key players of the autonomic nervous system, are strongly and positively affected by thoughtful needling. You will learn why. Electrical needling is discussed and you will learn why it increases efficacy, pain relief, and comfort of treatment. Advanced neurophysiology is discussed at length in regard to utilizing thoughtful dry needling to positively affect our autonomic nervous system and regulate it toward homeostasis.

Check out our online dry needling courses, blog, YouTube page, and in-person course schedule for more information.

Online DN 1: Dry Needling & the Autonomic Nervous System: 15 CEU’s, $299.

Online DN 2: Dry Needling to Improve Men’s & Women’s Pelvic Health: 10 CEU’s, $250.

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Statute

Dear Licensees: Recently the Board has received questions regarding whether it is appropriate for a physical therapist assistant (PTA) to perform dry needling. The Board believes this provides a good opportunity to review key information in the Practice Act and how the Administrative Code for physical therapy applies in the State of Alabama. The Administrative Code does not elaborate on which treatment techniques are or are not within the individual PTA’s skill set. The Administrative Code allows for the fact that different clinicians have varying levels of training and skill above entry-level. To that end, the Administrative Code places responsibility on the directing physical therapist (PT) to determine what treatment is appropriate to delegate to a PTA. However, a PTA is also responsible for refusing to carry out treatment they believe is not in the patient’s best interests. Under Roles and Responsibilities of a Physical Therapist, Section 700-X-3-.03(3)(a) of the Administrative Code states in pertinent part: [t]he roles and responsibilities of a person licensed by this Board to practice physical therapy in the State of Alabama generally are… 6. [t]o select and delegate the appropriate portions of the treatment plan and program..7…. [t]o delegate only those patient care duties to supportive personnel who are qualified under the provisions of these rules to perform such duties. Furthermore, Section 700-X-3-.02(2), “Unbecoming Conduct/Conduct Detrimental To The Best Interest Of The Public Prohibited”, includes, “[c]ertain Conduct Specifically Prohibited…(k) [d]elegating responsibilities to a person when the licensee delegating such responsibilities knows or has reason to know that such person is not qualified by education, by experience, or by licensure to perform them.” According to Section 700-X-3-.03 (b): [t]he roles and responsibilities of a person licensed by this Board to practice as a physical therapist assistant in the State of Alabama generally are…1. [t]o practice only under the direction of a physical therapist licensed to practice in the State of Alabama…3. [t]o perform treatment procedures as delegated by the physical therapist but not to initiate or alter a treatment plan…7. [t]o refuse to carry out treatment procedures that they believe to be not in the best interest of the patient. To summarize, determining what treatment is appropriate to delegate to a PTA is the responsibility of the directing PT. Employers do not have the authority or responsibility to make that determination. Furthermore, the liability rests with licensees: the PTA and the directing PT. If any adverse event or mismanagement occurs leading to legal proceedings, the PTA and the directing PT are both accountable for what has been delegated to the PTA, and professionals are typically judged based on the acceptable standards of practice or care. It is not the role of the licensing board to establish best practices. There are many resources that provide guidance in this area, including the American Physical Therapy Association.