Trigger Point Dry Needling

David G. Simons, MD, co-author of the Simons, Travell, and Simons Trigger Point Manual, has stated that, “Since no medical specialty claims skeletal muscle as their organ, it is often overlooked.”

Indeed, several studies have confirmed that myofascial pain is one of the most commonly ignored causes of persistent pain. Many of our patients report that previous healthcare providers rarely have included the detailed and specific muscle examination that is common at MOST. The hallmark feature of myofascial pain syndrome is a so-called “trigger point,” which can be responsible for prolonged pain and dysfunction. A common characteristic of trigger points is referred pain, which may confuse those clinicians who are not familiar with common referred pain patterns. Dr. Janet Travell, MD, perhaps best known as President Kennedy’s White House physician, has mapped out the referred pain patterns of most skeletal muscles.

Although trigger points and myofascial pain are poorly recognized worldwide, there is a growing number of scientific studies that confirm that trigger points are indeed a very common source of pain and dysfunction. Physical therapists at MOST are very involved with researchers and clinicians worldwide and are among the world’s top specialists in myofascial pain syndrome. Trigger point dry needling is one of the most effective treatment options to inactivate myofascial trigger points.

Ralph Simpson is certified in trigger point dry needling through Myopain Seminars and Dr Jan Dommerholt. Dr. Dommerholt was the first physical therapist in the United States to teach trigger point dry needling courses and injection techniques to physicians, dentists, physical therapists, and other eligible health care providers. Several course instructors from other continuing education companies studied with Dr. Dommerholt.

He has published several articles about trigger point dry needling.

Have questions about dry needling? You might find the answers in this Dry Needling FAQ (pdf) publication. The sections Resources for Patients and Resources for Professionals on this site feature several other articles about myofascial pain.

For more information about trigger point dry needling and myofascial trigger point therapy, please do not hesitate to contact Dr. Ralph Simpson, PT, DPT, OCS, CMPT, CMTPT, LACT at 406-862-2348.

Back System3

Since the introduction of systemic postural evaluation and assessment by Florence Kendall, many physical therapists have demonstrated how muscular imbalances can reduce active and passive range of motion in the hip which cause and contribute to spinal disfunction. The orthopaedic manual therapy examination has also progressed through an evolution of not just looking at passive intervertebral and segmental mobility but looking at the overall scenario of lower lumbar disfunction as it occurs with both active range of motion and in varying postures. Dr. Shirley Sahrmann has also contributed to the body of knowledge of postural assessment and simple yet effective treatments which use active mobility techniques to gain range of motion in an otherwise stiff and inflexible joint. The simple principle of reciprocal inhibition is used and combined with joint loading during range of motion to gain mobility in hip joints. The BackSystem 3 is also used to facilitate active release-type stretching/mobilization of back soft tissues.

Class IV Lite Cure Laser

Laser therapy is a non-invasive technique to help reduce pain and inflammation. Laser therapy can be safely used as an adjunct or replacement for pharmaceutical drugs. This pain relief treatment is FDA cleared and enables patients to have an alternative to drugs and surgery.

Laser therapy treatments last between 5 and 10 minutes depending on the condition being treated. Laser therapy treatments must be administered directly to skin, as laser light cannot penetrate through layers of clothing. You will feel a soothing warmth as the therapy is administered.

Depending on the condition being treated your therapy may be administer through either a contact or non-contact hand piece. The contact hand piece is designed to allow the practitioner to physically manipulate the tissue while administering the treatment, resulting in a laser-massage treatment. This allows for light to penetrate deeper into tissues than the non-contact hand piece due to it’s ability to displace tissue through a laser-massage technique.

Patients generally see results after 3 to 5 treatments. Your doctor will develop a treatment plan that is optimal for your condition.

Learn more about Class IV Lite Cure Laser Therapy

Ralph and Gary

Gary Player and Ralph


Chronic Pain

Research shows people respond better when educated about how we feel pain, than the do when they are educated about anatomy. So, at MOST not only do we utilize class IV laser, dry needling and appropriate exercise, we also educate people as to the origin and nature of pain.

Free Pain Science Workbook for Therapists and Patients

Interviews on the neuroscience of pain, neuroplasticity, brain rehabilitation, CRPS/RSD, and more.

Chronic Pain? Watch this video series

This is a 3 part video series that I am hoping will help many patients coping with persistent pain. Watch the videos over 3 sessions so you don’t get overwhelmed with the information.

Video #1:

Video #2:

Video #3:


Why Things Hurt

Back Pain – Separating Fact from Fiction


Understanding Pain in 5 Minutes

Best Advice for People Taking Opioid Medication

“There are more people in North America addicted to prescription Opioids than Heroin & Cocaine combined”.“Opioid overdose is the second leading cause of unintentional death and the first being car accidents.”

“…chronic opioid use may unexpectedly worsen the perception of pain in some individuals.”

If you are shocked by the above statement please watch the 11 minute video. If you have a patient who is taking any opioids such as Oxycodone, OxyContins or Percocets for their persistent back pain, please have them watch this short Opioid video.


Shoulder, elbow, hand injuries we commonly see at MOST and utilize our expertise to treat not only the upper extremity injury but all the low extremity injury. Whether it’s work or recreationally induced. The painful heal syndrome is a specialty area we treat at MOST.

Read About Skiing Injuries

Post-Op Recovery

We have over 45 years experience helping people recover from orthopedic surgery.  In addition to our hands on professional experience, our staff has first hand knowledge from personal surgery recovery to aid our abilities.At MOST we specialize in ACL-reconstruction recovery and work as a team with your surgeon with our own protocols or one your surgeon prefers.Rotator cuff repair has improved considerably over the past decade with more and more repairs being done either partially or completely with the arthroscope.  At MOST we stay abreast of the latest developments in surgery as well as rehabilitation trends and models for rotator cuff reconstruction.Arthroscopic treatment of hip labral tears is more and more common and the rehabilitation of those surgeries are relatively new yet.  Dr. Marc Philippon at the Steadman clinic in Vail, CO is a pioneer of hip arthroscopy and has personally tutored MOST staff in surgical and rehabilitation approaches.
Using a team approach with your surgeon allows the staff at MOST to consistently achieve great results for all types of orthopedic surgery recovery.

Total Joint Replacement

Joint replacements have evolved from a procedure allowing people to walk and do household duties without pain to a procedure that allows a return to sport.  Rehabilitation has evolved as well with less time spent with CPM for instance after total knee replacement and more time spent on functional recovery.  Anterior hip replacements have lessened the chance of dislocation and reduced the amount of needed post-op PT and changed our emphasis as well.Rest assured as continual changes occur, MOST will be at the forefront of rehabilitation trends and procedures.

Golf Fitness

In the early 90′s, golf fitness was just beginning on the PGA Tour and Ralph Simpson was lucky enough to be there in the early years.  From those years on the PGA Tour, Ralph Simpson developed a 3-pronged approach to golf fitness:

First, a musculo-skeletal examination is performed.  At MOST we use the TPI evaluation or portions of it when establishing a base line for assessing a golfer’s physical attributes.  Golf requires flexibility, strength, and coordination to perform at one’s best and these are components assessed in the MOST golf fitness evaluation.
Secondly, we use the KVest 3D system to evaluate torso, pelvic, and upper body movement in real time during the golf swing as an evaluative process as well as a training tool for learning movement position and awareness.
And thirdly, we use the Instant Replay system (which in not used at TPI) to enhance kinetic linking and motor learning with the golf swing. This is a system invented and patented by Ralph Simpson; it was developed over a decade of working with the best players in the world.  Although strength enhancement can improve club head speed a small amount, learning to sequence and weight shift optimally has a much greater effect on a golfer’s ability to generate club head speed. There is no faster way to affect this process than the Instant Replay.