Level 2 is aimed at the practitioner  with some needling training and experience who wishes to expand their knowledge and skills in the treatment of musculoskeletal conditions. Level 1 is not a prerequisite as Level 2 will commence with a review of material specific to the dry needling plus approach. It will be assumed that physiotherapists attending Level 2 have  completed a basic level of dry needling training that satisfies the requirements of the “APA Guidelines for the Safe Practice of Acupuncture”.

Theory Component

• Review of treatment principals of dry needling plus
• Discussion of specific clinical applications
• Acute v chronic presentations
• Acute cervical spine pain
• Acute lumbar spine pain
• Clincal approach to the treatment of elbow pain
• Expanded pain physiology-the interesting stuff!
• Clinical discussion based on questions accumulated since completing Level1

Practical

• Review of dry needling plus needling techniques
• dry needling plus:Upper Quadrant
• dry needling plus:Lower Quadrant
• dry needling plus:Spinal techniques
• Advanced needling techniques
  • Anterior cervical spine region
  • Occipital region
  • Inguinal region
  • Abdominal region
  • Axilla/brachial plexus
  • Plantar fascia and subtalar region
  • Intra articular needling-tibiofemoral joint/OA knees
  • TMJ
  • Interphalangeal region of hands and feet 
• Dynamic needling of lumbar spine
• Single point release cervical facet joints
• Costovertebral techniques
• Deep needling techniques for thoracic and lunbar regions
• Cupping and spooning (traditional soft tissue release techniques)

The emphasis in Level 2 is on practical content. There is ample time in the course programme to allow for questions and discussion from participants who have previously completed Level 1.

In short-The needle insertion technique your mate showed you in the clinic after work one time that he finds is great for piriformis releases is unlikely to be considered by insurers, registration boards or the APA to constitute minimum training for safe  dry needling practice.

Until recently there has been no   standardisation  of dry needling training for physiotherapists  wishing to practice in Australia . For this reason the “soon to be released”  APA Guidelines for Safe Acupuncture practice document  has been created. The Guidelines recommend  a minimum of 2 days training for safe practice. Basic level training typically covers the following areas in addition to basic needling skills :

• Contraindications and precautions
• Management of needle accidents and adverse reactions
• Hygiene requirements
• Safe needling of vulnerable regions of the thorax
This is the minimum training for safe practice not expert practice and advanced level courses  are aimed at achieving some level of expertise.

If your previous  training has not covered the above areas over a 1-2 day period you would be best to start with Level 1.

Level 2 does not address these areas at all and assumes that this training has been previously done.

Please spread this amongst any co-workers you know may be interested or who are practising needling with less than a minimum standard of training.

The recent increase popularity of dry needling amongst physiotherapists in Australia has occurred in the relative absence of regulation by the relevant professional bodies. In the past the traditional acupuncture course which has been run for many years by the APA for physiotherapists, was considered to be the minimum standard of training required for physiotherapists to practice needling by the APA, some state registration boards and physiotherapy indemnity insurers.

Several years ago this was deemed by the APA to no longer be the case.
No replacement recommendation was made for minimum training for needling of any sort by physiotherapists by the APA.

As a result of an increase in adverse incidents as a result of needling practice by physiotherapists, it became apparent that physiotherapists were practicing dry needling with as little as 3 hours instruction and even with no formal instruction.

A work party of physiotherapists experienced in the practice and teaching of acupuncture and dry needling has recently worked in consultation with the APA and representatives of the indemnity insurance industry to produce a document of guidelines for the practice of acupuncture and dry needling by physiotherapists.

The “Guidelines for Safe Acupuncture Practice” document has reached its final draft format . It is not yet available to physiotherapists however should be very soon via the APA Acupuncture Study Group.

It is the hope of those in the work party that these guidelines will become the nationally recognized standard rather than the current situation which varies from state to state.

The minimum training requirements in the draft of the guidelines is 2 days for dry needling and 8 days for traditional acupuncture

Physiotherapists wishing to practice dry needling are currently required to comply with the recommendations regarding skin penetration and acupuncture of the Physiotherapy Registration Boards in each state.

Physiotherapists should check the stance of the physiotherapy registration board in their state for themselves however it would seem that there is some debate as to whether or not physiotherapists are able to practice needling in WA . The SA registration board currently maintains that the APA traditional acupuncture course is required as minimum training for needling in that state.