Is the Integrated Dry NeedlingTM (IDN) course approved by the College of Physiotherapists?
In Ontario, the College of Physiotherapists doesn’t approve or certify specific courses for the purpose of authorizing physiotherapists to perform dry needling. Rather, in Ontario physiotherapists must add themselves to a roster in order to perform certain legally restricted or controlled acts, including dry needling. Prior to rostering, it’s up to the individual physiotherapist to determine and be able to prove that they’ve completed the necessary training for the specific authorized activity/controlled act they’re rostering for. This training must include the learning of indications, contraindications, adverse outcomes and risks associated with the controlled act.
Furthermore, during training physiotherapists must practise the controlled act while being supervised by an individual authorized to perform it as well as be evaluated on their skills, knowledge and decision-making ability to perform the activity. The curriculum of the IDN course has been designed to meet the required competencies established by the College of Physiotherapists of Ontario for a physiotherapist to use dry needling in their practice and to roster for this skill set.
The rules and regulations surrounding the performance of dry needling by physiotherapists in the rest of Canada vary depending on the province you practise in. In some provinces, the respective Colleges will only permit physiotherapists to perform dry needling following the completion of an approved course. Prior to offering the IDN course in any of these provinces, we will ensure that our course is approved.
If you’re travelling from another province in order to take our course, please check with your College to see if it’s on their approved list or meets the relevant criteria.
Why is your course called “Integrated” Dry Needling?
We consider our approach to dry needling to be an integrated one for a few reasons. Firstly, we rarely advocate that dry needling be employed as a stand-alone intervention. While sometimes treatment may commence with only dry needling, most of the time it can be safely and effectively combined with other modalities such as exercise or manual therapy.
For longer term functional gains, a multi-modal treatment regimen is usually required, whether this be a biomechanical approach or graded exposure to activity for patients who are centrally sensitized. Secondly, we use the term “integrated” because our course content integrates various frameworks and concepts for dry needling including neuropathic/radiculopathic and myofascial trigger point paradigms.
Lastly, the skills learned on this course integrate a wide array of dry needling methods including deep perpendicular and transverse insertions as well as dry needling techniques adapted from myofascial trigger point injection methods.
What types of conditions can I treat with IDN?
IDN can be applied to a wide range of neuromusculoskeletal conditions and presentations. In some cases, IDN can be used to treat primary myofascial pain resulting from overload injuries isolated to a single muscle or region. At other times, IDN may form only one component of the treatment plan to address myofascial contributions to biomechanical conditions e.g. shoulder impingement or tendonopathy. Lastly, IDN has a role to play in the treatment of myofascial pain of radiculopathic/neuropathic origin as well as central sensitization.
During our course, we use a series of case histories to help with clinical reasoning through a wide variety of patient presentations. Techniques will be learned that are applicable to the neck, back, pelvis, upper and lower extremities, temporomandibular region as well as for headaches.
Are there prerequisites and why are they required?
Prior needling experience e.g. acupuncture is an asset but is not required. Course participants must have been in physiotherapy practice for a minimum of three years and be registered** to practice in the province where the course is being offered. Participants must also have one of the following:
- Acupuncture Canada’s ACC designation (Level 1 Certificate) or completion of AA1 and AA2 courses (previously offered as the CAFCI designation or AFCI courses: Level 1 – Part 1, 2a, 3a)
- McMaster University Acupuncture Program (or equivalent certification)
- A minimum of Level 2 upper and lower quadrant courses from the Diploma of Advanced Manual and Manipulative Physiotherapy program run through the Orthopaedic Division of the Canadian Physiotherapy Association (Preference given to Level 3 applicants).
**For out-of-province physiotherapists, you will have to contact the College of Physiotherapists in order to obtain temporary courtesy registration in order to take the course.
We require these prerequisites as participants are more optimally able to integrate dry needling into a multi-modal treatment approach when they already have a sufficient level of: experience, clinical reasoning ability, manual skills and exposure to a broad range of patient presentations and conditions.
How is the course delivered and what resources are provided?
The course is delivered through various formats including lecture, practical lab sessions, case histories, as well as small-group experiential learning and reflection exercises. We provide adequate supervision by ensuring an optimal instructor to student ratio for the practical labs.
For courses offered in Ontario, time will also be spent in the cadaver lab to help review anatomy relevant to the dry needling skills learned in the course as well as any vulnerable underlying vascular, neurological and organ structures. A course manual will be provided that includes both a theory section (outlining the background, physiological effects and relevant research related to dry needling) and a practical section that describes with specific detail each needle insertion that is learned on the course along with pertinent anatomical information and diagrams. You’ll also receive a starter dry needling kit to take home after the first weekend.
Are there exams?
Participants taking the course are assessed using written tests pertaining to anatomy and theory such as the physiological effects, indications, and contraindications for dry needling. There will also be a practical evaluation of needling skills and judgement concerning the management of adverse events.
Do I have to do anything to prepare for the course ahead of time?
There are no required pre-course readings but we recommend a review of anatomy prior to the course with an emphasis on musculoskeletal, vascular and neurological structures of the upper/lower extremities and spinal regions.
Will I receive a certificate and what credential can I use to demonstrate completion of the course?
Upon successful completion of the course, you’ll receive a Certificate of Integrated Dry Needling. For those wishing to indicate that they’re certified, we recommend the abbreviated credential “CIDN” be listed after your name if this is permitted by the College of Physiotherapists in your province of practice.
Is there an annual fee to remain certified or be listed on the website?
Once you’ve successfully completed the certification process, there are no annual fees to remain certified. As part of the course fee you’ll also receive an ongoing free listing on our website of physiotherapists who are IDN certified.
Do I have to be needled myself while taking this course?
Yes, everyone taking the course will serve as models for their fellow participants. As is the case for many other physiotherapy methods, it’s ideal for learning to be able to experience the intervention that you’ll be applying to patients in your practice. If you’re pregnant, or if there are medical reasons for which you can’t be needled, please inform us prior to the start of the course so that alternate arrangements for a model can be made.
Why isn’t a short introductory course or the option to take the course as progressive levels offered?
It’s our experience that dry needling is a skillset that is best learned during the course of a full certification program so that once completed, graduates are fully able to apply dry needling across a broad spectrum of conditions and anatomical regions. This will allow you to fully integrate dry needling into your clinical practice without being limited to only a small number of muscles or regions. At the same time, the course takes place over multiple weekends in order that you have time to apply the learned techniques so they can be reviewed and refined before progressing to more advanced needling skills.
Do I have to be a physiotherapist to take this course?
At this time, our course is only open to physiotherapists.