In-Patient/Hospital Experiences

Dr McLean has worked in a variety of hospital settings to small Rural Alaska settings with 3-4 in-patient and skilled nursing beds to large, 450-bed trauma facilities. Her experiences have included in-patient ICU, trauma rehab, long-term rehab, cardiovascular surgical rehab, and in-patient post op orthopedic care. Prior to becoming a physical therapist, Dr McLean was trained and worked in the USAF as a surgical scrub technician and later worked for Parkland Memorial, Breckenridge Hospital Austin and St Joseph Hospital in Paris Texas as a surgical technologist assisting in general, OB/GYN, orthopedic, hand and neurological surgeries. This experience gives her a unique perspective in utilizing her skill sets as a physical therapist.

Fascial Manipulation (FM)

Fascial Manipulation (FM) is an evidence-based treatment for pain relief which involves manual treatment of the myofascial system to restore muscular balance and reduce stiffness. Recent evidence has shown that muscle action is not merely along origin and insertion lines. Instead, muscles and fascia form continuous lines from head to toe allowing efficient tension and mobility for shock absorption and force generation to support the entire neuromusculoskeletal system during movement and activity.

Many changes within the skeletal system, such as arthritis and joint degeneration, are accepted as normal age-related changes which do not always lead to pain. All too often, imaging findings of these normal adaptations are used as justification for risky and invasive treatments leading to disability and pain management.

The reality is that the myofascial system is well equipped to compensate for non-traumatic changes in the skeletal system. However, pain and dysfunction often occur due to tissue overload and stiffness in the myofascial chain. Myofascial stiffness can lead to improper movement patterns causing excessive tissue strain and overload of joint structures (capsule and cartilage).

The goal of fascial manipulation is to restore gliding along fascial layers and normal activation of myofascial lines of tension to restore balance within the neuromusculoskeletal system.

Dr McLean utilizes this evidence-based technique to naturally resolve pain and facilitate healing with improved movement and stability throughout the entire body. Fascial manipulation is a safe and effective alternative to clients seeking pain relief without the risk of surgery or medications.

Dry Needling

What is Dry Needling?

Dry Needling is an effective treatment technique for soft-tissue dysfunction and pain-related conditions.  Dry Needling utilizes sterile, solid filament needles to improve local tissue nutrition near the site of muscle or nerve injury.  It can also be used to deactivate and desensitize over sensitive areas called Myofascial Trigger Points or commonly known as ‘knots’ in muscles. These Myofascial Trigger Points contribute to pain, decreased flexibility or motion, and decreased muscle function.  Dry needling allows the physical therapist to efficiently treat dysfunctions throughout a chain of muscles causing a painful condition such as knee pain, neck pain, or back pain.

What kinds of conditions can be treated with Dry Needling?

Muscle dysfunction can be the primary or secondary contributing factor to many neuromusculoskeletal conditions.  Such conditions can include repetitive stress injuries, carpal tunnel,  muscle tendonitis, neck pain, back pain, elbow pain, knee pain, headaches, rotator cuff injuries, shoulder impingement, frozen shoulder, patellofemoral dysfunction, plantar fasciitis and tennis elbow.

How can Dry Needling help me?

Dry Needling can be used to treat a variety of musculoskeletal issues including neck, back and shoulder pain, arm pain (tennis elbow, carpal tunnel, golfer’s elbow); headaches (migraines and tension-type headaches); temporomandibular (TMJ); knee, buttock, and leg pain (sciatica; hamstring strains; calf tightness/spasms).

Is Dry Needling Similar to Acupuncture?

The only similarity to acupuncture is the use of an acupuncture needle. Dry Needling actually started with the use of a hypodermic needle, except there is no infiltration or injection of fluid, hence the term ‘dry’ needling.  Acupuncture is one aspect of Traditional Chinese Medicine approach which includes diagnosis and clinical reason using various Chinese medicine assessment methods. Dry needling does not rely on Chinese medicine at all.  Western or Medical acupuncture also aims to stimulate acupuncture points along meridians, but applies it to western medical reasoning.  Dry Needling is a therapeutic intervention based on anatomy and neurophysiology with strong scientific evidence supporting its effectiveness.  The primary aim of Dry Needling is to needle altered or dysfunctional tissues in order to improve or restore function and facilitate healing.  Effective dry needling depends on the practitioners skills based in strong scientific medical background in anatomy, physiology, neurology, sound clinical  reasoning and evidenced based treatment approaches.  Physical Therapists are well educated in these foundation topics often with years of experience and/or a doctorate background  in addition to specific training in dry needling techniques and theory.  It is important to seek a certified provider when considering dry needling.

Is Dry Needling Painful?

The needle used in dry needling procedures is very thin.  Most patients don’t even feel it penetrate the skin. The twitch response usually elicits a very brief (less than a second painful response. The local twitch response elicits a very brief cramping and/or deep aching sensation. Some patients describe this feeling as a little electrical shock or cramping sensation. This may last up to 24-36 hours after treatment and is known as ‘post treatment soreness’.  Dry Needling may reproduce symptoms directly in the muscle being treated or may refer to other areas of the body. This is a form of referred pain, which is one of the hallmarks of trigger points.  Elicitation of local twitch responses and recognizable referred pain patterns is a good and desirable reaction because it confirms a possible source of dysfunction that needs to be treated.

How Long does it take for the procedure to work?

In some cases, decreased pain and improved mobility is immediate.  Typically it may take a few treatment sessions for a lasting positive effect.  The goal of Dry Needling is to cause mechanical, biomechanical and neurological changes without any pharmacological means.  Therefore, we are looking for a cumulative response to deactivate trigger points, disrupt pain and to restore optimal muscle function.

How do I know if I’m a candidate?

Contact our office to schedule an initial evaluation appointment to determine if dry needling may be an appropriate treatment for you.  Dry Needling in combination with other manual therapies such as soft tissue and joint mobilization, as well as an effective exercise program can help you achieve your overall goals.





Post Surgical Rehabilitation

Many Orthopedic Injuries require repair by an Orthopedic Surgeon/Specialist.  Dr. McLean has worked closely with many surgeons in Anchorage, The Mat Su Valley and the Kenai Peninsula for over 25 years including Kenai Peninsula Orthopedics, Kenai Spine, Anchorage Fracture and Orthopedic, Orthopedic Physicians Anchorage, Alaska Spine Institute, The Rhyneer Clinic, and Denali Orthopedics in the Valley.  Dr. McLean’s common Post Surgery experiences include:  Total Joint Replacements of the hip and knee; Anterior Cruciate Ligament repairs, Rotator Cuff Tear repairs, Surgical Fracture Repairs of the ankle, leg, arms, or shoulders, Hip Labrum repairs, and many more.  You can have confidence that Active Abilities communicates closely with your patients referring physicians or surgeons to assure your patients best recovery possible.

Orthopedic Physical Therapy

Orthopedic Physical Therapy is a specialty area providing services many times as an extension of your Orthopedic Surgeons specialty areas.  Orthopedic injuries involve muscles, nerves and bones.  Dr. McLean provides qualified hands-on physical therapy treatments for many musculoskeletal injuries involving fractures, ligament tears, muscle and tendon sprains and strains and much more. Specifically some treatments include  Sprains/Tears/Repairs and rehabilitation for the Anterior Cruciate ligament, Posterior Cruciate Ligament, Meniscal  Cartilage, Medial and Lateral Collateral ligaments, Rotator Cuff Tendons, Cervical, Thoracic and Lumbar Spine Disc injuries, Hip labrum, Total Joint Replacements, Elbow injuries, Wrist and Hand injuries, and many more.