I am writing in support of amending current legislation to permit certified and licensed athletic trainers to perform dry needling. I work directly with athletic trainers on a daily basis in my role as a sports medicine physician, and I am intimately aware of the training and skills that they utilize in their current scope of practice. I am in full support of permitting their utilization of dry needling as a treatment modality after appropriate training in this technique.

Athletic trainers utilize dry needling most commonly in the treatment of musculoskeletal conditions to improve pain and function after an injury. They are now required to obtain a master’s degree learning about human anatomy and appropriate treatment and management of a wide breadth of musculoskeletal conditions.

Under current Virginia statutes, athletic trainers are already permitted to perform skin-breaking procedures, including suturing, lidocaine administration, and IV placement. The Commission on Accreditation of Athletic Training Education also requires training in the invasive procedures noted above. In my professional opinion, these procedures, which have already been deemed to fall under the scope of athletic training practice and are a mandated part of the educational process, carry the same inherent risks associated with dry needling (infection, damage to surrounding structures, etc.). Particularly with the additional counseling on these risks and appropriate safety measures provided in a training course, athletic trainers are more than well-equipped with the baseline knowledge and skillset to perform this procedure safely.

We already trust our athletic trainers to handle complex and potentially dangerous injuries – traumatic brain injuries, spinal cord injuries, fractures and dislocations, etc. To deem their understanding of anatomy, comprehension of procedural risk management, and overall scope of care as inadequate to be able to perform dry needling isn’t congruent with currently permitted practice patterns.

In regards to details around training, I’d humbly suggest applying similar parameters already deemed adequate for our physical therapist colleagues as detailed in 18VAC112-20-121.

Athletic trainers work with some of our most dedicated patient populations – young student-athletes, military personnel, etc. – and often in a setting where there is no financial incentive for performing a procedure such as needling. They are not pursuing this amendment in order to create additional revenue streams or to elbow out other professionals who use similar modalities. The motive for this request is simply for highly-trained medical providers to practice to the full scope of their training in order to provide easily accessible, high-level patient care in a manner consistent with currently recognized practice standards. For the reasons detailed above, I am in full favor of approving this amendment.

Ben Ferry, MD, CAQSM

Collaborative Health Partners Sports Medicine Physician