Good evening,

I want to give my support to athletic trainers and their desire to add dry needling to the state practice act.

It should be common sense that healthcare professionals, including athletic trainers, receive the consent of the patient before the use of any therapeutic intervention.  It is also common sense that all therapeutic interventions need to move a patient towards achieving their patient-centered goals in an ethical and safe manner.  It is my belief that existing regulations entrust that athletic trainers are competent with both their knowledge and skills.  Additionally, existing regulations demonstrate that the Virginia Board of Medicine believes that licensed athletic trainers are more than capable of choosing and applying therapeutic interventions that best serve their clientele in an ethical and safe manner.  It is my belief that the same high ethical standards and safety would be followed if dry needling was added to the athletic training practice act.

Some opposing posts make it sound like athletic trainers have very little knowledge in anatomy and physiology and thus will evoke debilitating patient outcomes if allowed to practice dry needling. This is far from the truth.  Anatomy and Physiology are at the core of many classes within the professional athletic training curriculum; a curriculum that produces multi-skilled health care professionals specifically trained in the prevention, examination, diagnosis, treatment and rehabilitation of medical conditions and emergent, acute and chronic injuries.

Additional opposition posts make it sound like athletic trainers want to stick everyone in the Old Dominion with needles (i.e., dry needles).  This, too, is far from the truth.  Any clinically competent clinician would agree with the Hippocratic Oath and follow a “system of regimen which, according to my ability and judgment, I consider for the benefit of my patients.”  In other words, I believe that once dry needling is added to the athletic training practice act that athletic trainers would choose to use dry needling only when it benefits the patient.

Risk is another point that the opposition makes.  Their statements may be summarized in this manner, “because athletic trainers are not knowledgeable of traditional Chinese medicine, athletic trainers pose a higher risk implementing dry needling.” First, risk is inherent in everything that a human encounters and participates.  Second, risk is also modifiable; therefore, risk can be reduced.  Take therapeutic cupping for example, historical Chinese medicine used a flammable fluid inside of therapeutic cups and ignited it before placing them on the patient.  As you can imagine, some patients received severe burns from this practice.  The therapeutic cups that athletic trainers use to treat patients, are applied through less risky means that does not subject the patient to burns yet yields the same therapeutic benefit.

As I am near the end of my post, I would like to draw your attention to Sue Falsone’s post on the afternoon of April 28, 2025. I believe that you will gain valuable insight into the art of dry needling and additional perspectives from an athletic trainer with years of experience treating patients. Like Sue, I see benefits of adding dry needling to the athletic training practice act.

Thank you for the opportunity to voice my opinion and ask that the Virginia Board of Medicine approves and adds dry needling to the athletic trainers’ practice act.

Dr. Ashley