hi I'm James Escalon physical therapist with wellward medical here in Lexington Kentucky and for the American Academy of manipulative therapy Fellowship in muscular skeletal ultrasonography we're going to be demonstrating dry needling of the quadriceps tendon using the clarus L7 probe this probe has a voice activated function which will assist in this process so that I can be using a hands-free approach for better patient safety and effectiveness of the technique so after playing with the settings so that I can hit the voice control then I will be able to clearly visualize in this patient position supine with about 30° of knee flexion with a bolster so there's a little bit of a tug on the quadriceps tendon and it better exposes the superior patellar pole for targeting with dry needling in this position I am long access to the quadriceps tendon with good visualization of the exact targeted position I'm going to be going for an area where the enthesis would be or the connection of The osteotendinous Junction now going into the voice controls increase depth needle mode now going from a long axis position make sure there's good pressure from the guide tube and there's going to be clear visualization of the needle as it penetrates the tendon and as it moves deeper until we get to the patellar pole the superior one after I get to the targeted designation now I'm going to be having some periostal pecking to elicit a better healing response of the tissue the patient will also confirm that this is the familiar pain they have during their functional activities that's how you do dry needling of the quadriceps tendon using the L7 clarus probe