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Acupuncture For Sports Injuries?


When rehabilitation methods are simply not enough, what else may facilitate return to competition? Chiropractor, Dr. Alexander Jimenez looks at the evidence for and against acupuncture…

The use of acupuncture has been documented for centuries and it is regularly utilized in traditional Chinese medicine (TCM). Acupuncture involves the use of disposable, single use, sterilized needles to pierce the skin’s surface to a depth. The location and depth of needle insertion is dependent upon the treatment effects that are desired and the injury. Meridians; that are the channels or pathways in the body based on TCM are often followed by place.

TCM is an early form of medication that dates back to 1000BC. It’s a holistic strategy that the Chinese used to (and still do) treat anything and everything including systemic ailments, long-term illness, and psychological stresses like depression and irritable bowel syndrome. TCM aims to restore balance like our body functions require homeostasis for mobile regulation. The doctrine of TCM is to offer the stimulation to trigger healing mechanisms. The strategy has been influenced by this doctrine, in which the fundamentals remain similar, but in which using acupuncture is reliant upon proof and findings.

Why Acupuncture?



Acupuncture can offer a number of advantages, including:
  • Pain relief needles Can be put where the harm occurred in tissue or the muscle, and also the neighboring areas. Their insertion gives a minor trauma to the skin, which stimulates the production of pain relieving compounds both indoors in the injury site, and in the brain and spinal cord level. Chemicals like endorphins and opioids are discharged and pain feedback channels from the pain origin to the brain are blocked so that the level of pain perceived by the mind is reduced(1).

  • Inflammation reduction — The micro- Trauma of needle insertion also stimulates a natural anti- inflammatory reaction by releasing chemicals that cause vasodilation (blood vessel dilation) and vascular permeability (that allows greater flow of chemicals through the vessels)(2). These reactions permit the removal of inflammatory mediators in the injury site, along with recovery mediators’ improvement to the area.

  • Trigger point release — In addition to Promoting anti inflammatory and pain relieving mechanisms, acupuncture may be used to solve regions of called trigger points that were tightened. Trigger points (also referred to as muscle cramps) occur when there’s that the over-contraction of a small number of muscle fibres in one region(3). Needling in to the trigger points causes mechanical disturbance of the contracted muscle fibres to promote comfort. It also stimulates blood circulation and the delivery of nutrients and oxygen through vasodilation, and lessens the elevated electric activity in the muscle, permitting them to unwind(4).

Acupuncture In Rehab — Intense Intervention

Given the potential advantages treatment may help accelerate the return to rehab and training for athletes. With pain regulating and inflammatory reduction consequences the athlete is then placed to begin loading the injury and their body . One example is trigger point release.

Trigger points can develop after repetitive action, eccentric and concentric exercises, and in association with pain(5). The acute onset of pain from spasm or a muscle contraction is normally the consequence of overloading action without prep or adequate warm up, or the muscle, over extending it. The trigger point development providing an overall loss of function, reduce the range of movement, and might change gait patterns, will create pain.

One case study describes the acute beginning of hamstring muscle strain at a football player whilst warming up prior to a game(6). Serious injury such as a muscle tear was ruled out and the participant was considered essential to the match so instant intervention has been required. During these game situations there isn’t time for protracted rehabilitation methods and treatment can provoke disability and further pain.

The abrupt onset of pain with loss of limb motion suggested an inflammatory and component to his harm. The player received acupuncture needling into the trigger points within his hamstring muscles, along with needling along the ‘bladder meridian’ (see Figure 1 below). This is the meridian that promotes anti-inflammatory effects for the thoracic and the pain relieving. Treatment time was only 4 minutes long because the game was expected to start. However his pain levels decreased and he recovered function. He managed to play with the full match.


This case study demonstrated Intervention, which facilitated yield to play no negative effects. Trigger point acupuncture can be utilized after training or games when intense muscle spasms happen and further stimulus to relax is needed by the muscle. Where muscle contraction and additional pain can provoke, this can be a more gentle solution to this severe situation.

Acupuncture In Rehab — Chronic Facilitation

Injuries such as tendinopathies account for 30-50% of sports injuries and may be debilitating for up to 32 months(7). Tendinitis is the inflammatory stage of a tendon injury. Tendinopathies would be the result of response to therapy and unsuccessful healing. As the injury prevails, it will become persistent with degeneration of the tendon tissue and repeated microtrauma; this is a tendinopathy(8).

Athletes can be prevented by tendinopathies from training as a result of continuing pain they experience, and the doubt of the safety limits with exercise in order not to damage the tendon. This pain may dissuade athletes from doing loading Acupuncture can help by decreasing pain and allowing athletes to begin rehab involving eccentric loading of the tendon.

Patellar tendinopathy can keep athletes from sport for long periods of time. One acupuncture study emphasized a semi-professional rugby player who’d significant quadriceps muscle wastage, shortening and pain upon any action that involved the quadriceps so that he was unable to train in any capacity(9). The acupuncture treatment’s aim was to reduce pain levels enough to facilitate a gradual return to instruction. Following six sessions of acupuncture his pain decreased by pain happened frequently and greater than 50 percent. This intervention enabled him to start gentle exercises and continue to training and rugby- drills.

Another example is Achilles tendinopathy, which is still a problematic injury and accounts for 11% of all injuries. Achilles frequently contributes to gait and important limping when pain persists. A case study involving a marathon runner having a serious onset of achilles tendinopathy received acupuncture treatment over four weeks(11). These results provide some evidence that the acupuncture therapy helped to encourage healing effects enabling maintenance in the form of loading to be executed, while rest would have played a role in the healing process.


Although less researched, the the use of acupuncture has recently been applied to chronic pain, and especially ligament sprains. Regardless of being a distinct tissue from muscles and tendons, there’s absolutely absolutely no reason as to why a ligament injury would not benefit from acupuncture. The therapy has been proven to decrease pain levels considerably and allow recovery of joint range of motion with six remedies, following a nine month history of chronic ankle ligament sprain(12). This shows that despite the injury diagnosis that is specific, the effects of acupuncture can still occur when the symptoms are of inflammatory or nociceptive origin.

Working Better Together

With all strategies, a holistic and joint strategy can often offer the most speedy healing. One study provides an illustration of the use of acupuncture and other treatment approaches in patellar tendinopathy (9).

Summary

Acupuncture provides another adjunct to pain-relieving, rehab and anti-advantages, which can be stimulated via the needling the activation of receptors. Acute ailments such as the onset of pain or trigger points can be treated With acupuncture when time is restricted. Chronic conditions such as tendinopathy can also benefit, as acupuncture reduces Pain levels rehabilitation methods such as eccentric loading, weight training and sports- specific exercises. Another benefit is that acupuncture is virtually without major side effects and detrimental effect to training, making it the ideal addition to athlete rehabilitation.


References

1. Curr Opin Pharmacol. 2001; 1(1): 62-65.

2. Eur J Appl Physiol. 2003; 90(1-2): 114-119.

3. Br Med J. 2005; 39: 84-90.

4.Am J Phys Med Rehabil. 2001; 80(10): 729-735.

5. Radiology. 1999; 212(1): 133-141.

6. J AACP. Spring 2014; 103-110.

7. Am J Sport Med. 2005; 33(4): 561-567.

8. Manual Ther. 2002; 7(3): 121-130.

9. AACP. Autumn 2014; 43-51.

10. Clin Orthop Relat Res. 2008; 466: 1539-1554.

11. AACP. Autumn 2013; 87-93.

12. AACP. Autumn 2014; 67-72.

13. Acupunct in Med. 2001; 19(2): 93-102.

14. Acupunct in Med. 2006; 24(Suppl), 53-57.

15. Evid.Based Complement. Alternat. Med. 2013; DOI:10.1155/2013/581203.

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