Articles in Category: Acupuncture

Shin Splints

on Thursday, 02 May 2013. Posted in Sporting Injuries, Acupuncture

Shin Splints is the common term for anterior or medial
tibial stress syndrome. It is a common lower leg injury predominantly found in
those who participate in running sports.
The most common aggravating factors include an increase in training
volume, speed work or hill training or a change to a harder training surface.
In the non-running population walking on uneven ground for long periods or foot
control issues may be aggravating factors.[i]

 

 

Sports Medicine Acupuncture

Written by Richard McMahon, BSc (Acupunture), Dip Remedial Massage on Wednesday, 11 March 2015. Posted in Acupuncture, Chinese Medicine

Sports Medicine Acupuncture

By Richard McMahon

BHSc (Acupuncutre), Dip Remedial Massage

 

This series of articles aims to explain the basic considerations of modern Sports Medicine acupuncture that is still a part of the broader field of Chinese Medicine and how it is separate from what is commonly referred to as “dry needling”.

When acupuncture is used for musculoskeletal conditions the focus is predominantly on the affected tissue and external channel theory and less on internal constitutional considerations ie. organ theory. In saying that there are many cases in which the internal state of the body; dominant emotional patterns, convalescence from colds and flues, the ability to tolerate cold, wind or dehydration or generalized fatigue will have a strong effect on the musculoskeletal complaint and as such a full assessment is always made with the onset of treatment and addressed if appropriate.

The standard method of treatment of traditional Chinese acupuncture involves the combination of local points (at the site of the problem), adjacent points (nearby the site of the problem) and distal points (at the other end of the affected channel on which an injury or dysfunction is found).

In contrast, “Dry needling” as it is now known, involves the insertion of a needle directly into a painful band in a muscle. This technique is commonly used by Chiropractors, Physiotherapists, GPs and others who specialise in musculoskeletal pain. Dry needling generally involves very strong manipulation of the needle to try to obtain a muscle twitch or fasciculation and is often quite uncomfortable. The needle is not retained as is the practice of traditional acupuncture.  Dry needling is not considered a part of the acupuncture tradition springing from the work of Travell and Simons who brought to the attention of the west the awareness of trigger points ( hypersensitive nodules found along taught bands in muscle that refer pain in specific patterns). Prior to this time many patients with chronic pain were tragically considered to be more in the realm of psychotherapy, rather than for hands on treatment.

In the early days treatment involved the use of hypodermic syringes with anaesthetic or saline solution but this was found to have a comparative effective without the liquid so the term “dry needle” is used today. Interesting though is the fact that a large number of the standard trigger points are traditional acupuncture points and the referral patterns often follow the traditional channel pathways. The Chinese channel framework was not familiar to Travell and Simons at this time.

Chinese acupuncture does utilize tender point needling known as “Ashi” needling, but it is generally not as vigorous and the needle is retained in place and combined in with the rest of the treatment considerations.

In traditional acupuncture there is a saying “where there is free flow, there is no pain and where there is pain there is no free flow”.  Pain is considered to be caused by an obstruction in the healthy flow of blood and energy through the site of discomfort. This needs to be assisted to move via treatment with acupuncture, massage, cupping, stretching and movement. Heat is often used as it dilates blood vessels and encourages increased circulation and muscular relaxation. Ice is used extremely cautiously and for a very limited period of time in Chinese medicine as it constricts blood vessels. The use of adjacent and distal points is considered to be very important as they encourage the body to re-establish the circulation through the entire channel as it is seen to be one functional component of our connective tissue.

In the next instalment of this article series we will look at some of the physiological changes that acupuncture has been shown to induce in the body in regards to modulating pain and the inflammatory cascade.

 

Sports Medicine Acupuncture Part 2

Written by Richard McMahon, BSc (Acupunture), Dip Remedial Massage on Wednesday, 11 March 2015. Posted in Acupuncture, Chinese Medicine

Sports Medicine Acupuncture Part 2

By Richard McMahon

BHSc (Acupuncutre), Dip Remedial Massage

 

In part 2 of our “Sports Medicine Acupuncture” series, we will look into some of the mechanisms that have been found for the pain relieving effects of acupuncture.

As mentioned in the first part of this article the standard method of treatment of traditional Chinese acupuncture involves needling a combination of local points (at the site of the problem), adjacent points (nearby the site of the problem) and distal points (at the other end of the affected channel on which an injury or dysfunction is found). This combination of local, adjacent and distal needling ties in nicely to western research and its division of local effects, segmental effects and extra segmental system effects.

Local effects include the direct stimulation of local nerve fibres and a subsequent release of pain relieving chemicals. The triggering of a small localised inflammatory process that stimulates the release of the chemicals histamine and bradykinin. These chemicals then cause dilation of the local blood vessels and an increase in blood flow to the area. There is also an increase in collagen remodelling and thus improved healing rates in connective tissue.  And if the target tissue is a muscle, needling will improve the length tension relationship after deactivation of painful points or the stimulation of local motor points of the muscle. The effect of acupuncture on connective tissue healing will be further elaborated on in part 3 of this series.

The brain becomes aware of pain and sensory information from our skin and soft tissue through signals received by the dorsal horn of the spinal cord. Segmental effects of acupuncture refer to the needling of points near the injured tissue or along the same dermatome or myotome to moderate and inhibit the transmission of pain signals through the spinal nerve root.

Extra segmental or Central Nervous system effects refer to acupunctures ability to cause changes in the brain itself. These refer to more generalised effects such as general pain relief, improvement in mental state or sleep and it is interesting that for these effects to be measured the traditional transport points are used. These points are found between the hand and the elbow or the foot and the knee and are seen to have a stronger effect on the channel and organ systems as a whole in traditional acupuncture.

In the “Sports Medicine Acupuncture” style that is referred to in these articles it is common practice to needle the target tissue, for example an Achilles tendon (local effects). Other tender motor points in muscles supplied by the same nerve root for example the gastrocnemius and hamstring muscles (segmental effects). These would be accompanied by the points which directly release pressure at the spinal level itself for example the JiaJi points that are adjacent to the L5 nerve root and constitutionally supporting points mostly chosen from the traditional transport points(extra segmental effects).

In part 3 of this series we will look closer at the concept of the San Jiao in traditional Chinese theory and how it is related to the connective tissue support structure in the body. New research is opening a bridge between traditional channel theories and our modern understanding of the importance of fascia in regulating health.

References:

Bradnam L, A Proposed Clinical Reasoning Model for Western Acupuncture, Journal of Physiotherapy –March Vol. 31, 1

Callison M, Lecture notes for module 1 of the Sports Medicine Acupuncture Certification course, AcuSport seminars, October 2014

Hopward V & Donnellan C, Acupuncture in Neurological Conditions, Churchill Livingstone, 2010