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Ask an expert - muscles and bones - sports injuries

5 questions

Q:  I'm am thinking about acupuncture for reactivating & stimulating my left leg & glute due to a sport injury from many years ago.  I have been having physio for a year with no affect will acupuncture  help?

A: As out fact sheet shows
 
http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/sports-injuries.html
 
there is a growing body of evidence that acupuncture is being used more routinely for dealing with sports injuries. Anecdotally we are aware of a number of world athletic teams who use acupuncture as a routine part of their maintenance programme, and many physiotherapists now specialise in sports medicine in which acupuncture plays a prominent role.

 

If you have been having physio for over a year with little impact, it suggests that whatever is causing the blockage or restriction in the flow of energy to your gluteus muscles and legs is not straightforward. We are assuming that you have had a full neurlogical assessment, and if you have not, then we woudl recommend that you see your GP and arrange for this to be done. If there has been nerve damage in the lower spine, then you may need to seek specialist advice on your options.

 

Assuming that this is a straightforward failure to repair, from a Chinese medicine perspective it will be a matter of exploring whether the blockage or loss of flow, which is often the case with this type of presentation, is down to a local obstruction or whether the problem overlies a more systemic weakness or difficulty which is hindering your progress. A skilled practitioner should be able to tell you very quickly what kind of problem this is and offer you advice on how best to proceed. Visiting a BAcC member local to you will give you the clearest assessment of what can be achieved.

 

One thing we need to mention is that we often find that people trying to regain fitness tend to over-exercise in pursuit of their former levels of performance. Exerting full force on muscles, even in the super-fit, can cause micro-tears which take a few days to recover. If someone starts to exercise too soon, or carries on to work through it, it will simply a low level but continuous niggle which will not improve. We would recommend that alongside your acupuncture treatment, should you decide to go ahead, you might want to seek the advice of a specialist in sports injuries to assist your recovery. Many of these are associated with or attached to professional sports teams, and it should be relatively easy to track down one who works in your area. If they are any good their reputation will go before them!       
  

Q:  Can acupuncture help severe pain and swelling due to inflamed and torn posterior tibialis tendon? This resulted after an operation to remove navicular accessory bone 5 years ago. i have always had some chronic pain but now severe swelling and pain means I cannot work.  My GP suggested normal pain killers / rest / physio / orthotics none of which gives me relief.

 

A:  This is quite a difficult question to answer without sight of the specific problem. Generally speaking tendonitis is quite often treated by both traditional and western medical acupuncturists, and to good effect. Research of good quality is not that easy to come by because it is often individuated to specific kinds of tendon problems, such as rotator cuff injuries and specific sports injuries, and the studies are often small and methodologically flawed, as our factsheet on sports injuries demonstrates please click here 
 
You can find occasional single case studies through google, such as this one
 
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2652628/
 
which seem to show that acupuncture has a role to play in tendonitis, but our difficulty lies in being able to determine exactly what is going on in your case. We can't tell from your description whether the problem arose as a direct consequence of something done during the operation, or whether the operation as a whole then put additional strain on the tendon, causing the rupture and swelling.
 
However, one of the great strengths of Chinese medicine is that successful treatment does not depend on establishing exactly what the pattern of causation is, but in correctly identifying how the flow of the body's energies have been affected and whether this is a local problem or one which is a manfestation of a more systemic pattern. In cases of swelling and inflammation treatment often involves both the local insertion of needles and also systemic treatment to help the whole body to support the healing process.
 
The best advice that we can give you, as we do with many problems, is to visit a BAcC member local to you and seek their advice. Our main concern, given that we believe that treatment will have an effect, would be to establish how much change was effected and how sustainable it was. Many forms of treatment have an effect, often partly explained by the placebo effect of trying something new and different, but if this is always short-lived it raises questions about whether it is appropriate to carry in with treatment. We are aware that for people in extreme pain even a day's relief is a boon, but if this is so, the practitioner has to be very clear what his or her objectives are and maintain a regular review and dialogue with the patient to ensure that they carry on the work with the patient's full and informed consent.
 
 

Q. Will acupuncture help with an old football injury? I have small broken bones in my foot and arthritus, I am taking cyzpain relief but am now walking with a limp. I enjoy walking and a Munroe bagger with one mountain to finish all of them.

 

A. The adage that the longer a problem has been around, the longer it takes to shift tends to be true. It depends to a great extent on how old 'old' is. This is not simply a question of the injury itself, but of the kinds of secondary accomodations which the body has made to cope with the original problem. It is not unusual for people with a severe pain on one lower limb to start to favour the other, and the slight change in posture can then lead to lower back pain and other musculo-skeletal aggravation.

 

 

There is some evidence that acupuncture can help osteoarthritis, although clearly if a joint has badly deteriorated there is not much that treatment can offer. Reducing the inflammation may be the best that one can hope for, but relief will probably be temporary. Our factsheet here gives a good indication of the kinds of research which exist.

 

It is very likely that if the problem is quite old, you may need to consider some other kinds of help if the inflammation and pain start to reduce. Physiotherapy or osteopathy may well be a good secondary treatment for the realignment of the body's structure, and there are a substantial number of BAcC members who are dual qualified. If one works in your area it may well be worth asking their advice on what may be possible.

 

And we wish you every success in reaching the top of that last peak!

The treatment of muscular injuries by BAcC members is relatively common, and often takes place within an existing course of treatment for another presenting condition - many patients are surprised to find that their practitioner can do something about a contingent injury while they are being treated for somethin entirely different. Their experience is usually of western medicine, where each condition opens up a new path for treatment. Chinese acupuncture, however, treats the patient, not the condition, and while some things are simply a consequence of injury or accident, there are often underlying patterns which inform why the problem has arisen and how to deal with it.

There are, however, relatively few studies of the treatment of specific muscle groups, and most studies are often very diffuse, or tend to look at specific and very precise physiological mechanisms, as our factsheet on sports injuries shows.

 

Where someone has a specific injury of this kind we always recommend that they visit one of our members for a better and more informed view of whether treatment will help their specific situation. They may want to look at the way that the problem manifests, as well as asking what makes it feel better or worse, whether the time of day makes a difference, whether medication helps and whether it causes other side effects, before giving you an idea of how acupuncture may be of use to you.

Q. I have had a sports related injury since September 2011. During a football match I felt a tear in my upper leg / groin area.

I haven't noticed any information on your website regarding this area - so is it possible to treat using accupuncture?

I look forward to your response...

 

A. There is no doubt that acupuncture is used quite frequently by traditional acupuncturists, doctors and physiotherapists in direct treatment of muscle tears. The points which they use, where needles are inserted, are often the same, even though the theories on which the selection is based are often very different.

 

Heretical as this may sound to some of our members, where sports injuries are concerned it is often essential to be treated by someone who specialises in working with athletes or sportsmen because there are often additional exercises and manipulations which will aid recovery and advice about what to do and not do which will speed up healing. Many BAcC members do actually have some background in sports medicine, but there are also a significant number of physios who use acupuncture alongside conventional sports medicine to great effect.

 

Your best course of action is to start by finding out who local to you offers sports medicine, and then to ask who within that network uses acupuncture alongside conventional skills. We have no doubt that traditional acupuncture alone would be able to resolve the problem, but there will be a large component of recovery management in getting you back to full fitness, and this is an acquired skill.

World Health Organisation


The World Health Organisation lists a wide variety of diseases or disorders for which acupuncture therapy has been tested in controlled clinical trials

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