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Acupuncture and Sports Medicine: the Treatment of Repetitive Injury and Strain

By Lynn Van Airsdale, M.A.O.M., L.Ac., Cert. Herbalist

            Traditional Chinese Medicine, encompassing acupuncture and Chinese Herbology, perceives pain as an obstruction of the body's Qi flow.  This can result in decreased circulation and an impaired healing process of bones, tendons, muscles and soft tissue.  Acupuncture, Chinese Herbology, and other adjuncts facilitate and improve joint and muscle recovery after trauma or repetitive strain. This is done by enhancing circulation and Qi flow, which improves the body's ability to adapt to present and future strain or injury.  TCM can be used alone or in combination with other modalities such as chiropractic, massage therapy, physical therapy, and yoga.


Western science has helped us to see the microscopic aspects and biomolecular impacts of acupuncture (see “Literature Review’) and Chinese Herbology, and the Eastern view helps us understand the story, or rather the etiology, the causation of a disease or syndrome.  In regards to physical strain and injury TCM terms this realm “Traumatology”.  This is a perfect word because it sets a stage for explaining how an injury occurred and the successive complications thereafter.  There are three main etiologies for injury and pain: 1) Qi and blood stagnation, 2) malnutrition, and 3) imbalance of Yin and Yang.  These are general headings; each can contain other imbalances and or pathological consequences.  We will explore each.


Qi and blood stagnation can occur from an initial trauma or injury.  If the injury or strain goes untreated then the stagnation of Qi and blood flow can lead to chronic pain issues and malnutrition of the injured area.  The vulnerability of this area from chronic stagnation and malnutrition can lead to easy recurrent injury of the bones, tissues, tendons, and muscles.


Malnutrition occurs from decreased blood flow to an area, which is often due to initial Qi and blood stagnation (injury or trauma).  We can look at this as decreased nutrient and oxygen flow that is vital in proper healing.   Malnutrition can also occur from an imbalance in Yin and Yang.  If there is pain with no initial injury, then it may be due to an underlying deficiency or imbalance from improper nutrition, overwork, and overstrain.  Yin, Yang, Qi and blood are the theoretical foundations of TCM.  A chronic imbalance between them results in disease and an inability for the body to heal in a sufficient manner. 


Yin and Yang are separate but inseperable entities that perform continuous back and forth homeostasis.  The health of the body depends upon a balance of Yin and Yang, which depends upon the prevalence and smooth flow of Qi and blood.  The body’s ability to recover and adapt depends upon its relative abundance of self-healing potential.  Our body and mind have great strength to take care of themselves, however, we easily can wear down our reserve power.  Often the body needs external support such as the use of modalities that will decrease inflammation, move blood, and enhance the ability to adapt to stress and injury.  Modalities within TCM include acupuncture, moxibustion, Chinese Herbology, cupping, gua sha, and shiatsu or tuina.


Acupuncture is, by definition, the use of fine needles placed at specific points along meridians with the goal to encourage Qi and blood movement and distribution.  Meridians, also known as channels, are pathways that traverse the body and provide a highway system for Qi and blood flow.  Meridians assist communication between the external and internal body.  We can compare the pathways of the nerves, blood vessels, and lymphatic system to the pathway of the meridians; all have a tendency to run parallel to each other.  The difference is that merdians cannot be dissected.  I like to consider meridians as electromagnetic pathways that influence the movement of the other systems: nervous, cardiovascular, and lymph. 

Qi can be understood in a physiological way.  TCM defines Qi as the body’s vital energy.  Qi can be considered to be one’s chemistry in motion, circulating via the meridians and influencing the movement of blood.  Qi flow can be easily impeded and the goal of TCM is to return proper Qi and blood movement.  Acupuncture, as clinical research is continuing to investigate, has specific effects on the body’s physiological processes, of which can go beyond mending injuries and chronic strains. 


Moxibustion (moxa) is a form of external herbal therapy that is used as a heating element.  It is often applied directly or indirectly to the acupuncture needles or the skin.  Moxa is usually composed of Artemisia vulgaris with the common name of mugwort.  Moxa increases blood flow, which allows for easier blood and nutrient movment towards and away from an area.  It is very useful for chronic stagnation and arthritis, as well as trauma with bruising or swelling. 


There are other external herbs that are often used as soaks or linaments with the intention of decreasing inflammation and increasing blood flow and healing.  Internal Chinese herbal therapy can be used with the same purposes, with the addition of supporting one’s constitution and their body’s adaptation reserve.  Internal herbal therapy consists of dietary/food supplementation or changes, tinctures, bulk, tea, and patents/pills.  It is always important to keep in mind the breadth of use of Chinese herbs, which act as anti-inflammatories, anti-microbials, analgesics (pain relievers), and adaptogenics (increases the body’s adaptation power under prolonged or severe stress).


Though acupuncture and Chinese herbal therapy work effectively in musculoskeletal recovery and healing, there are a few other avenues of direct muscle tissue manipulation.  Cupping, gua sha, and tuina all help break up stagnation and increase blood flow through loosening muscle and fascia.  Cupping involves the use of applying a round glass cup that has the air sucked out to the body.  The vacuum created raises the skin and superficial muscle layer into the cup.  Gua Sha involves the use of a ceramic spoon edge that is scraped in repeated strokes with pressure over a lubricated area of the body.  Tuina is considered a form of “Chinese manipulative” therapy, and looks much like deep tissue or trigger point massage body work.  One note on Shiatsu; it is often linked with Tuina, however, Shiatsu is a form of Japanese acupressure therapy and focuses on the diagnosis and treatment of the meridians, not limited to local areas of the body.


TCM approaches injury and repetitive strain within the department of Traumatology.  Several aspects are considered when diagnosing an area that has experienced trauma or chronic pain and stagnation, of which include Qi and blood stagntion, malnutrition, and relative Yin and Yang imbalance.  It is important to keep in mind the body’s own ability to heal itself, however, there are times when its reserve power is compromised and warrants outside assistance.  Assistance can be in the form of the following: acupuncture, moxibustion, Chinese herbal therapy, cupping, gua sha, tuina, and shiatsu.  The beauty is that one or all can be utilized within the course of treatment, and profound healing and recovery can occur even in the event of chronic, severe, cases.

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