Author: Valley Health Clinic

The Martial Arts Training Schedule: Long-Term and Short-Term Goals

The Martial Arts Training Schedule

When creating a training program for Taekwondo or any other sport, we start by addressing the client’s long-term goal. Then, we work our way into the details of more short-term goals.

In this way, short-term goals should work as a scaffold, helping to reach the client’s longer-term goal.

One way to do this is by starting with our yearly goals, and then reverse-engineering our, monthly, weekly, and daily goals. For clients who are athletes, the process is much the same; but instead of yearly goals, we look at goals for each of the three phases of a training cycle.

Training Cycle Goals

First, we’ll look through the largest lens: the yearly goal.

For athletes, the year is a cycle comprised of three phases: pre-season, competition, and post-season.

Each of these phases typically lasts between three and four months.

Pre-Season Phase

The first phase to look at is the pre-season phase. During this phase, we’re typically working on sports-specific movements and conditioning. That is, movements and conditioning that apply directly to the client’s sport.

To identify an athlete’s sport-specific movements, we look at these four categories:

1. The distance and velocity requirements of the sport.

  • Short distance
  • Medium distance
  • Long distance
  • Low speed
  • Moderate speed
  • High speed

2. The type of directional movement that the sport requires most.

  • Horizontal and/or vertical
  • Forwards and/or backward
  • Lateral and/or rotational

3. The type of resistance that is encountered during movement.

  • Heavy: ~300 lb
  • Medium: ~100 lb
  • Low: ~20 lb
  • None: ~0 lb

4. The length of rest periods between exertions.

  • No rest
  • Short rest: ~30 seconds
  • Medium rest: ~1-5 minutes
  • Long rest: ~5-10 minutes

Using Pre-Season Sport-Specific Movement in Practice

Type Taekwondo Basketball Cross Country
Distance and Velocity 26ft; High/Moderate 95ft; High/Moderate 5 miles; Moderate
Movement Lateral & Horizontal Vertical & Forward Horizontal & Forward
Resistance Low Low None
Rest Medium & Long Medium None

During the pre-season phase, we can use sport-specific movement in two ways:

  • Special preparatory exercises engage the same muscles and energy systems as the sport, but utilize different movement patterns than those used during competition.

    One example of this is barbell and dumbbell training for maximum explosive strength. General jumping drills can fall into this category as well, but are more specific and will transfer more directly to the sport.

    Special preparatory exercises for Taekwondo include the following:

    • Quarter squats;
    • High-intensity interval training with lateral jumps;
    • Rotational medicine ball throws; and
    • Single leg box jumps.
  • Special developmental exercises engage the same muscle and energy systems as the sport; unlike special preparatory exercises, they also utilize the same movement patterns seen in competition. The competitive movements are typically trained and overloaded in some way to promote adaptation.

    It’s essential that these exercises are overloading in some way. The activity must be specific to the sport, and it must overload the system enough to stimulate adaptation and growth.

    Often, people will choose exercises that are exactly the same as the sport-movement, and they’re not overloading the system in any way.

    With special developmental exercises, the key is pushing the athlete to produce more force, or to move at a higher velocity, than they usually would in the ring. Overloading one of those qualities is what creates growth. (Tip: resistance bands are a great way to increase resistance for kicking.)

    Example: A standard Taekwondo match is contested over three 2-minute rounds with a rest of 1 minute between rounds. To create overloading in practice, we can change these variables.

Overload Rounds Length Rest
Number of Rounds 4 2 Minutes 1 Minute
Length of Rounds 3 4 Minutes 1 Minute
Rest Period 3 2 Minutes 30 Seconds

Competitive Phase

The next phase is the competitive phase, during which your client competes in their sport.

During this phase, the focus is again on sports-specific training. But we should spend less time building strength and cardio, and more time executing plans. (Focusing too much on strength-building and cardio in this phase increases the likelihood of injury and underperforming during competition.)

We want to continue strength-training so that we don’t lose any progress from the pre-season phase. But want to make sure not to overwork our athletes.

Another difference from pre-season is that in pre-season, you may work on more on special preparatory exercises, while in the competitive phase, you may work more on special developmental exercises.

Post-Season Phase

Last, we have the post-season phase. This is the time for the body to recover from competition. The goal during this phase is focusing on general physical fitness.

Post-season is also an opportunity to have fun, learn new skills, hone new movements and develop different energy systems.

General physical fitness can be categorized into the following movements and energy systems:

Movements

  • Squat/hip hinge or hip extension;
  • Single leg lunge;
  • Upper body press;
  • Upper body pull;
  • Forward flexion/v-sit; and
  • Rotational or twisting exercises.

Energy Systems

  • ATP-Phosphocreatine;
  • Glycolytic System/lactic acid; and
  • Oxidative System/aerobic.
  • These exercises engage different energy systems and movement patterns than those that are involved during regular sports performance training.

    General fitness exercises in this phase can be thought of as rehab: they won’t transfer to the sport directly, but instead, work to build a solid foundation of health and movement.

    Focusing on general fitness in this way is especially useful for young athletes; sports-specific development can cause imbalances if training is done incorrectly.

    This is also a time to focus on new skills. During the competition and pre-season phases, it’s unproductive to throw in new techniques that can’t be adequately learned and executed. But the post-season phase is the perfect time to do so.

    Tips for Taekwondo

    Taekwondo is different from most sports in that there are three main skill sets: forms, sparring, and self-defense.

    These skillsets overlap, but they’re also unique, and each has its own specific needs.

    Keep in mind that training for Taekwondo is like training for a triathlon rather than for basketball.

    In general, it’s best to have each workout focus mainly on one discipline. For example, Monday and Wednesday focus on sparring; Tuesday and Thursday focus on forms; Friday focuses on self-defense.

    During the post-season phase, workouts can incorporate more self-defense training, and during the competition phase, you may want to drop self-defense altogether because it’s not crucial at this time.

    Taekwondo matches are three 2-minute rounds, generally with 45 seconds between them, depending on the event. But at Nationals, Pan Am Games, US Open, or World Championships, a fighter will often have more than 40 competitors in their division. To win gold in this case, they have to win five–or even six–matches. This requires enormous endurance. Essentially, you have to take what you would do to prepare for one match, and then multiply it by six or seven.

    Matches are taxing–mainly to the ATP-Phosphocreatine and glycolytic system (lactic acid). But the recovery period after an activity is purely aerobic.

    The aerobic system in comparison to other systems can create the highest number of ATPs from a single glucose molecule, but it requires a more extended period to do so.

    For longer events, aerobic exercise comes into play. This does a few things for an athlete in the ring:

    • The athlete is not worried about getting tired, so there’s no having to think about conserving energy. He’s able to attack at will and not be winded at all.
    • When he attacks, he can choose how long the attack lasts without worrying about tiring.
    • When he does make it to the semi-finals and finals, he’s still fresh and ready to go.

    We found that conditioning is perhaps more important than technique at a certain point. Everyone can kick pads and things like that. But not many can do it full-bore for 5 or 6 matches. If we expect to have 5 matches to get to the finals, that’s 15 rounds plus the chance we are tied and go to golden round (golden point/overtime). So we train for 20 rounds allowing for the overtime and then, to be sure we don’t run out of gas we train for 23-25 rounds.

    Monthly, Weekly, and Daily Goals

    After addressing the long-term goals, we can now delve deeper into short-term goals on a monthly, weekly and daily timeframe.

    Monthly
    It’s essential to have a monthly goal because body adaptation–whether it’s mental or physical–takes time and repetition. Switching up goals too frequently will decrease long-term retention.

    Weekly
    Weekly goals are a breakdown of monthly goals into achievable smaller goals. In general, these goals will move from basic to more advanced.

    Early on when learning a new skill, most of the adaptation is neurological, which means coordination is the most critical aspect.

    It’s vital to learn the perfect technique with low to medium intensity, going through the motions and acquiring the necessary skills slowly. When the athlete is comfortable with a new method, then you can increase the intensity, speed, and randomness.

    Lastly, you can begin to increase the conditioning difficulty to try and maintain perfect form at longer intervals and higher intensities. Start with higher reps, and move to a higher velocity.

    You must first learn the technique correctly and safely to be able to use the technique in a competitive and variable environment.

    In this way, you’re able to use high repetition to teach correct form, which reduces the risk of injury when the movement is performed in a variable environment at high velocity. The progression allows for the transfer of training to competition.

    When picking weekly conditioning exercises and drills to supplement and improve the sport, we ask ourselves, “How do these drills and exercises transfer to the athlete’s performance in the ring?” This concept is known as the transfer of training.

    Tips for Transfer of Training

    • Use sport-specific movements and energy systems. Match categories (see pre-season).
      • The distance or velocity requirements of the sport.
      • The type of movement that the sport utilizes the most.
      • The type of resistance that is encountered during movement.
      • The type of rest/ energy system.
    • Look for similarities between previously-learned skills and new skills.
    • Maximize the similarity between training activities and competitive conditions. Simulate various elements of competition (e.g. arousal level, game intensity, spectator noise) occasionally during training sessions, particularly during the competition phase.
    • Provide adequate experience with fundamental skills before advancing to more complex skills. Well-learned lead-up skills can positively influence an athlete’s performance in more demanding conditions at the next level of play (e.g., T-ball to baseball).
    • Develop more general capabilities, such as critical gross motor skills, which apply to a variety of sport tasks. For example, in basketball, the vertical jump is a key element of rebounding and blocking shots.
    • Point out to the athlete how training activities will improve sport performance. For example, call attention to the shifting of weight, the hip lead, and the arm movement in softball throw when teaching the javelin throw.

    Daily
    When structuring a workout for a taekwondo athlete, there are two daily goals: practicing a skill to improve performance and conditioning to improve the performance.

    A general rule of thumb is that the skill comes before the conditioning. In other words, neurologically-taxing activities should come before physically-taxing activities. Neurologically-taxing activities involve paying attention, like when you learn and practice a new skill. You’re building new neural pathways and connections in the brain.

    High-intensity training and efforts approaching 90% of the athlete’s capability are also severely taxing on the nervous system. In other words, weight follows speed–not only in the chronological sense (you go to the weight room after doing sprints and jumps on the track) but also in terms of priority. The more speed, power, and intensive, high outputs that an athlete is capable of, the less they need to do in the weight room.

    Energy Management

    An athlete’s energy every day, week, month, or season is like a cup with a limited amount of space: every stressor and stimulus imposed on an athlete is like a drop in that cup. The more stressful the activity, or the bigger stimulus, the larger the drop.

    Part of our job as a trainer is deciding what should take up the most space in that cup–which stressors to impose at what times. Generally speaking, we want the most significant portion of that cup to be taken up by sport-specific practice.

    The amount of space sports practice takes up will vary depending on the time of the year, but the thing that’s always the most beneficial to athletes is practicing their sport. Sports practice is the only irreplaceable part of an athlete’s training, so that’s what should fill the cup the most and what we should reserve the most space for.

    After that, sprinting and jumping drills likely have a higher correlation to sporting success than most lifting movements. If a movement happens fast in the sport, faster movements are going to correlate better compared to slow ones.

    Teach, Learn, Compete

    There’s a lot to remember when you’re strategizing for a martial arts training schedule. But a good acronym to use is TLC: teach, learn, compete. At the beginning of a workout or training cycle, you teach by example. Then, you give the athletes learning opportunities with controlled focus drills. Finally, the athlete transfers their skills to compete in a more variable environment.

    Rethinking Muscle Cramping and How to Treat It

    Rethinking Muscle Cramping and How to Treat It with Valley Health Clinic in Albany, Oregon

    Contrary to popular belief, muscle cramping after exercise has little to do with dehydration and electrolyte imbalance. While hydration and electrolyte restoration are important following a bout of intense exercise, there’s much more to cramping than formerly understood.

    In this article, we will discuss the real reasons behind exercise-induced muscle cramping and address treatment methods for this condition.

    Myth of Electrolytes

    A study of 43 triathletes reported cramping (cramping group) and were compared with the 166 who did not report cramps (non-cramping group). There were no significant differences between groups in any pre-race–post-race serum electrolyte concentrations and body weight changes. The development of cramps was associated with faster predicted race times and faster actual race times, despite similarly matched preparation and performance histories in subjects from both groups. A regression analysis identified faster overall race time (and cycling time) and a history of cramping (in the last 10 races) as the only two independent risk factors for exercise associated muscle cramps (EAMC).

    The study suggests that electrolyte levels are not a factor in cramping. Rather, competing at a faster pace and high intensity then what is normal can cause (EAMC). So why is this? The most up-to-date scientific theories attribute exercise-induced cramping to a body state called “alpha motor neuron excitability”. It may sound complicated, but alpha motor neuron excitability is relatively easy to understand and identify.

    Read more: https://bjsm.bmj.com/content/45/8/650.short

    Alpha Motor Neurons Explained

    Alpha motor neurons (also referred to as alpha motoneurons) are an essential part of the body’s central and peripheral nervous systems. They’re present in the brainstem and spinal column, and they’re directly responsible for telling muscles when to contract.

    Any time you contract (flex) a muscle to make a movement (for example, when you take a step, grasp a pencil or touch a finger to your nose), you’re putting your alpha motor neurons to use. During a bout of intense exercise, your alpha motor neurons work overtime.

    Importantly, when it comes to understanding muscle cramps: the more active your alpha motor neurons are, the more prone your muscles are to contracting when you don’t necessarily want them to.

    What is Alpha Motor Neuron Excitability?

    Alpha motor neurons are an essential part of the body’s nervous system. However, they must strike a delicate balance with other neurons and body systems for your muscles to work correctly. One of these balancing agents is the Golgi tendon organ, which we’ll discuss in more depth further on.

    When these systems become out of balance, your alpha motor neurons aren’t properly kept in check, and they enter a state of excitability. And since alpha motor neurons cause our muscles to contract, the result of this excitability is involuntary and prolonged muscle contraction: i.e. muscle cramps.

    Causes of Alpha Motor Neuron Excitability

    There are several factors that can cause alpha motor neuron excitability, including the following:

    • Fatigue
    • Dehydration and/or malnutrition
    • Inadequate conditioning
    • Muscle damage

    Just one of these factors can lead to alpha motor neuron excitability and subsequent muscle cramping. However, the real problem begins when several of these factors coalesce, causing more severe excitability, and therefore, more intense pain.

    Understanding the Golgi Tendon Organ

    As briefly mentioned above, the Golgi tendon organ (GTO or tendon spindle) is one of the most important balancing agents to the body’s alpha motor neurons. Golgi tendon organs are proprioceptive sensory receptor organs, located in the tendons, adjacent to the myotendinous junction (MTJ).

    So, how do the Golgi tendon organs located in the tendons keep alpha motor neurons in balance, and how can this aid in treating muscle cramps?

    The Golgi tendon organ performs almost the opposite role of alpha motor neurons. Whereas alpha motor neurons tell your muscles to contract, the GTO’s role is to make sure your muscles don’t contract too forcefully.

    When the body is fatigued, not only does alpha motor neuron activity increase, but Golgi tendon organ activity decreases, furthering the potential for unwanted muscle contractions.

    This is important in understanding muscle cramps and how to treat them because by stimulating the Golgi tendon organ, we can essentially “switch off” unwanted muscle contraction.

    The Answer is TRP Channels

    If you’re familiar with the electrolyte depletion theory, you may be familiar with the theory that pickle juice relieves muscle cramps. It was originally thought that pickle juice does this by balancing electrolytes in the body. We now know this is not true. A study by Miller found that it takes pickle juice 30mins to leave the stomach and that the cramp revealing effects happens much faster. Instead, the researchers theorized that pickle juice worked to inhibit the firing of alpha motor neurons by triggering a reflex-response in the mouth, throat and stomach called transient receptor potential (TRP) channels.

    https://www.ncbi.nlm.nih.gov/pubmed/19997012

    https://www.ncbi.nlm.nih.gov/pubmed/21062184

    TRP Channels and Muscle Cramps

    TRP channels are pathways through which the body transports positively charged ions (i.e. magnesium, sodium, and calcium). These pathways, or channels, can be stimulated by small molecules like capsaicin and menthol, and by spices like red pepper, cinnamon, ginger, and mustard.

    Numerous physical scenarios can also be explained by the alpha motor theory, where they cannot be explained by the traditional serum electrolyte depletion theory alone. For example, marathon-runners often suffer cramps when fully hydrated and electrolyte-balanced

    TRP channels help the body rapidly and accurately interpret the surrounding environment and adapt. And when it comes to muscle cramping, strong simulation of the TRP channels can calm alpha motor neurons and diminish cramping (fasebj.org)

    Read More: https://www.sciencedirect.com/topics/neuroscience/transient-receptor-potential-channel

    Cramps and the Taste of Herbal Medicine

    Since ancient times, Chinese herbalists have classified medicinal materials according to their tastes. The taste was understood to have a relationship to the effect of the herb when ingested. This relationship was seen as having great importance in guiding the combining of herbs within formulas. In most traditional Chinese herb books, taste was the first property of an herb to be mentioned, helping to orient the reader to the information that followed. There are five tastes—sweet, salty, sour, bitter, and acrid (sometimes called pungent or spicy)—consistent with the five element concept.

    It is reasonable to raise the question whether or not the tastes really have a strong correlation with herbal effects. Now that we know about Transient receptor potential channels and their location in the mouth and esophagus, the answer to this is yes.

    If we take pickle juice as an example of a way to control cramps and overexertion. It’s flavor is sour. Lemonade is another example of how sour can control the outward energy of excessive sweating and fatigue. There is norther better then a cool glass of lemonade on a hot day.

    There are two major connotations of the sour taste in Chinese medical theory:

    • In five element systematic correspondence, the sour taste is associated with the liver. It has a moistening and softening effect, usually reducing contraction of the ligaments and tendons. Persons who are overly flexible may find that the sour tasting herbs worsen that condition. Peony, cornus, achyranthes, are among the main sour herbs used to affect the liver function and said to relax the tendons.
    • According to the taste/action dogma, the sour taste has an astringent and fluid recollecting function (that is, helping to reabsorb fluids as they begin to escape). Chinese medicine considers the sour and astringent qualities as restraining the leakage of any fluid, including perspiration, and blood. Tannins, a class of complex molecules with notable astringent effect, are present in some of the herbs. Schizandra, terminallia, cornus, and sanguisorba are commonly used as astringents.

    Here is a Formula that can help with muscle spasm and cramps:

    • Bai Shao (Radix Paeoniae Alba) and Gan Cao (Radix Glycyrrhizae) are commonly combined to relieve muscle spasms and cramps. Clinically, they may be used for musculoskeletal spasms and leg cramps associated with external or sports injuries.
    • (Radix Paeoniae Alba) and Gan Cao (Radix Glycyrrhizae) have strong antispasmodic and anti-inflammatory effects as confirmed by modern research. Furthermore, Bai Shao (Radix Paeoniae Alba) and Gan Cao (Radix Glycyrrhizae) are effective in treating both skeletal and smooth muscles.

    Summing Up Exercise-Induced Muscle Cramps

    It’s easy to see how muscular fatigue—like that following a bout of intense exercise — can wear down the body’s natural systems and balances, leading to muscle cramps. When the body is fatigued, alpha motor activity increases and Golgi tendon organ activity decreases, leading to painful and involuntary muscle contraction. But by understanding the root cause of exercise-induced muscle cramps, and that TRP and taste has a strong we can better treat the issue in sports acupuncture and herbal medicine.

    Proprioception in Sports Acupuncture

    Proprioception in Sports Acupuncture

    Strictly using our orthopedic acupuncture methods, we can quickly get a suffering athlete out of pain.

    However, after that pain—what we do next—can make all the difference. After an athlete of ours has gone through treatment, they are at a vulnerable phase, and if not treated correctly can easily re-injure themselves.

    At this point in treatment, their are not working optimally at 100 percent just yet, with their muscles “turned off”. Critically, these muscles need to go through yet another stage to get them back on again to function as effectively as possible.

    Deeper Look at the Turn-Off Point

    Before we find that on-switch, let’s look into what happens in the off-stage:

    • Competitive Plasticity connects directly to the state the muscles are in. If the athlete is not able to perform a particular skill or use this set of neuronal connections at this point, their brains will re-purpose them to use for something

    If your athlete has hurt him or herself, the brain will stop using that muscle and decrease range of motion to allow it to heal, which can explain why during an athlete’s ankle sprain, the joint’s movement is very limited.

    • Damage to the Proprioceptive System may also cause the ‘turn off’ of the muscle. Proprioception is the term used to describe an athlete’s awareness of their body and its movement.

    This ability in an athlete (or anyone else for that matter) can be hindered or impaired when that particular ligament or tendon in the joint is injured. Since the proprioceptors are generally located in this area, this can cause an unstable sensation in the joint.

    If your athlete is suffering from an ankle sprain, the damage to the ligament’s neurotendinous spindle can cause even more problems ahh the origin and insertion point of the skeletal muscle fibers and tendons of the skeletal muscle—which will lead to the giving out of the joint.

    Conclusive Data and Its Connection

    This damage is not just a theory.

    Through multiple studies, it was concluded that an alteration of proprioception occurs in patients or athletes who have ankle injuries or unstable ankles. The have found that impairment in the proprioception can lead up the kinetic change from ankles to knees, hips, and lower backs.

    This weakness and turn-off point can be treated through orthopedic techniques. However, just as will be explained in this article, the distal methods or press tacks are often found to be much more effective.

    What Are Press Needles?

    These intra-dermal needles can help make that relationship work between acupuncture treatment and exercise all at once. While the patient or athlete may be having trouble with a particular movement or exercise, press needles can be implemented to help with the mild pain or lack of proprioceptive awareness.

    Although press tacks increase skin sensitivity, which can supplement feedback and improve it’s important to note, however, that it has been proven to successfully work only in people that have a dysfunction.

    When Are They Effective?

    With an athlete’s busy schedule, it’s hard to find the time to lay on the table for traditional style treatment. However, with the combination of press tacks, tape, and other aids, you can get them game-ready without hindering performance whatsoever.

    How Do They Work?

    By implementing the insertion of the press needles during exercise at specific points, the proprioceptive system of the athlete will have added input. This can help remove all the type of obstructions that may be occurring at different channels which leads to discomfort.

    While using the press needles, you need to also be aware of the patient’s level of discomfort or pain. If they are experiencing too much, it’s normally a sign that the exercise is too difficult or painful for the injury.

    The needles are also responsible for improving the movement of qi and blood in the jing luo. It has a direct impact on movement patterns.

    A Deeper Look

    In understanding the functional role of proprioception, it is crucial to be able to distinguish this proprioception from the athlete’s tactile senses.

    The tactile senses are information drawn from the skin’s mechanoreceptors. The information being sent off can include pain, temperature, and movement, helping the become much more aware of their surroundings.

    The need to distinguish between this and proprioception is important—and also very difficult to do. The concepts are very similar to one another because both of them contribute to the movement of a person, his or her accuracy in that movements, consistency, and force adjustment in their power.

    They are even more connected because tactile feedback actually is used in proprioceptive feedback—through augmentation of estimating movement distances—which makes them even more intertwined.

    Regardless of their similarities, however, it is important to note that there is a distinct difference in two organs: proprioceptors and mechanoreceptors.

    Making The Comparison

    The two organs, in these functions, seem to work as allies.

    The propriocetors are the primary source of information. They are found in the tendon ligaments, joint capsules, and the muscles.

    The mechanoreceptors secondary source of this necessary data for your body can be found through the deep skin fascia layers and the skin’s tactile sensation.

    While making the comparison, you cannot avoid the impacting role the location of the muscle and joint plays on the body. The relationship between proprioceptive perceptions also tends to differ depending on the area of the body.

    For example, highly ligamentous and sensitive skin of the hand will use a different proportion and magnitude of proprioceptive input than an area like the hip will.

    The areas of the ligament, joint capsules, and skin also receive the most input while they are stretched to the end of their individual range of motion, where tension is rather high.

    The muscles spindles, on the other hand, are measured equally across the entire range of motion.

    Implementation in Our Practice

    If you want to improve the proprioceptive system, you have two ways

    • Enhance sensitivity of the proprioceptors
    • Enhance neurophysiological efficiency of signal conversion and transmission.

    In other words, we can either increase the signal or find a way to make the path more effective.

    Our ultimate goal being to overcome our central nervous system limited attention capacity. To move away from motor and movement skills and into cognitive demands like anticipating movements. Through treatment, your patient or athlete will also spend much less energy on the actual motion in their body and can use it to evaluate the playing field.

    This can help an athlete anticipate injury (before it happens) because they are then much more observant and aware of their surroundings during play and less on what they are physically doing.

    Boosting the signal, increase the muscle stiffness which increases ligament and tendon output or skin sensitivity with press tacks and tape. To help improve the pathway, we simply need to use the neural pathways with practice.

    A closer look:

    • The Signal

      Patients or athletes who generally have good proprioception do not tend to benefit from patellar taping. However, when taking a closer look at the healthy subjects with poor proprioceptive ability, patellar taping actually provided proprioceptive enhancement as measured through active and passive ankle reproduction.

      Although further studies are needed to investigate the effect of patellar taping on the proprioceptive status of patients with patellofemoral pain syndrome, the data thus far is deemed promising.

      Contrary to popular belief, a balance training strategy does not improve proprioception. It instead focuses on the Central Nervous System’s ability to control neuromuscular and musculoskeletal factors. It improve the muscle and skill of balancing.

      Done correctly, balance training is deemed crucial in patients who need to control slow to moderately fast, conscious and reactive movements in a closed loop. A single leg stance can be improved greatly through this type of training.

      Unfortunately, balance training will not help with postural reflex against an unexpected disturbance since it simply isn’t fast enough.

      For example, during an impact movement like running, an athlete’s ground reaction force will happen within less than the first 50 milliseconds. Although this seems extremely fast, it is a large enough span of time for the ankle to invert at a dangerous angle and cause injury.

      The balance or proprioceptive system reacts at a slow rate of 100 milliseconds in response to external imbalances. There is no way that a healthy system can respond in time to prevent this sort of injury. This is why for performance and injury prevention we need athletes increase focus on enviromental factors.

    • The Pathway

      If you are working a healthy individual, a much better strategy is simply to focus on the presentation of that injurious joint position instead of the aftermath reaction from the proprioceptive system.

      This anticipatory present of correct joint alignment and protective muscle stiffness is the correct strategy in this situation.

      A deeper look in the strategy would focus instead on teaching proper body mechanics and movement patterns to the athlete while in motion. This little details—like proper body alignment—will help in transferring the athlete’s center of gravity and weight down to the hip, knee, and ankle. This is important for safety during direction change while running.

      In addition to balance training, plyometrics can also be used, which helps train the neuromuscular system to hold proper muscle tension—in the stretch-shortening cycle—and with body mechanics.

    Avoiding Athlete Joint Injuries

    To help an athlete avoid getting injured, we, as professionals, need to establish adequate motor behavior in our patient.

    We can do this through two theories:

    • The Motor Program-based Theory: This is a Top Down theory. In this theory, the CNS will store motor programs and be trained to retrieve them when necessary. With this method training is often through repetition.
    • The Dynamic Pattern Theory: this is a Bottom up theory. In this theory, movement coordination is instantly controlled based on the information that is relayed in the environment. Here we can emphasize the interaction between the patient and his or her CNS reaction to the environment. With this training method use balance beams, resistance bands or obstacles .This sort of sensory information force a learning response.

    For an effective training program, you should really have both theories integrated within. It should involve repetition of skills, improving memory-based motor functions, and changing of the sensory environment, which can help stimulate dynamic patterning.

    Treating An Athlete’s Injury

    For an effective treatment program post-injury, balance training not only improves balance after the injury occurs but can also reduce the rate of repetitive injury from happening.

    If your athlete or patient cannot find balance or incorporate a stable structure into their movement while not moving—during movement will be that much harder.

    A Closer Look At Balance

    Balance is achieved and maintained by a complex set of Peripheral Receptors.

    These include sensory input from a few things, including:

    • Vision (sight)
    • Somatosensory (touch)
    • Vestibular System (motion)

    This means that a balance program can affect a few very important concepts in an athlete’s performance.

    When taking an even closer look at balance, you will find that an athlete’s ankles, toes, wrists, and fingers are the most active and dominate muscles commonly used. Within these joints, there are multiple articulating structures that allow for small adjustments throughout movement.

    An athlete’s core is also very active during balance exercises but is only focusing on stability during more gross movements.

    A Closer Look At Balance Programs

    While going through the balance program, the exercise can progress as the athlete or patient improves through:

    • Eyes open, which allows for the three systems to function.
    • Eyes closed, which allows for the two systems—touch and motion—to function.
    • Eyes closed with head movement, which allows for one system—touch—to function.

    For beginners, exercises should be performed successfully first with their eyes open, then again with their eyes closed. If the exercise cannot be done with their eyes open, it is advised to not progress on to the next step.

    Head motion should only be used for advanced athletes.

    For a quality exercise program, progression should start from the core, then head to the knees and elbows—activating the shoulder and hips—then the hands and feet—which should then activate the forearm and calves.

    Training Healthy Athletes

    Working with a healthy athlete can lead to a whole new challenge.

    Although balance training can fix broken proprioception or help improve unstable back and ankles in athletes, it does not improve the proprioceptive system in healthy patients.

    This means that a healthy athlete will get very little out of traditional balance training when simply looking into injury prevention.

    Instead, look into creating an ideal learning environment for the CNS.

    This means that an exercise program should distinctively train different motor skills with adequately changing task goals and visual environment.

    This training should help a healthy athlete’s CNS overcome its limited attentional capacity by adequately imposing multiple task demands.

    A Closer Look

    Researchers suggest that skill-focused attention is important during the initial stage of motor learning, but then becomes counterproductive for the experienced individual.

    Researches have also noted that multiple task training—for example, motor and cognitive demands—were more effective for performance developments of experienced athletes.

    After athletes have perfected a movement or skill, the limiting factor to advancement is how quickly they can interpret their environment. Can they read their opponent while playing? Can they look down the field for an opening or weakness while still moving?

    This is focused on the concept of cognitive demands.

    Post-Exercise Recovery: Research & Perspectives

    Post-Exercise Recovery: Research & Perspectives

    While much of sports acupuncture today focuses on the treatment of injury (pain relief and restoration of strength), there is a much larger field that acupuncturists are uniquely qualified to treat, yet often skip over: post-exercise recovery.

    Recovery is a vital component of an overall exercise or training program. It’s essential for high-level performance and continued athletic improvement. With the appropriate recovery treatments–including acupuncture–athletes can achieve higher training volumes and intensities while avoiding many of the detrimental side-effects of overtraining.

    Purpose

    This essay aims to present and analyze the research and perspectives on the complex topic of post-exercise recovery and the role of sports acupuncture therein.

    Primarily, it will look at the parasympathetic system, how it affects recovery, and how it is stimulated by acupuncture practices.

    It will also address the physiology of the time period immediately after exercise as an important biological phenomenon that acupuncturists can use to the advantage of their clients.

    Finally, this essay aims to show that sports acupuncture professionals can and should play a larger role in helping athletes recover after exercise.

    What is Recovery?

    Defining exercise recovery is a challenging task: there are many varied definitions of “recovery”. In the sports acupuncture world, the two most common definitions or views of recovery are as follows:

    • As a distinct period of time. Recovery can refer to a specific time frame. This period of time can range from minutes, as in the case of the heart rate returning to near-resting levels, to weeks, as in the return of strength after muscle-damaging exercise.

      These time frames also vary from person to person. For example, a trained athlete will display a different recovery timeline from that of a healthy individual. Both of these individuals will display vastly different recovery timelines than that of a person who is chronically ill.

    • As a physiological state or process. “Recovery” can also refer to a certain set of physiological processes or states which are distinct from resting physiological states and from the physiological state of exercise.

      This view of exercise recovery is usually localized: it assesses whether the muscles are ready to perform on the day of an event, or if they are weakened or injured.

    Within these two definitions of recovery, treatment strategies tend to focus on symptoms of exercise-induced muscle damage and mainly work to blunt the inflammatory responses associated with muscle injury.

    Treatments that are based on these perspectives of recovery typically aim to hasten regenerative processes of the muscles with limited consideration for other mechanisms (Minett and Duffield, 2014). This may be through lifestyle (active recovery, sleep), physiological treatment (post-exercise cooling, massage, compression), or nutritional and pharmacological interventions (supplements, anti-inflammatory medications).

    These perspectives of recovery are too narrow, and they exclude factors such as illness, sleep, and psychology. These each have a significant impact on recovery and must be managed, in conjunction with the methods described above, in order to allow better performance and reduce the risk of injury.

    Evidence for Expanding the Definition of Recovery

    Various studies have found that single session of intense exercise and prolonged heavy training negatively influences the immune system function (Pedersen, 1998). This was done primarily by measuring SIgA levels, with SIgA being the predominant immunoglobulin found in the saliva other mucosal fluids. It neutralizes toxins and viruses and inhibits the attachment and replication of pathogens (Gleeson et al., 1999).

    These studies have demonstrated that (Mackinnon et al., 1993):

    • Frequent upper respiratory tract infections (URTI) in elite athletes result in suppression of salivary secretory immunoglobulin A (SIgA) levels.
    • The exercise-induced decrease of salivary SIgA was inhibited in the acupuncture treatment group during a competition period.
    • The data suggests that acupuncture treatment enhances SIgA secretion in the saliva during the period of continuous physical exercise.
    • Therefore, it is possible that the increased risk of URTI in athletes during the competition period is due to a decrease in SIgA levels.
    • Acupuncture treatments could reduce the likelihood of infection in athletes and maintain their physical wellbeing by improving levels of SIgA and immunogenic actions.

    Sympathetic vs. Parasympathetic Involvement in Exercise Recovery

    The human body is intelligently balanced with a complex, built-in network for adapting to stress. This network is known as the autonomic nervous system, and it is comprised of two unique subsystems: the sympathetic nervous system (SNS) and the parasympathetic nervous system (PNS).

    The parasympathetic and sympathetic nervous systems both deal with metabolism, which is a biochemical process within the body that allows healing, growth and adaptation. Metabolism is the pattern of building up and breaking down resources within the body, and can be divided into catabolic and anabolic processes.

    The SNS is catabolic, meaning it breaks down resources, usually creating energy that is easily accessible. It mobilizes the these vital resources to help the body defend itself when it’s in danger. The sympathetic nervous system is what sends you into “fight or flight” mode in threatening situations. This system is upregulated during workouts, but ideally, the body only uses the SNS to its full capacity in life-threatening emergencies.

    The PNS is anabolic, meaning it builds up resources within the body, usually requiring energy to perform. The parasympathetic nervous system allows the body the resources it needs to adapt and recover. It helps the body to rest, digest, and recover after workouts and strenuous activity. A well-balanced nervous system spends most of its time on parasympathetic activities. An active PNS helps muscle soreness and swelling subside more quickly.

    Athletes are vulnerable to becoming SNS-dominant because they experience increased physical stress on a routine basis. By spending more time on sympathetic activities–and, therefore, less time on parasympathetic activities–an athlete’s nervous system will have a harder time helping the body recover.

    In addition to the physical stress athletes experience regularly, emotional/mental stress can also play a role in an athlete becoming SNS-dominant. The following stressors can put an additional burden on an athlete’s nervous system:

    • Stress at home or at work;
    • An upcoming event or season that requires increased training intensity and/or frequency;
    • Nervousness or anxiety about an upcoming event or season;
    • Acute or chronic psychological disturbances including depression or anxiety;
    • Physical illness, either transient or chronic; and/or
    • Restricted caloric intake due to an upcoming weigh-in or their sport having another weight component (i.e. wrestling or ballet).

    Most athletes will fall into at least one of the above categories. In addition to the regular physical stress their bodies undergo, stressors like these can tip the balance towards the sympathetic nervous system and strain the body’s natural process of maintaining homeostasis.

    This is especially true if pertinent treatment methods are not used to minimize sympathetic dominance and boost parasympathetic activity.

    Evidence of Sympathetic Dominance by Heart Rate Variability

    Heart rate variability (HRV) is a measure that indicates how much variation there is in your heartbeat intervals. The more consistent your heartbeat intervals within a given time frame (i.e. 60 seconds), the lower your HRV. The more varied the lengths of the intervals between your heartbeats, the higher your HRV.

    Heart rate variability has been found to be a valid indicator of decreased parasympathetic response and/or increased sympathetic activity.

    Researchers have found that parasympathetic activity or increased sympathetic activity will result in reduced HRV (Billman, 2013). Though previously thought to reflect only SNS activity, it is now widely accepted that changes in heart rate variability express variations in both the sympathetic and parasympathetic nervous systems (Haker et al., 2002)

    In a study by James, Munson, Maldonado-Martin & Croix (2012), subjects participated in an intense exercise session (defined as running 800 meters six times at 95% VO2 max with a three-minute recovery period between each run). The subjects experienced an increased sympathetic influence on the heart and heart rate variability and a decreased parasympathetic response (James et al, 2012).

    While the subjects in this example returned to baseline numbers after 24 hours, the study demonstrates that repeated, intense exercise stressed the subjects’ ability to engage parasympathetic responses and maintain homeostasis.

    Acupuncture & the Parasympathetic System

    When an athletes is under stress, such as during intense physical training, his or her autonomic nervous system can deviate, leading to the athlete’s becoming sympathetic-dominant. In this state, the athlete’s parasympathetic nervous system is impaired, causing the athlete to experience more difficult recovery. A full restoration of the natural balance between sympathetic and parasympathetic is the ideal solution.

    In western medicine, there aren’t many safe maneuvers to enhance parasympathetic performance while suppressing sympathetic functions. Acupuncture, however, is one of the most effective tools for doing just this.

    Various experiments have shown that acupuncture treatment does in fact modulate the autonomic nervous system, in addition to alleviating muscle tension, improving local blood flow, and increasing pain threshold (Barlas et al., 2000).

    One example is a study of hypertensive rats, wherein direct stimulation of the sciatic nerve produced decreased sensitivity to pain and a profound decrease in arterial pressure and activity in the splanchnic sympathetic nerve. The change lasted for several hours following treatment (Yao et al. 1982).

    Another study showed that magnitopuncture–a combination of acupuncture point pressing and magnetic treatment at Dazhui (DU14) and Neiguan (PC6) points–resulted in reduced sympathetic nerve activity and increased parasympathetic nerve activity at the end of a three-hour simulated driving task (Li et al.2003).

    It was also reported that needle insertions in the vagal innervated area of the ear could reduce narcotic and alcohol withdrawal symptoms and the underlying physiological mechanisms–a result of increased parasympathetic nerve activity (Mendelson et al., 1978)

    More data pointing to the fact that acupuncture can upregulate the parasympathetic nervous system found that acupuncture can induce release of endogenous (natural) opioids (Basbaum et al., 1984; Holaday et al.,1983; Terman et al.,1986; Watkins et al.,1986).

    Downregulation of the sympathetic nervous system has also been implicated by research. For example, it was found that acupuncture can trigger a somato-autonomic reflex (Budgell et al.1996), which can in turn induce vasodilation–a parasympathetic response (Kaada et al.,1982). This can result in increased relaxation and calmness and reduced distress (Knardahl et al., 1998).

    Acupuncture has been shown capable of significantly reducing heart rate, oxygen consumption (Lin et al.2009). This is thought to be a result of a reciprocal process: an increase in parasympathetic activity and a decrease in sympathetic activity (Nishijo et al. 1997).

    There is still much to be learned about the relationship between acupuncture and the autonomic nervous system. However, there is significant enough evidence to show that acupuncture is a noteworthy treatment or adjunct treatment for the reversal of sympathetic dominance.

    A Window of Opportunity

    While stressors like physical exertion can create an an unhealthy state of sympathetic dominance, exercise recovery (handled correctly) grants a unique window of opportunity for the body to maximize the positive outcomes of its altered state.

    Many of the processes that are responsible for the beneficial effects of exercise remain highly active during exercise recovery period. This window of time can be put to good use, with the correct acupuncture interventions, to improve the body’s adaptation to exercise training.

    Research shows that a period of intense exercise increases insulin sensitivity, decreases blood lipid levels and reduces blood pressure after exercise, making the recovery period after exercise an ideal time for therapeutic acupuncture intervention (Halliwill et al., 2013).

    These responses occur anywhere from two to three hours immediately following exercise (e.g., post-exercise hypotension), and they may last up to 48 hours or more (e.g., altered blood lipids).

    Athletes have long taken advantage of this recovery period to improve training and athletic performance by strategically consuming macronutrients during recovery. This is because the metabolic changes associated with both endurance and resistance exercise and recovery may be enhanced with appropriate nutrient timing strategies.

    Optimizing the intake of macronutrients using exercise recovery is a large area of research related to human performance that may translate to clinical populations and older adults (Esmarck et al., 2001). In the context of general populations, recovery from exercise may be used to mitigate the negative effects of some chronic diseases (Luttrell et al., 2015).

    Evidence of Acupuncture and the Window of Opportunity

    In the general population, this window of opportunity could be used to apply acupuncture interventions during a state of enhanced insulin sensitivity and blunted blood lipid levels. Ideally, these interventions could slow, or even reverse, the progression of chronic diseases, reducing the need for pharmacological interventions and improving quality of life.

    Research presented in Effects of acupuncture on heart rate variability in normal subjects under fatigue and non-fatigue state by Zengyong Li, Chengtao Wang, Arthur F. T., Mak Daniel and H. K. Chow sheds more light on how acupuncture can work in tandem with this window of opportunity.

    The goal of this study was to analyze the effects of acupuncture applied at Hegu (LI 4) points and Neiguan (PC6) points on heart rate variability in normal subjects under fatigue and non-fatigue states. Stimulations of the LI 4 points and PC 6 points created inverse effects to the stress and fatigue response.

    In a fatigue state, stimulation of the LI 4 points and PC 6 points indicated a shift of sympathetic balance. In a non-fatigue state, the acupuncture adopted in this study apparently induced a significant increase in activity of both the sympathetic and the parasympathetic nerve system during the post-stimulation period in normal subjects, which was similar to the study by Haker et al. (2000), suggesting no modification in sympathetic balance in non-fatigue state.

    This study concluded that acupuncture on the Neiguan (PC 6) and Hegu (LI 4) points seemed to enhance vagal (parasympathetic) activity and to suppress sympathetic activity. These effects on the autonomic nervous system were opposite to the stress and fatigue response, indicating that the acupuncture treatment was capable of reducing the effects of fatigue in a fatigue state.

    These different effects of acupuncture on heart rate variability suggests that the modulating effect of acupuncture on HRV not only depends on the acupuncture points used, but that it was also connected to the functional state of the body (such as fatigue or non-fatigue) in normal subjects.

    Since the temporary change in autonomic nervous system activity is associated with the functional state of human body, such as mental stress or fatigue (Pagani et al. 1989, 1994), it is reasonable to hypothesize that the effects of acupuncture on autonomic nervous system activity are associated with the functional state of the human body.

    Conclusions

    The research presented and analyzed in this essay shows that sports acupuncture can and should play a larger role in the field of recovery. While the treatment of injury is still a cornerstone of acupuncture for athletes, more attention must be paid to the recovery period and the window of opportunity. By focusing more on recovery, acupuncturists can help their clients to not only recover faster and more effectively, but also to improve their sports performance by utilizing key recovery states.

    To help athletes properly recover and avoid overtraining it is important to:

    • Monitor the intensity of athletes’ prescribed workouts; and
    • Ensure that rest or active recovery days are part of the training program.
    • Utilize acupuncture to help athletes switch out of workout induced sympathetic dominance and into parasympathetic state.

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    Acupuncture & Sports Medicine with an Athletic Team

    Acupuncture & Sports Medicine with an Athletic Team

    An acupuncturist on a sports team isn‘t the most publicized or celebrated, the role they play behind the scenes on the medical staff and the impact they make on each individual athlete is a pretty huge one.

    I want to share more with you about being an acupuncturist on a team and how you can become one too.

    A Vital Member of the Coaching Staff

    If you‘ve followed sports teams over the past few years, you‘ve seen the all-star, professional line-up of on-staff training personnel. In some cases, you may even have seen more staff members on the sidelines than actual players on the roster.

    You‘ve got your head coach, your assistant coach, your athletic trainer, and your graduate assistants.

    You have your fitness instructor and your weight trainer specialist. You have your lead scout and your sports manager, your exercise physiologist, team doctor, and nutritionist.

    These teams have all these people on staff and yet—no acupuncturist.

    Well, let‘s hope they make room because with you—it‘s all about to change.

    Whether your local winning high school football team practices down the street from your house or you‘re willing to drive several miles in search for your new job, your ability to practice sports acupuncture can be the key to pinning your place (excuse our pun) in a new position on a sports team.

    From high school to professional sports and everywhere in between , being a team acupuncturist can help you bring something new (and extremely useful) to the—medical—table. Your practice can help them practice, with a skillset that can be an incredible asset to your favorite local team.

    Highlighting what you bring to the team can help you land your new position but getting your foot in the door, well, that‘s where we come in.

    How to Introduce Acupuncture into Multi-Disciplinary Sports

    The integration of acupuncture into sports medicine can be the difference the team needs as far as promoting and caring for an individual with client-centered performance.

    Especially in team-centered sports, the needs of an individual are sometimes lost in the overall goals of the group. This is unfortunate because although team statistics make a difference in the season, an individual‘s performance can make a difference in the game.

    However, with a service like acupuncture, a client-centered model of practice can be implemented and emphasized as a focus on the individual‘s performance and not just the team performance as a whole.

    As sports research increases, the role of an individual is becoming more and more centralized. With that increase in individual need, from amateur to professional sports, the need for an acupuncturist (and not just someone that can practice it), is also becoming more and more prevalent.

    By taking a quick weekend course on acupuncture, any old athletic trainer can take your place crowd-surfing throne at the end of the game. Don‘t let them—your time has come.

    Local teams everywhere are in need of your practiced hands and your invaluable services to the everyday or professional athlete.

    In this article, we‘re not only going to show you how to introduce yourself as a vital member of the coaching staff, insert yourself into this open playing field, and help you land the position of your dream job, we‘ve also got the sources to back up our claims.

    From first-hand accounts of coaches telling you how to best approach the position, athletic trainers and assistants sharing how to contact their departments, and actual acupuncturists who have been in your shoes, we have everything you may need to know before you prepare for the interview that can make your dream job come true.

    You‘ll be reading testimonials from an acupuncturist on his own stories and recollections of how he has successfully implemented his skillset into prominent universities and sports teams.

    Our collection of professionals in the field today can help you witness and follow the stories of personal experiences working with individual athletes and college teams, as well as interviews with health professionals, athletic therapists, coaches, and assistant directors.

    History of Sports Teams Medicine

    Before we dive into how you‘re going to make a statement of the acupuncture movement in today‘s sports world, let‘s take a look at what we‘re up against in the already-present medical staff of the average sports team.

    Especially in a professional or high-level sports atmosphere, the most common practitioners of acupuncture have been left to the devices of physicians and physiotherapists. These primary healthcare providers and rehabilitation-centered practitioners have been known to whip out the acupuncture needles a time or two.

    And although the profession of athletic therapy has seen an increase in popularity, whether through the choice of study or through team hiring, not all athletic therapists are studied or fully-certified in acupuncture.

    As a former professional athlete who was lying on the medical table too many times to count, I would have definitely felt more confident in the hands of a certified acupuncturist—especially if those same hands were also holding quite a few very long, very sharp needles.

    With the primary responsibility of on-site care at all times during competition and in training, the athletic trainer (normally partnered with a graduate assistant) has a lot on their hands. Not only are they responsible for so many different medical aspects, but they are also normally the only ones on-site that have the credentials to help out in a medical situation.

    Especially in high school sports or with low-budget or lower-ranked university sports teams, you will normally only see one person on-staff during travel practices or those god-awful, 6 a.m. workouts that no assertive physical therapist professional would want to wake up for (especially since most of the time they just tape ankles and then sit for the remainder of the training).

    However, in most cases, these certified individuals present—although very practiced in their field—are not completely adept or proficient in acupuncture as you are.

    And although physiotherapy has evolved and expanded its scope of practice by establishing a sports physiotherapy specialization which includes the advanced training in dry needling, you all know that they can‘t truly replace what you do. But they will definitely try to slide you off the table (figuratively, of course)!

    So, before they completely take you off the map, get in there, needles up, and take back what‘s yours.

    Overcoming Acu-Obstacles

    You, as an acupuncturist, know that what you do is powerful. Unfortunately, the system as a whole in sports medicine is not so keen to letting you on the team.

    Since you are taught a complete system of medicine, you can even consider yourself over-qualified for the sole practice of acupuncture. However, this means that your entire scope of practice can overlap with others. This is what makes it tricky. This is what brings in a sort of “gray area”.

    Here are some obstacles you may have to overcome:

    1. Asserting yourself into the mix can step on some toes

    A massage therapist is welcomed into a team of sports physicians with open arms. Since most athletic therapists and physiotherapists have their hands full (quite literally), they are more open to passing on the service of massaging their athletes to more open and empty hands. Especially since it only encompasses the one task of massaging, a massage therapist‘s service doesn‘t jeopardize any scope of the roles of a different therapist.

    Acupuncture, on the other hand, does.

    Although you are practiced in acupuncture, your knowledge and services move also well-past it, handling practices that don‘t just succumb to needles—which is just the “tip” of what you can do.

    This means that your services will overlap with the roles of other medical professionals on-staff. Which also means, you might not be as welcomed into a team who sees your versatility as a threat.

    Since the skills of an acupuncturist also encompass those of most therapeutic professions, most notably of physiotherapy, you can be often referred to when they need any type of a range of therapies.

    This may cause tension in the workplace, setting the stage for a complicated web of occupational demands, professional relations, and practice settings.

    2. You‘re not taken seriously.

    In most cases, most Sports Medicine Professionals don‘t see acupuncture or those who are specialists of it as a real need in sports. Acupuncturists are cast-aside as “Manual Therapists”, specializing in a service not seen as commonly needed in most sports.

    Other sports medicine practitioners see what you do as simply just a single form of treatment, not realizing that what an acupuncturist does isn‘t the same as what they are.

    Not realizing that what an acupuncturist does stems from a different philosophy of medical care.

    Not realizing what you as an acupuncturist can truly do.

    Especially since this view isn‘t the most welcoming, you might have to overcome a few un-friendly, pre-determined mindsets about who you are and what you can offer a team. Fortunately, you have been trained as a primary caregiver at your home practice, which means that you‘ve got your mind right—seeing yourself as an all-encompassing entity.

    3. You‘re seen as a threat.

    As soon as the other staff members on the team recognize what you can do, they might not like that you can actually take care of some of their roles for them.

    Since an acupuncturist can treat patients and players more ways than one, you‘re not just seen as a new member of the team, you‘re seen as their biggest rival player.

    Although these pre-determined opinions about who you are and what you do may leave a heavy chip on your shoulder, you need to know what you‘re up against before you head into an all-out sports medicine war.

    It‘s important to have the right mindset—no matter what the case may be—so you can approach the setting in a calm, educated manner and get you that position on the team.

    You also might see this as a turn-off to being part of a team. However, there are so many benefits to asserting yourself as a prominent staff member of an all-star sports medicine lineup.

    Benefits of Being Part of a Team

    Although you might not be up to the challenge, being part of a team—on a team—working for a team—can be extremely fulfilling.

    Especially if you have been a solo practitioner for the majority of your medical career, getting into sports medicine on your local sports team or a professional club can be a great way to be a part of a group of like-minded people who all have one goal in common: the ultimate health for each patient and getting them to perform pain-free.

    No matter what sport you may be working with, the well-being of each individual athlete is important. Your role as a member of a sports medicine team can help you not only focus on the needs of a player but also be a part of a team that can take care of the entire group as a whole.

    With an on-team position, you will:

    • Have security in your job—once they see the necessity of your position and how you can help the individual athlete.
    • Have a common goal in mind and work with others to get to it. This team atmosphere can truly increase the feeling of fulfillment in your work.
    • Work from an individual standpoint and a team standpoint—you get the best of both worlds.
    • Have other people on-staff that can not only back you up but also partner with the treatment you do.
    • Be a part of a great cause—helping athletes do what they do best.

    Ready for Tryouts? The Coach Will Be Evaluating You

    If you‘ve ever been an ex-athlete, you know how nerve-racking a tryout can be.

    Before the day comes, you probably trained to your best abilities, prepared by eating a proper meal, stayed hydrated, and hoped you fit the bill according to what the coach was looking for.

    Well, what if we told you we have the exact checklist of what the coach will be looking for in a new member of their medical staff?

    You already have the odds stacked up against you, so, you might as well prepare yourself to take on the job:

    • Make sure you are ready to work as a team player. Just like sports, an acupuncturist on-staff needs to be willing to lay down his or her pride to take on whatever task the team may need.Especially as the all-encompassing medical professional that you are, this shouldn‘t be too hard since you are well-established with the training, education, and experience to handle most types of treatment.If you‘ve been practicing solo for quite a while (or your entire career), being part of a medical team might be a brand new situation for you. However, if you see your skillset as one functioning part (a very important one) of a fully-encompassing and well-equipped machine, this can help you get that team mindset and work with it.
    • You need to be able to work with clear boundaries. Especially coming from your own business or working in an acupuncture-only clinic, you might not be used to someone telling you what you should or should not do. However, as a sports acupuncturist, you need to be able to work within a team‘s framework.Keeping the athlete‘s concerns at the forefront of everything you do can help you stay within clearly-marked boundaries that staff may appoint to you. Each practitioner on-staff complements one another, not only through the scopes of their practices but also through the hierarchy of the physicians and other members on the team.Normally, you have to be okay with the physician having ultimate authority and say.

      This may mean hanging up your crown as King practitioner and replacing it with the armor of a knight or even the rags of a peasant (grim metaphor, I know). However, to humble yourself, take directions, and being responsible for less than you are actually capable of are all the not-so-fun but very important parts of being on a team.

    • Be ready to travel—and to not travel. In most cases with teams, there will be an away game, tournament or need to train off-campus or far away from home.As an acupuncturist, you might find yourself in one of two roles: either a part of on-site emergency care in competitive settings or staying in the back and dealing with management of long-term or short-term injury in rehabilitation settings.Most likely, (depending on the staff-size and availability), your medical spectrum will be assigned to out-of-competition injury rehabilitation and prevention. However, it is part of your role as a sports acupuncturist to be ready to fill the shoes of whichever pair you‘re given.

    Did You Make the Cut? Everything You Need for the On-Team Roster

    Let‘s say you got your foot in the door and the on-staff leader or appointed head coach is beginning to communicate with you about the possibility of being the newest member of their sports medicine team.

    There are a few things you need to be aware of and make your mind up about before you pack your medical kit and bring it to the athletic clubhouse.

    First and foremost, being aware of your predicament and placement in a team is important.

    In most professional sports teams, the staff includes members of medical and health professionals. When it comes to acupuncturists, an athlete will often be referred to one off-site who runs his or her own independent practice. Knowing this before you head off for your first day can be extremely helpful.

    You will need to know how you want to perform or offer your services before you pitch your presentation. To help you out, here are a few things you ought to know.

    Acupuncture can be taught in a couple of different ways. You can either present your services through:

    • Treating athletes at a private practice in your own offices. The team will work with you through referral from the AT, PT or MD on-staff.This type can benefit you through its flexibility and working from your “home” or main offices. In general, it is also pretty adapting to your particular style, location, and care.
    • Treating athletes at their on-site facility. This is the most recommended way to truly be a part of the team. If you‘re going to go ahead and make the commitment to be on a sports team medical staff, you will want to be thought of as a primary form of care instead of an afterthought referral.This type makes you accessible and hands-on. The athletes will see you much more often, thus creating a link in their mind about you being an everyday member of their team.To be seen as a part of a group and being accepted fully into an already-formed medical gang, it truly is about presence. You will need to know if you are willing to make the sacrifices to be physically supportive and there on-site when needed.

    The structure of sports medical staff and systems are different from school to school, team to team, and also can differ based on athletic level or competition.

    This can also help prepare you for what‘s in store for your typical workday. If you are wanting to commit to something once or a couple of times a week, you might not want to apply for a professional or division one athletic-level team.

    The structure of the sports systems can be defined as followed:

    High School and Smaller Colleges

    • Won‘t have such a huge budget for the sports medicine staff and might not be accepting an expansion of more roles on the team.However, if an opening is presented, an all-encompassing professional like an acupuncturist (YOU), can jump right into that role and even present a benefit of knowing more than just the standard forms of treatment.
    • Who to Contact: With high schools and smaller colleges, your initial contact should be with the Athletic Trainer or the Physical Therapist on staff.They are often responsible for multiple sports, (possibly) hundreds of athletes, and are generally overwhelmed with the need for more helping hands. They will normally have an athletic director as head of the medical team (and everything else).This director won‘t be familiar with medical knowledge him- or herself but is in charge of contracting and assigning personnel for medical care. This will be your go-to guy or gal for your contract.

    Amateur, Division One Collegiate, and Professional Level

    • Will generally have much more money to support a bigger or more advanced Medical Team, thus making them more open to taking you on as an acupuncturist and as a full-fledged member of their staff.
    • You‘ll most likely be working under the team‘s MD or PT, which will decrease your scope of practice. You‘ll also have to be able to communicate in “western terms” and work as a team.
    • Who to Contact: Your point-of-reference will be getting in contact with the Medical Director.This director is in charge of not only the team of Athletic Trainers but also of Physical Therapists, Psychologists, Massage Therapists, and the coaches.

    In general, getting your foot in the door is important. However, how you lodge your therapist, not-so-stylish clogs in there is also key to the beginning of a successful partnership.

    Other Ways You Can Make Contact

    You‘re in luck—as we mentioned before, these teams and positions exist to care for the athlete. An athlete-driven career is only as successful as the athletes themselves. Not only does this mean that the athletes have to perform well to make the entire team successful, but they also have to have the motivation to get better or to have optimal services available to them (like yours).

    Fortunately, building your network (not only through LinkedIn, but through real-life connections) with athletes and coaches can truly help you in getting an introduction to the Medical or Athletic Director. If the athlete or coach sees a need for your service, they can help be the liaison to your next job interview.

    Of course, contacting the Athletic Director or Medical Director Office Assistant directly will get you a quicker response. However, having an on-team member, who is already valued at the organization, referring you can help your chances of marching on into the office.

    Nailing Your First Practice: Pierce Them With Your Presentation

    Whether you‘ve just been hired and need to make your first impression a great one or you have this one last opportunity to make your case to the hiring staff, there are two types of presentations that should and need to happen.

    These presentations are vital to the integration of your role into the team and as the newbie on-staff. They are:

    Presentation to Other Healthcare Professionals

    Whether they are on staff as your equals or evaluating you as your superiors, this presentation can make or break how they view you in the workplace.

    Make sure you are founding this proposal on professionalism, medical experience, and background knowledge.

    You should use this as a full-on opportunity to dive into acupuncture, how it works, relevant research, and all kinds of statistics supporting acupuncture and its benefits with athletes.

    You need to emphasize your ability, willingness, and how the team can profit from the compatibility of your services, which are complementary of theirs (that you are not coming in trying to take their place).

    You need to define your expectations, motivations, and goals as a new member of this staff and what you can get out of it (like advertising or experience), as well as what they can get out of you.

    Presentation to the Athletes

    Most athletes (and people in general) are not very keen when it comes to needles, pricking, poking or anything sharp.

    They are also hesitant as patients when a practice comes into play that is unfamiliar to them—like acupuncture might be.

    This presentation can help you not only introduce yourself and what you do but also familiarize the athletes about how your services can benefit them. It will definitely help those needles look less scary!

    You should be emphasizing not only how acupuncture works but also how it relates to them. The athletes need to know how it can help their performance, how it alleviates their injuries, and how acu-awesome it is. Use specific examples and truly tailor it to their individual goals as athletes.

    Introduce acupuncture as a form of treatment and what to expect. If you are working off-site at your own practice, make sure they know your information: address, hours, ways of contacting you, etc.

    Especially since acupuncture isn‘t such a widely-used type of treatment, athletes might not even be familiar with it, decreasing the chances of them coming to you for treatment. This presentation can help you open those doors and start to build that connection between their needs and your services.

    First-Hand Accounts and FAQs

    We know that this might have been quite a lot to take in. We also know you most likely have some questions.

    Which is why we‘ve put together real-world answers to your most frequently asked questions. Answers by acupuncturists and other professionals like you, who have already gotten their feet wet in sports medicine.

    What would be the best way for an acupuncturist to approach you if they are interested in working with you?

    • Avoid cold calls if at all cost possibly. The best place to start is by asking your community and current patients. Who do you know who dances in the Oregon Ballet? Who do you know that plays for your local sports team? The first step is to just start the conversation with people. Let the world know what you want. Once you have a warm lead, you can use that person’s name to open the door. It is incredible valuable, because people will listen to you when they have a little trust in you. “ I have been working with X and I have found that acupuncture is the most effective tool for recovery and rehabilitation.” That will lead you into other opportunity for presentation or face to face contact. If you do have to do a cold call. Call and ask if they take presentations. “Acupuncture is such good medicine for your athletes can I come and talk to you team about the benefit of Acupuncture.” You could even ask to take the Athletic Trainer out to lunch to learn more about what they do, if asking for a presentation seem like too much.The biggest hurdle for you to overcome before you reach out sports teams is get through the tenderness and vulnerability of being scared that you will upset them or be judged about being an acupuncturist and the medicine.

      Jason Stein, Coach of successful entrepreneurs and small business owners

    • I think what works for me is to come to campus or initially an email which clearly stated the focus of the visits or work to be done… is it research, is it business expansion, is it development of clientele base, is is reaching out to new group of clients – age, athletic etc.

      Jayme Frazier, LBCC Roadrunner Women’s Head Volleyball Coach and full-time faculty for the Health & Human Performance Department.

    • Honestly, if you hadn’t given us a full presentation like you did, I am not convinced I would of followed through with believing you could help our athletes. After hearing your presentation, I was able to clearly see your professionalism, medical background knowledge and your character. That presentation led me to be more interested in the value of acupuncture for athletes.

      Debbi Herrold, LBCC women’s Head Basketball Coach

    • An acupuncturist should contact the athletic department or athletic director and request a meeting with the athletic director. During the meeting the acupuncturist should present the benefits of acupuncture for athletes and ask if they can make a presentation to coaches and coaching staff at a department. I would expect coaches and coaching staff to be enthusiastic about the benefits of acupuncture but the final decision will be made by the athletic director.

      Gayle Rushing, LBCC Administrative Assistant

    • I guess I would first say that they shouldn’t approach teams directly. There is staggering variety of professional relationships when we look at medical interventions and athletes. High school programs will be dramatically different than college teams and professional organizations will offer even more variety with regards to these relationships.The advice that I would give to practitioners interested in working with athletes would be to start with the person that coordinates the health care personnel for the given team or organization. For high school athletes this would generally be the athletic director for the school… For professional organizations (college, NFL, NBA, MLB, MLS, etc.) I would contact the Medical Director.The contact should be more introductory than anything. I really wouldn’t spend a lot of time, just a quick email introducing yourself, a bit of background, any relevant research that provides strong evidence in support of acupuncture and an offer to help in any way possible.

      This may seem dismissive or negative but let me explain:

      1. These positions (if a position even exists) are usually filled by multidisciplinary practitioners (Chirporactors, Physical Therapists, Massage Therapists) that simply “add” needling therapy to their treatments. If there isn’t anyone that is providing acupuncture in the organization there can often be a bias against it. If not, great! You’ve made an introduction and offered your services.

      2. Depending on the league and the organization of medical staffing, Acupuncture specific positions either do not exist or they are already filled… In these environments, the players are often left to seek out treatment on their own (this is common in the NFL and MLS). So there really isn’t direction by the team or organization to go to person X for care.

      As for my experience, I have been working with MLB players, Seattle Seahawks and Seattle Sounders now for 4 years. Even after all this time, there is no full time contracted position with the Seahawks or the Sounders. The players come to me because the Medical Director or other players have referred them to me. These relationships had nothing to do with a formal introduction or contact with the team. In every case the referrals came from treating someone who knew someone who knew someone…

      I do not believe that this is how things should be, I believe that all teams and organizations should staff acupuncturists full time… Unfortunately that is not how it is.

      Jason M. Landry EAMP, Licensed practitioner and the owner of Lake Washington Integrative Medicine

    What concerns do you have about using acupuncture to support your team and players?

    • Initially, I was wondering how we could meet the needs of the student athletes as a larger group and then be able to give each specific individualized time to make a difference. I also felt like I needed to plug the business some so that it made it worthwhile for the clinician. That was just my own feelings of guilt that this process might have been taking too much of your donated time. Also, I believe that I was not educated initially on the benefits of acupuncture – so there was reserve and hesitation that it would actually work…especially if used in place of formerly used modes of pain relief or recovery.

      Jayme Frazier, LBCC Roadrunner Women’s Head Volleyball Coach and full-time faculty for the Health & Human Performance Department.

    • I wouldn’t really have any concerns. I feel like we really had the best of both worlds. Our athletes were able to be treated with acupuncture, and still have the services of an athletic trainer as well. I do believe the athletic trainer and the acupuncturist have to respect each others profession and what each can do to benefit the athlete. Working together as a team is best for the athlete.

      Debbi Herrold, LBCC women’s Head Basketball Coach

    • It’s very important that the ACT knows what every athletes is doing. The ATC is hired to be the coordinator of the athletes care and communicate with the coaches. If there is not communications between the ATC and the care providers the athletes are seeing it is very hard to coordinate it all

      Erin Scharer, MS, ATC, Athletic trainer at LBCC and former Coordinator of Sports Medicine, Athletic Trainer at Willamette University

    • From an administrative viewpoint, the biggest concern would be liability so the acupuncturist will need to show proof of insurance coverage along with qualifications.For the student-athlete, acupuncture is not always covered by personal medical insurance or a college’s medical insurance plan so the student-athlete may be liable for any charges resulting from acupuncture care.

      Gayle Rushing, LBCC Administrative Assistant

    • The only voiced concerns from the medical staff (outside of the obvious request not to injure players) have been related to the communication with each individual player. I have often been directed to withhold any specific concerns that I may have about the potential for re-injury or full fitness. Teams want the players to have a positive outlook and mindset about their recovery. They do not want anyone to undermine the confidence that is necessary for these athletes to perform at their maximum potential.As for the athletes themselves, If they don’t like the therapy or treatment they won’t return. They know their bodies and they have received an enormous amount of medical care at the professional level. If you’re good they will know, if not they won’t come back.

      Jason M. Landry EAMP, Licensed practitioner and the owner of Lake Washington Integrative Medicine

    What are the two biggest hurdles with added acupuncture as part of your program?

    • Time as a larger group to meet specific needs and cost. I knew that if we were to go with this fully, there has to be a large cost commitment in an already strained budget. And.. deep down I did worry about whether or not one of my athletes might have some type of physical or emotional reactions to the therapy.

      Jayme Frazier, LBCC Roadrunner Women’s Head Volleyball Coach and full-time faculty for the Health & Human Performance Department.

    • Time to squeeze in treatment amongst school, practice, study hall, physical therapy (athletic trainer exercises if they are involved). Fear of needles some people have.

      Debbi Herrold, LBCC women’s Head Basketball Coach

    • I think just making sure the care fits properly into the sports schedule. Don’t want an athlete to get a treatment on the day before a game that is going to make them very sore. Coaches get pretty upset about that.

      Erin Scharer, MS, ATC, Athletic trainer at LBCC and former Coordinator of Sports Medicine, Athletic Trainer at Willamette University

    • Cost to the college to potentially add an acupuncturist to their payroll.Cost to athletes if acupuncture services are not a covered medical charge with personal medical insurance

      Gayle Rushing, LBCC Administrative Assistant

    • The biggest hurdle without a doubt is scheduling… The players are BUSY you have to fit treatment into their schedule and not your own. For me this has meant flying back to Seattle from holiday vacations early , coming in to the office on days off or staying late into the evenings to accommodate the players availability.

      Another hurdle can be the medical staff for the team. For example, I had a player with a grade 2 strain of the medial gastrocnemius. I was directed to treat that and that only. The player was giving me a history that sounded more like recruitment abnormalities and there was obvious atrophy. The medical staff had already “ruled out” any spinal pathology. After treating the lower leg with limited improvement, the low back was finally re-evaluated and nerve root impingement was diagnosed. If this were my patient I would have referred them for a second opinion with a spinal specialist after the first visit. I raised my concerns with the medical director… My instructions were to stick with the lower leg and they would re-evaluate the low back if. need be.

      Jason M. Landry EAMP, Licensed practitioner and the owner of Lake Washington Integrative Medicine

    Do you have any other thoughts or suggestions for acupuncturist?

    • I do know that it was very helpful to have the education along with the sessions. It educated the athletes and made them a little more accountable for their own health and opened their eyes to another form of therapy / recovery etc.

      Jayme Frazier, LBCC Roadrunner Women’s Head Volleyball Coach and full-time faculty for the Health & Human Performance Department.

    • Talk the athletes through the acupuncture procedure step by step. Teach them why you are doing what you are doing. A committed athlete will want to know everything they can about moving beyond injuries or regaining 100% function. The athletes themselves will be the best voices for acupuncture and its benefits.

      Debbi Herrold, LBCC women’s Head Basketball Coach

    • If they want to be accepted into a program it really important to understand that the ATC needs to be in the loop.

      Erin Scharer, MS, ATC, Athletic trainer at LBCC and former Coordinator of Sports Medicine, Athletic Trainer at Willamette University

    • I definitely heard a lot of positive comments and feedback from coaches, coaching staff and athletes as to the benefits of acupuncture. Acupuncture complimented the athletic trainer services and provided athletes another method to treat injuries.

      Gayle Rushing, LBCC Administrative Assistant

    • My take home for all acupuncturists is simple. BE GOOD AT WHAT YOU DO. Always push to learn more, improve your technique, sharpen your diagnostic skills and never believe that you have it all figured out. There will always be opportunities, some you may not be ready for and that’s ok. With hard work and a lot of effort you will eventually be more than good enough to take advantage of the opportunities when they come

      Jason M. Landry EAMP, Licensed practitioner and the owner of Lake Washington Integrative Medicine

    The Sports Acupuncture Pyramid

    Each level of sports acupuncture has a unique purpose and set of treatment goals. Each level also has its own sublevels—or phases—which build upon each other in the same way.

    What are the three levels of sports acupuncture? How do they build upon and work with one another?

    Sports Acupuncture Has Three Levels

    In sports acupuncture, our time falls into three main categories: injury, recovery and performance. These three categories work together and can be thought of as a pyramid with injury on the bottom, recovery in the middle, and performance at the top. Each level of sports acupuncture has a unique purpose and set of treatment goals. Each level also has its own sublevels — or phases — which build upon each other in the same way.

    About: The Injury Phase

    The Injury phase of the pyramid has three unique stages: pain, weakness and strength. Each process is equally important, but as acupuncturists, we tend to spend most of our time focusing on pain.

    While pain may the driving factor behind many of our athletes seeking our help, relieving pain is only a small part of what we aim to do in sports acupuncture.

    In the treatment of pain we often focus on musculoskeletal conditions and orthopedic acupuncture. This is only a small part of sports and performance acupuncture. Sports acupuncture is a greater field which includes orthopedic acupuncture, not vice-versa.

    Orthopedic acupuncture is important in the pain stage. This is where trigger points, motor points, manual muscle evaluations and palpation examinations are amazing tools to have.

    We can quickly get an athlete out of pain using orthopedic acupuncture methods, but what we do next–in the weakness stage–is just as important. The pain may be gone, but that doesn’t mean their muscles are working at 100%. At this point, we can say the muscles are “turned off”. We need to choose treatment methods that will turn them back on.

    This “turned off” state connects to what’s known as “competitive plasticity” (use it or lose it). If you don’t use a particular skill or set of neuronal connections, your brain will re-purpose them to be used for something you are using more regularly.

    If you hurt yourself (for example, if you sprain your ankle), the brain will try to stop using that muscle to allow it to heal. In doing so, the brain “turns off” the neuronal pathways that tell your ankle’s muscles to work.

    A muscle might also be considered weak if there is damage to the proprioceptive system. (Proprioception is the sense of knowing where your body part is in space.) Your proprioception capabilities can be impaired when a joint tendon or ligament is injured. This is where the proprioceptors are located. An injury like an ankle sprain can damage the ligaments neurotendinous spindle that lie at the origins and insertion of skeletal muscle fibers and into the tendons of skeletal muscle. When you lose proprioception of your joint after an ankle sprain, you may experience an unstable sensation of the joint. Your joint may even give out. When treating weakness, you can use orthopedic techniques, but you’ll often find distal methods or press tacks to be more effective.

    After you get rid of pain and restore muscle strength, you are able to move to the “Recovery” phase.

    About: The Recovery Phase

    During the Recovery phase, an athlete is not in pain but still dealing with stresses. This is where we need to focus on training stresses that affect the following:

    • Range of motion;
    • Sleep; and
    • Digestion.

    Most of this is controlled by the parasympathetic nervous system (PNS).

    When an athlete is training hard, they’re taxing their sympathetic nervous system (SNS); afterwards, they need to switch over to the parasympathetic nervous system (PNS) to rebuild and regenerate. The body’s sympathetic nervous system and parasympathetic nervous system balance each other out.

    The SNS is catabolic and mobilizes the body’s resources to help the body “fight or flight” threatening situations. This system is upregulated during workouts. The PNS is anabolic and helps the body rest, digest, and recover after workouts.

    Many athletes are especially vulnerable to being in a sympathetic-dominant state due to increased stress load. The chronic physical and mental stress that they experience may overtax their body’s ability to adapt and maintain homeostasis. Therefore, this type of athlete is more likely to experience challenges with recovery.

    The above is especially true if restorative techniques are not utilized to minimize sympathetic dominance and strengthen the parasympathetic response.

    During the Recovery phase, we are focusing on managing the PNS. We are watching and treating issues with sleep, digestion, and the immune system. We are also watching and treating issues in range of motion and muscle imbalances that are often the results of sport-specific movements.

    About: The Performance Phase

    The top level of the Sports Acupuncture Pyramid is the Performance phase. The Performance phase culminates on the day of an event or athletic performance, but it can also include up to two weeks leading up to the event.

    Most athletes will begin to taper or decrease training intensity during this time period, so focusing on recovery becomes less important. Instead, now is the time to treat the spirit; shift your focus to the mental game.

    Specifically, the three general areas of emphasis are as follows:

    • Stress vs. Relaxation;
    • Confidence & Optimism; and
    • Focus & Awareness

    Stress: Does the athlete perform better under stress, or does stress decrease their performance? Where do they feel gameday stress the most: physically or mentally?

    Russian sport psychologist Yuri Hanin suggested that different athletes had different levels of pressure at which optimum perform­ance occurs. He called these “zones of optimal functioning”. Some respond well to high tension and pressure; others do not. An athlete needs to learn what zone is best for him or herself.

    Confidence: Check in about internal motivations, positive vs negative attitudes, and feelings of self-confidence.

    Burnout is most common in athletes who feel like they’re playing for external motives, such as college scholarships or verbal commitments. Athletes who have a personal attachment to the sport or other internal motivations are much less likely to feel burned out.

    Focus: The ability to maintain a state of full concen­tration is vital to top athletic performance, particularly during a key game or tense moment.

    Visualization, for example, is a well-known technique in which the athlete imagines specific, important game-day situations as vividly as possible. When that specific situation occurs, the athlete feels better prepared, having already worked through the situation mentally.

    The day of an athletic event is not the time to do any major treatments. Treatments are kept to less invasive procedures, such as ROM evaluation and soft tissue work with Gha Sha, or cupping to help warm up tight areas.

    Press tacks or kinesio taping to clean up proprioceptive imbalances that are still present at that time can also be useful day-of.

    Injury Stage

    The Injury level is the base or foundation of the sports and performance acupuncture pyramid. This is where we tend to spend most of our time.

    Overview:

    A patient comes in with an injury. We treat the injury directly to relieve pain, overcome weakness and restore strength.

    • Pain. At the very bottom of the pyramid is the Pain phase of the Injury level. Before we can do anything else, we need to relieve the patient’s immediate pain. Treatment goal: Relieve pain.
    • Weakness. Treatment of an injury doesn’t end with pain relief. Once pain is resolved, the patient still has weakness in the injured area, where the muscles are essentially “turned off”. Treatment goal: Evaluate and overcome weakness.
    • Strength. Finally, once you’ve overcome weakness due to the injury, the patient can work to regain full strength. Treatment goal: Regain strength.

    Treatment Methods

    • Trigger points
    • Motor points
    • Manual muscle evaluation
    • Proprioceptive Aids, Press Tacks, KenisoTape, Distal Needling

    Recovery

    The middle level of the pyramid is Recovery. This level comes after Injury and before Performance. It is where we spend most of our time second to the three phases of the Injury level.

    Overview

    Treatment doesn’t stop once an injury has healed. After an injury is resolved, the patient enters the Recovery level, which is where you can help them reintegrate into normal training and activity healthily and safely. Recovery focuses mainly on range of motion, sleep and digestion.

    • Range of Motion (ROM). As the patient heals, they begin to tax their sympathetic nervous system with training, which can cause imbalances. To continue to increase strength in the affected area and make sure it heals properly, we focus on range of motion.
    • Sleep. As the patient recovers, they need to switch their focus to the parasympathetic nervous system in order to heal from the taxes they’re putting on their sympathetic nervous system. This means focusing on improving sleep quality.
    • Digestion.Another crucial part of the parasympathetic nervous system is digestion. As the sympathetic nervous system gets put to work with increased training, more focus on improving digestion is needed to recover.

    Treatment Methods

    • Traditional Chinese Medicine Diagnosis. Focus on Sleep, Digestion and Mood to evaluate Autonomic Nervous System

    Performance

    The top of the pyramid — Performance — is where we tend to spend the least of our time, but where we should try not to neglect important aspects of patient care.

    Overview

    Finally, the patient isn’t in pain, they’ve worked hard to train healthily and to avoid further injury, and now it’s the day of. Now, our job is to address and treat the spirit: fears, motivation and focus.

    • Stress. When treating the spirit, it’s important to identify and address any fears or Levels of mental, emotional physical stress that might hinder—or improve—performance.
    • Motivation. Identify and create a focus around what makes the patient want to succeed and perform well.
    • Focus. Identify and address any distractions that can detract focus and energy away from peak performance the day of.

    Treatment Methods

    • Acupuncture with Performance Visualization

    A new focus at Valley Health Clinic

    A new focus on sports acupuncture at Valley Health Clinic in Albany, Oregon

    I’m excited to announce a brand-new look to our website. I hope you’ll find it easier to get around and learn more about what we do.

    Plus, you’ll see a new focus on serving athletes of all levels. It’s long been a passion of mine to help people achieve their best in whatever sport they choose, and I’ll be looking forward to working with more of them.

    We offer individualized programs for athletes with nagging injuries who might feel like their performance level has been permanently reduced. For most people, I’m happy to show them it’s not true.

    I also love working with sports teams, especially young people, and we’re dedicating a page to our agility training programs designed to help those young athletes perform at their peak level while avoiding injury.

    Please take a look around and let me know what you think. If you are or know someone suffering from an injury that has impacted their game, get in touch. I’m looking forward to hearing from you.

    Acupuncture and Pain Types

    Acupuncture and Pain Types - Valley Health Clinic, Albany Oregon

    Identify your pain at triggerpoints.net.

    Acute Pain

    Acute Pain is the easiest to understand because there was a pain and it was recent. The patient can point to it and can remember what happened to cause it. The body is sending pain and location signals to the brain. Recent acute pain is often the east to treat and the body responds quickly because a chronic pattern or pain expectation has not set in. If the pain is sever, light local needling or distal needling is best. Strong local needling will add stress to a system that is already over stressed and aggravated. Light local needling with stimulation encourages a local healing response but not aggravation. It will act like a kind of homeopathic treatment. Distal points can block the pain and help the muscles rest.

    Chronic Pain

    Chronic Pain has affected the whole system and a correct local treatment will improve the condition but the pain will return because the body can not adjust to the pain free movement. You must treat local and adjacent points. With chronic pain the body can loose the location signal and the pain may feel vague or wandering. Local needling will stimulate the location nerves and help the body heal.

    Nerve Pain

    Nerve Pain is often described as burning or prickling or electrical shock. Some people with nerve pain will have hypersensitivity to temperature or touch. Very often it will radiate past two joints. Muscle pain radiation rarely passes two joints. Radiation will be along a path and patients will trace an area with there finger when describing it.

    Psychogenic Pain

    Psychogenic Pain aggravated with stress responds better to distal treatment. Pain will often feel better after treatment but always come back once the patient returns to work. It will be very frustrating to treat and can look like a repetitive injury that is aggravated from work. Often time psychogenic pain will be aggravated eerily in the work day will repetitive pain will be aggravated later.

    Muscle Pain

    Muscles Pain is classic. Dull, tight, and achy. It will be local and effected with pressure on the area either by aggravating or relieving pain. For tendon, meniscus, and ligaments, this pain is sharp and often sudden. Patients will describe a giving out of the joint or sudden weakness. For example patient has dull achy shoulder pain, this is muscle pain. When the patient does the arch of pain test at around 90 degrees they say ouch and drop their shoulder. The sudden sharp pain causing weakness would be the tendon being pinched. Another classic example is a tore meniscus or ligament in the knee. The patient will have dull achy pain and suddenly will step wrong and get a sharp pain. They will say it feels like their knee is giving out.

    Itis

    Inflammation will have swelling heat and redness. Arthritis is worse in the morning and better with heat and movement as the swelling is moved out of the joint. Muscle pain is also worse in the morning and better with heat and movement but it will not come back as quickly with rest. Muscle pain will be aggravated at the end of the day with when patient over does the activity.

    Bursitis will be painful with pressure on bursae, It will typically only be painful with exercises or excessive movement but fine with normal movement. For example, it will only hurt when the patient runs.

    Tendonitis is worse in the morning. The most common pain that is worse in the morning is “itis”. The joints fill with inflammation at night and when you first start to move can be painful. The best example of this is Plantar Fasciitis. It will feel like stepping on glass when they first get up in the morning but will feel better once they move around.

    The 4 Stages of Healing

    The 4 Stages of Healing - Valley Health Clinic, Albany Oregon

    Acute, or Inflammatory Phase (48 hours to 72 hours)

    The inflammatory phase begins immediately following your injury and is characterized by swelling, redness, and pain. Your body is dissolving blood elements and tissue debris. Often time pain leads to muscle spasms creating a pain spasm loop.

    Reparative Stage-Post Acute (48hrs to 6 weeks)

    At this stage your body is laying down fibrin collagen and fibroblasts to begin repairing the area. There is some redness, tenderness and a decrease in circulation and flexibility. It is during this time that your body is doing all it can to protect the affected area. This sense of guarding can echo into your mental state as well – many people tend to hole up in their homes to heal in private.

    At Valley Health we encourage you to get out and move as soon as you are able – and what better incentive to do so than coming in for a healing, calming, therapeutic appointment? Our clients say how helpful and positive it is to have a reason to leave the house for compassionate, focused care. It’s easy to forget how powerful human touch can be, and welcoming into your recovery. It changes your journey from a solo expedition into a team effort.

    Remodeling and Rehabilitation Phase (3 week to 12 months)

    Your body transitions into this second phase of repair. The body has fibrous deposition (scar tissue) and possible chronic inflammatiory reaction. To remodel is to grow by rapid production, and that is exactly what your body is going through during this stage. The visible signs of inflammation will subside, and new tissue forms. This new tissue is fragile, and susceptible to injury.

    It is during this phase that people feel like their mind is ready for them to be better, but their body is lagging behind. Oftentimes, remaining bruising and limited range of motion can bring about a sense of depression.

    “Can I get back to work? What about exercise?”

    “Is this my final result?”

    “I thought I’d be better by now.”

    The fear that tends to arise during this phase of healing can cause you to guard the area even further. You may be scared to move too much, and this anxiety can cause you to lock down and stay still in order to protect yourself. This fragile new tissue, however, is susceptible to more than just injury – it is also susceptible to stagnancy, and restricting movement can form adhesions. These adhesions can limit range of motion when movement is eventually reintroduced, so appropriate mobilization of the tissue during this stage is important.

    The benefit of working with your acupuncturist lies in their knowledge of what will and won’t be best for you. Some people close down, and we remind them to get out and move. Some people push themselves too far too fast, and we remind them to slow down and allow themselves to heal. Your greatest benefit lies in getting answers to your questions, and support to get through your fears and anxieties.

    Chronic, or Restorative Phase (Months to Years)

    This phase can continue for a period from several months to several years. It is during this stage that there is no pain but the tissues do not function normally. Often time there is stiffness, muscle tightness some aching and weakness.

    Your mind may continue to receive confusing messages from your body based on the memory of the trauma. Even when the body has fully healed, the alarm in your brain may still be turned on, and your body can continue working to heal the area of trauma. It is during this stage that these tissues may become stuck – your pain goes away, but you can be left with persisting symptoms that limit your range of motion and aggravate your mental well-being. This is when many people question when, or even if, they will ever be “back to normal.”

    The answer to that question has a caveat – your body is different now. Your skin, muscles, and sometimes even your bones are all in new places, in positions they have never been before. Because of this, “back to normal” really translates to “discovering your new normal.”

    Helping you discover your new normal is your acupuncturist primary goal. Remodeling can be difficult to push through, but much like the final few miles of a marathon, the support of your acupuncturist combined with your own awareness and strength will get you past the finish line.

    Health Maintenance

    Once you have passed through these four phases of healing, you once again have the freedom that comes with good health and well-being. You also gain the opportunity of choice when it comes to maintaining this health and well-being.

    Oftentimes, our clients choose to transition into receiving health maintenance treatments – regular tune-ups to keep their bodies in a place of wellness. Other clients come in and out of receiving further treatments by returning to valley Health when new injuries arise. Some simply continue moving forward, content with their newfound independence and imbued, freshly healed spirit. Whatever your choice the door is always open, and allies in healing will always be here for you, through all the seasons of your life.

    Speed, Agility & Injury Prevention Coaching for Young Athletes

    Speed, Agility & Injury Prevention Coaching for Young Athletes

    Even better, the same training that develops young athletes’ ability to accelerate, decelerate, and change direction quickly also helps prevent injury, so they can stay in the game well into adulthood.

    While of course coaches and parents want their kids to stay injury-free – and kids light up at the idea of being able to run faster – this kind of training is rarely part of the routine.

    We make it easy for you to change your speed and agility routine

    Inspired by his passion for sports and his commitment to effective preventative care, Valley Health Clinic’s Will Sheppy is offering concise, evidence-based coaching sessions for athletes of middle school age in the Albany, Oregon area. Learn more or schedule your workshop today.

    About Will Sheppy

    In addition to being an outstanding acupuncturist, Will is also a speed and agility coach certified with Athletes Acceleration. You can find his full bio here.

    “No one thinks you need to teach someone how to run, and yet you can and it will make them better human bodies with real world ability and less injuries if we do. [Since the workshop with Will Sheppy, they] literally run faster, and they also run safer and with less impact. The most improvement came from my least athletic [kids] which means you can teach athleticism and balance. I can now build my drills and warmups around that knowledge, confident that what I am doing is prolonging their athletics into their own adulthood. I’m excited that they’ve got a better chance of not telling of that old high school injury which prevents them from A, B, or C when they’re grown up.”

    Short workshops that make a big difference

    Over the course of just 2-3 hours, Will teaches basic agility and proper movement mechanics, with a focus on linear lateral and multidirectional movement. Each workshop is custom tailored to your team’s age and skill level. Will is fantastic with kids and gets them engaged right from the start.

    At the end of the workshop, you’ll see your team run faster and show better form – and you’ll be able to build on these results in your practice going forward. It’s an enormously worthwhile investment of a few hours that will pay off for decades to come.

    Learn more or schedule your workshop today.