Category: 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.

About the Author

Willard Sheppy is a writer and healthcare practitioner who seamlessly melds scientific knowledge with practical applications in engaging and authoritative articles. He holds a Bachelor of Science in Environmental Science from Oregon State University and a Master’s in Acupuncture and Oriental Medicine from the distinguished Oregon College of Oriental Medicine.

In his work, Willard skillfully combines his extensive educational background in scientific research with his practical experience as a healthcare practitioner. Willard balances his life with martial arts and cherished family adventures. As a father of three, he often leads his family on camping and hiking trips along the breathtaking Oregon coast.

Connect with Willard on LinkedIn at www.linkedin.com/in/valleyhealthclinic or learn more about his services at www.valleyhealthclinic.com. Embark on this journey towards holistic health with Willard guiding your way.

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.

About the Author

Willard Sheppy is a writer and healthcare practitioner who seamlessly melds scientific knowledge with practical applications in engaging and authoritative articles. He holds a Bachelor of Science in Environmental Science from Oregon State University and a Master’s in Acupuncture and Oriental Medicine from the distinguished Oregon College of Oriental Medicine.

In his work, Willard skillfully combines his extensive educational background in scientific research with his practical experience as a healthcare practitioner. Willard balances his life with martial arts and cherished family adventures. As a father of three, he often leads his family on camping and hiking trips along the breathtaking Oregon coast.

Connect with Willard on LinkedIn at www.linkedin.com/in/valleyhealthclinic or learn more about his services at www.valleyhealthclinic.com. Embark on this journey towards holistic health with Willard guiding your way.

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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

About the Author

Willard Sheppy is a writer and healthcare practitioner who seamlessly melds scientific knowledge with practical applications in engaging and authoritative articles. He holds a Bachelor of Science in Environmental Science from Oregon State University and a Master’s in Acupuncture and Oriental Medicine from the distinguished Oregon College of Oriental Medicine.

In his work, Willard skillfully combines his extensive educational background in scientific research with his practical experience as a healthcare practitioner. Willard balances his life with martial arts and cherished family adventures. As a father of three, he often leads his family on camping and hiking trips along the breathtaking Oregon coast.

Connect with Willard on LinkedIn at www.linkedin.com/in/valleyhealthclinic or learn more about his services at www.valleyhealthclinic.com. Embark on this journey towards holistic health with Willard guiding your way.

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

About the Author

Willard Sheppy is a writer and healthcare practitioner who seamlessly melds scientific knowledge with practical applications in engaging and authoritative articles. He holds a Bachelor of Science in Environmental Science from Oregon State University and a Master’s in Acupuncture and Oriental Medicine from the distinguished Oregon College of Oriental Medicine.

In his work, Willard skillfully combines his extensive educational background in scientific research with his practical experience as a healthcare practitioner. Willard balances his life with martial arts and cherished family adventures. As a father of three, he often leads his family on camping and hiking trips along the breathtaking Oregon coast.

Connect with Willard on LinkedIn at www.linkedin.com/in/valleyhealthclinic or learn more about his services at www.valleyhealthclinic.com. Embark on this journey towards holistic health with Willard guiding your way.