Use of acupuncture in Sports Medicine among top Chinese athletes M.D./Ph.D Igor Mićunović - TCM doctor P .E. teacher – Master sci. sports medicine President of association of acupuncturists of Montenegro www.igormicunovic.com www.kineskamedicina.me
With the high economic and social pressures towards athletes to perform at their peak performance, competitors are increasingly turning towards ergogenic aids such as steroids or nutritional supplements to help maintain their competitive edge. These aids, however, only address some of the factors that can affect athletic performance. Factors that can influence performance include cardiovascular fatigue, muscular fatigue, delayed-on set muscle-soreness, injury, and anxiety. Both theory and recent clinical evidence suggests that acupuncture can successfully address the physical and as well as the psychological factors that can prevent an athlete performing at his or her peak potential.
What is TCM? • Acupuncture (cupping, moxa, guasha) • Pharmacology • Tuina • Dietology • Physical exercises (Tai ji quan, Qi gong)
The most dramatic benefits “re-discovered” by Western doctors are the analgesic effects of acupuncture to treat joint pain and increased joint mobility. Chinese A level teams:
Athletic Enhancement Solutions Substances that are purported to increase athletic performance are called ergogenic aides. Examples of currently legal ergogenic aides being investigated include nutritional supplements and herbs. Clinical studies have been conducted in substances such as creatine, colostrom, and dihydroxyacetone pyruvate (DHAP). All of these occur naturally in the body as either a precursor or result of metabolic processes.
Specifically, three types of ginseng are available; Asian Ginseng ( Panax ginseng ), American Ginseng ( Panax quinquefollius ), and Siberian “Ginseng”. Siberian ginseng is actually a misnomer to describe an herb originally promoted by Russian scientists to function identical to Asian Ginseng. Of these three variations, only Asian Ginseng has demonstrated an ability to improve aerobic capacity in a clinical study.
• Background • Traditional Chinese Medicine is official medical system in P .R. China. Most commonly method of TCM is acupuncture. Acupuncture usage in sports medicine in P .R. China is not limited only to hospital since 1960’s but competing athletes as well. During athletes career acupuncture is performed for various reasons to all P .R. national and Olympic team members. Acupuncture is mostly used to treat both chronic and acute injuries and illnesses with traditions lasting centuries. Since 1980’s many researches are conducted about acupuncture in sports medicine and is being evaluated for an influence on human performance.
Objective The aim of this study was to investigate the effect of acupuncture on P .R. China national and Olympic team members following their results, investigate musculoskeletal injuries, mental readiness and finally athletic performances after receiving acupuncture treatments.
Acupuncture – brief history • TCM education in P .R. China • TCM international education • Legislation of practise in Europe and Montenegro • History of usage of acupuncture within athletes • Comparasion between Greeks and Chinese
• Acupuncture is an ancient traditional Chinese medical therapy that is used widely around the world. Animal and human studies have found a physiological basis for acupuncture needling in that it affects the complex central and peripheral neuro-hormonal network. Acupuncture care yields clinically relevant short- and long-term benefits for low back pain, knee osteoarthritis, chronic neck pain, headache, etc. The integration of acupuncture into a primary care setting also appears to be cost-effective. Furthermore, the practice of acupuncture in primary care and sport team involves rigorous training, financial discipline, and art of communication.
• Mao Ze Dong doctrine • Clinical Evidence before 1997 • Clinical Evidence after 1997
Sports are becoming more competitive every day, and athletes are always looking to enhance performance. Acupuncture has been proven to be a more natural, safe, and legal method to use as opposed to banned substances such as steroids. The goal of acupuncture treatment is to maintain and achieve overall health by stimulating specific points on the body.
When injuries occur, acupuncture is said to regulate nerve conduction and circulation in the area of inflammation. Pain could be managed the stimulation of endogenous opioids or endorphins. Endurance and energy may be enhanced through lung, liver, and digestive function. Also, muscle fatigue could be decreased through acupuncture’s promotion of recovery
-The major field in which acupuncture is utilized is pain management. It is a method of treatment for menstrual cramps, nerve pain, arthritic pain, pain from injury, muscular pain, back pain, sciatica, tension headaches, and migraines. It is also used to treat many other conditions such as allergies, hot fl flashes, irritable bowel syndrome, urinary tract infections, heart burn, respiratory problems, skin conditions and many more
Recently, sports medicine acupuncturists have emerged and focus on injury treatment and athletic performance. The main goal of this profession is overall health for athletes through a mind and body connection. Sports medicine acupuncturists combine range of motion tests, orthopedic evaluation tests, palpation, and manual muscle tests with TCM techniques to evaluate injuries.
THE MIND-BODY RELATIONSHIP Acupuncture seeks to balance the energies of the body internally. The harmony within the body may be disrupted through both internal and external factors. Some internal factors may include: stress, injury, and emotions. Acupuncture stresses the importance of the relationship between the mind and body. Many factors determine the performance of an athlete, but most would agree that psychological dynamics play a great role in competitive sports.
• What is Acupuncture Like? In large prospective studies, acupuncture has been found to be very safe with the most common side effects as needling pain, bruising, hematoma and dizziness. In very rare cases, severe tiredness, headache, and pneumothorax has been reported for needling the chest area. Most athlete patients perceive acupuncture as calming and relaxing. The course of acupuncture treatment typically includes 10 sessions, while many people require less and some need more.
Acupuncture complications are mainly from improper sterilization and utilization. Pneumothorax and central nervous system injury were the most commonly reported. Infection was also a common complication. Of all infection cases reported, over 60% were hepatitis B. External ear infection from auricular acupuncture was next common. rospective studies determined that the risk of acupuncture causing a serious adverse effect is estimated to be 0.05/10,000 treatments and 0.55/10,000 individual patients. Although serious adverse side effects may result from acupuncture, the likelihood is very low when administered properly
Methods Published literature from year 2000 until 2015 was reviewed based on research literature from Journal of Traditional Chinese Medicine Sciences, Journal of Beijing University of TCM, Journal of Tianjin University of T.C.M. Asian sports medicine journal, PubMed and Medline research network. Published literature was reviewed based on inclusion criteria of acupuncture and sports medicine use among athletes in P . R. China. Totally 1000 articles were included in this study.
Keywords used in this search include the word acupuncture in combination with the words: sports, medicine, athletic, injury, lateral epicondylitis, doping, performance, recovery, strength, flexibility, DOMS, musculoskeletal, and osteoarthritis. . Additionally, each article has at least one of the following inclusion criteria: the use of a control group, random assignment, or blinding of subjects.
ATHLETIC PERFORMANCE Acupuncture is most commonly known for its analgesic and healing affect. More recent studies are investigating the effects of physical performance such as strength, flexibility, and aerobic conditioning. Muscular Strength and Power Literature suggests that acupuncture may be used as a tool for hypertrophy of muscles by stimulating testosterone and growth hormone production and causing specific muscle contractions plus electromyography readings were different post – acupuncture.
Author Year Procedures - Summary of Muscular Strength and Power Studies in China Toma et al 2008 N=17, 1 acupuncture application for 15 min, wrist fl flexors and semitendinosus studied N=33, randomized, controlled, Hubscher et al 2010 No sig. dif. Between acu and sham for crossover, acu vs. MIVF, but both sig. dif. from placebo. No sham vs. placebo, rectus femoris sig. dif. In MPR or rebound height studied Huang et al 2007 N=15, randomized, controlled, acu Sig. ↑ in dorsiflexion strength compared to control vs. control, 4 weeks, tib anterior studied Costa & Araujo 2008 N=30, randomized, singleblind, ↓ force seen in local acu compared to local acu vs. adjacent acu, tib adjacent acu anterior studied N=12, randomized, controlled, acu Banzer et al 2007 Slight ↓ in ground contact time in acu vs. sham vs. compared to sham and control control, jumping performance studied
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