Biomedical Acupuncture for Sports and Trauma Rehabilitation : Dry Needling Techniques

Written by widely respected acupuncture expert Yun-tao Ma, PhD, LAc, Biomedical Acupuncture for Sports and Trauma Rehabilitation shows techniques that will enhance athletic performance, accelerate recovery after intensive workouts, and speed trauma rehabilitation after injuries or surgeries. Evidence-based research is used to support the best and most effective techniques, with over 100 illustrations showing anatomy, injury, and clinical procedures. Unlike many other acupuncture books, this book uses a Western approach to make it easier to understand rationales, master techniques, and integrate biomedical acupuncture into your practice. "Finally, a well-referenced, common sense approach to dry needling in sports medicine that discusses maintenance, overtraining, and the effect of the stress response in atheletes. This is a long-awaited book that will leave you feeling comfortable with a technique that is very useful not only for atheletes, but for all patients of your practice." Rey Ximenes, MD The Pain and Stress Management Center Austin, Texas "For any clinician involved with assisting atheletes recover from injury, as well as providing services to enhance physical performance, this text will be indispensible. This book is a major accomplishment in the field of sports injury and treatment of musculoskeletal and neurological pain." Mark A. Kestner, DC, FIAMA, CCSP, CSCS Kestner Chiropractic & Acupuncture Center Murfreesboro, Tennessee Unique! Explores acupuncture treatments for sports injuries in the acute phase, rehabilitation, and prevention. Includes acupuncture for performance enhancement and injury prevention, emphasizing pre-event acupuncture used to help increase muscle output, assist with pre-competition stress, and prevent soft tissue injury. Provides evidence-based research to show the science behind the best and most effective techniques, based on the author's background in neuroscience and cell biology and his 35 years of clinical acupuncture experience. Offers an overview of the science of biomedical acupuncture including the mechanisms of acupuncture, anatomy and physiology of acupoints, and discussion of human healing potential. Uses terminology and concepts familiar to Western-trained health professionals, making the material easier to understand and incorporate into practice. Includes more than 100 illustrations showing anatomy, injury, and clinical procedures. Covers useful techniques including those that increase muscle force output, joint flexibility and stability; prevent sports injuries like muscle sprain, tendonitis, bone strain, stress/fatigue fracture and bone spurs; reinforce muscle output for specific sports; normalize physiology of dysfunctional soft tissues; predict treatment response; reduce physiological stress; use the new Vacuum Therapy for deep tissue dysfunctions; and balance the biomechanics of musculoskeletal system. 1 2 Copyright 3 Dedication 4 Foreword 5 Foreword 6 Foreword 7 Preface Background A brief history of dry needling acupuncture Conceptual Approach Lesion mechanisms of dry needling Dry needling is a specific therapy for restoring soft-tissue dysfunction A systemic approach is necessary in dry-needling acupuncture Four types of myofascial pain and their different pathology The unique efficacy of dry-needling acupuncture in sports medicine The difference between dry needling and wet needling therapy Who will benefit from this book Dry needling acupuncture is not the acupuncture of traditional Chinese medicine (TCM) Preface References: 8 Acknowledgments 9 Integrative Systemic Dry Needling:A New Modality for Athletes Isdn and Athletes Athletes Expect More Than Pain Relief Chronic and Acute Stress Impede Physical Performance In Sports And Exercise Limitations of Human Performance in Sports and Exercise Isdn as An Effective Tool in Conventional Sports Medicine Isdn Versus Classical Chinese Acupuncture and Trigger-Point Medicine References 10 Homeostasis and Stress in Sports and Exercise Homeostasis in Sports and Exercise Stress in Sports and Exercise Overtraining Stress Homeostatic Regulation in Sports and Exercise Central Nervous System Integration of the Stress Response in Sports and Rehabilitation Appraisal Model of Psychologic Stress Stress and the Endocrine System Sports and Exercise as Physical and Psychologic Stress Exercise Responses Preparatory Phase Active Phase Exercise Can Be a Positive or Negative Stressor Overtraining Syndrome Responses of the Autonomic Nervous System to Overtraining Hormonal Responses to Overtraining Immune Function and Overtraining Summary References 11 Human Brain Plasticity, Sports, and Sports Injuries The Brain and Physical Training Imagination and Behavior Summary References 12 Musculoskeletal Systems and Human Movement Skeletal System Levers and Torque Force and Stress on the Skeletal System General Review of The Mechanics of Major Human Joints Joints of Class I Levers Elbow Neck Lower Back Joints of Class III Levers Reaction Forces Inside the Joints Support of Body Weight Upper Limb Muscle Protective Reflexes Through Sensory Feedback in the Musculoskeletal System Muscle Spindles Tendon Spindles Other Protective Sensory Organs Musculoskeletal Responses to Stress Summary Additional Readings 13 Overtraining Syndrome and the Use of Muscle in Exercise Skeletal Muscle Types of Muscle Contraction Muscle Fiber Types Type I Fibers Type II Fibers Physical Properties of Muscle: Tone, Tension, Contracture, Thixotropy, and Spasm Posture and Muscle Imbalance Fatigue in Muscle and the Central Nervous System During Exercise Muscle Soreness: Delayed-Onset Muscle Soreness (Doms) Exercise-Associated Muscle Cramps Overreaching Overtraining Syndrome Summary References Additional Readings 14 Clinical Mechanisms of Integrative Systemic Dry Needling Why Patients Respond Differently To The Same Isdn Treatment Needling Is Soft Tissue Therapy Types Of Soft Tissue Injury Pathologic Process Of Soft Tissue Dysfunction And Injury Inflammation Contracture and Cramp Adhesion Adhesion Caused by External Physical Impact Adhesion Caused by Internal Pathologic Insults Scarring Blockage of Circulation Atrophy Musculoskeletal Imbalance Histologic Features Of Soft Tissue Injuries Contracture Adhesion Scarring and Fibrogenesis Circulatory Deficiency or Blockage Three Stages Of Self-Healing Of Soft Tissue After Injury Osteofascial Compartment Syndrome Pathologic Conditions Of Human Organs Involve Chronic Soft Tissue Dysfunction Bone Spurs And Soft Tissue Dysfunction Electrical Acupuncture Needling Sensation Local Skin Reaction And Cutaneous Microcurrent Mechanism Needle Manipulation: Mechanical Signal Transduction Through Connective Tissue Local Relief Of Muscle Shortening And Contracture Neurochemical Mechanisms Of Acupuncture Analgesia General Review Of The Needling Reflex Segmental Axon Reflex Of The Spinal Cord Blood Coagulation System And Immune Complement System Summary References 15 Chapter 7: Physiology of Acu-Reflex Points Pathophysiologic Factors That Convert Latent Acu-Reflex Points To Passive Points Dynamic Physiology Of Acu-Reflex Points Three Dynamic Phases Of Acu-Reflex Points Physical Properties Of Acu-Reflex Points Sensitivity Specificity Sequence Electrophysiology Of Acu-Reflex Points Needling Restores Normal Energy Metabolism In Soft Tissue Dysfunction Ten Basic Anatomic Features Of Acu-Reflex Points Size of the Nerve Trunk Depth of the Nerve Penetration of Deep Fascia Passage Through Bone Foramina Neuromuscular Attachments Concomitant Blood Vessels Nerve Fiber Composition Bifurcation Points Sensitive Ligamentous Structures Suture Lines of the Skull Summary of the Anatomic Features of Acu-Reflex Points Summary References 16 Chapter 8: Neuroanatomy of Acu-Reflex Points Anatomic Survey of Homeostatic Acu -Reflex Points Cutaneous and Muscular Acu -Reflex Points Homeostatic ACU-Reflex Points on the Face: The Trigeminal Nerve and the Facial Nerve Anatomic Survey Trigeminal Nerve (Cranial Nerve V) Facial Nerve (Cranial Nerve VII) H19 Infraorbital (Cutaneous) H23 Supraorbital (Cutaneous) Other Facial Acu-Reflex Points Acu -Reflex Points Formed by the Cervical Plexus H2 Great Auricular (Cutaneous) Other Neck Acu-Reflex Points H3 Spinal Accessory (Muscular) Acu -Reflex Points Formed by the Brachial Plexus Homeostatic Acu-Reflex Points On The Upper Limb Preaxial Innervation H17 Lateral Pectoral (Muscular) H9 Lateral Antebrachial Cutaneous (Cutaneous) Postaxial Innervation H13 Dorsal Scapular (Muscular) H8 Infraspinatus (Muscular) H1 Deep Radial H12 Superficial Radial (Cutaneous) Homeostatic Acu-Reflex Points On The Lower Limb Lumbar Plexus Sacral Plexus H16 Inferior Gluteal (Muscular) H18 Iliotibial (Cutaneous) H11 Lateral Medial Popliteal H4 Saphenous (Cutaneous) H24 Common Fibular (Peroneal) H10 Sural (Cutaneous) H6 Tibial (Cutaneous) H5 Deep Fibular (Peroneal) (Cutaneous) Cutaneous Acu -Reflex Points of the Torso Homeostatic Acu-Reflex Points Formed By The Posterior Rami Of The Spinal Nerves H7 Greater Occipital (Cutaneous) H20 Spinous Process of T7 (Cutaneous) H21 Posterior Cutaneous of T6 (Cutaneous) H15 Posterior Cutaneous of L2 (Cutaneous) H22 Posterior Cutaneous of L5 (Cutaneous) H14 Superior Cluneal (Cutaneous) Symptomatic Acu-Reflex Points And Their Identification In Each Case Principles of Using Spinal Segmentation in Acupuncture Therapy How to Select Paravertebral Acu -Reflex Points Segmentation of the Body Structure Segmental Innervation of the Skin: Dermatomes Segmental Innervation of the Musculature: Myotomes Segmental Innervation of the Skeletal System: Sclerotomes Segmental Innervation of the Internal Organs: Viscerotome Summary Additional Readings 17 Homeostatic Acu-Reflex Point System Systemic Pattern of Acu-Reflex Point Sensitization Symptomatic Pattern of Acu-Reflex Point Sensitization The Integrative Neuromuscular Acu-Reflex Point System as a Clinical Guidance for Treatment Historical Review Charting the Acu-Reflex Point System Abcd Grouping or Quantification of Patients: the 16-Point Method Prediction of Treatment Outcome References 18 Trigger Points and the Integrative Neuromuscular Acu-ReflexPoint System Etiology of Trigger Points Acetylcholine Release Increased Fiber Tension Sensitizing Substances in Trigger Points Interactions of Myofascial Trigger Points Trigger-Point Nociceptors Myofascial Trigger-Point Sites Some Myofascial Pain Patterns Caused By Trigger Points Palpation Twitch Response Treatment and Prognosis References 19 Visceral Pain and Visceral-SomaticReflexes Diffuse Spatial Localization Uncertainty of Visceral Pathologic Processes Uncertainty of Temporal Correlation Referred Hyperalgesia Peripheral Organization Of Visceral Afferent Fibers Primary Visceral Sensory Afferent Fibers Central Terminations Of Visceral Afferent Fibers Interactions Between Visceral And Somatic Reflexes Referred Or Reflex Zones Of Major Viscera References 20 Pathomechanics of the Musculoskeletal System and Acu-Reflex Points Functional Anatomy and Pathomechanics of the Lower Limb The Hip The Hip Flexor Muscles The Hip Abductor Muscles The Hip Adductor Muscles The Knee Joint Muscles of the Knee Joint* The Knee Extensor Muscles The Knee Flexor Muscles: The Hamstrings The Lower Leg and Foot The Foot Muscles of the Foot The Arches of the Foot Subtalar Neutral Position Functional Anatomy And Biomechanics Of The Trunk Muscles of the Back (Erector Spinae) Abdominal Muscles Respiratory Muscles Functional Anatomy and Pathomechanics of the Upper Limb The Shoulder The Elbow The Forearm The Wrist Summary References 21 Using Dry Needling Acupuncture for Preventing Injury and Enhancing Athletic Performance Injury Prevention: Treating Asymptomatic Athletes Clinical Procedure for Preventing Injury and Enhancing Performance Evidence-Based Research Summary References 22 General Principles of Treating Soft Tissue Dysfunction in Sports Injuries Sports Injuries of the Skin Sunburn Frostbite Blisters Athlete’s Foot Sports Injuries of the Head and Neck Head Injuries Neck Injuries: Strain, Contusion, and Fracture Neck Strain Cervical Nerve Stretch Syndrome Whiplash (Neck Sprain) Acute Torticollis Cervical Disc Injury Cervical Radiculitis (Pinched Nerve) Cervical Spondylosis (Spur Formation) Sports Injuries of the Upper Limb Shoulder and Upper Arm Injuries Fractures of the Clavicle and Humerus Dislocation of the Shoulder Shoulder Subluxation Joint Separations of the Shoulder Girdle Biceps Brachii Tendon Rupture Biceps Brachii Muscle Strain and Bruising Bicipital Tendinitis Impingement Syndrome of the Shoulder Rotator Cuff Tendonitis Shoulder Bursitis Frozen Shoulder (Adhesive Capsulitis) Pectoral Muscle Tendinitis Sports Injuries of the Elbow Elbow Fracture Elbow Sprain Elbow Dislocation Triceps Brachii Tendon Rupture Lateral Epicondylitis (Tennis Elbow) Medial Epicondylitis (Golfer’s Elbow) Thrower’s Elbow Elbow Bursitis Sports Injuries of the Wrist and Forearm Wrist Fracture Wrist Sprain Wrist Dislocation Carpal Tunnel Syndrome Ulnar Nerve Injury Wrist Tendinitis Sports Injuries of the Hand and Fingers Metacarpal Fracture Thumb and Finger Sprain Finger Dislocation Hand and Finger Tendinitis Sports Injuries of the Back and Spine Muscle Strain of the Back Ligament Sprain of the Back Thoracic Contusion Disc Herniation Stress Fracture of the Vertebra Abdominal Muscle Strain Sports Injuries of the Hips, Pelvis, and Groin Hip Flexor Strain Hip Pointer Avulsion Fracture Groin Strain Osteitis Pubis Stress Fracture Piriformis Syndrome Trochanteric Bursitis Sports Injuries of the Thigh Femur Fracture Quadriceps Strain Hamstring Strain Thigh Contusion Iliotibial Band Syndrome Sports Injuries of the Knee Ligament Sprains of the Knee Meniscal Tear Knee Bursitis Patellofemoral Pain Syndrome Patellar Tendinitis Chondromalacia Patellae (Runner’s Knee) Subluxation of the Patella Sports Injuries Below the Knee Fractures of the Tibia and Fibula Calf Strain Achilles Tendinitis Medial Tibial Pain Syndrome (Shin Splints) Stress Fracture Anterior Compartment Syndrome Posterior Tibial Tendinitis Ankle Sprain Ankle Fracture Fibular (Peroneal) Tendinitis Fracture of the Foot Stress Fracture in the Foot Plantar Fasciitis Heel Spur Summary Additional Readings 23 Preventive and Therapeutic Treatment of Injuries in Selected Sports Running Patellofemoral Joint Pain Iliotibial Band Syndrome Shin Pain Achilles Tendinitis Plantar Fasciitis Cycling Upper Extremities Ulnar Nerve Neuropathy Median Nerve Neuropathy de Quervain Tenosynovitis Lower Extremities Chondromalacia Patella Patellar Tendinitis Quadriceps Tendinitis Biceps Femoris Tendinitis Medial Patellofemoral Ligament Pain Achilles Tendinitis and Iliotibial Band Syndrome Spine Microwhiplash Injury Basketball Lower Extremity Foot and Ankle Injuries Achilles Tendinitis Shin Splints Knee Injuries Hamstring Strains Thigh Contusions Spine Injuries Upper Extremity Heat Exhaustion Baseball Shoulder Rotator Cuff and Biceps Tendinitis Impingement Glenohumeral Instability Labral Injuries Elbow Overuse Injuries Other Position-Specific Injuries Golf Shoulder Elbows Spine Football Muscle and Tendon Sprains Brachial Plexus Injuries Achilles Tendon Rupture Injuries to the Shoulder, Back, and Knee Concussion Heat Exhaustion Other Common Injuries Soccer Lower Extremity Injuries Ankle Sprains Shin Splints Compartment Syndrome Knee Injuries Osteoarthritis Thigh Injuries Groin Injuries Upper Extremity Injuries Skiing Knee Shoulder Ice Hockey Injuries to the Head and Face Upper Extremity Injuries Lower Extremity Injuries Swimming Overtraining Syndrome Overuse Injuries Common Upper Extremity Injuries Swimmer’s Shoulder Thoracic Outlet Syndrome Elbow Injuries Common Lower Extremity Injuries Knee Injuries Foot and Ankle Injuries Back Injuries Neck Injuries Spontaneous Pneumomediastinum Other Medical Problems Tennis Wrist Injuries Elbow Injuries Shoulder Injuries Back Injuries Knee Injuries Ankle Injuries Volleyball Rotator Cuff Tendinopathy Suprascapular Neuropathy Hand Injuries Acute Knee Injuries Patellar Tendinitis Ankle Sprain Injuries In Other Sports Summary Additional Readings References 24 Safety Issues in Dry Needling Acupuncture Practice Short-Term Reactions After Treatment Prevention of Adverse Effects Prevention of Needling Accidents Understanding the Anatomy of Acu-Reflex Points Suggested Needle Sizes No Aggressive Needle Manipulation Proper Duration of Needling Time Using Electrical Percutaneous Stimulation Proper Body Positions for Treatment Needles and Skin Cleaning Patient Condition Physiologic Conditions Pathologic Conditions Understanding of Incidents in Needling Therapy Case Analysis: Pneumothorax Clinical Anatomy of Pneumothorax Signs of Pneumothorax Injuries of the Nervous System Injuries to the Peripheral Nerves Prevention of Peripheral Nerve Injuries Treatment of Peripheral Nerve Injuries Visceral Injuries Syncope Syncope Symptoms Prevention of Syncope Summary Reference Additional Reading 25 Credits List Chapter 2 Chapter 3 Chapter 4 Chapter 5 Chapter 6 Chapter 7 Chapter 8 Chapter 9 Chapter 10 Chapter 11 Chapter 12 Chapter 16 26 Index A B C D E F G H I J K L M N O P Q R S T U V W Written by widely respected acupuncture expert Yun-tao Ma, PhD, LAc, Biomedical Acupuncture for Sports and Trauma Rehabilitation shows techniques that will enhance athletic performance, accelerate recovery after intensive workouts, and speed trauma rehabilitation after injuries or surgeries. Evidence-based research is used to support the best and most effective techniques, with over 100 illustrations showing anatomy, injury, and clinical procedures. Unlike many other acupuncture books, this book uses a Western approach to make it easier to understand rationales, master techniques, and integrate biomedical acupuncture into your practice.'Finally, a well-referenced, common sense approach to dry needling in sports medicine that discusses maintenance, overtraining, and the effect of the stress response in atheletes. This is a long-awaited book that will leave you feeling comfortable with a technique that is very useful not only for atheletes, but for all patients of your practice.'Rey Ximenes, MD The Pain and Stress Management Center Austin, Texas'For any clinician involved with assisting atheletes recover from injury, as well as providing services to enhance physical performance, this text will be indispensable. This book is a major accomplishment in the field of sports injury and treatment of musculoskeletal and neurological pain.'Mark A. Kestner, DC, FIAMA, CCSP, CSCS Kestner Chiropractic & Acupuncture Center Murfreesboro, Tennessee Unique! Explores acupuncture treatments for sports injuries in the acute phase, rehabilitation, and prevention. Includes acupuncture for performance enhancement and injury prevention, emphasizing pre-event acupuncture used to help increase muscle output, assist with pre-competition stress, and prevent soft tissue injury. Provides evidence-based research to show the science behind the best and most effective techniques, based on the author's background in neuroscience and cell biology and his 35 years of clinical acupuncture experience. Offers an overview of the science of biomedical acupuncture including the mechanisms of acupuncture, anatomy and physiology of acupoints, and discussion of human healing potential. Uses terminology and concepts familiar to Western-trained health professionals, making the material easier to understand and incorporate into practice. Includes more than 100 illustrations showing anatomy, injury, and clinical procedures. Covers useful techniques including those that increase muscle force output, joint flexibility and stability; prevent sports injuries like muscle sprain, tendonitis, bone strain, stress/fatigue fracture and bone spurs; reinforce muscle output for specific sports; normalize physiology of dysfunctional soft tissues; predict treatment response; reduce physiological stress; use the new Vacuum Therapy for deep tissue dysfunctions; and balance the biomechanics of musculoskeletal system. Written by widely respected acupuncture expert Yun-tao Ma, PhD, LAc, Biomedical Acupuncture for Sports and Trauma Rehabilitation shows techniques that will enhance athletic performance, accelerate recovery after intensive workouts, and speed trauma rehabilitation after injuries or surgeries. Evidence-based research is used to support the best and most effective techniques, with over 100 illustrations showing anatomy, injury, and clinical procedures. Unlike many other acupuncture books, this book uses a Western approach to make it easier to understand rationales, master techniques, and integrate biomedical acupuncture into your practice. "Finally, a well-referenced, common sense approach to dry needling in sports medicine that discusses maintenance, overtraining, and the effect of the stress response in athletes. This is a long-awaited book that will leave you feeling comfortable with a technique that is very useful not only for athletes, but for all patients of your practice." Rey Ximenes, MD The Pain and Stress Management Center Austin, Texas "For any clinician involved with assisting athletes recover from injury, as well as providing services to enhance physical performance, this text will be indispensable. This book is a major accomplishment in the field of sports injury and treatment of musculoskeletal and neurological pain." Mark A. Kestner, DC, FIAMA, CCSP, CSCS Kestner Chiropractic & Acupuncture Center Murfreesboro, Tennessee Integrative systemic dry needling or dry needling acupuncture : a new modality for athletes Homeostasis and stress in sports and exercise Human brain plasticity, sports, and sports injuries Musculoskeletal systems and human movement Overtraining syndrome and the use of muscle in exercise Clinical mechanisms of integrative systemic dry needling Physiology of acu-reflex points Neuroanatomy of acu-reflex points Homeostatic acu-reflex point system Trigger points and the integrative neuromuscular acu-reflex point system Visceral pain and visceral-somatic reflexes Pathomechanics of the musculoskeletal system and acu-reflex points Using dry needling acupuncture for preventing injury and enhancing athletic performance General principles of treating soft-tissue dysfunction in sports injuries Preventive and therapeutic treatment of injuries in selected sports Safety issues in dry needling acupuncture practice.