Feature 3 Penetration of Deep Fascia

The term fascia is rather loosely applied in anatomy. Most fasciae are connective tissue layers and are arranged in sheets or tubes between or around anatomic structures. Superficial fascia is a padding that is connected with the dermis and located above the deep fascia. Deep fascia lies under the superficial fascia and often forms the outer connective layer or covering of the structures underneath, such as blood vessels, nerves, or muscles. Acupuncture points are formed at locations where a...

Appraisal Model of Psychologic Stress

The appraisal model of psychologic stress6 is illustrated in Figure 2-2. When people encounter an environmental stressor such as competition in sports, or illness or injury, they first test the situation for threat Is the stressor a threat or a challenge, or is it irrelevant This evaluation is based on beliefs, past experience, and commitment. Events are appraised as threatening if they violate beliefs, contradict experience, or reduce the ability to carry out a commitment. An ankle sprain is a...

Ulnar Nerve Injury

The ulnar nerve is susceptible to injury because it passes through the ulnar tunnel posteriorly at the elbow, between the medial epicondyle of the humerus and the olecranon of the ulna, and then across the wrist into the hand. Injuries at the elbow may affect the muscles innervated by the ulnar nerve in the forearm and hand, and injuries at the hand affect the intrinsic muscles supplied by this nerve in the hand. Overuse of muscles and tendons of the forearm or sudden trauma to the nerve within...

The Shoulder

The shoulder complex consists of three bones the clavicle, the scapula, and the humerus. The complex is connected to the axioskeleton via the ster num and rests on the thorax. Thus the shape of the thorax affects the function of the shoulder. The shoulder complex is composed of four joints sternoclavicular, acromioclavicular, scapu-lothoracic, and glenohumeral. The movements of the shoulder can be described as elevation and depression about the anterior-posterior axis, protraction and...

Three Dynamic Phases Of Acureflex Points

The sensitization of acu-reflex points is a dynamic physiologic process consisting of three phases latent, passive, and active. Latent acu-reflex points represent normal, non-sensitized tissues. Passive acu-reflex points have a lower mechanical threshold than does normal tissue and start to fire impulses to the spinal cord and the brain upon normal pressure. The same amount of pressure does not induce impulses on latent points. Active acu-reflex points have the lowest mechanical threshold and...

Feature 1 Size of the Nerve Trunk

Acu-reflex points are always associated with nerves, either cutaneous or muscular. The acu-reflex points associated with a bigger nerve trunk are more likely to become sensitized than these associated with a smaller nerve trunk. Electrical signals travel faster along thicker nerve fibers. For example, in patients with headache, the infraorbital nerve acu-reflex point (trigeminal V2) invariably becomes sensitized before the supraorbital nerve acu-reflex point (trigeminal V1), and this is...

H23 Supraorbital Cutaneous

This ARP is formed right on the supraorbital notch, which is the passage for the supraorbital nerve (see Fig. 8-13). This cutaneous nerve from the ophthalmic branch (V1) of the trigeminal nerve extends to the top of the head. The method of needling this point is similar to that for the H19 infraorbital. The supraorbital nerve is smaller than the infraorbital nerve therefore the H23 supraorbital becomes sensitive after the H19 infraorbital. For example, the H19 infraorbital point is always...

Other Facial Acu Reflex Points

The trigeminal nerve contains both sensory (afferent) nerves and motor (efferent) nerves and is responsible for general sensation in the skin of the face and the front of the head, as well as for controlling the muscles of chewing (mastication). Muscles of mastication and muscles of facial expression are the two kinds of facial muscle. Two important muscles of mastication, the temporalis and masseter muscles, are innervated by the motor nerves of the trigeminal nerve. The ARPs formed in those...

Shoulder

The function of the glenohumeral joint depends largely on the function of the scapulothoracic joint. Damage to the shoulder complex in golfers usually occurs in the lead shoulder (left shoulder for the right-handed golfer). Most of these injuries are of a chronic nature and may include rotator cuff strains and tendinitis, impingement syndrome, gle-nohumeral instability, bursitis, and snapping scapula syndrome. Acute damage can cause rotator cuff tears and glenohumeral subluxations. Usually the...

S

Sacral plexus acu-reflex points, 111 Sacroiliac joint dysfunction, and muscle acupuncture induced, case analyses in nervous system injuries, 260, 261 peripheral nerve injuries, 261 pneumothorax, 259 syncope, 262-263 visceral injuries, 262 adverse effect prevention in, 256-258, 257t anatomic features of acu-reflex points in, 256. See also Neuroanatomic features. body position in treatment in, 258 disposable needles in, 258 electrical percutaneous stimulation in, 258 needle manipulation in, 257...

Feature 10 Suture Lines of the Skull

Acu-reflex points are formed along the suture lines of the skull. The acu-reflex points can be palpated along the coronal suture, sagittal suture, lambdoidal suture, and other sutures. Such acu-reflex points appear at the nasion, fontanelle, bregma, and pterion. When chronic headache is not adequately treated, sensitive points eventually appear at these locations. Inferior transverse scapular ligament Superior transverse scapular ligament Inferior transverse scapular ligament Radial collateral...

Triceps Brachii Tendon Rupture

This relatively rare condition is also known as tendon avulsion. The triceps brachii tendon inserts into the back of the elbow. This location may be injured by falling or by the application of excessive force. Weightlifters and football linemen are at risk for this condition. The condition may also develop in nonathletes with hyperparathyroidism or diabetes mellitus. Dry needling acupuncture is a very effective modality for athletes who suffer from this injury. To reduce pain, swelling, and...

Feature 5 Neuromuscular Attachments

Acu-reflex points are formed at the loci where nerve trunks enter the muscle. Muscular nerve trunks contain afferent (sensory) fibers, efferent (motor) fibers, and sympathetic fibers. Two acu-reflex points formed in this way can be found at the centers of the supraspinous and infraspinous fossae, where the suprascapular nerve enters the supraspinatus and infraspinatus muscles (Fig. 7-6). In this example, one nerve forms two attachments with two muscles, but the infraspinatus attachment is more...

Swimmers Shoulder

Swimmer's shoulder is an overuse injury consisting of inflammation in the supraspinatus or biceps tendon, or both, and is usually caused by multidirectional glenohumeral instability or impingement of the tendons between the head of the humerus and the acromion process of the scapula. Local inflammation, swelling, ischemia caused by repetitive microtrauma, and tearing can alter the biome-chanics of the shoulder joint. Clinical examination may reveal that the shoulder has a restricted pattern of...

Steve Abel Dry Needling

12-degree patient classification method, 135-137, 145t Abdominal muscles, 193, 196t, 197 injuries of, 225 Acetylcholine release, at trigger points, 148 Achilles tendinitis, 230 in runners and cyclists, 236 Achilles tendon injuries, in basketball players, 238 Achilles tendon rupture, in football players, 243 Action potential, propagation of, 61-62, 62 Active phase, of exercise responses, 17 dry needling. See Dry needling acupuncture Integrative systemic dry needling. electrical, 53 modern, 5...

Primary visceral sensory afferent fibers

Two types of polymodal visceral sensory receptors have been described in association with some viscera low-threshold (about 75 to 80 of the afferent fibers) and high-threshold (about 20 to 25 ) mechanoreceptors. The low-threshold mechanoreceptors respond to mechanical stimuli in a physiologic range around, for example, distension of 5 mm Hg, whereas high-threshold receptors respond to a noxious intensity (60 to 80 mm Hg). These two types of receptors also respond to chemical and thermal stimuli...

Hormonal Responses To Overtraining

A physiologic imbalance of endocrine function has been recognized in athletes suffering from overtraining. Overtrained athletes often have higher-than-normal concentrations of urea in the blood, which is produced by increased protein catabolism. This is thought to be the mechanism responsible for loss of body weight in overtrained athletes. However, there are no conclusive data to confirm that higher levels of cortisol or epinephrine are related to long periods of overtraining. Serotonin is a...

Lumbar Plexus

The lumbosacral plexus consists of the lumbar and sacral plexuses. Immediately after L2, L3, and L4 roots of the lumbar plexus split off from their spinal nerves and emerge from the intervertebral foramina, they are embedded in the psoas major muscle because this muscle is attached to the lateral surfaces and transverse process of the lumbar vertebrae. Within the psoas major muscle, the roots split into anterior and posterior divisions, which then reunite to form the branches of the lumbosacral...

Osteofascial Compartment Syndrome

Soft tissue injuries increase the pressure in the space between the bone and fascia as a result of edema, contracture of soft tissues, and the consequential deficiency of circulation. Neighboring soft tissues such as nerves, blood vessels, and lymph vessels are adversely affected by the increased physical pressure. Edema, hypoxia, ischemia, tissue contracture, and necrosis may follow. Clinical data show that osteo-fascial compartment syndrome (OFCS) occurs when the compartmental pressure...

Clinical Anatomy of Pneumothorax

According to anatomic data (Table 16-3), pneumothorax can be caused by improper needling in the following areas (1) the back (from T10 up), (2) the side (from rib 9 and up), (3) the front (from rib 7 and up), (4) the supraclavicular fossa and upper border of sternal notch, and (5) the top of the shoulder. Table 16-3 lists the results from a study of acupuncture-induced pneumothorax conducted in China. These data are for reference only, inasmuch as the average body size among Chinese people is...

Pneumothorax

A 58-year-old woman had had lung and heart disease for 8 years, which was more severe during winter. The patient required acupuncture treatment for cough, shortness of breath, chest congestion, and excessive mucus. Needling treatment Points UB13 (acupoint at the level of T3) and UB15 (acupoint at T5) were needled to a depth of 1.5 cm. The patient felt chest and back pain and severe shortness of breath immediately after removal of the needles. Mouth respiration, sweating, and cold limbs were...

Stroke

A 59-year-old male patient had a history of high blood pressure and left hemiplegia. The patient was admitted to the hospital with cerebral stroke. After 3 weeks' hospital care, the condition was stable, and the patient requested acupuncture treatment. Acupuncture treatment The patient felt better after the first two sessions. On the third session, after Taiyang (temporalis muscle), Du 20 (Beihui, area between bregma and vertex on the skull), and UB10 (occipital area) were needled, the patient...

Facial Nerve Cranial Nerve VII

The facial nerve controls the muscles of facial expression. However, a smaller branch of the facial nerve, the nervus intermedium, carries fibers for the para-sympathetic nervous system (tears and salivation), taste, and general somatosensory functions. The facial nucleus is located in the branchial motor column, more caudally in the pons than is the trigeminal motor nucleus. The nerve exits 3 Spinal accessory 13 Dorsal scapular 8 Suprascapular (infraspinatus) 16 Iliotibial 11 Lateral popliteal...

Visceral Pain and Visceral Somatic Reflexes

The purpose of this chapter is to describe the basic concepts of visceral pain and the referred hyperal-gesia zones on the body surface, in order to enable clinicians to learn the pathophysiologic connection between surface acu-reflex points and visceral pathologic processes. The homeostasis of a musculoskeletal system is always affected by both mechanical behavior and visceral pathophysiologic processes. Therefore restoration of visceral homeostasis is always a part of restoration of systemic...

The Brain And Physical Training

Modern sports are unique human activities. They involve strenuous, repetitive physical and psychologic training assisted by modern equipment. Professional athletes (and some amateurs) are always preparing for competition. In many cases, modern sports training is pushing human systems to their physiologic limits. Thus, because of the intimate brain-body interaction, understanding the brain in sports is of utmost importance. It is a two-way process in that the behavior of the athlete modifies the...

Homeostatic Regulation In Sports And Exercise

Homeostatic regulation of the musculoskeletal system, in addition to other physiologic homeostatic regulation, is an important positive process of bodily adjustment in athletes. For example, research in evidence-based sports medicine has demonstrated that weakness of core muscles hinders movement of the limbs.4 Through an understanding of homeostasis, it is clear how the musculoskel-etal system is regulated during and after sports and exercise. Homeostasis is regulated by five physiologic...

Acureflex Points Formed By The Brachial Plexus

The brachial plexus enters the upper limb to provide both sensory and motor functions, which include the following Sensory innervation to the skin and joints Motor innervation to the muscles Influence over the diameters of the blood vessels via the sympathetic vasomotor nerves Sympathetic secretomotor supply to the sweat glands The brachial plexus arises just lateral to the scalenus anterior muscle. The ventral rami of C5, C6, C7, and C8 and the greater part of T1, in addition to a...

Overtraining Syndrome

During periods of intense training, athletes can experience unexplained levels of fatigue, as well as a decline in performance and physiologic function that cannot be restored by a few days of reduced training, total rest, or a carbohydrate-rich diet. These symptoms are collectively referred as overtraining syndrome, and it can last for weeks, months, or even years.13 When athletes are subjected to excessive training, they may eventually exceed their ability to cope with or adapt to the...

H2 Great Auricular Cutaneous

The great auricular nerve is the site of one of the most important ARPs in the human body. Its location is crucial for the balance of head weight and therefore to the balance of the entire head. The importance of this nerve can be understood from its relation to the homeostasis of both mechanical posture and systemic physiology. However, the vas-culature related to this point challenges clinicians because of safety concerns. This point is located just behind the earlobe and on the anterior...

Rotator Cuff Tendinopathy

Shoulder injuries account for 8 to 20 of volleyball injuries. The biceps and rotator cuff tendons are the tissues most commonly injured.62 The shoulder girdle musculature does not generate very powerful torque in the upper limb. About 85 of the energy needed to spike or serve a volleyball is generated by the legs and back. After repetitive overload or acute trauma, the athlete begins to alter movement patterns in an effort to minimize symptoms and maintain performance.64 This increases the risk...

Groin Strain

Muscles involved in this problem include the pectineus, adductor brevis, adductor longus, adductor magnus, and gracilis. Groin strain often occurs in sports that require pivoting and quick changes of direction, such as soccer and hockey. The injury may range from mild pain in the adductor muscles to severe pain, tenderness, and inflammation in this area. Damage is usually localized to the musculo-tendinous junction, about 5 cm from the pubis. Dry needling acupuncture is very effective in...

Preventive and Therapeutic Treatment of Injuries in Selected Sports

Dry needling acupuncture, with its unique physiologic mechanisms, can be used for preventing chronic injuries and injuries caused by overuse. It can also be used for enhancing physical performance because it promotes the coordination and smooth linkage of the musculoskeletal system, as well as treating soft tissue dysfunction and injury. The same dry needling acupuncture therapy protocol can be used to both prevent and treat an injury in sports. Dry needling acupuncture therapy normalizes the...

Medial Epicondylitis Golfers Elbow

The medial epicondyle is the insertion site of flexor muscles, and golfer's elbow is caused by repetitive overuse of these muscles for example, forceful, repeated bending of the fingers and wrist, repeated stress on the arm during the acceleration phase of the throwing motion, and repeated tightening of the flexor muscles and tendons during a golf swing or by trauma to the medial aspect of the elbow. Neck problems, arthritis, rheumatism, and gout may cause similar symptoms. The symptoms are...

A brief history of dry needling acupuncture

Like any medical procedure, dry needling acupuncture has gone through a period of development and may now be considered to be reaching its maturity. Dry needling as a medical technique has been observed in various human civilizations for over two millennia. From historical literature, we know that it appeared in Egypt, Greece, India, Japan, and China. The Chinese, as we know, systematically preserved this technique, developed its medical value, and formulated the well-known acupuncture of...

No Aggressive Needle Manipulation

Needles must not be manipulated strongly or aggressively (rotating or in a piston-like movement Acupuncture Accidents in TABLE 16-2 China Reported from 1950 to 2002* Modified from Zhang Ren Prevention of acupuncture accidents, Shanghai, 2004, Shanghai Science and Technology, p 17. **Soft tissue injuries were caused mostly by wet needling. Modified from Zhang Ren Prevention of acupuncture accidents, Shanghai, 2004, Shanghai Science and Technology, p 17. **Soft tissue injuries were caused mostly...

Subluxation of the Patella

The patella is attached to the quadriceps tendon proximally and to the patellar tendon distally and articulates with the patellofemoral groove on the femur to form the patellofemoral joint. The patella slides over the groove during knee flexion. However, if the vastus lateralis is stronger than the vastus medialis, the imbalance forces the patella out of the groove. The same misalignment may occur if the side of the patella sustains a physical impact or if the knee twists strongly, which may...

Plantar Fasciitis

Plantar fasciitis can also have many causes. The plantar fascia plays an integral role in stabilization of the midfoot and forefoot during running. As the heel begins to rise, the fixed length of the plantar fascia places it under greater tension as it is wound around the metatarsal heads. This creates further stability for the late support phase, and this effect is commonly referred to as the windlass mechanism. When midfoot stability is lost under the initial loading of the foot, the plantar...

Rotator Cuff and Biceps Tendinitis

Inflammation of the rotator cuff tendons or the tendon of the long head of the biceps is a common injury. The injured muscles produce pain during examination of range of motion. Dry needling acupuncture therapy is very effective in treating this injury. Treatment should focus on rotator cuff muscles, as well as associated conditions that contribute to impingement. When the shoulder is treated, the neck and back should be treated together as well. Partial- or full-thickness rotator cuff tearing...

Biceps Brachii Tendon Rupture

The biceps brachii muscles operate across three joints the glenohumeral joint and the two elbow joints. A biceps brachii tendon rupture is the detachment of the tendon from the bone, and it usually happens at the proximal end of the tendon. The injury is caused by sudden trauma to the biceps brachii tendon during weightlifting or throwing activities. The injury can also be caused by weakness of the biceps brachii muscle or tears in the rotator cuff muscle caused by repetitive strain. It may...

Other Neck Acu Reflex Points

Several ARPs on the neck are formed by three other nerves derived from the cervical plexus (1) the lesser occipital nerve, for which an ARP is located on the insertions between the sternocleidomastoid and the trapezius muscles on the occipital bone (2) the transverse cervical nerve, which curves around the middle of the posterior border of the sternocleido-mastoid and then passes transversely to the anterior border of the same muscle (several ARPs are formed over the anterior triangle of the...

Impingement Syndrome of the Shoulder

The major symptoms of impingement syndrome of the shoulder include shoulder pain during sleep when the patient rolls onto the injured arm, when the arm is rotated to reach the back, or when the arm is raised in the air. This injury is caused by a narrowing of the space between the rotator cuff and the acromion, and it impairs the joint movement. The rotator cuff consists of four muscles supraspinatus, infraspinatus, teres minor, and subscapularis and includes their musculotendi-nous...

Thumb and Finger Sprain

The ligaments of the thumb, which connect the metacarpal bone to the first phalanx at the base of the thumb, may be overstretched and torn. Repetitive overuse of the thumb with the index finger or other fingers may wear these ligaments and their muscles. Blows to the hand and hyperextension of the finger joints when falling may damage the dorsal or palmar ligaments of the finger. Finger sprain is a common injury in many sports such as football, basketball, cricket, and handball and in all...

Cervical Nerve Stretch Syndrome

Blows to the head, shoulder, or ear may cause injury to the brachial plexus in contact sports such as hockey, football, and wrestling, Patients may experience severe, burning pain radiating from the neck to the arm and fingers numbness, tingling sensation, pricking sensation, burning sensation, or creeping sensation of the skin and muscle weakness. Chronic symptoms may develop, and the rate of recurrence may be high, if the initial injury is not properly treated to the point of complete...

The Wrist

The hand contains 27 bones 8 carpals, 5 meta carpals, and 14 phalanges plus ulna and variable number of sesamoid bones. The relationship between anatomic structure and movement and the forces that apply in movement are complex. To achieve efficient movement, opti mal structure is required. Musculoskeletal structure may be out of balance, causing impairment of normal movement, as a consequence of the physical stress on soft tissue that results from overtraining, other types of misuse of the...

Injuries Of The Nervous System

When practiced without sufficient modern knowledge of anatomy, acupuncture needling may injure the central and peripheral nervous systems. It has been reported (see Table 16-2) that needle-induced injuries of the nervous system involve the cerebrum, cerebellum, brainstem, spinal cord, nerve trunks in the limbs and face, and visceral nerves. Of these injuries, subarachnoid-space bleeding is the most common. Peripheral nerves, cranial nerves, and spinal nerves are the targets of acupuncture...

Lower Extremity Foot and Ankle Injuries

Ankle injuries are common in basketball. Basketball players with a history of ankle sprains exhibit a larger mean postural sway and have a larger sway area. Ankle sprains are often the result of landing on the lateral border of one foot and rolling the foot inward. The injury may involve the anterior talo-fibular ligament, the calcaneofibular ligament, and occasionally the posterior talofibular ligament.9 Medial ankle sprains are less common but also can occur from landing improperly or by...

Bone Spurs And Soft Tissue Dysfunction

Abnormal bone growth is often related to soft tissue dysfunction. Contracture, or shortened tissue, usually applies increased physical force to the bone. This results in an abnormal growth of bone material to adjust to the increased pulling force on the bone surface. In addition, shortening of the soft tissues, adhesions, scars, and blockage cause changes in the biochemical environment, and this type of biophysical and biochemical abnormality leads to abnormal growth of bone tissue.

Osteitis Pubis

Inflammation of the pubic symphysis and the surrounding muscles may result from repetitive stress, or imbalance of the adductor muscles, iliotibial bands, or hip flexor muscles. Athletes who perform running, kicking, or rapid lateral movement, such as sprinters, soccer players, and hockey players, are more susceptible to this injury. Major symptoms include pain in the pubic symphysis, lower abdomen, and groin area. Dry needling acupuncture is very effective in alleviating this condition, but...

Anterior Compartment Syndrome

The tibia and fibula, the interosseous membrane, and the intermuscular fascial septa divide the leg into three compartments anterior (extensor), lateral (fibular), and posterior (flexor). Each compartment performs a different function. However, the fascia that covers the muscles and encases the compartment and the bone is in the form of inflexible fibrous sleeves. When intramuscular swelling or inflammation occurs as a result of repetitive overuse of the muscles or acute trauma to the muscles...

Understanding Of Incidents In Needling Therapy

Needling therapy is not free of side effects or danger, and its accidents can cause death. Acupuncture needling creates lesions in the body tissues. If the needle-induced lesions are created in the wrong locations, or in the correct locations but in the wrong person (e.g., patients with diseased or enlarged organs or thinner body walls), they may cause temporary or irreversible consequences. To maximize medical benefit of needling therapy to patients, the author makes the following suggestions...

Preaxial Innervation

Two primary homeostatic ARPs are formed by two terminal branches the lateral pectoral nerve, directly derived from the proximal lateral cord supplying the pectoralis major muscle, and the lateral antebrachial cutaneous nerve, derived from the muscular cutaneous nerve, which innervates the skin on the lateral elbow. As one of the small terminal branches of the lateral cord, the lateral pectoral nerve (arising from C5 to C7) pierces the clavipectoral fascia and enters the pectoralis major muscle...

Brachial Plexus Injuries

It has been reported that more than 50 of college football players have sustained brachial plexus injuries in the course of their playing careers.25 Players with this injury may feel burning pain or weakness, or both, in the upper limb or paresthesia and temporary disruption of nerve function after a block or tackle. Recovery is usual, but in some cases in which symptoms persist for months, neural degeneration is confirmed by electromyography. These injuries may involve the spinal accessory,...

Integrative Systemic Dry Needling A New Modality for Athletes

All athletes experience injuries, as all people experience pain and disease in their lives. Some athletes are never completely able to recover from injuries that become chronic and make them more prone to new injuries. Some athletes come to believe that their performance is irreversibly impaired by injury while they are still in their prime, and some do have to face the reality that their athletic career is limited by chronic injuries. For many, however, this limitation is not inevitable. Some...

Stress Fracture in the Foot

Stress fractures of the bones of the foot can be caused by repetitive stress from training that involves running and jumping on hard ground, by fatigued muscles that are no longer able to absorb shock and stress, by drastic changes to intensive training, or by improper footwear. Stress fracture can occur in any of the bones of the foot, but it is most common in the metatarsals and the calcaneus. The symptoms may include pain and swelling at the fracture site, pain with weight bearing, and...

Four types of myofascial pain and their different pathology

The majority of clinical pain is myofascial. It has been reported that 85 of back pain and 54.6 of chronic headache and neck pain is myofascial pain.8 We currently categorize myofascial pain into four types Each type of myofascial pain requires a different dry needling technique and will follow its own healing pattern. Unfortunately many clinicians are trained to concentrate on trigger points to the exclusion of the other types of myofascial pain. Such narrow emphasis is contrary to the...

A

Triceps brachii (three-headed arm muscle) Pectoralis major (greater chest muscle) Triceps brachii (three-headed arm muscle) Pectoralis major (greater chest muscle) Extensor carpi radialis longus and brevis (long and short radiuswrist extensor) Semitendinosus Tibialis anterior (anterior shin bone muscle) Extensor hallucis longus (long big toe extensor) Extensor digitorum longus (long toe extensor) Serratus anterior (anterior serrated muscle) Latissimus dorsi (broad back muscle) Obliquus externus...

Hand and Finger Tendinitis

Tendons bear considerable mechanical stress when transmitting forces between muscles and bone. Overuse of the muscles causes inflammation of the tendons, tendon sheaths, and muscles. Dry needling acupuncture is very effective in alleviating this condition. Fine needles can be applied to the inflamed tendon, and normal needles can be applied the related muscles. Treatment should be provided two to three times per week. The affected fingers should be properly cared for so as not to stress the...

Local Skin Reaction And Cutaneous Microcurrent Mechanism

Skin, with its neurovascular-immune function, serves as the first line of the body's defense system. When needling breaks the skin, it triggers a cascade of physiologic reactions to the intrusion. The needles encounter the following components of the skin 1. Afferent somatic neuron fibers (cutaneous AS and C fibers) and sympathetic nerve fibers (for controlling sweat glands and fine blood vessels) 2. Fine arterial and venous blood vessels (nutrition supply and temperature regulation) 3....

Fractures of the Tibia and Fibula

These fractures are caused by direct force on the bones, such that which occurs in landing from a high fall by violent twisting when the foot is fixed or by a rotational force on the bones, such as a tackle in football. The symptoms include extreme pain, inability to move the leg or bear weight on the bones, swelling, and tenderness. Deformity may be observable. Medical attention and emergency treatment should be obtained without delay. Dry needling acupuncture can be applied to the inflamed,...

Hamstring Strain

The hamstrings are composed of three separate muscles the biceps femoris laterally and the semi-tendinosus and semimembranosus medially. The three muscles work together to extend the hip and flex the knee. During running, the hamstrings slow down the leg at the end of the forward swing phase and prevent flexion of the trunk at the hip joint. Hamstring strain is a common injury in running and sprinting and is related to an imbalance in strength between the hamstrings and the quadriceps or to...

Case Analysis Pneumothorax

In acupuncture, pneumothorax usually occurs in the following way A needle punctures the lung tissue. Then the natural respiratory movement of the lung causes tearing at the injury and enlarges the puncture. The needling hole on the thoracic wall may become a one-directional valve such that air can be sucked only into the cavity and not the other way. If blood vessels are involved, both blood and air fill the cavity to form hemopneu-mothorax. All these conditions change negative pressure into...

Acureflex Points Formed By The Cervical Plexus

The neck is one of the most important parts of the body in acupuncture therapy. Because of its critical involvement in both postural and physiologic homeostasis, it should be examined in every case and treated in most cases. The cervical plexus is not given particular attention in most anatomy textbooks, but its importance here cannot be overemphasized. This nerve plexus is described briefly here in order for readers to understand its anatomic scheme. Some of the most important neck ARPs are...

Knee Bursitis

The knee has five bursae the suprapatellar, situated between the femur and the quadriceps femoris tendon the subcutaneous prepatellar, situated between the skin and the anterior surface of the patella the superficial infrapatellar, situated between the skin and the patellar tendon the deep infrapatellar, situated between the tibial tuberosity and the patellar ligament and the pes anserinus bursa, situated at the lower inside of the knee joint where the sar-torius, gracilis, and semitendinosus...

Patellofemoral Pain Syndrome

Incorrect running gait, weak or tight quadriceps, chronic patellar stress, and improper shoes may cause this injury. The symptoms include pain in and under the patella and a dull, aching pain in the knee. The pain worsens after sitting for long time or walking down stairs. Dry needling acupuncture is effective in treating this injury. Needles can be applied directly into the inflamed, tender, swollen, and painful area and into related muscles on the hip, thigh, and lower leg, especially the...

Feature 2 Depth of the Nerve

More acu-reflex points are formed along superficial nerve trunks than along deeper ones. The superficial nerve receptors become sensitized more easily than receptors of nerves located deep in the tissue. For example, the sciatic nerve is the biggest nerve trunk in the human body, but only a few acu-reflex points can be attributed to this big nerve in the gluteal and thigh region because there the nerve lies deep beneath the thick gluteal and hamstring muscles. As the sciatic nerve enters the...

Hip Flexor Strain

The iliopsoas and rectus femoris are the major hip flexors. Repetitive stress on the hip flexor muscles without adequate recovery is the major cause of muscle strain. Improper gait can also create this type of problem. This injury often occurs in running, in cycling, and in kicking and jumping activities. The symptoms include pain, tenderness, and inflammation in the groin area. Dry needling acupuncture is very effective in treating this injury. Needles can be applied to the ARPs on the...

Patellar Tendinitis

The patellar tendon is involved in extending the lower leg and is the area that experiences shock upon landing from a jump. When the quadriceps contracts to slow down the flexion of the knee, the tendon is forced to stretch. Repeated stress from flexion and extension may cause trauma to the patellar tendon. Dry needling acupuncture is effective therapy for healing this injury. Needles can be applied directly into the inflamed, tender, swollen, and painful area and into related muscles on the...

Frozen Shoulder Adhesive Capsulitis

Frozen shoulder is caused by scar tissue formed inside the space of the glenohumeral joint with reduced synovial fluid. This condition usually occurs after repeated tearing of soft tissue surrounding the joint, or it may be caused by scar tissue formed after shoulder injury or by adhesion after surgery. The joint capsule appears to be a major source of limitation of movement in this condition. A dull, aching pain is felt in the shoulder when the arm is lifted, and it often gets worse at night....

Syncope

Acupuncture-induced syncope happens mostly in young and very healthy men and in middle-aged women. Syncope is caused by a reflex of the vagus nerve. During this process, peripheral cardiovascular resistance decreases, and blood volume returning to the heart is low, which reduces the cardiac output and leads to low blood pressure and low perfusion to the brain. Syncope occurs in the following conditions Lack of acupuncture experience (new patients are prone to syncope in the first one to three...

Bicipital Tendinitis

Overuse of biceps brachii without proper relaxation or a sudden increase in the duration or intensity of training can stress bicipital tendons and result in tendinitis. This injury is common in athletes engaged in throwing sports and also in weightlift-ers, golfers, and rowers. The injury produces pain and tenderness along the length of the tendon over the bicipital groove during resisted forearm supination and elbow flexion. Dry needling acupuncture is very helpful in healing the tendinitis....

Elbow Dislocation

Elbow dislocation is caused by a blow to the elbow, by violent contact between the elbow and another athlete (as in football), or by a fall on an outstretched arm. The trauma may affect the nerves or arteries of the arm, or both. The athlete who suffers from this injury may have severe pain, swelling, and loss of feeling in the hand. Dry needling acupuncture can be used immediately after the accident to reduce swelling and pain. To reduce swelling, two to three needles per square centimeter may...

Electrical Acupuncture

Electrical acupuncture stimulates specific peripheral nerves, which send strong impulses to the spinal cord and brain. With different stimulating frequencies, electrical acupuncture can induce different endorphins at different levels of the CNS. Endorphins have many physiologic functions, such as modulating pain mechanisms to relieve pain, relaxing cardiovascular systems, and improving immune activity by reducing physiologic stress. Electrical acupuncture stimulation, therefore, results in...

Head Injuries

Traumas to the head are among the most serious injuries in sports they can cause permanent symptoms and even fatality. Head injuries include concussion, contusion, hemorrhage, and skull fracture. Major signs and symptoms of these injuries include loss of consciousness, confusion, amnesia, and shock. All these injuries necessitate immediate medical attention. Rehabilitation from head injuries varies widely, depending on the nature and extent of the injury. According to the author's experience,...

Shoulder Bursitis

Shoulder bursitis is often associated with rotator cuff tear, impingement syndrome, or regional soft tissue inflammation, and it is caused by overuse of the shoulder from the throwing motions of tennis, swimming, baseball, and weight training. The tendons of the rotator cuff muscle rotate the humerus, raising the arm by pulling down the humeral head down. At the same time, the deltoid muscle pulls up the arm. Through excessive repetitions of this action, the subacromial bursa that serves as...

Lateral Epicondylitis Tennis Elbow

This common injury is caused by strain from overuse of the extensor muscles of the hand or by direct impact to the elbow. Arthritis, rheumatism, or gout may cause the same symptoms. The inflamed tissues are painful and tender to the touch. Various muscles attach to the lateral epicondyle of the humerus, including the extensor muscles of the hand, the anconeus, and supinator muscles. Thus the treatment should include needling both the inflamed tendon and the strained muscles. Dry needling...

Baseball

Baseball is a sport enjoyed by young people as well as adult players. The act of throwing requires maximally accelerating and decelerating the arm within a short period of time. According to research of baseball injuries over a 3-year period among college baseball teams, 58 of the injuries were to the upper extremity, 27 to the lower extremity, and 15 to the trunk and back.18 The shoulder and elbow are the joints most vulnerable to injury in baseball players as a result of the high forces and...

Neurochemical Mechanisms Of Acupuncture Analgesia

Soft tissue pain often starts to subside immediately after needling therapy and even completely disappears within a few days. After needling, the peripheral mechanisms of normalizing soft tissue dysfunction are operating. Without central command from the brain and spinal cord, however, peripheral organs cannot work without central coordination therefore the role of the CNS is important. Even though this book focuses on clinically observable and measurable physical parameters such as...

Homeostasis and Stress in Sports and Exercise

Integrative systemic dry needling (ISDN), also known as dry needling acupuncture, is a nonspecific therapy for restoring and maintaining homeostasis by reducing physical stress. When exercise is performed under conditions of optimal homeostasis, it leads to health and the best possible sports performance. When exercise is performed under stress, it results in the deterioration of bodily function, which leads to illness and disability. Millions of people of all ages actively participate in...

Dry Needling For Patellofemoral

Common knee injuries include patellofemoral tracking syndrome and patellar tendinitis. These are overuse knee injuries and are caused by the explosive, repetitive, and multidirectional movements in the sport.60 Patellofemoral tracking dysfunction may be caused by biomechanical imbalance, pronated feet, or a tight lateral retinaculum.54 Dry needling acupuncture is very effective for reducing overuse stresses in soft tissue. The trigger points on the low back, hip, and lower extremity, including...

Upper Extremity Injuries

Upper extremity injuries are more common in goalkeepers than in field players. Fractures of the elbows, fingers, and wrists as a result of falls or collisions are the most common types. Common shoulder injuries include acromio-clavicular sprains. Shoulder dislocations or acro-mioclavicular sprains are occasionally related to capsular laxity or violent collision. These injuries should be treated by specialists, but dry needling acupuncture is very helpful in reducing pain and swelling if...

Acute Torticollis

Acute torticollis is a neck injury that can be caused by different mechanisms. Joint-related torticollis usually follows a sudden rotational movement of the head, such as that which occurs in many contact sports a fall that causes a sudden torsion in the neck, or a direct blow to the head that causes sudden twisting. This sudden physical force causes a sprain in one of the joint facets and compresses the nerves in the neck, resulting in muscle spasms, pain, and loss of movement. There may be...

General principles of Treating Soft tissue Dysfunction in Sports Injuries

Previous chapters introduced the concept of dry needling acupuncture as a nonspecific modality for treating soft tissue dysfunction. Dysfunction of soft tissue is involved in all human pathophysiologic processes, and most sports injuries are typical soft tissue injuries. Every athlete, professional or nonprofessional, experiences injury. Many never completely recover, and their injuries become the root of chronic problems. In reality, these injuries can be prevented or completely healed in many...

Needling Is Soft Tissue Therapy

Clinicians have observed that needling therapy can be used with some efficacy in almost all known pathologic conditions, from soft tissue pain to Parkinson's disease, cancer, and even acquired immune deficiency syndrome (AIDS), with varying results. Needling therapy does not reverse many of these conditions but is able to improve some symptoms for some time. This merits specific clarification. One of the most important concepts in ISDN medicine is that the nonspecific mechanisms of needling do...

Needling Sensation

Needling is a process of nociceptive stimulation with both mechanical and biochemical effects. Mechanical effects include physical pressure on and disturbance of the nociceptors of the sensory nerve endings. The biochemical effects are needle-induced neurogenic inflammation and the secretion of neuropeptides from nociceptive nerve endings and tissues, substance P, bradykinin, prostaglandins, serotonin, somatosta-tin, and calcitonin gene-related peptide (CGRP). Sterile, disposable...

H16 Inferior Gluteal Muscular

The H16 inferior gluteal ARP is located right in the center of the gluteal region (Fig. 8-23). The inferior gluteal nerve arises from the posterior divisions of Important Nerves That Have Peripheral Branches in the Leg Femoral nerve (L2-L4) Saphenous nerve Obturator nerve (L2-L4) Sciatic nerve (L4-S2) Tibial nerve (S1-S2) Superficial fibular (peroneal) nerve (L5-S1) Deep fibular (peroneal) nerve (L5-S1) Leg flexion at the hip Leg extension at the knee Adduction of the thigh Leg flexion at the...

Stress Fracture of the Vertebra

This common athletic injury occurs most often in gymnastics, weightlifting, and football. The injury is related to overuse, flexion, twisting, or hyperextension of the spine and most often is found in the fifth lumbar vertebra. The symptoms include back pain and muscle stiffness or spasms, with tingling sensation in the thigh or lower leg. Regardless of whether surgery is needed, dry needling acupuncture is very helpful in reducing the pain and tingling sensation and in restoring spine...

Respiratory Muscles

The diaphragm is the most important muscle of respiration (Fig. 12-21). This muscle arises from the lumbar vertebrae, from the lower ribs, and from the xiphoid process. The diaphragm arches up like a dome into the chest cavity. When the muscle fibers contract, they become less arched and thus cause the central tendinous part of the dome to descend. During contraction, the volume of the chest cavity increases (inspiration) and the volume of the abdominal cavity decreases. The diaphragm also...

Disc Herniation

Intervertebral discs provide absorption from shock and allow for the smooth motion of the spine by preventing the bones from rubbing against each other. The spine is the first part of the body to start degenerating, and this can happen even in a person's early 20s thus discopathy is a common problem in adults. The biomechanics of the spine is briefly introduced in Chapter 12. In addition to natural degeneration or age-related wear, disc her-niation can be aggravated by improper lifting of...

Medial Tibial Pain Syndrome Shin Splints

This injury is common in running and jumping. The tibialis anterior muscle is the largest of the dor-siflexor muscles. It originates from the lateral con-dyle of the tibia and inserts into the medial and plantar surfaces of the medial cuneiform bone. The tibialis anterior muscle is responsible for ankle dor-siflexion and inversion of the foot. Its innervation is supplied by the deep peroneal nerve (L4 and L5). Repetitive stress on the muscle causes inflammation, swelling, and a dull, aching...

Thoracic Outlet Syndrome

Thoracic outlet syndrome is a specific group of signs and symptoms resulting from compression of the subclavian artery, subclavian vein, and brachial plexus. The compression can occur at scalene muscle level, between the clavicle and the first rib, or in the area of the coracoid process. The structure being compressed can be the brachial plexus, an artery, or a vein. The athlete may complain of muscle tightness and pain about the shoulder, neck, and clavicle at the position in the stroke in...

Stress Fracture

The tibia is a weight-bearing bone and sustains a large amount of impact, and so it is more likely to sustain stress fractures if it is exposed to repetitive stress, as in running and jumping sports. Fatigued leg muscles reduce the leg's ability to absorb shock, and this lessened ability, combined with training on hard surfaces, results in stress fracture. Bones are constantly repaired and rebuilt by movement of calcium from one area to another, and this process creates weak areas that are...

Posterior Tibial Tendinitis

The posterior tibialis muscle is the deepest muscle of the posterior compartment and has both medial and lateral origins. The medial origin is on the posterior surface of the interosseous membrane and the lateral area of the posterior surface of the tibia. The lateral origin is on the upper two thirds of the posterior fibular surface, deep transverse fascia, and intermuscular septa. The muscle's insertion tendon runs from the calf muscle behind the medial mal-leolus to the navicular bone in the...

Soccer

Soccer is the most popular sport in the world and is considered to be relatively safe. The risk of injury is 85 for a high school football player, in contrast to 30 for a soccer player.27 Of all injuries in soccer, 80 occur during physical contact between two players. Contact includes being kicked by and colliding with another player.28 At higher levels of play, more injuries are caused by the mechanisms of running.29 Further research has demonstrated that 69 of injuries occur because of...

Fractures of the Clavicle and Humerus

A sudden blow to the clavicle resulting from the collision of two athletes (in sports such as football) or a fall on an outstretched arm can cause fractures of clavicle or humerus. Immediate medical care is needed, but dry needling acupuncture can be used to reduce swelling and pain immediately after the accident and before surgery. Dry needling acupuncture can be used in all phases of rehabilitation from the fracture, regardless of whether surgery is needed. Fine 15-mm-long needles should be...

Dry needling acupuncture is not the acupuncture of traditional chinese medicine tcm

Dry needling has been developed on a foundation of the general principles of Western medical science. The understanding and practice of dry needling require that the practitioner has formal medical education, with comprehensive training which should include coursework in basic science as well as clinical courses like human anatomy, physiology, pathology, neurology, clinical diagnosis, etc. In addition, practitioners need clinical experience dealing with patients in terms of personal...

Pectoral Muscle Tendinitis

The pectoralis major muscle forms the anterior wall of the axilla. It originates in the clavicle, sternum, and first six costal cartilages and inserts in the greater tubercle of the humerus. This muscle serves several functions, such as adduction and medial rotation of the humerus. Thus it is used in many sports when arms act to push away a weight or during climbing when one arm pulls the body up to the other arm, which is fixed. Excessive force against the muscle from pushing by other athletes...

Syncope Symptoms

The presyncope stage may occur for only a few seconds. It is characterized by upper-body or whole-body discomfort, pale face, ringing in the ears, blurred vision, fast heartbeat, nausea, cold sweating, and excessive yawning. The syncope stage is characterized by dizziness, chest congestion, nausea and desire to vomit, cold A 37-year-old male patient had pain in the stomach and upper abdominal area and asked for acupuncture treatment. During the third session, both kidney areas were needled. The...

Fibular Peroneal Tendinitis

The tendons of the peroneal longus and peroneal brevis muscles pass around the lateral malleolus and insert into the lateral side of the base of the first metatarsal bone and the lateral side of the base of the fifth metatarsal bone, respectively. These tendons help stabilize the foot and assist eversion of the foot. Inversion of the foot causes these two tendons to stretch. Repeated stretching of these tendons, which may occur in running and jumping, causes irritation, swelling, inflammation,...

Ankle Sprain

Lateral ankle sprain accounts for 15 to 65 of all volleyball injuries.63 In mild (grade 1) sprains, the anterior talofibular ligament may be stretched. In grade 2 sprains, one or two ligaments may be partially disrupted. Grade 3 sprains are characterized by complete tearing of one of more lateral ligaments. In early examination, the amount of swelling is typically correlated with the severity of the injury. Of all known therapeutic modalities, dry needling acupuncture is most effective in...

A systemic approach is necessary in dryneedling acupuncture

Clinical observation and evidence-based research reveal that an injury produces both local symptoms and systemic dysfunction, especially in active athletes.7 Systemic dysfunction will continue if treatment is directed only at local symptoms. For example, knee pain can affect how the muscles are used to control the gait of the other leg, the movement of both feet and the hips, the spinal balance from the sacral to the cervical regions, and the functioning of the neck and even the eye muscles....