Athletes Foot

Athlete's foot is a skin infection that affects 70 of the population at various times. It is caused by a fungal infection produced by a class of parasites of the skin known as dermatophytes. The fungus thrives in the moist conditions produced by sweat. The site most commonly affected is between the fourth and fifth toes, where the fungus causes irritation, maceration, and fissures and scaling of the outer layer of skin. The symptoms are reddened, cracked, and peeling skin with itching,...

H3 Spinal Accessory Muscular

This point contains both spinal and accessory nerves, as indicated by its name. The spinal accessory nerve (XI) originates both from cranial roots (nucleus ambiguus in medulla) and from spinal roots (C1 to C6), and it contains both afferent (sensory) and efferent (motor) fibers. A branch of the spinal accessory nerve enters the trapezius muscle, in the middle of the upper front edge, at the point over the shoulder bridge. This point is a neuro-muscular attachment point. The H3 spinal accessory...

Electrophysiology Of Acureflex Points

Muscles and nerves are excitable tissues generating electrical signals when stimulated. When undisturbed or at rest, they are electrically silent. Barlas and colleagues1 investigated the electrical activity at trigger points, and they found two significant components (1) intermittent high-amplitude spike potentials and (2) continuous, lower amplitude, noise-like recordings, which they called spontaneous electrical activity. The author discovered similar electrical activity in response to...

Exerciseassociated Muscle Cramps

Athletes may experience cramp in skeletal muscles during the height of competition, immediately after competition, or at night during sleep. Investigators have not been able to pinpoint the cause of muscle cramping. Most exercise-induced or exercise-associated muscle cramps are unrelated to disease or medical disorder. Exercise-associated muscle cramps have been defined as painful, spasmodic, involuntary contractions of skeletal muscles that occur during or immediately after exercise.10...

Dry needling is a specific therapy for restoring softtissue dysfunction

Dry needling creates minute lesions in specific areas of soft tissue to normalize the soft tissue dysfunction without the involvement of any pharmacological process. By its physiological nature, dry needling is a specific therapy for myofascial pain and other soft-tissue dysfunction. Muscle accounts for 50 of human body mass, and so most human pathological conditions involve soft tissue dysfunction, whether in the case of physical injuries such as muscles damaged by overuse in daily life or in...

Human Brain plasticity Sports and Sports Injuries

This chapter is a brief review of some basic brain-body interactions and neural processes that occur during physical exercise and training. Understanding this interaction is essential for designing training programs, preventing potential sports injuries, and assisting rehabilitation by using integrative medical procedures. The aim of this review is to understand why dry needling is used and how it can benefit athletes by reducing physiologic stress during the different phases of their sports...

Force and Stress on the Skeletal System

External and internal forces are always acting on the body, and it is important to understand their effects and how these forces can facilitate movement or, conversely, cause damage to the skeletal system. The skeletal framework is a series of long and short bones connected at joints. Each joint has a specific design that allows for movement in certain directions. Movement at joints is produced by either internal or external forces. Internal forces are generated by muscle contraction, whereas...

Overtraining Syndrome

Overtraining is common among swimmers. Between 10 and 21 of swimmers experience signs of overtraining during the course of a competitive season.44 Early signs of overtraining may include recurring minor illnesses, changes in sleep patterns and nutritional habits, and overall mood instability. Female swimmers are often susceptible to the female athlete's triad eating disorders, amenorrhea, and osteoporosis.45 Overtraining syndrome develops when training outpaces rest and recovery. The symptoms...

Posture And Muscle Imbalance

Posture is the state of balance and coordination of musculoskeletal and visceral systems. Skeletal asymmetry is a major source of muscle strain inasmuch as compensatory muscular control is necessary to maintain a working posture and to keep the eyes level. For example, a length discrepancy between the lower limbs causes a chain reaction of muscular overloads of the entire musculoskeletal system. The tilted pelvis requires contraction of the quadra-tus lumborum muscle to curve the lumbar spine...

Who will benefit from this book

Dry needling therapy is easy to learn and offers unique efficacy in treating soft tissue dysfunction. Increasing numbers of medical doctors, physical therapists, chiropractors, occupational therapists, physician assistants, and nurses have recognized the clinical value of dry needling therapy and are learning this modality and using it with their patients. The ultimate purpose of dry needling is to integrate physiological systems to achieve homeostasis for better body fitness. This integration...

Stress In Sports And Exercise

Psychologists have conceptualized stress in three ways 1. Stress is viewed as a stimulus if the person perceives events or circumstances as threatening or harmful (stressors). 2. Stress is a response to environmental challenges, if the person examines the physical and psychologic stress that stressors produce. 3. Stress is a process that involves continuous interactions and adjustments between the person and the environment. On the basis of these concepts, stress can be defined as the condition...

Ten Basic Anatomic Features Of Acureflex Points

Nerves are the major component of all acu-reflex points, but each point has a particular neural configuration. For example, different acu-reflex points may consist of cutaneous nerves, muscular nerves, a-motor nerves, and y-motor nerves some contain both afferent and efferent fibers and some contain nerves and blood vessels. These different neural configurations result in different physiologic mechanisms of sensitization. Dr. H. C. Dung, professor of anatomy at the University of Texas Health...

Spontaneous Pneumomediastinum

Spontaneous pneumomediastinum, also known as mediastinal emphysema, is relatively uncommon but well documented in athletes. The major symptoms include neck and chest pain, shoulder and back pain, abdominal pain, weakness, dyspnea, dysphagia, sore throat, and swollen neck. Some patients may experience shortness of breath and difficulty swallowing. Subcutaneous emphysema is the most prevalent physical finding.53 Spontaneous pneumomediastinum may be caused by several conditions that allow free air...

Exercise Can Be a Positive or Negative Stressor

Sport and exercise are physically stressful to the body, and stress is usually regarded as undesirable. However, medical experts agree that well-managed exercise is beneficial for health and mood enhancement. People enjoy sports and exercise because they are different from negative events encountered at other times. People like this kind of activity because it produces a positive mood, and they experience benefits and satisfaction from it. In most cases, the body is capable of handling the...

Isdn Versus Classical Chinese Acupuncture And Triggerpoint Medicine

Acupuncture is one of the oldest techniques of sports medicine. From its beginnings more than 2500 years ago, traditional Chinese acupuncture was an indispensable part of Chinese martial arts. All the martial arts masters were also masters of acupuncture, and they used acupuncture to treat injuries incurred in the practice of martial arts. Contemporary ISDN is not the same as traditional acupuncture. The cornerstone of Chinese acupuncture, which has guided clinical acupuncturists for at least...

B

Oblique popliteal ligament Posterior cruciate ligament Figure 12-5 Ligaments of the knee. A, Anterior view. B, Posterior view. Anterior cruciate ligament Femur, lateral condyle Fibular collateral ligament Tibia, lateral condyle Posterior ligament of fibular head Head Figure 12-5 Ligaments of the knee. A, Anterior view. B, Posterior view.

Iez

Sustentaculum tali Medial collateral ligament, tibiocalcaneal part Groove for tendon of flexor hallucis longus Plantar cuneonavicular ligaments Plantar cuboideonavicular ligament Sustentaculum tali Medial collateral ligament, tibiocalcaneal part Groove for tendon of flexor hallucis longus Fibularis peroneus , brevis, tendon Fibularis peroneus , brevis, tendon Tibialis anterior, tendon Plantar tarsal ligaments Figure 12-10 Ligaments (A), tendons (B), and plantar aponeurosis (C) that support the...

Muscle Soreness Delayedonset Muscle Soreness Doms

Muscle soreness is one of the many common symptoms that can be successfully treated by dry needling, even when the usual physical procedures such as massage, stretching exercises, or manipulation have had no effect. A sore muscle becomes inflamed, shortened, and weak, and this can lead to tendinitis, avulsion of muscular attachment, or abnormal bone growth. Early treatment by needling, especially right after exercise, is necessary and very effective for preventing the injury of muscle and soft...

Feature 6 Concomitant Blood Vessels

Arteries and veins course along the nerve trunks to form neurovascular bundles to reach the muscle attachments. Acu-reflex points associated with neu-rovascular bundles tend to become sensitive more readily than do acu-reflex points associated only with cutaneous nerves, because the cutaneous nerves are not accompanied by concomitant blood vessels. The deep radial nerve is a clear example of how an acu-reflex point is formed by concomitant blood vessels and nerves. At the lateral surface of the...

Musculoskeletal Responses To Stress

The curves in Figure 4-9 show stress reactions in muscle, tendon, and bone. Muscle is elastic, and in reaction to a relatively small stress, it extends Figure 4-8 Each of the three different sensory organs is responsible for sending specific sensory information to the brain. Pacinian corpuscles are sensitive to pressure, Ruffini corpuscles are sensitive to position and speed, and free nerve endings are sensitive to pain. Figure 4-8 Each of the three different sensory organs is responsible for...

The difference between dry needling and wet needling therapy

Dry and wet needling share many common mechanisms, but there are significant differences between the two modalities. Dry needling can be used alone or in combination with wet needling to treat soft tissue pain, and when they are used together dry needling is a very good adjunct procedure to wet needling therapy. Dry needles inoculate minute lesions in soft tissue, and so multiple points can be needled in one treatment session, and the same procedure can be repeated many times until maximal...

Sacral Plexus

The anterior rami of S1, S2, and S3 emerge from the anterior (pelvic) foramina of the sacrum and proceed laterally on the anterior surface of the piriformis muscle. The lumbosacral trunk joins the sacral roots and fuses with S1. The sacral nerve plexus lies in the posterior wall of the pelvic cavity (see Fig. 8-8). All the roots, including L4 and L5 (contained in the lumbosacral trunk), split into anterior and posterior divisions. However, the separation of these divisions can be observed only...

Iliotibial Band Syndrome

The iliotibial band is a nonelastic collagen cord that stretches from the iliac crest, blends with the tensor fasciae latae and gluteus maximus muscles, and then descends to insert into the tubercle on the lateral proximal tibia. The tensor fasciae latae muscle flexes, abducts, and medially rotates the hip joint and stabilizes the knee. Repetitive hip and knee flexion and extension while the tensor fasciae latae muscle is contracted creates tension and inflammation of the iliotib-ial band,...

Spine

The torque and shear forces of the full swing motion put stress on the spine. Poor cervicothoracic posture, limited rotational mobility, and degenerative conditions can irritate preexisting spine disorders. Research evidence indicated that a large number of costal stress fractures in the lead-side rib cage of beginning golfers were misdiagnosed as nonspecific back pain.23 Pain and hypomobility in the lead (left) scapulothoracic area and paravertebral muscles are signs of vertebral and...

Achilles Tendon Rupture

This injury is common among quarterbacks and is the result of overuse or repeated injury. A quarterback may throw the football as many as 50 times in a game and a few hundred times during practice. Repeating the motion of dropping back to throw the football may cause inflammation of the tendon. This tendinitis weakens the tendon and makes it susceptible to tearing. The tendon also can tear as a result of the trauma of a one-time violent deceleration and planting motion, even in the absence of...

Responses Of The Autonomic Nervous System To Overtraining

The symptoms of overtraining definitely illustrate an imbalance between the sympathetic and para-sympathetic branches of the autonomic nervous system. People who engage in intensity-related activities, such as sprinters, may exhibit sympathetically dominant symptoms Increased blood pressure and resting heart rates Elevated basal metabolic rate Emotional instability and sleep disturbance The symptoms can be parasympathetically related in people who engage in endurance activities Decreased...

Lesion mechanisms of dry needling

Understanding the basic physiological mechanisms of dry needling is of the most fundamental importance to the practitioner. These mechanisms underlie the actual process of stimulation by needles, and how such stimulation brings about therapeutic effects. Needling is both a physical disturbance to soft tissue and a minute biological traumatic inoculation into soft tissue. The physical movement and manipulation of the needles in deep tissues increases the tension of the muscle fibers and...

Athletes Expect More Than Pain Relief

Working with athletes is a great pleasure for any health care professional. Because of their healthy bodies, positive emotion, strong willpower, good nutrition, and willingness to cooperate, they respond superbly to ISDN. With regular and well-designed maintenance procedures, patients can maintain optimal performance, and can even achieve better results than in previous years. What is unique about working with athletes Most seek medical attention at first for pain relief, which in most cases...

Isdn As An Effective Tool In Conventional Sports Medicine

In addition to enhancing athletic performance and preventing injuries, ISDN can also be used to rehabilitate injured athletes. The most common injuries in sports are soft tissue dysfunction such as contusions, muscle strain, ligament sprain, swelling, inflammation, and deficient microcirculation. During recovery and rehabilitation, adhesion and the formation of scar tissue are major concerns. ISDN is an effective modality for managing most of these soft tissue dysfunctions. It has been shown to...

Clinical Mechanisms of Integrative Systemic Dry Needling

In the practice of integrative systemic dry needling (ISDN), nothing is more important than understanding the biologic mechanisms of needling. ISDN is a unique therapy because it entails the use of fine needles to inoculate minute intrusive traumas, or lesions, into soft tissues to activate self-healing processes. When a needle is inserted into the human body, it breaks the skin the first defense line of the immune system and then inoculates lesions into all the soft tissues it encounters,...

Why Patients Respond Differently To The Same Isdn Treatment

As mentioned previously, ISDN activates the built-in survival mechanism of the human body to achieve self-healing for many different pathologic conditions. Thus ISDN is effective for any symptoms that can be partially or completely healed through the biologic regulatory mechanisms of the body. Humans inherit self-healing potential for biologic survival. However, this potential to self-heal is considerably affected by stress level, medical his tory, nutrition, and lifestyle, as well as by...

Scarring and Fibrogenesis

After injury, self-healing proceeds in three stages inflammation, cellular regeneration and differentiation, and tissue replacement. During this process, primordial cells and fibroblast cells are produced. They secrete fibrogen for the construction of tissue fibers. Usually the formation of connective fibers predominates over formation of muscle, capillary, and capsule tissues. Some of this scar tissue will be absorbed and some will persist, which may cause permanent dysfunction of the organs...

Inflammation

Inflammation, or inflammatory response, is the physiologic process of local accumulation of fluid, plasma proteins, and white blood cells that is initiated as a result of physical injury, infection, or a local immune response. Acute inflammation refers to early and often transient episodes, whereas chronic inflammation occurs when the infection persists or when there is autoimmune disease. Inflammation is a built-in survival mechanism to protect the system from foreign invasion and to promote...

Contracture

Contracture is a self-protective mechanism of soft tissue. It may be reversible or irreversible. When the shortening of the tissue is within the physiologic limits and is caused by overuse, overloading, misuse, or physical insults, it is reversible. Contracture from severe injuries, in which substantial amounts of tissue are destroyed, are irreversible. This may be the result of physical injury or surgery. During the self-healing process that follows surgical procedures, adhesion and scars are...

Kidney injury

The kidneys are located between T11 and L3 the right kidney is 1 to 2 cm lower than the left one. The medial borders of the kidneys are about 3.5 cm from the midline. Respiration may move the kidneys up and down, but no more than the distance of one vertebra. In case of light injury from acupuncture, the patient may feel slight pain in the lumbar area. When urine is examined under a microscope, a minor amount of red blood cells may be observed. This condition can be self-healing. Sometimes...

Heel Spur

When a section of bone becomes injured or irritated by chronic stress such as tight muscles or tendons, an abnormal calcium deposit or bone growth occurs. Athletes with previous injuries have a higher risk of bone spurs. Dry needling acupuncture is a helpful therapy for this injury. Needles can be applied directly into the inflamed, tender, and painful tissue. In addition, use the treatment to balance the entire muscu-loskeletal system. Two treatment sessions per week should be provided. Dry...

Mms

Trendelenburg Sign

Muscles related to movement of the foot. A, Extensor muscles of the leg. B, Lateral (fibular) muscles. C, Triceps surae muscles. D, Deep flexor muscles. the plantar surface of the foot from compression during weight bearing they help the foot absorb shock during impact with the ground and they help store mechanical energy and release it to improve the efficiency of locomotion. Integrity of the arches depends primarily on ligamentous support, in addition to bone alignment and...

Muscles of the Back Erector Spinae

From the perspective of functional anatomy, the muscles of the back can be classified into three groups 1. Long back muscles that pass at least seven vertebrae (Table 12-5 and Fig. 12-18) 2. Back muscles of average length that pass two to six vertebrae (Table 12-6 see Fig. 12-18) 3. Short back muscles that pass only over the nearest vertebra (Table 12-7 and Fig. 12-19) The muscles work together as a unit (Table 12-8). The most important muscles for turning the trunk are the rotators. A...

Calf Strain

Calf muscles, or triceps surae, include the gastroc-nemius, soleus, and plantaris muscles. They insert into the foot through the Achilles tendon and are responsible for extending the foot and rising on the toes. When a person takes off from the ground or changes the direction of walking, the calf muscles must contract forcefully. If the muscles are fatigued or not strong enough to manage situations in which forceful contraction is necessary, especially eccentric contraction (when contracting...

Back Injuries

Low back injuries in swimmers are caused most often by repetitive stress during turns and the strain of poor head and body position in the water. Mechanical problems include spondylolysis, spon-dylolisthesis, and Scheuermann kyphosis, which is found in adolescent swimmers and results from repeated flexion of the thoracic spine.52 The typical swimmer's posture manifests as increased thoracic kyphosis, abducted or protracted scapulae, and a forward head position. These postural tendencies are...

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...

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

Medical Human Outline Drawing

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...

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...

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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

Dry Skin 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...