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 mechanical and physiologic homeo-stasis of the musculoskeletal and other systems by means of various regulatory reflex systems. Some types of repetitive stress or overtraining fatigue develop silently in certain anatomic structures during intensive training and competition. These hidden problems impair musculoskeletal ability and reduce athletic performance but escape conscious recognition by the athletes, their coaches, and their physicians. Because of these hidden problems and declining capability of the body systems, there is more chance that these structures will suffer injury. At this stage, preventive treatment is most effective.
Because of the unique ability of dry needling acupuncture therapy to remove deep stress and fatigue of soft tissues, regular de-stressing treatment on a weekly basis is strongly suggested for all athletes. This treatment should focus on mechanical and physiologic homeostasis of the kinetics of the entire musculoskeletal system.
If an injury occurs, the same dry needling acupuncture treatment as was used for prevention can be used, in conjunction with other modalities, to accelerate recovery from the injury and heal the musculo-skeletal dysfunction. The process of treating injuries has three phases: the acute phase, the rehabilitation phase, and the functional restoration phase.
In the acute phase, treatment focuses on the athlete's symptoms, and the injured tissues are given an opportunity to begin healing. Common conventional interventions include anti-inflammatory and analgesic medications, thermal modalities, and protection and relative rest of the injured body part. During the rehabilitation phase of care, the athlete's injured tissue continues to heal. Biomechanical alterations and consequent tissue overloads should be identified and treated with a program of progressive strengthening and conditioning, including flexibility and proprioceptive neuromuscular training throughout the kinetic chain. At the conclusion of the rehabilitation phase, the athlete is ready to progress to sport-specific functional exercises, culminating in a return to participation. During the functional restoration phase, the emphasis shifts from rehabilitation to systemic and specific reconditioning in order to achieve complete healing, to minimize the risk of repeating the injury, and to restore the previous functional ability.
Dry needling acupuncture therapy should be used in all three phases of injury management. In this chapter, common injuries in various sports are described for the purpose of detailing both prevention and treatment. A detailed discussion of the causes of the injuries is beyond the scope of this chapter, but a list of additional readings is provided for that information.
Because of the specificity of its mechanisms for passively normalizing soft tissue dysfunction, dry needling acupuncture therapy should be used first, before other modalities, as a routine preventive measure and during rehabilitation. Dry needling acupuncture therapy is a passive approach and does not involve any "active" procedure, such as stretching or joint mobilization. The passivity of dry needling acupuncture therapy, in fact, prepares tissues and joints for active or strengthening procedures and minimizes stress in the tissues.
Dry needling acupuncture therapy does not and cannot replace other preventive procedures such as strength-building exercises and other conventional medical examinations and procedures. Because it has no side effects, dry needling acupuncture therapy does not conflict with any other modalities.
The repetitive and cyclic nature of running often leads to an accumulation of mechanical stress that exceeds the adaptation threshold of the musculoskeletal system and results in a variety of injuries. The structures that commonly accumulate mechanical stress and tissue injury include the knee, ankle, shin, hamstring, Achilles tendon, calf muscle, and plantar fascia. This stress can be reduced and injuries prevented if regular de-stressing treatment protocols are adopted.
After examining 180 runners, James and Jones1 reported 232 injuries at the knee (34%), posteromedial tibia (13%), Achilles tendon (11%), plantar fascia (7%), stress fractures (6%), and other sites (29%). Most of these injuries can be prevented and reduced if de-stressing and balancing is achieved through dry needling acupuncture treatment on a regular basis.
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