Acupuncture for Athletes

This triathalon site did a very good job of bringing together and summing up several studies which demonstrate the effectiveness of acupuncture for strength and endurance training.  A substantial excerpt from this article follows along with the references culled by the author, Alex MacDonald, MD. We treat large  numbers of athletes to help them heal from injury as well to help them prepare for competition at the Northside Holistic Center. It is quite nice to read such a thorough article as Dr. MacDonalds which summarizes a substantial bit of the research which has been published in the literature.

There have been several studies, which point toward improved athletic performance with the use of acupuncture. Although there are certainly several different pathways involved, the major factors are most likely, reduced tension in the muscle, increased blood flow, increased oxygen utilization, and psychological effects. 

Endurance athletics is particularly attuned to the effect of oxygen consumption and utilization and acupuncture has been shown to increase VO2 max. In one study by Lin et al. 3 groups of athlete’s were run to exhaustion. The control group had no treatment, the acupuncture group had auricular acupuncture treatment, and the third group had auricular acupressure treatment (no needle). The group that had received acupuncture treatment had a statistically significant higher measured VO2 max at exhaustion. 

Muscular force production and recovery has also been shown to improve with acupuncture . In one study by So et al., participants completed 3 successive days of isokinetic knee exercises. The treatment group received TEAS right after exercise for 15min, where electrodes and current was applied to specific acupuncture points. A second, control group received pseudo-TEAS for 15min right after exercise, where electrodes where placed on points which were not established acupuncture points. Maximal muscular force was measured before and after exercise, as well as at 5min increments during the 15 minutes of TEAS or pseudo-TEAS treatment. The results showed that the group treated with TEAS had significantly improved recovery time and were able to generate greater maximal force and create it sooner than the pseudo-TEAS group. There have been additional studies, which demonstrate improved recovery after endurance exercise with acupuncture treatment, showing lower heart rate and lactic acid levels (lin). 

In addition to allowing for higher muscle force production after acupuncture, studies have also demonstrated reduced muscle tension (de Sousa). Muscle fibers have an optimal length at which state they function best. If the muscle is stretched to long then contraction will be sub maximal, additionally, if the muscle is pre-contracted and too short then, again, contraction will be sub maximal. Part of the theory behind why muscular forces are greater after acupuncture is that the muscle is better able to relax to it’s optimal length. Acupuncture likely achieves this through two methods. First, it functions to relax the muscle itself. Secondly, it release tension in the fascia surrounding the muscle. Connective tissue, known as fascia is continuous and contiguous throughout the entire body form the bottom of the feet to the top of the head. This is one reason why treatment to one specific area, such as the leg can positively impact distance structure such as the shoulder. In one anecdotal, albeit uncommon situation, a woman with knee pain experienced symptom relief after acupuncture releasing tight fascia in her jaw. 

Acupuncture has been shown to increased blood supply throughout the body, particularly to the muscle during and after acupuncture treatment (Ohkubo). This is one probable reason for why VO2 max has been shown to increase with acupuncture treatment. The act of microtrauma to muscle seems to create a healing response form the body without actually cause notable trauma. When an injury occurs there is a highly sophisticated response of hormonal, neural and metabolic intermediates that stimulate the healing response. Most notably in this situation, increased blood flow and resultant increased oxygen flow. Although slightly out of the scope of this article, acupuncture has been show to be beneficial during injury rehabilitation for many of the same reasons. Injured structures require blood flow to provide nutrients and metabolites to repair damaged tissue, as well as carry away waste products. Acupuncture has been show to be particularly helpful to increase blood flow to tendon injuries which typically have a very low blood flow, such as the achilles (Kubo). 

Lastly, acupuncture has been show to decrease pain. The application of acupuncture has been show to have potential analgesic effect through the activation of endogenous opioid system within the body (Ma). That is to say, that acupuncture causes the release of substances naturally found in the body, known as endorphins, which act on the same neural pathways where medicines such as morphine and codeine. We have all experienced this sense of invincibility, or “no pain” during moments of emergency. 

References: 

Improved performance in endurance sports through acupuncture].

Benner S, Benner K. Sportverletz Sportschaden. 2010 Sep;24(3):140-3. Epub 2010 Sep 15. German. 

Local increase in trapezius muscle oxygenation during and after acupuncture.

Ohkubo M, Hamaoka T, Niwayama M, Murase N, Osada T, Kime R, Kurosawa Y, Sakamoto A, Katsumura T. Dyn Med. 2009 Mar 16;8:2. 


Immediate effects of acupuncture on strength performance: a randomized, controlled crossover trial. Hübscher M, Vogt L, Ziebart T, Banzer W.

Eur J Appl Physiol. 2010 Sep;110(2):353-8. Epub 2010 May 25. 


Ergogenic effect of acupuncture in sport and exercise: a brief review.

Ahmedov S. J Strength Cond Res. 2010 May;24(5):1421-7. Review. 

Effects of acupuncture and heating on blood volume and oxygen saturation of human Achilles tendon in vivo. Kubo K, Yajima H, Takayama M, Ikebukuro T, Mizoguchi H, Takakura N. Eur J Appl Physiol. 2010 Jun;109(3):545-50. Epub 2010 Feb 6. 

Lundeberg T, Lund I, Sing A, Näslund J. Is placebo acupuncture what it is intended to be? eCAM ( 2009;) doi:10.1093/ecam/nep049. 

Goal-directed Acupuncture in Sports--Placebo or Doping?

Usichenko TI, Gizhko V, Wendt M. Evid Based Complement Alternat Med. . [Epub ahead of print] 

So RC, Ng JK, Ng GY. Effect of transcutaneous electrical acupoint stimulation on fatigue recovery of the quadriceps. Eur J Appl Physiol ( 2007;) 100:: 693–700. 

Nichols AW, Harrigan R. Complementary and alternative medicine usage by intercollegiate athletes. Clin J Sport Med ( 2006;) 16:: 232–237. 

Ma SX. Neurobiology of acupuncture: toward CAM. eCAM ( 2004;) 1:: 41–47

Lin ZP, Wang CY, Jang TR, Ma TC, Chia F, Lin JG, et al. Effect of auricular acupuncture on oxygen consumption of boxing athletes. Chin Med J ( 2009;) 122:: 1587–1590. 

Effects of acupuncture stimulation on recovery ability of male elite basketball athletes. Lin ZP, Lan LW, He TY, Lin SP, Lin JG, Jang TR, Ho TJ. Am J Chin Med. 2009;37(3):471-81. 

Electromyographic evaluation of the masseter and temporal muscles activity in volunteers submitted to acupuncture. de Sousa RA, Semprini M, Vitti M, Borsatto MC, Hallak Regalo SC. Electromyogr Clin Neurophysiol. 2007 Jul;47(4-5):243-50.