Although sports injuries occur through a variety of tissues and in different areas of the body, they do possess common denominators; namely pain, trauma and soft tissue involvement. As a result of these common denominators so to speak, physiological factors, such as the inflammatory process which influences healing and recovery, are also shared. Acupuncture as a modality has been shown in a variety of studies to positively influence pain and inflammation without significant side effects. This makes it an ideal intervention when managing sports injuries.

How does it work?

A variety of studies have shown that the analgesic pain killing mechanism of acupuncture in both humans and animals is considered to be opioidergic. The insertion of an acupuncture needle into skeletal muscle tissue has been shown to stimulate local nerve fibres that send impulses to the spinal cord and these in turn activate three neural regions; the spinal cord, midbrain and supraspinal pituitary hypothalamic complex. This stimulus causes the release of chemical neurotransmitters such as endorphins and monoamines that then 'block' the subsequent pain messages. These neurotransmitters consist of met-enkephalin, beta-endorphin, norepinephrine and serotonin to name but a few.

Evidence suggests that acupuncture and dry needling techniques themselves are generally most effective when conducted at traditionally recognised acupuncture points. There is considered to be a direct correlation between myofascial and neural structures and traditional acupuncture points although the exact level of that correlation remains under investigation. There is also thought to be a close relationship between the location of traditional acupuncture points and 'trigger points'. Some researchers have suggested a 90% crossover between acupuncture points and trigger points and areas of myofascial pain. This, and acupuncture's lack of significant side effects, makes it a useful modality for treating both myofascial pain and dysfunction.

What can it treat?

The range of sports injures that research has shown to benefit from acupuncture include plantar fascial pain; medial tibial stress syndrome; acute low back pain; patellofemoral pain; and rotator cuff tendinopathy. From a clinically reasoned perspective however, the potential exists for it to be used for the treatment of any myofascial pain and dysfunction.

Is it safe?

A number of extensive systematic reviews covering thousands of acupuncture treatments have concluded that while it is an invasive procedure and therefore carries an inherent level of risk, it is actually a very safe modality in skilled, trained hands. As a result, practitioners should be appropriately trained and always respect the client, the anatomy and the technique during every treatment.

Who can practise the techniques?

Western medical acupuncture and dry needling are forms of acupuncture practice that have their philosophies firmly based in anatomy and physiological principles. This means that providing a prerequisite knowledge of the body is in place (ie graduate sports massage therapist, sports therapist, physiotherapist or osteopath) a foundation level of acupuncture can be taught as an accelerated protocol over a few months. This is the type of acupuncture that is most commonly employed by physiotherapists and sports therapists clinically at all levels, from treating keen amateurs to elite Olympic athletes.

• For more information on the study of acupuncture and dry needling for sports injuries please contact the FHT www.fht.org.uk