Kaiser Permanente Training Tips

Acupuncture for Endurance Athletes

Scott Clemensen, MD DABMA; Kaiser Permenente Baseline Medical Offices; Family Medicine; Centers for Complementary Medicine

As a family physician and medical acupuncturist practicing in the front range of Colorado, I have a great opportunity to work with athletes of all ages in the full spectrum of activities. One of the most enjoyable parts of my practice is to use acupuncture to maintain the healthy function of and reduce pain in the musculoskeletal system. These benefits are often most evident in the athlete. Whether competition triathletes or aging weekend warriors, there are common scenarios of stress and strain that respond great to acupuncture and help minimize dependence and overuse of medications like non steroidal anti inflammatories (NSAIDS). When it comes to distance running in particular, I have found acupuncture (specifically electroacupuncture or acupuncture augmented by electrical stimulation) to play a significant role in runner’s training and recovery.

As a simple case report, I had one patient that came to see me in his late 40’s due to progressive low back pain that was severely limiting his activity. He was an avid runner just a few years prior to his back getting in the way and was having difficulty in his job as a physical education instructor. Our relationship started with the initial treatment goals of managing his chronic back pain and reduction of dependence on pain medication. After a few courses of treatment and relative improvement, the goals of therapy soon moved on to supporting him in getting back into running.

Within a few months, my patient was setting his sights on getting back into marathon running and at age 50 met his goal running a sub 4 hour race in upstate New York just this last fall. Part of the secret of this success story is how we worked regular acupuncture into his training and recovery schedule.

In my own personal experience in endurance events, I have deeply contemplated the significant role postural muscles have in making your day a success or an absolute misery. The most obvious example is the musculature of the axial spine that run up and down the back. In most endurance events (running, cycling) these muscles are continually working hard but without moving through a significant range of motion. I have been on many runs and bike rides where the limiting factor in my performance has very little to do with fatigue in my legs, but strain and cramping in my neck and back. These muscles are the unsung heroes of athletic performance and often get neglected in training routines. Axial muscles tend to go into patterns of spasm when overworked and not allowed to move through their designed range of motion. Spasms can be diffuse or localized (sometimes called a trigger point). It is not uncommon for recurrent patterns of muscle spasm to plague the same person over and over again in similar conditions. Acupuncture treatments can help diffuse muscle spasm patterns in muscle and engage the body’s natural pain relieving substances (endorphins) to treat both acute and chronic back pain.

So what is an acupuncture treatment like? There are a lot of misconceptions about acupuncture. Most people associate acupuncture with needles and pain and often avoid the thought of acupuncture due to their experiences with medical needles in phlebotomy labs or doctor’s offices. Acupuncture needles are dramatically different from medical needles, so much so, that I wish we had a different name for them. Acupuncture needles are about the width of a human hair and bend easily like a thin wire. The heads of the needles are rounded if you saw them under a microscope. They are designed to separate tissue instead of cut through tissue like larger, beveled hollow medical needles. Acupuncture needles are sterile and only inserted through the skin once and discarded after use. The insertion of needles is usually painless. A typical acupuncture treatment for low back issues, like used in my marathoner patient, usually involves about 12 needles spaced in the lower back muscles, with a couple of needles placed deeper in the buttocks area toward the hip. The needles are linked together using a group of electrical wires and attached to an electrical stimulator creating four individual circuits. Two circuits are stimulated with a high frequency stimulation that feels like a buzzing or a tingling. Two other circuits are stimulated with a low frequency stimulation that feels like a tapping sensation. All of the circuits are adjusted to patient’s comfort and most find it very relaxing and even doze off and have a nap during the 15 to 20 minute treatment time. Most patients reach a point of improvement where they determine a maintenance schedule of treatments based on their response and treatment goals. As in most things, no two patients are exactly alike, and treatments are often tailored to the specific patient need and physical exam at the time of treatment.

From an acupuncturist’s perspective, helping to manage recurrent axial muscle pain is just one of the many approaches where the art and science of acupuncture can be applied to physical athletic performance and recovery. Traditional Chinese medicine and energetic acupuncture have untold benefits beyond the scope of this article to represent and should not be ignored. Happy Running!