HOTAL TRADITIONAL ORIENTAL MEDICINE LETTERS, VOLUME 2, NUMBER 2

2015

Acupuncture and Moxibustion Treatment for Sports Injuries
Nobuyuki Otsuka
Hotal Ancient Medicine Research Institute (HARI)
3-8-14 Hotarugaike-nakamachi, Toyonaka, Osaka, 560-0033 Japan
E-mail: hari@otsuka.holding.jp
Keywords: sports injury, overuse syndrome, muscle fatigue, muscle pain, conditioning,oriental medicine, acupuncture and moxibustion

Sports injuries include sports external
injuries and sports disorders. They include
shoulder joint disorders, hand disorders,pelvis and hip joint to thigh disorders,knee joint to lower leg disorders, and ankle to foot disorders [1]. This paper will
discuss the causes of sports injuries,
Western medical treatment, acupuncture
and moxibustion, and conditioning to prevent sports injuries. According to a survey
by the Sports Safety Institute, the mostcommon sports injuries are hand, knee,and ankle injuries. The most commontypes of external injuries are sprains, fractures, and contusions [2]. When limited tosports, there are reports that injuries aremore common in the ankle joint, which ismore prone to loading.
There are both internal and external
factors that contribute to the occurrenceof sports injuries. Internal factors include
technique, physical factors, and the influence of past injury. For physical factors,alignment and flexibility are important.
Examination of alignment can reveal factors that contribute to injury. People whoare prone to sports injuries often haveproblems with lower extremity alignment.
Flexibility of the body during movement
during play is also important. Treatment

involves understanding alignment andflexibility to prevent sports injuries in advance. As for past injury, patients are notallowed to return to games immediately
after the pain of the disease is removed,
but only after sports-related physicalfunctions, such as muscle strength andjoint mobility, are recovered before returning to games and other activities. External factors include the use of inappropriate equipment and practices andgames in inappropriate environments.
In Western medical treatment, treatment should not be concentrated solely
on the affected area. Various sites aretreated considering their relevance to thecause of the injury. The choice of treatment strategy takes into account sportlevel, sport event, life planning, and timing of treatment. Professional athletes
have a different level of medical care thanthe ordinary people because of their different sporting levels. In terms of life
planning, professional athletes will not beable to continue treatment because theiravenues of income will be cut off if theirplaying career is cut off. Therefore, having
a separate source of income is importantwhen considering a treatment plan. To
achieve the level of medical care required

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by athletes, the damage to the bodyshould be minimized as much as possible,
and a method should be selected thatprovides maximum functional gain withminimum invasion.
Acupuncture and moxibustion treatment is expected to have analgesic effects, relieve muscle tension, improveblood flow, and promote tissue repair. In
particular, acupuncture and moxibustion
treatment can be widely applied inoveruse syndromes, whereas Western
medicine's treatment methods are limited
to poultices, etc. Field studies[3] and clinical studies[4] of acupuncture and moxibustion treatment make steady progress.
In shin splints, pain was relieved and tissue blood flow increased. Improvements
have been shown in the interphalangeal
distance and straight leg raise test[5] during low back pain in athletes, patellar tendonitis (jumper's knee) evaluation
scores[6], tenderness in ankle sprains[7],muscle pain in the lower extremities aftera marathon[8], and tennis elbow[9].
Acupuncture and moxibustion methods include acupuncture needle, electricalstimulation, press needle, and moxibustion. Acupuncture needle is used in thetreatment of sports injuries in general.
Long and thick needles are used on thegluteus, while thin needles are used on
the tendons to avoid damage. Electricalstimulation is used when pain or muscle
tension is strong and relaxation is desired.
The frequency is 2 to 5 Hz or 50 to 100 Hz
depending on the area. Excessive stimulation may leave the muscles feeling uncomfortable or fatigued. Press needle isused for sustained or in-play effects. Diameter of 0.9 to 1.2 mm is used. Since2015

they can be used all the time, they may
be more effective than transient acupuncture needles. Warm-tube moxibustion isused when there is strong muscle tension
around joints. It is also effective for symptoms accompanied by coldness, and isused for female patients with shinsplints.
Acupuncture treatment will consider
methods other than acupuncture alone. It
is important to use a combination ofWestern medical treatment and acupuncture and moxibustion to improve range of
motion and strengthen muscles, and toavoid leaving instability [10].
Prevention is the key to sports injuries, rather than treatment after injury.
For prevention, it is important to checkthe conditioning of athletes on a daily basis and to educate athletes on self-conditioning. The meaning of conditioning is torealize good condition. The condition is all
the factors that affect an athlete's performance. These factors include mental,medical, physical, schedule, external environment, tactics, skills, and daily physicalcondition. The definition of conditioning isto tune all the factors necessary for performance into a desired state toward acertain goal [11]. The purpose of conditioning is to prevent sports injuries, injuries treatment, improve performance,
suppression of muscle fatigue and muscle
strain.
In conditioning, proper training intensity, adequate rest and nutrition, planning
the schedule for game, feeling wellrounded and injury-free are important.
Conditions are affected by muscle fatigue,
muscle pain, and muscle tension. The effects of acupuncture and moxibustion
treatment have been shown to restore

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tension after muscle fatigue with retaining needle [9 , 12], reduce muscle weakness and subjective fatigue with press
needle [13], reduce and prevent muscle
pain with needling to tender points [14],reduce tardive muscle pain [15], and reduce muscle tension in the gastrocnemius
muscle [16]. Conditioning affects the athlete's internal disease and indefinite complaint [9]. Expeditions add to changes inphysical condition due to environmental
changes, changes in living hours, pressure, etc. In doping problems, acupuncture and moxibustion treatment that does
not rely on drugs can be effective.
Acupuncture and moxibustion treatment
methods for internal disease and indefinite complaint exist and can use somatovisceral and visceral-somatic reflexes.
In the prevention of sports injuries,
the concept of chapter 77 in Nan Jing, inwhich excellent doctor treats before
symptoms appear, can be applied. Since it
is too late after an injury, it is important toprevent the patient from going from an
pre-symptomatic state to a sick state. Before pain appears, dysfunction can be detected and treated as a pre-symptomaticcondition. It is also important to take theviewpoint of Oriental medicine, whichlooks at the body as a whole, rather thanfocusing on the painful part of the body.
In order for athletes to achieve high performance, a health management systemthrough self-conditioning of athletes mustbe established. Athletes need to understand the concept of self-conditioning toprotect their own health, acquire the necessary knowledge and techniques, and actively implement them in their daily lives.
It is an important job of acupuncturists
working with athletes to educate athletes

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from the perspective of Oriental medicine
so that athletes do not leave conditioning
to others, but rather grasp their own condition and consider how to deal with it.
In discussions of sports injuries, there
are many cases in which acupuncture andmoxibustion treatment has been applied,demonstrating the effectiveness ofacupuncture and moxibustion treatment.
In the treatment of sports injuries, conservative therapy is the first choice inmany cases, so acupuncture and moxibustion treatment can be widely applied. The
range of application of acupuncture andmoxibustion treatment is expected to expand more and more in the future. In
sports injuries, prevention is important
rather than treatment after injury. Oriental medicine can educate athletes about
prevention. In the acupuncture and moxibustion treatment of sports injuries, it isnecessary to fully utilize the Oriental
medicine approach. Instead of treating
only the symptoms, the causes leading to
the symptoms should be clarified. It isnecessary to look at the athlete's body as
a whole and eliminate the factors thatlead to symptoms. In conditioning athletes, self-conditioning by the athlete isextremely
important.
In
Oriental
medicine, it is required to take care ofone’s health. Education of athletes basedon Oriental medicine will be effective.
The problem that acupuncturists areprone to is that they are too outspoken,
sticking to the treatment techniques andtraining methods they want to use, or imposing their principles and style of treatment on the athletes more than necessary. It is important for the acupuncturist
to figure out what the athlete wants, not

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what the acupuncturist wants to do to theathlete, and what the acupuncturist can
do in response to what the athlete wants.
The acupuncturist needs to work behind
to figure out the best way to treat athletes to help the team and the athletes
reach their goals. For this reason, it is important for acupuncturists to have theability to communicate with athletes.
While empirical rules of acupuncture andmoxibustion treatment are important, it isnecessary to correctly understand theplayers' condition and treat them basedon scientific evidence. In order for theathletes to perform at their best,acupuncturists must properly understandthe effects, limitations, and risks ofacupuncture and moxibustion treatment
and utilize them in the conditioning of theathletes. In addition to acupuncture andmoxibustion treatment, acupuncturists
need to apply the concepts of pre-symptomatic treatment and care of one’s
health, take a preventive approach, andprovide a wide range of services for player
education including self-care and environmental conditioning. Since it is a clinicalstage, not a research stage, it is important
to improve the communication skills tounderstand what the athlete wants andwhat the acupuncturist can do in response to the athlete's wishes, not what
acupuncturist wants to do to the athlete.
Through communication with the athlete,
the acupuncturist must strive to help theathlete perform at his or her best. By doing so, the coverage of acupuncture andmoxibustion treatment will be expanded
step by step.
In summary, acupuncture and moxibustion treatment for sports injuries canbe expected to provide analgesia, relieve

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muscle tension, improve blood flow, andpromote tissue repair, and is likely to become increasingly widespread. In particular, acupuncture and moxibustion treatment can be applied to overuse syndrome, for which Western medicine haslimited treatment options. Factors affecting conditioning for the prevention ofsports injuries include muscle fatigue,muscle pain, and muscle strain. Acupuncture and moxibustion can reduce or prevent muscle fatigue, muscle weakness,muscle pain, and muscle tension. It canalso treat internal disease and indefinite
complaint of athletes. Acupuncture andmoxibustion treatment, which utilizes theconcept of Oriental medicine, looks at
the athlete's body as a whole and eliminates factors that contribute to symptoms. In self-conditioning by athletes, education of athletes based on Oriental
medicine is important. Acupuncturists
need to have a proper understanding of
the effects, limitations, and risks ofacupuncture and moxibustion, andthrough communication with athletes,
strive to help them perform at their best.
[1] Nobuyuki Dohi, Japan College Association of Oriental Medicine
edited Rehabilitation Medicine 4th edition, Ishiyaku Pub. 2015.
[2] Sports Safety Association, Investigation of accidents involving sportssafety insurance subscribers.
[3] Toru Fukubayashi, Sport Oriental Therapy Handbook, Idononippon,2001.
[4] Kenji Katayama et al., Journal of Kansai Clinical Sports Medicine andScience, vol.1, pp.95-97, 1991.
[5] T. Miyamoto et.al., CESU 18th universiade 1995, pp.318-319, 1995.
[6] Kenji Katayama et al., Journal of Kansai Clinical Sports Medicine andScience, vol.3, pp.47-49, 1993.
[7] S. Meguriya et.al., CESU 18th universiade 1995, pp.328-329, 1995.
[8] Takaharu Ikeuchi et al. , Journal of Kansai Clinical Sports Medicineand Science, vol.7, pp.13-15, 1997.

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2015[9] Kenji Kawakita et al., Acupuncture Clinical Latest Science, Ishiyaku
Pub., 2014.
[10] Yukihiro Yoshida. Meiyuukai Workshop of Meiji school of oriental
medicine, 2015.
[11]Japan Sports Association edited Athletic Trainer Textbook, JapanSports Association, 1997.
[12] Yuzuru. Ito, Journal of the Japan Society of Acupuncture andMoxibustion, vol.46, pp.326-333, 1994.

Dr. Nobuyuki OtsukaHe graduated from Tohoku University in 1985 and completed the first[13] Eiji Furuya, Journal of the Japan Society of Acupuncture andhalf term of doctoral course of Tohoku University graduate school in

Moxibustion, vol.59, pp.375-383, 2009.

1987. He was awarded doctor degree in 1997 from Tohoku University.

[14] K. Itoh et.al., Chin Med, vol.3, No.14, 2008.

He established Hotal Ancient medicine Research Institute (HARI) in[15] Kenji Katayama et al., Journal of the Japan Society of Acupuncture

1999. Now, he is enrolled at Meiji school of oriental medicine fromand Moxibustion, Vol.64, pp.144-148, 2014.
[16] Yoshito Mukaino, Sports Acupuncture Handbook, Bunkodo, 2003.

2014. He is engaged in research on oriental medicine such as traditional
Chinese medicine, acupuncture and moxibustion, qigong etc.

(Received 29 December 2015)

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