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Introduction

As a nationally licensed Japanese acupuncturist who also holds a degree in health and sports science,
I have always been fascinated by the search for the optimal methods of treating sports injuries and helping athletes improve their performance.
In the last 15 years, I’ve treated thousands of athletes, ranging from weekend warriors to elite professionals.
Through this experience, I’ve been able to shape and develop a new type of integrated therapy that is especially well-suited to sportsmen and women.

At NAOKI HATTORI Traditional Japanese Therapy, we have learned that combining the essence of modern modalities and traditional theories can provide the best option for the treatment of athletes’ body/mind.
For injured athletes, pain relief is, of course, the primary outcome they are seeking both for their comfort and to enable them to recover their physical function and performance capability.
For many athletes, however, pain relief is just the beginning.
After suffering an injury, their longer-term goal is not only to restore their physical capabilities to a pre-injury level, but also to acquire an improved level of overall health and fitness that will minimize further injuries.
This is where the integration of Traditional Japanese Acupuncture with the concepts and techniques of modern western sports medicine can be especially beneficial.
This is a new type of therapy, which we call Integrative Neuro-Meridien Acupuncture.
It achieves these aims by reducing the client’s bodily stress and restoring and maintaining their mind/body balance, what practitioners of western medicine might refer to as their optimal homeostasis.
With this restored, athletes can function better.
They can adjust to physical and psychological challenges better, leading naturally to more rapid and complete recovery from injuries.

What are trigger points?

The trigger point concept was first coined by Dr Janet Travell, a practicing cardiologist.
In the course of her work as a cardiologist she noticed that many cases of angina were unaccompanied by any signs of heart problems and were, in fact, spasms of the pectoral muscles that caused referred pain that mimicked the pain referral patterns of cardiac ischemia.
Numerous experiences and observations of this phenomenon led Dr Travell and her long-time colleague Dr David Simons to investigate, understand and document myofascial pain that exhibited almost identical symptoms to angina, and might often lead to misdiagnosis.
In the course of their dedicated work in the field, Drs Travell and Simons stated that the data they obtained in one of their studies led them to estimate that myofascial pain is actually a primary cause of regional pain in around 75 per cent of cases such as radiculopathies, tendonitis, migraines, tension-type headaches, carpal tunnel syndrome, pelvic pain, etc.[1]

During the course of my practice and research in the field, we have come to the realization that traditional acupuncturists have in fact been working with what western medical experts now call trigger points for hundreds, if not thousands, of years.
In fact, it has been shown that over 70 per cent of trigger points correspond to acupuncture points used for the treatment of pain.[2]
It can understood, therefore, that such similarities between traditional acupuncture and modern western therapeutic techniques can also be found when treating patients who present with myofascial pain symptoms.

What is dry needling?

Dry needling as a therapeutic modality is an adaptation of traditional Chinese acupuncture which also draws upon current western medical knowledge and the principles of evidence-based medicine.
“Dry” needling (as opposed to “wet” needling) is defined by Drs. Janet G. Travell and David G. Simons as “needling the soft tissue without injection of any liquid substance to treat human pathology”.[1]
This modality is rooted in western anatomy & physiology and the evaluation of pain patterns, posture and movement impairments.

When dry needling is applied to a dysfunctional muscle or trigger point, it can decrease banding or tightness, increase blood flow, and reduce local and referred pain.
When dry needling is employed, the typical sequence of neurophysiological mechanisms[3] is as follows:

  • Reduction in the peripheral nociception related to pain and inflammation
  • Decrease in the spinal dorsal horn neuron activity, such as central-antinociception
  • Regulation of the brainstem induces complex endogenous pain modulating mechanisms

At NAOKI HATTORI Traditional Japanese Therapy, our dry needling employs softer and finer needles than those used in standard dry needling modalities.
This is due to our adaptation of Traditional Japanese Acupuncture (TJA) and refinement of its techniques to allow for its integration with western treatment styles.

What is electroacupuncture?

Electroacupuncture (EA) is an acupuncture technique that utilizes electrical stimulation of needles.
EA is a modified form of traditional manual acupuncture, in which an electrical current is induced between pairs of acupuncture needles.
When EA is applied to unhealthy or adhered connective tissues, it produces the following biophysiological cascade.

  • Relaxation of hypertonic muscles and increase in microcirculation and oxygenation[4]
  • Activation of different parts of the brain, which in turn leads to the release of different neurotransmitters or pain-relieving chemicals via the central nervous system[5]
  • Release of endogenous opioids, such as endorphins, which have many physiologic functions, including the modulation of pain mechanisms, relaxation of the cardiovascular systems, and improved immune system activity[6]
  • Modulation of the transmission of nociceptive signals and reinforcement of the function of the endogenous pain inhibitory system to help reduce persistent feelings of pain[7]

These elements are all crucial to the successful healing of sports injuries. EA has, therefore, been demonstrated to reduce inflammation and speed up the healing time of muscles, tendons, ligaments and bones.

How does electroacupuncture + trigger point dry needling relieve pain?

Electroacupuncture (EA) + trigger point dry needling is an integral approach we have developed for providing more comprehensive treatment.
This combination is achieved by neutralizing the tissue dysfunction caused by local or systemic pathology as well as possible to address acute and chronic pain.
Trigger point dry needling induces a neurophysiological response which means that it works both at a physical level to release myofascial trigger points, and at a deeper level to affect the nervous system[4] as a whole.
EA induces its analgesic effects via neuronal mechanisms associated with both the peripheral and central nervous systems, involving many brain regions as well as different neurotransmitters and modulators.[8]
These integrations are able to treat acute and chronic pain on multiple levels because we are needling the muscles locally as well as addressing the underlying nervous system dysregulation that also contributes to the pain globally.

Integrative Neuro-Meridien Acupuncture : a new modality for athletes

The traditional acupuncture framework looks at sophisticated patterns of disharmony to identify body/mind dysfunctions, enabling the selection of the most appropriate acupuncture points to promote homeostasis.
Our integrative method also differs from single trigger point dry needling or electroacupuncture in that it encompasses a systemic and holistic approach for restoring homeostasis in local tissues and in the entire musculoskeletal system, whereas standard trigger point dry needling or electroacupuncture focus primarily on the local pathologic processes in the connective tissues.

We call this new method we have developed “Integrative Neuro-Meridien Acupuncture.”
This Integrative Neuro-Meridien Acupuncture is especially effective for the assessment and treatment of acute and chronic pain syndromes and dysfunction due to myofascial trigger points, muscle spasms, inflamed tissues and increased tonicity.
Our system draws upon many different disciplines: anatomy, physiology, neuroscience, fascia approach, trigger point dry needling, electroacupuncture, the TCM meridian system, the five element theory, Japanese Zen Stillness acupuncture and our own clinical experience.
It also reflects the results of both basic and specialized research in the field of sports medicine.
With our integrated approach, we are able to find and address the root cause of your pain using holistic paradigms.
At NAOKI HATTORI Traditional Japanese Therapy, we seek to combine evidence-based approaches with the most effective complimentary and integrative medicine to provide the best care possible for every athlete.

References

  1. Simons DG, Travell JG, Simons LS: Travell & Simons’ myo- fascial pain and dysfunction—the trigger point manual: Philadelphia, 1999, Lippincott Williams & Wilkins.
  2. Dorsher, P.T. (2009) ‘Myofascial referred-pain data provide physiologic evidence of acupuncture meridians.’ J. Pain 10, 7, 723–731.
  3. Fernández-de-Las-Peñas C, Nijs J. Trigger point dry needling for the treatment of myofascial pain syndrome: current perspectives within a pain neuroscience paradigm. J Pain Res. 2019;12:1899-1911. Published 2019 Jun 18. doi:10.2147/JPR.S154728
  4. Kimura K, Ryujin T, Uno M, Wakayama I. The effect of electroacupuncture with different frequencies on muscle oxygenation in humans. Evid Based Complement Alternat Med. 2015;2015:620785. doi:10.1155/2015/620785
  5. Holden JE, Jeong Y, Forrest JM. The endogenous opioid system and clinical pain management. AACN Clin Issues. 2005 Jul-Sep;16(3):291-301. doi: 10.1097/00044067-200507000-00003. PMID: 16082232.
  6. Ma, Y., 2011. Biomedical acupuncture for sports and trauma rehabilitation. St. Louis: Churchill Livingstone/Elsevier.
  7. Lv, Zt., Shen, Ll., Zhu, B. et al. Effects of intensity of electroacupuncture on chronic pain in patients with knee osteoarthritis: a randomized controlled trial. Arthritis Res Ther 21, 120 (2019). https://doi.org/10.1186/s13075-019-1899-6
  8. Hsieh, C.L., Kuo, C.C., Chen, Y.S., et al. (2000) ‘Analgesic effect of electric stimulation of peripheral nerves with different electric frequencies using the formalin test.’ American Journal of Chinese Medicine 28, 2, 291–299.

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