Acupuncture: Reversing the Stressful Effects of Running

December 8th, 2010

Needles pinpoint the root cause of pain, imbalances and chronic conditions

Growing up in North America, like many others, I originally thought of acupuncture as some exotic placebo, questionably effective and a little frightening. My first direct exposure came following a hard marathon in Tochigi, Japan, in November 2006. Looking for a post-race massage, I found that organizers were instead offering complimentary post-race acupuncture treatments. I decided to give it a go and was pleasantly surprised by the experience; a flicker of pain as the needles made contact, a dull pressure as the acupuncturist tapped the needles in position and then the sensations fading to a feeling of relaxation. A year later, I suffered a major injury to my right thigh, which showed no signs of improvement after nearly six months of medical and massage treatments.  I turned to acupuncture and after only two-and-a-half months, was back to the point of running one of my fastest half marathons. My thigh injury has never recurred, and acupuncture has become a regular part of my training regimen.

Despite anecdotal evidence such as my own experience, acupuncture remains relatively uncommon as a means of treatment for runners in North America. Whether it is because of its invasive nature or lack of rigorous scientific methodology, acupuncture’s benefits compared to massage, chiropractic and other forms of alternative treatment are little known in the West. In Japan, acupuncture is as common as massage in treating the ailments that afflict marathoners. Idaten, a Tokyo clinic that offers acupuncture alongside massage and physical therapy, treats the country’s best professional and university runners as well as amateurs. “Roughly 60-70% of our clients are runners,” says the clinic’s director, Jiro Konno. “Many of the elite runners get acupuncture treatments twice a week, but even the amateur runners we treat come in once a week.”

New York-based acupuncturist Russ Stram treats elite Japanese marathoner Arata Fujiwara

Although several U.S.-based elites, including Deena Kastor and Shannon Rowbury, incorporate acupuncture as a means of treating an existing ailment, acupuncture may prove most beneficial as preventative medicine. Arata Fujiwara (pictured), 2010 Ottawa Marathon champion and course record-holder, combines frequent acupuncture treatments with massage and general physical therapy.     

Chinese Origins and Japanese Evolution

Acupuncture, the treatment of pain and injury using thin, disposable needles, has a history dating back thousands of years in China. Although its practice and theory have evolved since being introduced to Japan, both styles share a similar focus: reducing pain and muscle imbalances by treating specific points of the body. Russ Stram, a New York-based licensed acupuncturist at Brill Physical Therapy, practices a mixed style. “Acupuncture follows Chinese medicine theory with the philosophy of restoring balance to the body,” he explains. “A practitioner takes a thorough history and examines the body for tight and painful areas, choosing points based on the meridian point system.”

The meridian system follows the Chinese belief that the body is an integrated whole with interconnections between disparate areas that are accessible at specific meridian points. In Chinese acupuncture, which uses relatively thick needles and deep penetration to access deep muscles, it is common for pain in one area to be treated by needles in a completely different part of the body by the meridian lines. The aim of treatment is to restore the body’s overall balance.

The Japanese method involves thinner needles and superficial penetration, but more significantly, it focuses on stimulating trigger points specific to each individual muscle. Hiroshi Kawaguchi, an acupuncturist who operates the Yamate Street Acupuncture Clinic in Tokyo’s trendy Nakameguro neighborhood and who treated Joan Benoit-Samuelson last year at her appearance on a Japanese game show, describes the Japanese method this way: “When dealing with a sports injury, we approach it in terms of the whole muscle and its tendon connections. When a muscle is tired, the contraction of its fibers is limited. Acupuncture helps to relax the muscle and restore the natural motion of the fibers.”

Despite these differences, the three practitioners agree that both Chinese and Japanese methods have benefits for runners that extend beyond those of the average person. “The physical fatigue and damage runners experience is different from a regular person,” says Konno.    

In terms of injury recovery, the point at which most people seek physical treatment, “Acupuncture is able to promote increased blood flow to an area and stimulate healing—similar to a histamine response—from the slight irritation that the needles produce,” says Stram. “Tight muscular restrictions can be released, which will allow the body to work on healing itself instead of getting constantly restrained by poor patterns of movement caused by pain or restriction.” 

The advantages of acupuncture compared to other forms of treatment are two-fold. “Where massage involves manipulation of surface muscle in dealing with underlying tissues, acupuncture allows treatment of deeper muscle tissue without aggravating surface muscle, making it the most effective and direct method of treatment,” says Kawaguchi. Secondly, since the symptoms of pain or fatigue can occur somewhere other than where the problem actually lies, acupuncture is effective in treating the root cause of the problem, rather than only the area of symptomatic expression. Kawaguchi raises the example of IT band pain. “IT band pain is one of the most common issues for runners. It often manifests itself on the outside or rear of the knee, but the actual problem is with the band as a whole. By treating the trigger point near the hip, we can correct the problem by restoring the balance of the entire band.”

Supplementary techniques used by some practitioners include moxibustion, burning herbs to heat needles, which increases blood flow to the insertion point. Gentle, rhythmic electrical stimulation of inserted needles is another common supplementary technique, one that Kawaguchi says amplifies the restoration of proper contractile mobility to muscle fibers. Konno also utilizes laser acupuncture, a recent technique permitting treatment of tendon injuries, which can be hazardous to treat with standard needles.

On Point with Injury Prevention

But more than recovery from injury, acupuncture’s greatest potential may come in injury prevention. According to Stram, “Running and training hard, whether it is fast acceleration sprints or long distance, takes a toll on the body. This is especially true of problem areas such as the back, hips and legs, which are most affected by running. Acupuncture needles can get directly to deep muscle bands to maximize the treatment effect. For example, when a deep muscle of the hip is treated directly, it will be more susceptible to stretching and can relax more. There is subsequently less stress on the joint, and the muscle has more potential to fire and contract without fear of spraining muscles or tearing ligaments.”

Kawaguchi agrees. “Regular treatment can help prevent problems through improving muscle fiber mobility,” he says.  For these reasons, Konno recommends regular treatment—two or three times a month, or at most once a week for amateur runners—as a key component of maintenance and injury prevention. 

Whether for injury or prevention, acupuncture can help improve chronic running-related stresses.  Kawaguchi puts it simply when he says, “If you have a problem with your form, pain will continue to return. If done properly, one session can help relieve this pain, but regular treatment can help improve flexibility and correct these problems.” Stram expands on this, saying, “Some acute muscle strains may respond well to one treatment and never return. Other more chronic conditions, which come and go depending on an individual’s conditioning or intensity of training, may require several sessions to reduce the severity of pain or tension, and may be best followed up by a program of physical therapy and stretches to prevent recurrence. Finally, there is the scenario of more severe or chronic conditions, which have seen little to no relief from treatment such as massage, physical therapy, chiropractic or surgery. Such patients may see some change in their symptomatic complaints with acupuncture, and should feel empowered by these changes to plan a program that best supports their body and allows them to maintain their goal levels of training.”     

Overcoming the fear of being stuck full of needles is one of the main obstacles to trying acupuncture, but Konno compares it to going to the dentist. “There’s no need to be afraid,” he says. “Start easy, and ask the acupuncturist to use light needles. When you are accustomed to the sensation, you can move up to a more thorough treatment.”

Finding a Respected Specialist

To find a reputable practitioner, it is key to make sure the acupuncturist is licensed and uses sterilized, disposable needles. American acupuncturist licensing regulations vary by state. Because California and New York have the toughest regulations, Kawaguchi says residents of those states are most likely to find good practitioners. “These days it’s easy to research online to find out about different therapists’ reputations,” he says. “You can also talk directly to licensing agencies for recommendations. As with any doctor, be sure to check if the acupuncturist has experience dealing with sports injuries, as the sorts of soft-tissue problems to which runners are prone differ from those of non-runners.” 

“If you are interested in trying acupuncture but are worried about your insurance not covering the treatments of a licensed acupuncturist, you should check out a local acupuncture school where you can get treated by student practitioners under supervision,” says Stram. 

AVAILABLE: http://runningtimes.com/Article.aspx?ArticleID=20198&PageNum=2

Brett Larner lives in Tokyo, where he is the editor of Japan Running News. A lifelong runner, acupuncture has been a part of his training regimen for the last three years; he visits his specialist once or twice weekly when training strenuously, and about twice per month otherwise.