Sports Medicine Acupuncture: An Integrated Approach Combining Sports Medicine and Traditional Chinese Medicine

This beautiful, full colour acupuncture textbook contains foundational information on the integration of sports medicine and traditional Chinese medicine, along with detailed information on over 93 sports and orthopedic injuries.

This ground-breaking text is packed with indispensable clinical information, including innovative advanced needle techniques, therapeutic exercise recommendations and herbal medicine treatments. Over 780 detailed drawings and photos help make the material more accessible to the reader.

The text is divided into three sections. Section I consists of Chapters 1 through 5 and begins with a review of some of the basic principles of sports medicine and traditional Chinese medicine, particularly in reference to musculoskeletal health and injuries. The information is presented in such a way that truly blends the theories and ideas of traditional Chinese medicine and sports medicine. Specific topics help to illuminate how these two systems of medicine complement each other. The rest of Section I reviews the basics of different treatment options including: acupuncture, therapeutic exercise, internal and external herbal medicine, moxibustion and adjunctive techniques like kinesiological taping, cupping, bloodletting and gua sha.

The second and third sections of this book consist of Chapters 6 through 12, also known as the “injury chapters.” Section II presents the reader with numerous injury conditions involving the neck, shoulder and upper extremity, while Section III covers the low back, hip and lower extremity. Each injury contains a detailed description, including typical mechanisms of injury, assessment and treatment suggestions, and a list of common TCM patterns that present in the localized area of the injury. A detailed prognosis that discusses the amount of treatment necessary and the timeframe for rehabilitation is presented at the end of each specific injury.

At the end of Chapter’s 6-12 contains a section on rehabilitative exercise that includes proprioceptive, stretching and strengthening exercises that are appropriate for different injuries.

The first thing one notices when this book arrives in the post is its sheer weight – it is a very heavy book of over 1,000 pages! A two-volume edition might have been easier to handle (I believe one is earmarked for a future edition). Once the packaging is unwrapped, the next thing that hits the reader is the high quality of the cover and the paper, together with the excellent full colour drawings, artwork and photographs. The first part of the book highlights the differing approaches towards musculoskeletal and sports injuries of Chinese medicine and Western biomedicine, including how each understands the process of injury and subsequent healing both in younger and older patients. It then explains patient assessment according to each of these two paradigms. From the Chinese medicine perspective this includes palpation, questioning, pulse and tongue, the ‘Hua Tuo Arc’ (integrating the Huatuojiaji points with the agonist and antagonist motor points – a very interesting method that I look forward to bringing into my clinical repertoire), and palpatory assessment of qi oedema and tender points (specifically luo-connecting and xi-cleft points for jing luo disharmony, and front-mu and back-shu points for zang fu disharmony). Although I personally tend to use the shu-stream points, palpatory assessment of all the transporting points (shu points) and how they affect range of movement and pain presentation is an important part of channel assessment and differentiation for musculoskeletal conditions. The text then moves on to describe the principles of diagnostic testing, including range of motion testing, manual muscle testing and orthopaedic evaluation such as through dermatomes, sensory testing and special tests, much of which would not be out of place in an osteopath’s library. More importantly it goes on to describe very clearly the forcecouple relationship (how muscles or muscle groups move in a synergistic manner to produce movement around a joint) and how imbalance in this can lead to latent stagnation and recurring injury. In my experience understanding this and its application is invaluable in diagnosing and treating musculoskeletal conditions. Also included are instructions on how to use a goniometer, as well as how to use a background grid for postural assessment. The different Chinese medicine treatment modalities are clearly explained, including needling techniques, moxa (especially for tendinopathies), gua sha, cupping, bleeding and herbal formulas. The integration of the two paradigms is made clear in discussions of the effects of qi and blood stagnation on proprioception and a very useful section on rehabilitation exercises, including where acupuncture fits in to a structured clinical approach. Rehabilitation is an important (and often overlooked) part of the long term healing process to ensure an injury does not recur, and I am glad to see this included in the text. Case studies are included and by the end the reader is clear on how to make a systematic evaluation of a patient and establish a rational treatment strategy. The text is then divided into anatomical sections: neck, shoulder, low back, hip, etc. For each section the anatomy of the area is described (in enough detail to be practical and in-depth but without being overwhelming) using some excellent full colour illustrations. For each muscle group, the relevant Huatuojiaji points, motor points and needle techniques are shown, utilising excellent diagrams. The appropriate diagnostic tests for each specific area are also provided along with - crucially - what they mean. The typical acupuncture clinician will find very useful, since what to do with the information is so often overlooked in similar textbooks. Finally at the end of each anatomical section the author covers the diagnosis and treatment of a selection of common sports and orthopaedic injuries (over 93 in total). Each has an introduction (which includes the latest evidence), relevant orthopaedic assessments and Chinese medicine patterns and treatment principles. Treatment strategies and points are given based on the outcomes of the diagnostic findings (again using full-colour photographs to illustrate the needling of specific points), including the use of moxibustion. Basic specific rehabilitation exercises and proprioceptive neuromuscular facilitation stretching exercises are then given that might be taught to the patient to undertake themselves as part of a long-term treatment strategy – this is crucial in empowering the patient and greatly improves treatment outcomes. Each section finishes with the probable prognosis and expected treatment duration – answering a common question asked by patients. A couple of minor gripes: I would have liked a little more data as to the specificity and sensitivity of each of the orthopaedic tests by way of a guide as to which ones to use. In addition, whilst there are many indications of syndrome differentiation for specific conditions, I would have liked a bit more on channel differentiation. However, given the size of the book, one presumes the editorial line had to be drawn somewhere. This book is clearly a labour of love. It is expensive and is probably not going to be purchased by someone who is merely going to dabble in musculoskeletal and sports injuries. I personally do not resent paying for quality, and to date I have not read another such comprehensive and well-presented book integrating acupuncture and western orthopaedic medicine in such a systematic and dynamic way. It includes many excellent tips for patient assessment and also an invaluable compendium of many of the common musculoskeletal injuries patients present with. Much of the information in this book can be used immediately in the clinic and the wealth of supporting information and research is impressive – explaining the ‘why’ as well as the ‘how’. A great resource, this is definitely a ‘keeper’. Alex Brazkiewicz