Acupuncture?

In recent years the practice of acupuncture has become very much more mainstream, however, I am still often asked what does it do and how does it works?

So I thought I would try and answer a few questions:

• What is Acupuncture?

• How does it work?

• What can acupuncture help with and what is the evidence?

• Is it safe and are there any risks?

What is Acupuncture?

Acupuncture is the insertion of fine needles into the body at specific points along recorded channels called meridians.  Acupuncture is based on traditional Chinese medicine principles with records dating back to 1000BC. The body is designed to be  in balance - homeostasis- and injury can upset this balance. Acupuncture supports the body to regain this balance.

How does it work?

As the acupuncture needle enters the tissues there is an increase in circulation to the area. This will cause release of chemicals to modulate inflammation.  The needles also stimulate the release of endorphins and oxytocin, these chemical relieve stress and reduce pain.  Acupuncture enhances the release of melatonin promoting good sleep and encourages a sense of well-being by stimulating the release of serotonin. Acupuncture also stimulates nerve fibres to inhibit pain signals and helps to reduce levels of discomfort in the body.

So what can acupuncture help with and is there evidence to support its use?

There is a large body of scientific research emerging to prove the effectiveness of acupuncture.   The AACP (Acupuncture Association of Chartered Physiotherapists)  have produced a chart to demonstrate how acupuncture can help and shows some of the extensive evidence available.

Is Acupuncture Safe?

Acupuncture is a very safe procedure when carried out by fully qualified professionals.   Victoria at ThamesPhysio is fully trained in Acupuncture and has been practising the technique since 2002.  Victoria is a member of the AACP - which means she has completed a recognised accredited course and kept her knowledge up to date with regular courses.  The needles used are sterile and single use only and are disposed of by incineration.

Acupuncture needles are the very thin between 0.2mm and 0.4 mm and are thus much smaller than an injection needle, so having acupuncture does not feel the same as having an injection.

Any side effects tend to be mild and short-lived. They may include: fatigue, feeling light headed, bruising, localised bleeding or soreness or redness or mottling of the skin around the needle sites. If you continue to feel tired after a treatment, it is recommended that you do not drive or operate machinery.  

Can anyone have Acupuncture?

There are a few contraindications, or restrictions, to the use of acupuncture and Victoria  would discuss these with you if acupuncture would be an appropriate adjunct to your physiotherapy.  

The AACP have released an interesting video diary of a patient who received acupuncture as part of her physiotherapy management of sciatica.

Kirsty, a 25 year old graphic designer, has been suffering with Sciatica since the age of 19. She has previously been prescribed pain-killers and anti-inflammatory drugs by a GP but neither provided long-term management of her pain. Her video diary follows her six sessions of acupuncture with physiotherapy.

If you would like to discuss acupuncture and its possible use for your problems please contact Victoria at ThamesPhysio.

Heat or Ice?

A frequently asked question is

“Should I use heat or ice?”

I tend to give the answer that if the problem is acute or sharp in nature Ice is usually the answer but if the problem is more chronic in nature, dull and achy the answer is usually heat. However I thought it might be useful to explore the benefits of heat and Ice.

Heat

The application of heat to an area:

• Increases blood flow - this has brings with it oxygen and proteins to the area.   This aids the healing of the injury.

• Stimulates the sensory receptors in the skin - this can decrease the transmission of pain signals to the brain which can help to alleviate pain.

• Promotes tissue flexibility - this allows more freedom of movement and can aid the restoration of mobility.

Ice

The application of ice to an area:

• Decreases blood flow to the area - this can prevent swelling and further injury. However inflammation is part of the healing process so there is debate on whether ice application may slow down the healing process.  I believe the use of ice in the first 48 hours has benefits in preventing secondary tissue damage due to excessive swelling. However, after the 48 hours ice can be used more sparingly to allow a level of inflammation to occur to allow the natural healing process to progress but still control pain.

• Stimulates the sensory receptors in the skin - as with heat application ice can slow down the transmission of pain signals to the brain and can help alleviate pain.

Ice must not be used for longer than 20 mins per application - prolonged ice use has the opposite intended effect and causing the body to go into protection mode and push blood to the area to prevent cold damage.

Conclusion

Heat and Ice are cheap and easy to access - I do not believe there is any great added benefit to using expensive heat or ice pads when a hot water bottle and bag of peas can do the job.  Care must be taken to avoid the risk of a heat or ice burn, this is especially important to consider if the skin sensation of the patient is compromised.

Ice should not be applied directly to the skin but though a damp tea towel and heat through a cotton towel.

Warm Up For Golf

Well it feels like spring is in the air and the golf courses are getting busier again! So, I thought I would address another question that  I get asked:

“Should I warm up for golf?”

As a physiotherapist this seems like a obvious answer -YES you should warm up for golf -   Just as you would warm up for any other sport. Although on the surface golf may seem like a fairly gentle activity it actually involves lots of walking with intermittent strong bursts of activity.  This can be a recipe for problems especially with the spine. It is important to warm up the body for the activity and prepare yourself to play the best golf you can.  

1.AIM: Warm up the Whole body:

Start with warming up the whole body by a brisk walk - allow the arms to swing by your sides - slowly increasing the range that you swing the arms through.

Continue the walk for 5 minutes.

2.AIM: Loosen the trunk:

Cross the arms over the body - keep the hips square and rotate the trunk in each direction.

x 5 repetitions.

3. AIM: Stretch the back of the arms:

Take one arm across the body at a horizontal level and gentle add pressure on the upper arm to further increase the stretch.

Hold 20 seconds each arm.

4. AIM: Stretch the upper back, shoulders and arms:

Take the fingertips behind the head: Shrug shoulders and then drop shoulders. / Take the elbows back and then forward / Take the arms out to the side palms up and return to the start.

x 5 repetitions.

5. AIM: Mobilise the whole spine into flexion:

Roll downs: Lean against a tree with feet approx 1 foot from the tree. Nod the head and roll down - try to roll bone by bone as you curl down - if you feel any tension in the legs or back bend the knees to allow you to continue the roll down.

X 5 repetitions.

6. AIM: Mobilise the whole spine into extension:

Put your hands on your bottom and gently lean back.

X 3 repetitions.

7. AIM: Improve balance and stretch the sides of the body:

Take two arms up in the air and reach for the sky.

Hold the body straight then  lean to the right and then the left.

Return to the vertical and then relax

X 3 repetitions.

8. AIM: Loosen the hips:

Stand on a curb and allow one foot to dangle off.  Swing the leg back and forth to release the hips. Do not to try to push the legs just allow momentum to move you.

X 20 repetitions. each leg.

9. AIM: Stretch the calves:

Lean against wall and stretch the leg behind you. Ensure the rear foot faces forward. Stretch with the leg straight and bent.

Hold each x 20 seconds.

10. AIM: Improve the dynamic movement of the trunk.

Hold the hands together, flex the trunk as if you were leaning forwards to take a swing and start to rotate the body to the right and left - slowly increase the speed of the movement.

Continue 30 seconds.

11. AIM: Improve the balance and improve the neuro - muscular connection:

This is very important for golf as golf is very much a mind - body activity so it is important to “wake up” the neural system to improve the neuro - muscular (brain to muscle) connection.

Balance on one leg try to keep tall.

Try to maintain for 20 - 30 seconds - if this is too easy then close the eyes.

12. AIM: Get golf ready:

Finish the warm up with some putting, chipping and driving practice.

These exercises are of course not a comprehensive warm up but are intended to get you started and help improve your game and prevent injury.

You should not feel pain with any of the above exercise and should seek advice from a doctor or professional if you have any symptoms or concerns.  Victoria would be very happy to guide you through a warm up for golf.

Walking For Health

I often get asked “Is walking really so good for you?” Well the answer is yes it is!  Here you will find some of the benefits to regular walking.

• Walking is a weight bearing activity so helps to maintain bone density and prevent osteoporosis.

• Walking improves muscle strength, balance and endurance.

• Walking is a a cardio -vascular activity and so helps to protect the fitness of the heart and lungs.

• Walking helps in weight management.

• Walking can improve mental health and give a sense of well being.

• Regular walking can help in the management of condition such as diabetes, high cholesterol and high blood pressure.

I am also often told “I can’t walk due to my arthritis.”  

This is not quite true but you may need to modify where you walk and for how long. Walking on uneven ground or hard pavements can be aggravating for arthritic conditions but walking across a park or on firm grass can cushion the joints and allow you to access the great outdoors again. Walking will boost the muscles around the joints which will help to protect them. You may of course need to limit the length of time you walk for until you can build your strength.

If you are finding your walking endurance is failing due to joint or muscle pain I would be happy to see you for an assessment and devise a plan to address any problem areas. Before you embark on a new exercise please do also seek the advice of your GP.