By Emma Van Loock Lic.Ac 2016

Chinese Cupping Therapy: Six Questions Answered...

1. Why were people talking about Cupping Therapy so much during the Rio Olympics?

Cupping has exploded into public attention during the Rio 2016 Olympics as Michael Phelps, the most successfull Olympian of all time has been seen with highly visible cupping marks on his shoulders and upper back, fuelling much renewed interest in the ancient technique.

2. What is cupping therapy?

Cupping is first mentioned in early Chinese texts (Ma Dang Dui medical manuscripts) around 168BC, but we also find mention is various other traditional medicine systems.  Cupping involves placing a hollow vessel on the skin and creating a vaccum using fire or a vacuum pump in order to stimulate circulation to local tissue and mechanically lift the muscle and fascia with the aim of reducing pain and tension, or enhancing a traditional acupuncture treatment. It is commonly used for musculoskeletal problems and pain but traditionally has been used for a wider range of health problems for example chronic respiratory problems.  It is usually used alongside acupuncture.

3. Why is Michael Phelps using cupping?

Michael Phelps is not the first athlete to turn to cupping.  In the 2008 Beijing Olympics, swimmer Wang Qun was famously seen sporting the tell tale signs of cupping. Sports therapy interventions may be aimed at recovery, injury prevention or injury treatment .  The Olympics are the culmination of a lifetime of swimming and 4 years of focussed work. Michael Phelps needs to be able to perform at his best without being limited by any injuries or pain that he might be carrying.  Shoulder pain in elite swimmers is extremely common.  One survey of elite swimmers found 91% had shoulder pain, 84% had positive shoulder impingement and 67% had tendinopathy of the supraspinatus.  Many turn to anti inflammatory medicine, but the usefulness of these are disputed and additionally carry risk of stomach irritation or worse. Cupping is a low risk non-invasive intervention that has been proven to improve short term pain compared with other interventions. Phelps may be using cupping to help manage short-term pain, or to aid recovery through stimulation of circulation through the tissues and muscules of the shoulder and upper back.  As a mature and ultra-succesful athelete with the weight of expectation on his shoulders, Phelps cannot afford to mess around with an intervention that may not compare favourably with another.  You can be sure that he chooses cupping because he perceives it to be a worthwhile addition to his arsenal of therapeutic techniques.

4. How does it work?

There is a saying in Traditional Chinese Medicine that when the 'qi' is obstructed there is pain, but when the 'qi' flows properly there is no pain.  Tension, trauma, inflammation, scar tissue, histological changes in the tissue structure during healing are all examples of physical causes of the obstruction of qi.  Additionally emotional stress leads to voluntary (if unintentional) tension in the body.  The simple strategy of traditional chinese medicine is to restore the correct function of qi circulation by treating the obstruction directly and addressing the cause of the obstruction. Pain is a complex experience involving inflammatory, neural or structural inputs (physical) with social and psychological influences. Cupping promotes circulation and gently lengthens the tissues by drawing them upwards into the vaccum space.  Its is thought that this improves healing and reduces pain.

5. Is there any science?

The exact mechanism of how cupping works has not been established although hypotheses exist that suggest the analegic effect may be similar to that of acupuncture eg through counter-irritation or perhaps through drawing circulation to the affected area.  Clinical studies on how this impacts recovery or pain is not yet conclusive.
However, a 2014 Systematic Review attempted to study all evidence to date on cupping therapy. The studies included both wet cupping (involves bleeding and is used in other clinics but not Belfast Community Acupuncture) and dry cupping (the type we use).
Of 55 trials identified, 16 were high enough quality to make it through to final inclusion in the study (this is good, it means they eliminated poor quality studies).
The results found overall that patients reported reduced short term pain intensity after cupping compared with conventional care, wait list, heat therapy and drugs.

6. What are the circular marks, they look painful?
The classic cupping marks are essentially caused by extravasation from the small superficial capillaries during the therapeutic process.  Although these bruises might look painful in above systematic review only 10% of patients reported mild adverse effects of bruising or mild pain at the site of cupping.  These marks are extremely common and should fade within several days.  Phelps may have been shown grimacing during a treatment but there is no need for cupping to be painful.  The strength of the vacuum may be varied to suit.  Causing a patient pain may lead to further contraction of muscles, and the British Acupuncture Council states that cupping should not be a painful procedure and to seek a licenced acupuncturist.

Listen to Emma talk about cupping on BBC Radio Ulster

Further Reading:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289625/
http://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0031793

By Emma Van Loock Lic.Ac 2016

By Emma Van Loock Lic.Ac 2016

If you have suffered with pain or a lingering musculoskeletal disorder, you are not alone. Musculoskeletal conditions are the leading cause of work absenteeism in Ireland (Athritis Ireland, 2013; Health and Safety Executive, 2015) with chronic pain affecting up to one in three people (McGuire, 2011).  In the UK, 9.5 million working days were lost due to work-related musculoskeletal disorders in 2014-2015 (Health and Safety Executive, 2015).  This can have a big impact on professional and family life, mental health and general quality of life, but despite this it can take over four years to get a diagnosis, plus a further wait for treatment, despite medical consensus supporting an early intervention (Zheltoukhova et.al, 2012).
 
The health benefits of regular physical activity includes decreased risk of cardiovascular disease, diabetes, obesity, cancer and depression (World Health Organisation, 2016) and participation in sport is on the rise (Sport England, 2015; Irish Sports Council, 2011) leading to an increase in strains, sprains, and overuse injuries (Young et al., 2005).  Treatments include rest, over the counter medications or exercise therapy, and acupuncture is widely used.  Approximately 3.8 million acupuncture treatments are given in the United Kingdom each year of which 59% are due to musculoskeletal complaints such as back, shoulder, neck and knee pain (Hopton et al., 2012).
 
How Does Acupuncture Treat Musculoskeletal Injuries and Pain?
 
In Traditional Chinese Medicine it is said, “when there is free flow of Qi there is no pain, and when there is pain there is no free flow of Qi”.  ‘Qi’ may be interpreted as a metaphor used to describe many different functions, depending on the context. Mechanical trauma or overuse can lead to inflammation, bruising, scar tissue, tension or persistent abnormal pain signals leading to pain and dysfunction.  These ‘obstructions in the flow of Qi and Blood’ may be alleviated through acupuncture, moxibustion (heat), Chinese cupping therapy, electro-acupuncture and massage in order to stimulate the ‘free flow of Qi’, reduce pain and restore function.

Another Chinese concept is that of yin and yang. In a sporting context yin refers to rest and recovery, whereas yang refers to performance and competition (Reaves, 2012). Studies have demonstrated a positive effect of acupuncture on Delayed Onset Muscle Soreness (Itoh et al., 2008; Hübscher et al., 2008). Tour de France 2014 winners Team Astana employ Traditional Acupuncturist Eddie de Smedt on tour to manage stress, stomach problems, pain and recovery (Cycling News, 2014).  Acupuncture is an effective intervention for a number of sports injuries (Young et al., 2005).
 
Acupuncture may be used on its own or as an adjunct to conventional treatments.  For example, a review of all interventions for shoulder impingement found that acupuncture improved outcomes when added to exercise therapy (Dong et al., 2015).  Sustained longer term benefits of acupuncture have also been linked to improved ‘self-efficacy’ (MacPherson et al., 2015).  You can expect your traditional acupuncturist to give advice around exercise, stretching and lifestyle factors based on the traditional diagnosis (MacPherson & Thomas, 2008).
 
Where to Get Acupuncture
Private appointments are widely available at Traditional Acupuncture Clinics and fees may be covered by private health schemes. Acupuncture Foundation Professional Association registered members have undertaken training over a minimum of three years, adhere to professional guidelines and complete mandatory Continuing Professional Development training annually. 

Emma Van Loock Lic.Ac ITEC.Dip (2016)


References (click "read more")

Acupuncture and chronic pain, real or placebo?
 
Introduction
 
The traditional explanation for pain in Chinese Medicine is ‘If there is free flow, there is no pain: if there is pain, there is no free flow’.  Trauma leads to inflammation, scar tissue, bruising, restriction of circulation at local or distal tissues, taut bands of muscles, impinged nerves, trigger points etc and all of these are a disruption of the normal circulation of qi and blood.  Acupuncturists who work with patients, and patients who receive acupuncture may experience pain reduction, improved circulation, improved range of motion, improved mobility and for those of us who have had positive experiences, the proof of the pudding is in the eating.

However there are a number of questions bouncing around regarding ‘why that particular point there, instead of somewhere else?’  And ‘is it just placebo?’

Belfast  Community Acupuncture will be attending the Infertility Network UK Information in Northern Ireland on Saturday 27th September, Riddell Hall, Stranmillis, Queens Quarter Belfast.  For more information see our facebook event page or the Infertility Network Website . 

We have also produced a factsheet on acupuncture and fertility which we hope you find useful.

A recent meta-analysis of acupuncture trials involving patients with headache and migraine, osteoarthritis and back, neck and shoulder pain. Twenty-nine trails met inclusion criteria for the study.  True acupuncture was compared with penetrated and non-pentrating sham and the authors conclude that penetrating needles appear to elicit important physiological activity and recommend that this type of sham be avoided in acupuncture studies.  (This has been a problem in previous studies attempting to demonstrate acupuncture superiority to sham-acupuncture, where the sham-acupuncture was designed to act as placebo but was in fact eliciting a physiological response).

Full text: Influence of control group on effect size in trials of acupuncture for chronic pain: a secondary analysis of an individual patient data meta-analysis. PLoS One. 2014 Apr 4;9(4):e93739). Available here

From Friday January 10th 2014, Mary will be working as an acupuncturist with Action Cancer in a six month pilot programme for people with, or recovering from, cancer who are experiencing poor health or side effects as a result of their diagnosis or treatment.

“I am really looking forward to starting up the acupuncture clinic at Action Cancer, Belfast. The charity already offers other complementary therapies and I know acupuncture will be a good addition to the range of therapies. Over the last few months, while setting up the project, I have got to know some of the staff and therapists and I am thrilled to be working with a bunch of very dedicated people.”

The evidence for using acupuncture to treat some of the major side effects of chemotherapy or radiation is compelling. Reducing the emotional and physical symptoms commonly experienced by people being treated for cancer can help improve their quality of life.

In the US, acupuncture has increasingly become integrated into mainstream cancer care. Most of the major cancer centres there have an integrated care component which includes acupuncture treatment as a supportive care modality. Hopefully, in the not-too-distant future this will also become a reality here in Northern Ireland.

For more information contact Mary Gribbin Lic.Ac, BSc.Pharm. 

Introduction to Low Back Pain

Low back pain is a very common complaint in the general population, affecting around one-third of the UK adult population each year (NICE 2009).

A definitive diagnosis is often elusive and this can be a source of enormous frustration to those seeking help from acupuncturists and professional healthcare providers. In fact, less than 10% of cases may be attributed to a clear cause, however, it is encouraging that management and treatment of non-specific or somatic pain is still possible even without a precise diagnosis (Brukner and Khan 2012). 

Treatment options for persistent non-specific low back pain include acupuncture, manual therapy and exercise therapy, and clear guidelines are provided by The National Institute of Clinical Excellence.

Often the clinical picture is complex and involves treatment of the presenting signs as well as identifying and addressing a number of possible contributing factors.  Those at an increased risk of developing low back pain include those involved in heavy physical labour involving twisting and lifting, as well as the other end of the spectrum, those with a relatively sedentary lifestyle (such as prolonged sitting, standing still or driving).

An integrated approach is more effective than one approach (Brukner and Khan 2012) as well as recognising and addressing exacerbating factors. 

In our experience at Belfast Community Acupuncture, learning to identify these exacerbating factors is key to long term success.  This will be a reflective learning process, in which one learns from ones successes and set-backs, developing awareness and adapting behaviours.  We would suggest perhaps through keeping a ‘pain diary’ in which you record your pain levels from 1-10 each day, noting any activities which aggravated or alleviated pain.  By learning to recognise triggers, you can gradually learn to take adaptive, corrective action to prevent reoccurrence. 

Acupuncture and Low Back Pain

In Traditional Chinese Medicine there is a saying that “when there is free flow of Qi there is no pain, and when there is pain there is no free flow of Qi”. 

Let’s say that Qi may be interpreted as a metaphor which describes many different functions, depending on the context, and in the case of back pain, an obstruction to the normal circulation of blood, motor and/or sensory nerves may be caused by bruising, inflammation, scar tissue, a reduction in local circulation, stiff muscles, trigger points or other trauma.  This is one way of interpreting “when there is pain there is no free flow of Qi”, at least within the narrow context of low back pain.  We may attempt to alleviate these obstructions through therapeutic intervention using acupuncture, moxibustion (heat), Chinese cupping therapy or electro-acupuncture in order to stimulate the free flow of Qi. 

However, in Traditional Chinese theory, it is not possible (or at least it is not Traditional Chinese Medicine) to isolate or reduce one factor from the bigger picture.  This is a fundamental difference between Chinese Medicine and a solely orthopaedic approach.  When a condition becomes chronic we will also look at the overall health picture, with your permission.  For example from a Chinese point of view, chronic emotional frustration or anger also obstructs the free flow of Qi.  Interestingly this same functional system is said in Chinese theory to ‘govern the sinews’.  So we can see that there are two quite different functional causes contributing to a similar diagnostic picture in Chinese theory ie the obstruction of the Qi mechanism.  It makes logical sense that by holding onto tension, we contribute to myofascial pain, or inhibit our recovery and it can be helpful to recognize this. 

From a medical perspective, acupuncture may help the symptoms of low back pain by providing pain relief (through the release of endorphins altering the perception of pain), increasing local microcirculation to improve tissue healing, reduce inflammation, releasing tension in taut muscles and myofascial trigger points, improve the outcome when added to other conventional treatments in a multi-disciplined approach to treatment (British Acupuncture Council 2013).

At Belfast Community Acupuncture we believe in an integrated approach, using our training in Traditional Chinese Medicine but allowing ourselves to be guided also by the available evidence, our clinical experience and the work of expert modern clinicians such as Whitfield Reaves and Kevin Young.  NICE guidelines recommend up to 10 sessions of acupuncture over 12 weeks.  We recommend that you attend 3-4 weekly treatments before reviewing your progress.  By this stage you should have some confidence that acupuncture is beginning to establish a therapeutic benefit. 

Finally, Chinese Medicine has a rich and varied history and there are many approaches to the management and treatment of low back pain.  We continue our journey as you continue yours, learning, reflecting and adapting our treatments to provide the very best care within the scope of our practice.  We look forward to assisting you in your journey.

Emma Van Loock Lic.Ac
Belfast Community Acupuncture
December 2013
www.facebook.com/belfastaacupuncture
Tweet @emmavanloock

References:

British Acupuncture Council. (2013). Back Pain. Available: http://www.acupuncture.org.uk/a-to-z-of-conditions/a-to-z-of-conditions/back-pain.html. Last accessed 3rd December 2013.

Brukner and Khan (2012) Clinic Sports Medicine, 4th ed, Australia: McGraw-Hill

NICE (2009). Low back pain: Early management of persistent non-specific low back pain. Available: http://www.nice.org.uk/nicemedia/live/11887/44343/44343.pdf. Last accessed 3rd December 2013.

We are delighted to announce the opening of our new clinic in North Belfast tomorrow October 7th. The clinic is located in the Community Room on the second floor of the Newington Credit Union Building, 239-243 Duncairn Gdns, just off the Antrim Road and will open every Monday afternoon and evening. The clinic is in a lovely bright modern space and we are grateful to the staff of the Credit Union for supporting us in this venture. We look forward to welcoming you to the clinic.

Mary and Emma

Culture Night Belfast is a family-friendly night out where Belfast transforms into a vibrant, buzzing, multicultural European city, with free events, workshops and performances for all tastes and ages, and all free!

This Friday 20th September Belfast Community Acupuncture returns to CNB to celebrate its 1st birthday in the Cathedral 1/4 with a free workshop in Chinese Tongue Diagnosis, "What does your tongue tell you?"

Drop-in to see us anytime between 6pm and 9pm and we'll informally group together at regular intervals to demonstrate how the Chinese have used the tongue as a barometer or health over the centuries.  We will also offer a number of free mini-ear acupuncture treatments, which were so popular last year! 

1st Floor, 52a Hill St (Flow Studio Belfast), BT1 6-9pm (invite attached).

Please feel free to share the invitation with anyone you think would be interested.

A warm welcome awaits,

Emma and Mary
www.belfastcommunityacupuncture.com
info@belfastcommunityacupuncture.com
www.facebook.com/belfastacupuncture
@emmavanloock

Mary and Emma will be flying over to Donegall Pass Community Centre after our regular Thursday Clinic at Shaftesbury Recreation Centre, on Thursday 22nd August at roughly 7pm in order to give some free consultations and mini treatments as part of the Inner South Health Project. 

For more info on Health Outreach contact Camilla Reynolds Health Outreach Worker at LORAG (028) 90 312377

For more information about acupuncture contact us

The question of how many treatments are needed can be a difficult one to answer exactly, as so much depends on the type of illness and the treatment goals, and it is not always clear how someone will respond.  There may be competing set backs, sometimes unavoidable, in a person's life.  If you are attending regularly, you should be making gradual progress, it doesn't happen suddenly later on.  This is how you can monitor that acupuncture is an appropriate therapeutic intervention. 

We begin by setting a goal based on our training, clinical experience and the available evidence base.  This means our treatments are informed by the traditional Chinese approach, while ensuring as far as possible that it is realistic to expect acupuncture to help and ethical to offer treatment as such. Initially, I usually suggest 3-4 weekly treatments then together, as a partnership, we can re-evaluate our treatment aims from there. Many practices encourage twice weekly treatments to begin with.  We recognise that this is difficult for many people and we do not generally request this.

A course of several treatments is usually necessary, 6-8 as a guide, in order to achieve "Maximum Therapeutic Benefit" and then to stabalise this by increasing the intervals between treatments.  It can take longer but we will discuss this in advance.  It is very unusual for conditions to resolve altogether in one or two treatments.   Mild to moderate symptomatic relief within the first few treatments is likely.  Sometimes there can be a temporary worsening of symptoms, a little more soreness, changes which evidence a response, but that the body is adjusting to a long-held habitual pattern, and it needs time.  Healing is a process which takes time.  Acupuncture helps remove barriers to healing, through a number of mechanisms, but it doesn't heal.  You do!

So if it is necessary to attend regularly, for a number of treatments, how much will it cost? Community Acupuncture makes this more affordable by offering a 'middle way model' of reduced cost in return for a shared space.  As a registered member of the Association of Community and Multibed Acupuncture Clinics, Belfast Community Acupuncture has committed to offer high quality acupuncture such as you should receive in any reputable clinic.  The guidelines for pricing these clinics (and we are the only registered multibed clinic in Northern Ireland) are roughly from a minimum price of half the going local rate up to a maximum of the local going rate.  We thrive on being busy, as we are not funded or subsidised.  We charge the minimum possible to sustain a small local business. Clients are encouraged to commit to a full course of treatment by choosing Community Acupuncture, availing of our sliding scale rates and attending regularly!

For more information on Community Acupuncture please visit ACMAC

The highly reputable British Acupuncture Council discusses the question of "How many treatments" on its website, which is also an excellent resource for current research: http://www.acupuncture.org.uk/public-content/public-ask-an-expert/ask-an-expert-about-acupuncture/ask-an-expert-about-acupuncture-nhs-private-healthcare/how-much-does-acupuncture-cost-and-how-many-treatments.html

Sun Simiao was a 7th century scholar and doctor who continues to fascinate modern day scholars of Chinese Medicine and who was famed with creating the first "code of ethics" or vision for the practice of Chinese Medicine.

“Whenever a great doctor treats an illness, he must first of all calm his spirit and fix his resolve. He should not give way to wishes and desires but should develop first of all an attitude of compassion. He must vow to rescue the sufferings of all sentient beings. If someone comes for help, he must not ask if the patient is noble or common, rich or poor, old or young, beautiful or ugly. Enemies, relatives, good friends, Chinese or barbarians, foolish and wise, all are the same. He should think of them as his closest relatives. He should not be overly circumspect and worry about omens or his own life. He should look on others’ sufferings as his own and be deeply concerned. He should not hide away in the mountains. Day and night, in cold and heat, in hunger, thirst, and fatigue, he should single-mindedly go to the rescue. Whoever acts in this manner is a great doctor for the living. Whoever acts contrary is a great thief for those who still have their spirits.” - Sun Simiao, "On the Absolute Sincerity of Great Physicians,"

Numerous sources of information on Sun Simiao exist but here is one suggestion for further reading

[All in the same boat: a qualitative study of patients’ attitudes and experiences in group acupuncture clinics Online First doi 10.1136/acupmed-2012-01050]

Acupuncture can relieve the pain of knee osteoarthritis and offer a low cost alternative to surgery for the condition, finds research published online in Acupuncture in Medicine.

The researchers base their findings on 90 patients with knee osteoarthritis, who were referred for group acupuncture to two knee pain clinics in St Albans, Hertfordshire, in 2008 and subsequently monitored for two years.

Fifty patients said they would be prepared to have surgery; four said they would only have the operation as a last resort; and 29 said they did not want surgery.  They were given acupuncture once a week for a month after which the frequency was reduced to a session every six weeks.

Each patient received an average of 16.5 treatments.

From the British Medical Journal.  Full article available here

Belfast Community Acupuncture will be offering free auricular (ear) acupuncture at the Shaftesbury Recreation Centre Health Fair 2013. 

Thursday 17th Janurary 10am to 12pm (normal clinic resumes upstairs 1pm - 6.30pm)
Shaftesbury Recreation Centre, 97 Balfour Avenue, Ormeau Road.

Belfast Community Acupuncture supports the Inner South Belfast Health Project.

Quitting Smoking with Belfast Community Acupuncture

Welcome to Belfast Community Acupuncture and congratulations on deciding to quit smoking!  We’re delighted that you have chosen acupuncture to help you through the difficult first few weeks.  We have compiled this basic factsheet to explain some of the symptoms you can expect and how acupuncture can help...

Emma and Mary at Belfast Community Acupuncture would like to wish all our clients, friends and supporters a wonderful end to 2012 and best wishes for 2013! 

Thanks also to LORAG for supporting a funded pain clinic for residents of the Lower Ormeau, Markets and Donegall Pass and for providing us a venue to work from.  Thanks also to Flow Studio Belfast for allowing us to share their beautiful shared space.

2012 has been a great journey, bringing affordable, professional acupuncture for pain, stress and illness to communities in Belfast.  Thank you to all of you who have made our first year of running this new social enterprise a success. 

January will bring new challenges for us and for individuals, and our treatment focus will move towards new determinations as people seek help with smoking cessation, or addressing illnesses and injuries which are barriers to healthy, happy living. 

We're operating reduced hours for existing clients over Christmas from Thursday 20th December and will reopen for new appointments on Wednesday 9th Jan in our clinic in Hill St, Cathedral Quarter Belfast and Thursday 10th Jan in the Ormeau Clinic.

Looking forward to talking with you in 2013.

Keep up with us on facebook and twitter!

Belfast Community Acupuncture will be regularly reviewing aspects of our practice in order to develop in the best possible way and help you access professional acupuncture at affordable rates.  We'll be reviewing our opening hours in 2013 and we'd really appreciate your help by choosing your favourite time of day to have acupuncture in our ONLINE POLL.  It will take a few seconds of your time, that's all.  Thank you! Emma and Mary

An Introduction to Fertile Mucous – Emma Van Loock www.belfastcommunityacupuncture.com

At home, outside of the clinic, a woman can monitor her vaginal discharge to help indicate when ovulation will happen and therefore indicate her most fertile time and the best time to plan intercourse.  She can also monitor a basal body temperature (BBT) to indicate that ovulation has happened....(full article available by clicking 'read more'!)

In what may be the most significant research to emerge in the last five years, an international collaboration, involving some of the UK’s top acupuncture researchers, has provided definitive evidence that acupuncture is effective for chronic pain. The authors analysed raw individual patient data – an approach that allows for statistically precise results – for 17,922 participants enrolled in 29 high-quality, randomised trials of acupuncture for chronic back and neck pain, osteoarthritis, shoulder pain and chronic headache. The study, published in the prestigious Archives of Internal Medicine on September 10th, showed that for each of the four conditions, the analgesic effect of true acupuncture was slightly better than that of placebo acupuncture. However, the difference between true acupuncture and usual care alone was found to be much larger and of clinical significance. The authors hope their findings will encourage clinicians to recommend acupuncture as a safe and effective treatment and inform future clinical and policy decisions. (From www.jcm.co.uk)

Iliotibial Band Syndrome is a repetitive stress condition characterised by pain at the lateral knee and thigh.  The pain is caused by friction under the IT band leading to chronic inflammation, aggravated by exaggerated flexion and extension of the knee (such as running with speed work or hills) and the pain is relieved by rest.   Confirmation of IT band involvement is performed with palpation to the band 2-4cm proximal to the lateral joint space of the knee in the region of the acupoint GB-33. Differential diagnosis should be ruled out (eg lateral collatoral ligament sprain).  There may also be involvement of gluteal muscles (tenderness at Jian Kua) and Quadratus Lumborum.  Primary treatment involves "thread needling" of the underside of the IT band in combination with other local and distal points.  Electro-acupuncture may also be used.    This particular condition responds very well to acupuncture. Recommended treatment up to twice per week for 3 weeks then re-evaluate.

Sports Acupuncture has progressed massively in recent years with greater integration between traditional acupuncture and western anatomical understanding.  Properly licensed acupuncturists  specialising in sports acupuncture learn to integrate western anatomy for the best outcome. (Look for Lic.Ac and then evidence of ongoing sports education). Educators such as Colorado-based Whitfield Reaves have really raised the bar with their specialised knowledge and training programmes. 

Emma is a licensed acupuncturist and ITEC Sports Massage therapist and completed post-grad training in sports acupuncture with Kevin Young at CICM Reading, and is also currently continuing her studies with the sports acupuncture online programme with Whitfield Reaves online seminars.  Emma's approach is to treat sports injuries with acupuncture and integrate manual techniques as appropriate to the specific injury.