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Sports Injuries and Acupuncture

Sports Injuries and Acupuncture

Sports Injuries and acupuncture

Sports injuries are common, and vary from minor toe injuries to major complex trauma. Usually, only soft tissue is damaged, but there can also be fracturing of bone. Soft tissue injuries include sprains, strains and bruising. A sprain is a partial or complete rupture of a ligament, a strain is a partial tear of muscles and a bruise is a rupture of tissue leading to a haematoma. Any soft-tissue injury can lead to a tenderness, swelling, haematoma, scarring, fibrosis and loss of function.


Most commonly, sports injuries affect the lower limb, particularly the ankle (e.g. Achilles tendinopathy, sprains) and knee (e.g. patellofemoral pain syndrome, ligament injuries). Other common sporting injuries include those of the shoulder (e.g. dislocations, acromioclavicular joint injuries, rotator cuff injuries); elbow (e.g. tennis, golfer’s); wrist (e.g. strains, sprains, breaks); leg (e.g. shin splints, stress fractures, hamstring injuries); foot (e.g. plantar fasciitis); groin (strain); and back (e.g. acute lumbar sprain).(Andres 2008; Arthritis Research Campaign 2004; Jarvninen 2000, McGriff-Lee 2003; Mitchell 2005; Wolfe 2001). Injuries can be caused by trauma as a result of a sudden impact or awkward movement, or can develop over time often due to continual use of the same joints or muscle groups. Contributing factors can be: not warming, using inadequate equipment or training too hard for current level of fitness.

The aims of therapy are to relieve pain, control inflammation, hasten resolution of a haematoma, and accelerate repair. Also, there should be restoration of function and recovery of muscle power. Conventional approaches to sports injuries include RICE (rest, ice, compression and elevation), anti-inflammatory drugs and analgesics, immobilisation, corticosteroid injections, physiotherapy and surgery.

How acupuncture can help

Generally the research indicates that acupuncture is beneficial in the treatment of sports injuries. Research is usually specific in terms of the injuries covered. Positive evidence from individual randomised controlled trials, shows that:

  • acupuncture reduced pain in patients with plantar fasciitis (Zhang 2001);
  • electroacupuncture had better therapeutic effects than medication, both in the short and long term, in patients with acute lumbar strain (Yao-chi 2007);
  • acupuncture plus warmed needle relieved the pain of chondromalacia patella (Qui 2006);
  • acupuncture reduced NSAID intake and relieved pain in patients with shin splints (Callison 2002);
  • acupuncture reduced the pain of patellofemoral pain syndromes (Jensen 1999);
  • acupuncture was effective for soft tissue disease (Yuan 1989).

One systematic review found strong evidence suggesting that acupuncture is effective in the short-term relief of lateral epicondyle pain (Trinh 2004). Case studies suggest acupuncture might be helpful in the treatment of shoulder injuries (Osborne 2010), medial collateral ligament injuries of the knee (Yan 2008) and plantar fasciitis (Tillu 1998).

In general, acupuncture is believed to stimulate the nervous system and cause the release of neurochemical messenger molecules. The resulting biochemical changes influence the body’s homeostatic mechanisms, thus promoting physical and emotional well-being. Stimulation of certain acupuncture points has been shown to affect areas of the brain that are known to reduce sensitivity to pain and stress, as well as promoting relaxation and deactivating the ‘analytical’ brain, which is responsible for anxiety (Wu 1999).

Acupuncture may help relieve symptoms of sports injuries, such as pain and inflammation by:

  • stimulating nerves located in muscles and other tissues, which leads to release of endorphins and other neurohumoral factors (e.g. neuropeptide Y, serotonin), and changes the processing of pain in the brain and spinal cord (Pomeranz 1987, Han 2004, Zhao 2008, Zhou 2008, Lee 2009, Cheng 2009);
  • delivering analgesia via alpha-adrenoceptor mechanisms  (Koo 2008);
  • increasing the release of adenosine, which has antinociceptive properties (Goldman 2010);
  • modulating the limbic-paralimbic-neocortical network (Hui 2009);
  • reducing inflammation, by promoting release of vascular and immunomodulatory factors (Kavoussi 2007, Zijlstra 2003);
  • improving muscle stiffness and joint mobility by increasing local microcirculation (Komori 2009), which aids dispersal of swelling.


Andres BM, Murrell GA. Treatment of tendinopathy: what works, what does not, and what is on the horizon. Clinical Orthopaedics and Related Research 2008; 466: 1539-54.

Arthritis Research Campaign, 2004. Plantar fasciitis. Information and exercise sheet (H02). [online]. Available:

Bizzini M et al. Systematic review of the quality of randomized controlled trials for patellofemoral pain syndrome. Journal of Orthopaedic and Sports Physical Therapy 2003; 33: 4-20.

Callison M. Clinical study: Acupuncture & tibial stress syndrome (Shin splints). Journal of Chinese Medicine 2002; 70: 24-7.

Cheng CH et al. Endogenous Opiates in the Nucleus Tractus Solitarius Mediate Electroacupuncture-induced Sleep Activities in Rats. Evid Based Complement Alternat Med 2009 Sep 3.

Goldman N et al. Adenosine A1 receptors mediate local anti-nociceptive effects of acupuncture. Nat Neurosci 2010 May 30.


Green S et al. Acupuncture for lateral elbow pain. Cochrane Database of Systematic Reviews 2002, Issue 1. Art. No.: CD003527. DOI: 10.1002/14651858.CD003527.

Han JS. Acupuncture and endorphins. Neurosci Lett 2004; 361: 258-61.

Hui K.K.-S. The salient characteristics of the central effects of acupuncture needling: limbic-paralimbic-neocortical network modulation. Human Brain Mapping 2009; 30: 1196-206.

Jarvinen TA et al. Muscle strain injuries. Current Opinion in Rheumatology 2000; 12: 155-61.

Jensen R et al. Acupuncture treatment of patellofemoral pain syndrome. Journal of Alternative & Complementary Medicine 1999; 5: 521-7.

Kavoussi B, Ross BE. The neuroimmune basis of anti-inflammatory acupuncture. Integr Cancer Ther 2007;  6:  251-7.

Komori M et al. Microcirculatory responses to acupuncture stimulation and phototherapy. Anesth Analg 2009; 108: 635-40.

Koo ST et al. Electroacupuncture-induced analgesia in a rat model of ankle sprain pain is mediated by spinal alpha-adrenoceptors. Embase Pain 2008; 135: 11-9.

Lee B et al. Effects of acupuncture on chronic corticosterone-induced depression-like behavior and expression of neuropeptide Y in the rats. Neuroscience Letters 2009; 453: 151-6.

McGriff-Lee N. Management of acute soft tissue injuries. Journal of Pharmacy Practice 2003; 16: 51-8.

Mitchell C et al. Shoulder pain: diagnosis and management in primary care. BMJ 2005; 331: 1124-8.

Murray IR et al. How evidence based is the management of two common sports injuries in a sports injury clinic? Br J Sports Med 2005; 39: 912-6.

Osborne NJ, Gatt IT. Management of shoulder injuries using dry needling in elite volleyball players. Acupuncture in medicine 2010; 28: 42-5.

Pomeranz B. Scientific basis of acupuncture. In: Stux G, Pomeranz B, eds. Acupuncture Textbook and Atlas. Heidelberg: Springer-Verlag; 1987: 1-18.

Qiu L et al. Combined therapy of acupuncture with warmed needle and muscle strength training in the treatment of 34 chondromalacia patellae patients: Randomized controlled observation on curative effect. Chinese Journal of Clinical Rehabilitation 2006; 10: 170-1.

Tillu A, Gupta S. Effect of acupuncture treatment on heel pain due to plantar fasciitis. Acupuncture in Medicine 1998; 16: 66-8.

Trinh KV et al. Acupuncture for the alleviation of lateral epicondyle pain: a systematic review. Rheumatology 2004; 43: 1085-90.

Wolfe MW et al. (2001) Management of ankle sprains. American Family Physician 2001; 63: 93-104.

Wu MT et al. Central nervous pathway for acupuncture stimulation: localization of processing with functional MR imaging of the brain–preliminary experience. Radiology 1999 ; 212: 133-41.

Yan XN, Ren CX. Cause and treatment of sports injury in knee joint medial collateral ligament. Journal of Clinical Rehabilitative Tissue Engineering Research 2008; 12: 5567-70.


Yao-chi W et al. Observation on short-term and long-term therapeutic effects of electroacupuncture at Houxi (SI 3) on acute lumbar sprain. Chinese acupuncture & moxibustion 2007; 27: 3-5.

Yuan CX et al. Observations on clinical therapeutic effect in treating soft tissue injuries by acupuncture, with pain threshold and electromyography as parameters. J Tradit Chin Med 1989; 9: 40-4.

Zijlstra FJ et al. Anti-inflammatory actions of acupuncture. Mediators Inflamm 2003; 12: 59-69.

Zhang SP et al. Acupuncture treatment for plantar fasciitis: A randomized controlled trial with six months follow-up. Evidence-based Complementary and Alternative Medicine 2011: 154108.

Zhao ZQ.  Neural mechanism underlying acupuncture analgesia. Prog Neurobiol 2008;  85: 355-75.

Zhou Q et al. The effect of electro-acupuncture on the imbalance between monoamine neurotransmitters and GABA in the CNS of rats with chronic emotional stress-induced anxiety. Int J Clin Acupunct 2008 ;17: 79-84.