As more athletes and individuals who engage in regular physical exercise learn of the benefits of acupuncture both to treat injuries and to enhance their physical activities, acupuncturists are increasingly seeing more musculoskeletal disorders that arise from improper exercise or insufficient stretching. One of the most common of these injuries relates to the hamstrings.
The hamstrings are particularly interesting because frequently, even in those who exercise, they are underdeveloped and tight. Many specific aerobic exercises such as running or walking, and weightlifting exercises such as the squat, tend to work the quadriceps more (although they certainly work on the hamstrings as well). Furthermore, many of the stretches that people practice do not stretch the hamstrings, even if they think they do. Frequently these exercises involve stretching and grasping the feet from either a standing or a sitting position. Most of the time, however, this is done with the knees locked, which takes some of the "stretch" away from the hamstrings. Taken singly or together, these factors contribute towards a propensity for hamstring tension, weakness or even injury, whether at the distal tendinomuscular junction, the origin at the ischium, or in the belly of the muscle itself.
In general, the hamstrings are part of the urinary bladder tendinomuscular channel, though overstrength of the tendinomuscular channels of the gallbladder or stomach might be the cause of hamstring dysfunction. It is also important to realize that dysfunction of the urinary bladder tendinomuscular channel may be a result of imbalance in the three leg yin channels as well.
A good evaluation performed by a qualified provider will indicate the cause of dysfunction or pain. Sometimes injuries are severe and require Western medical treatment. At other times, teaching patients proper stretching and balanced strengthening techniques - or referring out to an appropriate physical therapist or other practitioner if necessary - may significantly help them overcome dysfunction and improve strength and flexibility. Massage, in particular tui na, may be useful as well.
In either case, acupuncture can play an important part in the overall treatment scheme. The choice of local points along with points such as UB40, GB34 and UB36 is easy, and the general "ropiness" of the hamstrings makes it easy to indentify a-shi points and areas of disruption of qi flow. The key to using acupuncture in treating the hamstrings lies in selecting proper distal points that adequately affect the region involved.
I would suggest five distal points (or sets of points) that, through a variety of channel relationships, may prove to be key to affecting the hamstring area, whether used with needles, moxa, or both.
As has been clear in my previous columns, when dealing with musculoskeletal disorders, my concern is more on the particular effect of a point on a particular individual than with point functions per se. Therefore, in order to evaluate whether these points will be effective on any individual, it is necessary to test them out before needling and to test both contralateral and unilateral points.
My recommendation is to put moderate pressure on the most uncomfortable a-shi point on the hamstrings and test whether pressure on each of these distal points reduces the level of discomfort. You can test each point sequentially. In general, if one or more of these points reduces discomfort by at least 50%, I would consider using it (or them) as distal points. Furthermore, you can check to see whether pressure on distal points along or against the flow of the channel makes a significant difference and needle accordingly. Patients should notice improvement within a few treatments.
Chronic pain afflicts over 20% of the adult population. Sadly, most MDs have essentially no education in treating pain, beyond offering a few toxic medications. Then they tend to steer people with pain away from those health practitioners who are trained. This puts the acupuncture community on the front lines for addressing this epidemic.
When the body is going through a stressful event, the sympathetic system is activated. This activation will help the body with a life-threatening situation. If this state is activated for prolonged periods of time, it starts to consume energy. These traumatic events that generate stressors in the autonomic nervous system (ANS) will eventually become internalized.
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One of the things that makes acupuncture so difficult to measure is that the medicine actually does contain some esoteric aspects. There have been numerous studies that demonstrate the neurochemical reasoning behind why acupuncture points stimulate the autonomic nervous system to enact change However, not all the benefits of TCM can easily be measured by randomized, controlled trials. But does that make them fundamentally and definitively untrue?
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