A Reactive Versus Proactive Treatment Mentality

Now that the Beijing Olympics are over and the hype has subsided, athletes have gone on to professional teams, returned home or back to school, or moved on to other pursuits. For some, it is back to training for 2012, while for others it may be time for retirement.

Most Americans only remember the athletes who "won" (specifically gold medalists), those whose stories were featured prominently, and of course, those whom they know personally. But what about all the other athletes, each one sacrificing eight to 15 years of their lives to make the Olympic team? The Olympic endeavor requires not only a great deal of self-discipline, but more importantly, motivation, drive and determination. A significant amount of sacrifice is involved in pursuing the "athletic dream" and the toll is quite high, ranging from numerous injuries due to overtraining to mental fatigue, burnout and sometimes even serious diseases from the years of training.

Of those athletes who did not medal, many are not even known by the public. Luckily, regardless of whether an athlete is fortunate enough to win a medal, they take with them an "in-the-moment" experience they will never forget. The recognition only lasts for the first few months following the ceremonies. Maybe (if they are lucky) they will participate in a few Olympic venues as a veteran athlete. And the issue of retirement is always just right around the corner.

The maturity that comes with age does, however, provide some situational advantages. Veterans have the mental focus, muscle memory, knowledge of what to expect, and familiarity with the qualifying process and what it takes to place in those events, as well as in medal-contention events. Most important perhaps is the knowledge of their limitations and a preventative outlook, since the key to extending an athlete's competitive career is in a proactive (rather than reactive) approach to training and treatment. The downsides include an increased awareness of the abuses the body endures from training, longer warm-ups, and a need for more attention to detail with regard to recovery.

As a result, the use of massage therapists, athletic trainers, chiropractors, physical therapists and, yes, acupuncturists constitutes a more significant portion of their regimen as part of a preventative (proactive) approach, especially when compared to the regimens of their younger counterparts. Fortunately, there are mature athletes in competition who appreciate the power of prevention, take the necessary steps to prolong their career, and actively advocate this approach. Unfortunately, younger athletes are at risk due to the reactive mentality prevalent not only on the personal level, but also within the team system and indeed permeating the very infrastructure of the established medical protocol.

Although many coaches, athletic trainers, sports therapists and others still do not recognize the benefits of Asian/Oriental medicine, many athletes independently seek these treatments on their own. Unfortunately, there has also been an increase in the number of cases in which medical professionals have implemented segmental theory and/or trigger-point acupuncture. Although this implementation is based purely in reactive treatment protocols, there are serious limited interpretations of the profound effects acupuncture has that extend far beyond the scope of segmental and trigger-point theories.

Within Eastern philosophy, the channel theory (segmental/trigger-point is an interpretation of this theory) represents only one of many theories for Asian/Oriental medicine. This is analogous to geometry in that there are many different theorems, but if you rely on only one theorem to define the entire scope of geometry, it can be problematic. Although segmental acupuncture fits the evidence-based model and the current critical-thinking paradigm for now, it is an extremely limited application of Eastern diagnostic methods. These diagnostic methods are all-inclusive critical thinking models with more well-rounded treatments. They are able to address a multitude of issues in conjunction with or without pain. However, there is a serious lack of understanding within the academic community by so-called "experts" (usually not trained in any of the complementary alternative medicine therapies), who read the literature and draw conclusions without any genuine knowledge. This is of course problematic since it promotes not only misinformation among those who read such articles, but also a poor quality of care arising from a lack of proper well-rounded education.

While working with the U.S. men's volleyball team (gold medalists at the 2008 Olympics), I have used acupuncture on a number of athletes to assist with inflammation, spasms, post-operative recovery, strains, etc., while addressing other underlying conditions in conjunction with the injuries. As noted in my previous articles, the full potential of Oriental medicine - that of proactive rather than reactive prevention - is still neither fully recognized nor implemented. Even in the volleyball setting, the application of acupuncture is more reactive than proactive, as most players seek care only after sustaining an injury, as this is the standard protocol. This team, however, differs from others I have worked within the past; previously, the athletes were typically open-minded but the sports medicine trainers and medical doctors were not. Aaron, director of sports medicine, has put together a fabulous team that is able to work synergistically. The guys are great and many are open-minded and curious. The head coach, Hugh, also understands the benefits of Asian/Oriental medicine, as he also receives TCM treatments.

Over the years, my experience within the professional sector has been very different. I currently work with the Anaheim Ducks of the National Hockey League, and some of the players are very open-minded about acupuncture and receive massages and manipulations on a regular basis in their pursuit of career longevity.

These players approach CAM from a preventative rather than a post-injury (reactive) standpoint. They proactively incorporate treatments into their regimens before an injury occurs. Although many athletes still opt for acupuncture as a reactive option, there are a few I have worked with who really understand the benefits of a proactive approach and consistently use it to enhance recovery, prevent injuries and increase mental focus.

Another issue for athletes, many of whom I have treated both during their athletic career and after retirement, is transitional difficulties. The emotional letdown after competition, transitioning to new training levels and regimens, altering food consumption (athletes must watch their diet since they no longer train at the same levels their bodies were once accustomed to), burnout in their particular sport, post-competition career goals: going back to school, family, new occupations, health care benefits and pre-existing conditions - these are just a few of the issues these athletes face. All are factors contributing to depression, anxiety, insomnia and other conditions Oriental medicine is able to address and typically treat reactively rather than proactively.

It is important to understand that the proactive approach is by nature a dilemma within the evidence-based model - how can one quantify something that has yet to occur? Although evidence-based is the current "gold standard," with numerous advances, much is lost in translation, and in this particular case (segmental/trigger-point applications), this interpretation is being treated as the definition rather than as one possibility among many. This of course has a significant impact on the qualifications to practice acupuncture and ultimately the quality of care our patients/athletes receive. This is where multi-variable research methods and collaboration can help identify how things work synergistically.

For example, quantum computers have the ability to analyze data synergistically and potentially can quantify data in this type of research application. So, rather than the traditional academic community dismissing this mindset as invalid, in actuality (through historical relevance), technology is catching up to the preventative diagnostic methods already implemented for centuries in other cultures. It is just a matter of time.

It is necessary to not only recognize, but also understand the implications of a proactive versus reactive treatment when incorporating acupuncturists into the sports medicine team. Those trained in the TCM diagnostic methods can enhance the current recognized reactive medical treatment protocols by collaborating on a more integrated individualized proactive (preventative) medical treatment, resulting in a treatment that addresses pain and injuries while emphasizing performance enhancement, increased mental focus, and injury prevention. Athletes will attain longevity in their competitive careers, and upon retirement, their injuries, pathologies and emotional stressors can be reduced significantly. In turn, this provides an easier lifestyle transition. It's all about having a more proactive rather than purely reactive mentality.