Goal-directed

acupuncture

in sportsin sports

Taras Usichenko

Department of Anaesthesiology and Intensive Care Medicine

Ernst Moritz Arndt University of Greifswald

Outline

1. Case report: acupuncture in modern pentathlon

2. Review of the literature & discussion

3. Conclusion

Modern pentathlon

"The most perfect sportsmen, therefore, are the Pentathletes because

in their bodies strength and speed are combined in beautiful

harmony.“ Aristotle

1. Shooting: 4.5 mm air pistol 10 m distance, 20 shots

2. Fencing: epée, one-touch, max. 1 min. fight

3. Swimming: 200 m free style

4. Horse riding: 400 m parcours with max. 12 obstacles 120 cm high

5. Cross: 3000 m cross-country

Modern pentathlon – physiological challenge

• Endurance

• Rapid force

• Concentration

• Change of various functional systems

ALL SPORT disciplines on one DAY!!!

“BALANCE - THE PENTATHLETE”

Richard Ennis, 2007

• Male athlete, 20 yrs old

Case report

Start for 3000 m at 2008

• 183 cm, 75 kg

• Candidate to national team

• Limiting performance - CROSS

• Main problems during cross:

Start for 3000 m at 2008

Beijing Olympic Games

- pain in epigastrium (2nd part of distance)

- „Heavy“ knees

http://news.xinhuanet.com

1. Clinical examination

2. Palpation: “five-element” points

Muo-and Shu- Points

Diagnostics

Muo-and Shu- Points

Akabane-Test

3. Thermography of acupoints using „Agema Thermovision 870,

resolution 0.13°

Diagnostics revealed the points of GB and ST meridians

BL18 and 19

GB 31, 32, 34 and 40

ST36 and ST40

Complaints

Acupoints used to improve cross performance…

1.Pain in epigastrium

2.„Heavy“ knees

GV26

Usichenko et al. eCAM 2009

Points

1.ST36, GB34

2. GV26

Complaints

1. General fatigue

…Fencing

1. General fatigue

2. Arm fatigue

PointsGV26

1. GV 26

2. LI4, LI10, LI11, TH5

Complaints

…Shooting

LI4

1. Psychic agitation

2. Tremor of the arm

Points

LI4, H7

Complaints

…Swimming 200m free style

Complaints

„Stiffness“ of the shoulder muscles

Points GV26

1.LI4, 11, 14, TH5, GB21

2.GV26

• Nr. 1 in national team during the active career

• Continuous improvement of performance

• Strong psychological component (acc. to coach‘ opinion)

Results

Cross• Strong psychological component (acc. to coach‘ opinion)

10 Min.

Cross

09:25

Discussion

Cross

1. Only case report

2. Training effect?

3. Placebo?

10 Min.

Cross

4. Acupuncture as doping?

09:25

Increase of performance in top athletes after TENS applied to acupuncture point LI4

Placebo? – not only

LI4

Kaada Acupunct Electrother Res 1984

Acupuncture for athletes of Chinese national team

Doctors at Bejing Sports University use

acupuncture to treat up to 70% sports injuries

Medal ranking Olympic Games 2008 in Beijing

Watts Lancet 2008

„We use a mix of modern western

and older Chinese techniques...“

Dr. Jiao Wei

Director of University Sport Medicine

http://en.wikipedia.org/wiki/2008_Summer_Olympics_medal_table

WADA doping criteria

World Anti-Doping Code

a substance or method shall be considered a doping if WADA determines that a substance or method shall be considered a doping if WADA determines that

the substance or method meets any 2 of the following 3 criteria:

(i)medical or other scientific evidence that the substance or method has the

potential to enhance or enhances sport performance;

(ii) medical or other scientific evidence that the use of the substance or

method represents an actual or potential health risk to the athlete;

http://www.wada-ama.org/rtecontent/document/code v2009En.pdf.

method represents an actual or potential health risk to the athlete;

(iii) WADA’s determination that the use of the substance or method violates

the spirit of sport

Results

Acupuncture as doping?

Design

• The idea of goal-directed and symptom-oriented

Conclusion & future directions

• The idea of goal-directed and symptom-oriented

stimulation of acupuncture points in top athletes is

suggested

• The expected “performance-improving” effects of

acupuncture should be verified using appropriate

methodology (RCT and experimental investigations)

• Question of acupuncture relation to doping should be

clarified

Thank you for your attention

Reuters 2008