Your shoulder can protect you

Can your shoulder muscles act to protect you from something coming at you without you even thinking about it, regardless of what position your arms are in? A study by Indiana State University athletic training professor Kellie Huxel, published in the January 2008 issue of “The Journal of Bone and Joint Surgery,” says yes.

Based on previous research performed on cadavers, common wisdom held that when the shoulder joint is in a compromised position, such as with arms up and behind the head, like a baseball pitcher’s, the shoulder muscles are less effective, and therefore not able to protect the joint as well. In Huxel’s study, “Stiffness Regulation and Muscle-Recruitment Strategies of the Shoulder in Response to External Rotation Perturbations,” which looked at 40 healthy, college-aged males and females, she found that the shoulder was just as stable with arms up and behind the head, as it was when the arms seemed to be in a more prepared position directly out at the sides.

“We believe that the body knows how to protect itself, regardless of the position it is placed in.” Huxel said, “It just uses different tissues to get the important information to the brain that triggers muscle contractions to stabilize and protect it.” When something is coming toward a person, the brain knows how much to turn on the muscles, based on past experience and anticipation, Huxel said. This information from past experience is stored in the brain and accessed when a similar situation occurs.

Huxel used the example of a person versus a leaf. “You will instinctively turn your muscles on more for another person coming at you than for an errant leaf falling across your path,” she said. “Before our study, we thought that the position of the joint affects how much, or how well, muscles can turn on for these purposes, because of the anatomy of the joint and muscles; but we didn’t find this to be the case.” What this suggests, Huxel said, is that healthy people are not at increased risk for injury when their arm is in an awkward position, such as back and overhead, like a pitcher’s. “Your body knows how to adapt and protect itself if it is healthy,” she said.

What this also means for athletic trainers, as well as the everyday person, is that muscles need to be exercised at a variety of joint positions so that when they “kick on” to protect the joint, they can elicit an adequate response, Huxel said. “In addition to pull-ups and push-ups, which will strengthen the muscles, do exercises that will focus more on stability and the smaller muscles around the shoulder,” Huxel said. “For example, use elastic tubing to target the rotator cuff muscles and shoulder blade muscles; the rhomboids, lower trapezius and serratus anterior.”

http://www.tribstar.com/healthfitness/local_story_135214309.html

Acupuncture and trigger points

Acupuncture and myofascial trigger points therapy each focus on hundreds of similar points on the body to treat pain, although they do it differently, says a physician at Mayo Clinic in Jacksonville who analyzed the two techniques.  Results of the study, published May 10 in the Journal of Complementary and Alternative Medicine, suggest that people who want relief from chronic musculoskeletal pain may benefit from either therapy, says chronic pain specialist Dr. Peter Dorsher of the Department of Physical Medicine and Rehabilitation at Mayo Clinic.

“This may come as a surprise to those who perform the two different techniques, because the notion has been that these are exclusive therapies separated by thousands of years,” he says. “But this study shows that in the treatment of pain disorders, acupuncture and myofascial techniques are fundamentally similar – and this is good news for anyone looking for relief.” Classic Chinese acupuncture treats pain and a variety of health disorders using fine needles to “reset” nerve transmission, Dorsher says. Needles are inserted in one or several of 361 classical acupoints to target specific organs or pain problems. “This is a very safe and effective technique,” he says.

Myofascial trigger-point therapy, which has evolved since the mid-1800s, focuses on tender muscle or “trigger point” regions. There are about 255 such regions described by the Trigger Point Manual, the seminal textbook on myofascial pain. These are believed to be sensitive and painful areas of muscle and fascia, the web of soft tissue that surrounds muscle, bones, organs and other body structures. To relieve pain at these trigger points, practitioners use injections, deep pressure, massage, mechanical vibration, electrical stimulation and stretching, among other techniques.

In the study, Dorsher analyzed studies published on both techniques and demonstrated that acupuncture points and trigger points are anatomically and clinically similar in their uses for treatment of pain disorders. In another recent study, he found that at least 92 percent of common trigger points anatomically corresponded with acupoints, and that their clinical correspondence in treating pain was more than 95 percent. “That means that the classical acupoint was in the same body region as the trigger point, was used for the same type of pain problem, and the trigger point referred pain pattern followed the meridian pathway of that acupoint described by the Chinese more than 2,000 years before,” Dorsher says. Myofascial pain therapy has lately incorporated the use of acupuncture needles in a treatment called “dry needling” to treat muscle trigger points.

“I think it is fair to say that the myofascial pain tradition represents an independent rediscovery of the healing principles of traditional Chinese medicine,” Dorsher says. “What likely unites these two disciplines is the nervous system, which transmits pain.”

Mayo Clinic (2008, May 14). Acupuncture And Myofascial Trigger Therapy Treat Same Pain

 Trigger Points & Acupuncture. Are they different or the same?

There are still debate by clinician whether these two are the same or not.

Melzack, Stillwell, and Fox (1977) published a landmark article claiming to have demonstrated that acupuncture points and trigger points correlate and are essentially the same thing, the parents of trigger point therapy.  This article reported that the studied acupuncture and trigger points had a 100% anatomic correspondence and a 71% clinical correspondence in treating pain syndromes. The study examined only 48 distinct trigger points, fewer than 20% of the points subsequently described in the Trigger Point Manual and compared them to 50 acupoints typically used for major pain syndromes or discrete pain locations.

However, Travell and Simons (1983) who wrote the first text on trigger points, analyzed the Melzack et al. study and concluded: “Acupuncture points and trigger points are derived from vastly different concepts. The fact that a number of pain points overlap does not change that basic difference. The two terms should not be used interchangeably”.

In 2003, Dr. Stephen Birch, an acupuncturist from Stichting Foundation for the Study of Traditional East Asian Medicine, Amsterdam, The Netherlands, analyzed both the data and theoretical foundations of that study and reached markedly different conclusions about the correspondences of trigger and acupuncture points. Birch concluded that conceptually trigger points should only be compared to a shi points, and that, conceptual issues aside, likely fewer than 20% of the studied acupoints would correlate with trigger points for their pain uses, rather than the 71% correspondence reported by Melzack et al.

On the other hand, recent study by Peter Dosher (2007) demonstrated that more than 92% of the common trigger point locations described in the Trigger Point Manual are in locations anatomically similar to acupuncture points. Dosher in his new article (see above) concluded that common trigger points and classical acupuncture points can conceptually be compared in the treatment of pain disorders, as both types of points are tender (sensitive) points,  both types of points have consistent anatomic locations, and 99.5% of classical acupuncture points do have pain indications to compare to those of trigger points.   Although separated by thousands of years in their development, both the myofascial pain and acupuncture traditions have extensive clinical and basic science research that can complement each other in enhancing the contemporary understanding of pain physiology and optimal pain treatment.

Nonetheless Birch further argues that according to the theory of TCM “The acupuncture point at the joint is where shen qi  comes and goes. It is not (of) the skin, flesh, muscles, bones.” The very nature of the acupoints according to is to do with movement and circulation of qi and not the underlying anatomic structures. So the two theories cannot be compared.

Well, you decide for yourself, I think they both are the same.