Get to know the benefits of this healing practice.
Bicycling | March 2022
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Cyclists, physicians, and researchers have turned to acupuncture for healing and pain relief for a range of acute and overuse biking injuries, from ligament strains and tears to muscle tension and aches.
“I was very intrigued with acupuncture when I graduated from medical school 32 years ago,” says Gloria Beim, M.D., a board-certified orthopaedic surgeon and sports medicine orthopaedist who founded her practice in the late 90s. “Acupuncture has been around for thousands of years… But, I’m an evidence-based medicine gal and need science to recommend a practice for patients.”
The growth of anecdotal and quantitative research has since led Dr. Beim to partner with acupuncturists at her clinic in recent years. And she’s not the only one teaming up with acupuncturist to help patients get the most well-rounded care.
The National Institutes of Health has a dedicated branch for acupuncture research and education. The Cleveland Clinic, Johns Hopkins Medicine, and Mayo Clinichost integrative wellness departments that provide licensed acupuncture services. And due to the global uptick of clinical application, the World Health Organization published a benchmarks report for acupuncture practice (a guide to administering treatment) in May 2021.
Now, “there is so much science and peer-reviewed literature to support acupuncture,” Dr. Beim says. “It doesn’t replace physical therapy but is a great adjunct for many if not all injuries.”
Whether you’re road racing, cruising around town, or mountain biking, here are the cycling-related injuries acupuncture can complement as a recovery tactic. Plus, how it can help with preventative measures.
What is acupuncture?
Acupuncture, a health pillar of traditional Chinese medicine, involves inserting very fine, solid needles into the skin’s surface along strategic meridians (or energy channels) of the body.
Acupuncture operates on the Chinese medicine meridian theory. “The inserted needles open up blockage in the body’s channels of energy or Qi (pronounced ‘chee’)—which flow like a river system—to rebalance the circulatory, nervous, and organ systems, as well as influence the muscles that are penetrated with the needle,” explains Amy Wais, a certified diplomate of acupuncture.
The fine-point needle therapy also influences changes in the brain that are connected to neurological effects, the limbic and para-limbic networks, as well as the stimulation of the body’s natural endorphins and other opioids, reports the Cleveland Clinic, where acupuncture is one of the most popular services in the Centers for Integrative and Lifestyle Medicine.
Are different types of acupuncture available?
Adjunctive therapies exist within acupuncture, too, which not all practitioners choose to offer, explains Wais. For certain injuries and conditions, adding stimulation to the needles can be helpful for boosting energy and blood flow.
Wais occasionally adds techniques like moxibustion, the burning of moxa: a small, compact cone of ground mugwort leaves that’s placed on top of the acupuncture needle and burned, sending heat that warms the meridians. “Moxibustion helps relax the muscle and increase blood flow. It’s very soothing,” says Wais. She also implements cupping, which “helps to release lactic acid and bring fresh blood to the area to break up stagnation.”
Another key technique is electromagnetic energy: an electrode is attached to the top of the needle, sending a gentle amount of electricity that subtly vibrates the point. “A low-level electric current placed in a certain part of the fascia releases a chain of neuroreactions that can help with recovery and reduce inflammation,” says Dr. Beim, referencing a study published in Nature in October 2021.
Dr. Beim adds, “Another study published in 2017 showed that electroacupuncture triggered a neurological mechanism that can promote tissue and injury repair by stimulating stem cells.” In the study, the Indiana University School of Medicine researchers also found that electroacupuncture reduces injury-triggered pain.
How can acupuncture help cyclists?
“There’s huge evidence that acupuncture dilates the blood vessels, which increases blood flow to improve recovery, reduce inflammation, reduce the heart rate, and improve immunity,” says Dr. Beim, who treats countless cyclists and served 15 years as the team physician for the US Track Cycling Team.
Led by principal investigator Qiufa Ma, the study published in 2020 mentioned above found that acupuncture activated signaling pathways resulting in an inflammation-fighting response. “Acupuncture reduces inflammation whether the cause is overuse, traumatic, or post-operative,” Dr. Beim adds.
It’s not just inflammation that acupuncture can help address. Here, other specific injuries that might benefit from the needle-based practice. (Note, the medical experts we spoke with also agree that cycling form and a dialed bike fit significantly influence cycling overuse injuries including some we mention.)
Neck Tension and Whiplash
To help neck discomfort and crash-induced whiplash, acupuncture releases muscle tension, reduces inflammation, and increases circulation to promote healing, explains Wais.
“Cycling posture in general puts strain on the neck, and muscle tension impinges on the brachial plexus [network of nerves] at the first thoracic vertebra (T1). Subsequently, riders can get numbness or tingling in their arms or neck pain,” says Wais. “If you suffer a fall, the T1 can shift and put pressure on the nerve plexus, too, which is a really good time to see a chiropractor in conjunction with an acupuncturist.”
Shoulder Injuries
“The majority of cycling injuries happen to the upper body. Clavicle and shoulder injuries often happen from riders falling on their shoulders or with outstretched arms,” says doctor of physical therapy, Hana Bucholz. Dr. Beim also sees this in her practice.
Depending on how a rider falls, they might experience AC joint (the joint formed by the cap of the shoulder and the collar bone) dislocations or clavicle fractures. These cyclists might also experience rotator cuff strains, tendonitis, or general joint pain. Similar to neck pain, acupuncture can help relieve muscle tension in the shoulder area, increase circulation to the needle-treated area, and break down blockages that cause pain.
To confirm a rotator cuff strain versus a tear, you’ll need to visit your M.D. or orthopedic surgeon, notes Wais. Other treatments might also be necessary.
Overuse Injuries
The patellar tendon, which attaches to the bottom of the kneecap, can commonly get aggravated in cyclists, especially if riders have overdeveloped quads, which puts strain on the knee, notes Wais.
“Acupuncture can help speed the healing with those knee injuries, but with any suspected tear of the MCL or ACL, you’ll need to see an orthopedic surgeon. Post-surgery, acupuncture can help increase blood flow, decrease swelling, and ease pain,” says Wais.
Dr. Beim often treats cyclists for patellar tendinitis, often caused by a poor bike fit with the seat height too low. She also sees IT band tendinitis when the seat is too high. She says, “An orthopedic background is helpful for treating patients surgically but it’s important to treat patients non-operatively too. I get excited when I can avoid surgery for a patient and enjoy alternative treatments like physical therapy and acupuncture.”
What You Should Know Before Trying Acupuncture
If you try acupuncture, be sure to work with a licensed practitioner, which you can find listed in the directory of the National Certification Commission for Acupuncture and Oriental Medicine.
Treatments are cumulative, so anticipate scheduling sessions once or twice weekly in the beginning, in order to make progress. Then, the treatments should be less frequent. “The longer you’ve had a chronic injury or pain, generally the longer it will take to treat,” notes Wais.
“People often say they want one treatment, but there’s not one be all, end all fix. Integrative therapies are just that—they work together and with other forms of treatment like physical therapy, massage therapy, chiropractic care, functional exercises, or analysis from an M.D. Sometimes you need to attack from all angles to get the desired results,” Wais adds.
So don’t shy away from combining physical therapy, acupuncture, or other practices offered by some physical therapists like dry needling. Each treatment assists the body in a unique way.
