Tong zhi bu tong; Bu tong zhi tong

(“Where there is free flow, there is no pain; where there is pain, there is no free flow.”)

This is definitely a tough one to have to write. While injuries are a part of the game, it can be extremely challenging for a player and team, doubly so when the injury prematurely forces someone to the bench for the remainder of the season.

Injury

Yacine Diop left the first game of the South Point Thanksgiving Shootout against Arizona State last Friday in pain following a knee injury. Coach Jeff Walz confirmed on Monday that she had been diagnosed with a torn ACL and would miss the rest of the season.

Diagnosis

The size and function of the ACL generally allow for an initial diagnosis based on symptoms and palpation of the knee joint during physical exam. Typically, this is confirmed by MRI during which the severity of the injury can be assessed.

Symptoms and Anatomy

The anterior cruciate ligament (ACL) functions to give stability to the knee joint, preventing undue rotation or twisting of the tibia against the femur. Injuries often occur when athletes make quick stops, pivot, or rapidly change direction, which puts excessive torque force on connective tissues and joints, primarily in the lower body”

This is why we see a lot of knee and ankle injuries in basketball and football. Quick, athletic playmaking often requires taxing the ligaments designed to resist torque on the joints, and when the force is greater than the elasticity of the ligament, the player may feel or hear the telltale pop.

The symptomology of a torn ACL includes pain that prohibits use of the knee, loss of range of motion, instability of the knee joint, inability to bear weight, and swelling.

Standard Treatment

Surgery is necessary to resume athletic activity. Even with a low-grade perforation of the ACL, the potential for severe injury with moderate torquing of the knee is very high. Torn pieces of ligament do not naturally grow back together the way skin and bone do, so a lattice is created upon which the ligament tissue can attach itself. Nowadays, the surgery is arthroscopic and uses small parts of another tendon to bridge the gap at the site of the tear. Think of it as inserting a small piece of Velcro to hold things together so the tissue and reintegrate and heal. From there, rehabilitation focuses on strengthening the joint and restoring range of motion and stability

Dr. Colby’s Treatment

I love my work as an acupuncturist, and one of my primary goals with patients is often to prevent the need for surgery. In 10 years, I’ve worked on thousands of knees, and I can tell you, if a person wants to pursue any level of rigorous activity, surgery is required for a torn ACL. Acupuncture’s role in cases like this is to ensure that surgery is completely successful and that recovery is as smooth and quick as possible

First, immediately after the injury, acupuncture is used to relieve pain and swelling. In most cases, surgery is postponed until the local area has healed enough to tolerate reconstruction, meaning inflammation and micro-debris from the injury have been cleared out through the body’s natural healing process. This is something that acupuncture can greatly accelerate. As the patient prepares for surgery, acupuncture is then used to strengthen the immune system to prevent complications during and following the procedure.

Post-surgery, the acupuncture treatments focus more directly on the healing of the injury itself. Indeed, the surgery is, in essence, a new injury to work on. It is during this time that I focus on invigorating blood circulation to help nourish and heal the ligament, encouraging reuniting of the tissues along the ligament graft. Acupuncture points around the knee joint are employed, and a pair of points on either side of the patellar ligament called xi yan (“The Eyes of the Knee”) are very useful for reaching deep into the joint space near the ACL. With ligament injuries, GB 34 is always utilized, as it is the Command Point for tendons and ligaments. This means that stimulating this acupuncture point signals to the body to focus on healing and nourishment of the dense connective tissue.

Acupuncture is also going to reduce the formation of scar tissue, both from the initial injury and from the surgery, as scar tissue is considered to be condense blood stasis in Chinese medicine. Keeping things flowing helps alleviate inflammation and scar tissue formation, and down the road, this translates into lower instances of osteoarthritis. All of this ultimately goes hand in hand with the goals of the rehab process: restoring strength and stability. The exercise and conditioning at this stage is so important, and acupuncture is an excellent supplement to these therapies, which will help to shorten the overall recovery time.

With long-term rehabilitation of injuries, particularly where surgery is necessary, it is also a good idea to include a dietary approach. In addition to taking an herbal formula (again Yi Guan Jian will be the go-to for most sports injuries), food therapy is very beneficial. Protein is needed to repair body tissue, so meats are always good. Other Blood building foods that can be helpful include: beets, celery, avocado, cherry, blueberry, pomegranate, goji berry, dark leafy greens, black sesame seeds, and black strap molasses. The absolute best thing one can eat for ligament injuries follows a principle called the Doctrine of Signatures, which states that substances that resemble parts of the body (or *are* those parts of the body) can be used as medicinals to treat those parts of the body. To that end, beef tendon is extremely nourishing to the body, and slow cooking or stewing beef tendon is excellent food therapy for torn ligaments. It can be difficult to find, so a good substitute would be making soup from a whole chicken. That way you get the nutritional essence of the tendons and bones as well as the meat.

Prognosis

As always, this is going to depend on the severity of the injury and the overall constitution of the body. With surgery being required, it is certainly a months-long recovery process and unfortunately a season-ending injury. This is more to sports medicine than getting a player back on the field right away, however. Hopefully Yacine will have a smooth and quick recovery and be able to continue her basketball career the way she wishes. Get well soon, Yacine!

 

 

 

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Colby Helton is a Louisville native who pronounces it "Louie-ville." He has lived in Chicago, Germany, China, and San Diego, but people don't watch college basketball in those places, so he moved home. He did his undergraduate studies at Northwestern University and has a Master's of Science in Traditional Oriental Medicine and a Doctorate of Acupuncture and Oriental Medicine from the Pacific College of Oriental Medicine. Colby is also co-owner of AcuBalance Acupuncture & Integrative Medicine in Middletown. He is passionate about UofL basketball, bourbon, and enjoying the two together.

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