Despite skeptics, acupuncture finds favor with athletes

Aaron Rodgers has thanked his acupuncturist at least twice in news conferences since injuring his calf 3½ weeks ago.

So it's safe to say he thinks this traditional Chinese medicine that dates back 2,000 years is helping.

The science on acupuncture isn't definitive, and there remains plenty of skepticism in Western medicine about its efficacy. But there are studies at least suggesting acupuncture can help certain conditions, and it is becoming more common in the United States for patients to include acupuncture with other Western-based treatments for injuries and illness.

"It won't hurt (Rodgers)," said Dr. John Cianca, an associate professor at the Baylor College of Medicine Department of Physical Medicine and Rehabilitation who also is a licensed acupuncturist.

"It could very well help him in aspects of the problem. If there's some muscle damage, it's going to have to heal. That process takes time and is vulnerable to re-injury if you're trying to be as active as he is. The short answer is, yes, it could help him. Is it definitely going to help him? Can't say that. Given everything else he's doing, I can't say what's working."

The point of this column isn't to endorse or debunk acupuncture. I don't know if or how well it works, or what it might work on. My inkling after researching it for a few hours the last couple of days is there might be something to it, at least for some ailments. But obviously I don't know, and it appears to still be a contentious issue in medical circles.

You might be surprised by the list of pro athletes who have turned to acupuncture. It includes current and former NFL players Michael Strahan, James Harrison, James Farrior and Marcus Stroud; baseball players A.J. Burnett and Randy Johnson; NBA players Kobe Bryant, Steve Nash, Grant Hill, Shaquille O'Neal and Charles Barkley; and professional golfers Fred Couples and Gary Player.

Even the U.S. Army, as reported by NPR in 2012, is using acupuncture to treat chronic pain in injured soldiers.

But there are plenty of skeptics in the medical community as well, and they think it works no better than placebo. For what it's worth, a 2012 meta-study (a study of multiple studies) in the medical journal Archives of Internal Medicine concluded that acupuncture works better than placebo for treating chronic pain.

If it's helping Rodgers, it's likely for reducing pain and inflammation.

"We don't know exactly how it works," said Dr. Ken Jung, a foot and ankle surgeon at Kerlan-Jobe Orthopaedic Clinic in Los Angeles. "But obviously it's been around for years, and it definitely has an effect with regards to pain control and decreasing inflammation."

Rodgers on his radio show on ESPN Milwaukee on Tuesday said he first tried acupuncture for a sore hamstring earlier this season on the advice of his girlfriend, actress Olivia Munn.

Rodgers has not offered any details about acupuncture on his calf and declined a request for an interview about it Wednesday. So the precise nature of his treatment is unclear.

William Leach, a chiropractor and physiotherapist at BASIC Spine in Newport Beach, Calif., said he had acupuncture for glute and calf pain that consisted of one long needle inserted into the injured area. The acupuncturist manipulated it for several seconds, then removed it and the treatment was done.

"It kind of hurts, and then they'll pull (the needle) out," he said. "The weird thing is you get almost this miraculous immediate relief in that area. It's darn near sniper specific. It's crazy."

Cianca said that kind of treatment is unusual and suspected that Rodgers is getting more conventional acupuncture that consists of needles placed in various points on the body, perhaps in the injured area but not necessarily. However, even those acupuncture points can vary depending on the practitioner and patient.

Traditional Chinese medicine views the human body as an energy field and describes acupuncture as a way to balance that energy via meridians that flow throughout the body. Western practitioners sometimes describe acupuncture as a way to stimulate nerves, muscles and connective tissue.

"It's a different treatment modality that's not very well understood by most Western physicians," said Cianca, who also is medical director of the Houston Marathon. "Some people like me do both.

"I've been practicing acupuncture for 20 years. Around the world it's quite accepted. It's really in the hands of the practitioner as to how well it works. Meaning, can I interpret the problem and design a treatment that works for that particular situation and individual. That's the limiting factor, not whether it's a viable option."

Matt Flynn, the Packers' backup quarterback, said he's tried acupuncture and a related treatment, dry needling, on the tendinitis in his throwing arm that sidelined him for part of training camp with Seattle in the 2012 season.

Dry needling is a Western technique that uses acupuncture needles and relies on trigger points based on the understanding of the musculoskeletal and nervous systems. The difference is that acupuncture is based on traditional Chinese medicine that treats the body as whole energy system with meridians.

Flynn said dry needling helped reduce the pain in his throwing arm.

"(Rodgers) is doing some kind of acupuncture," Flynn said. "I know he does it, and I know he likes it."

Rodgers' calf has been strained in two places over the past month, first at Tampa Bay on Dec. 21 and again against Detroit on Dec. 28.

Based on his limited mobility and obvious efforts to protect his calf in the Packers' win over Dallas last week, Rodgers' injury remains significant. The injury likely requires a four- to six-week recovery if all he were doing were treatment and rehabilitation.

Rodgers said his calf was a little worse coming out of the game then it was going in. That suggests he might be a little healthier this week in Seattle than last week, but with only a week of treatment and rest, he probably won't be close to full strength.

"He's not at a total new starting point either, because he didn't have an event to re-aggravate it as seriously as it was before," said Jung, the ankle and foot specialist. "A lot of it depends on how he responds when they let him practice, and even (testing it) before game time."

Along with acupuncture, Rodgers no doubt is getting the gamut of more traditional therapies to expedite the healing.

The basics are rest, icing, compression and elevation.

He also likely is stretching it regularly; getting electrical stimulation, ultrasound, laser treatment and deep-tissue, myofascial massage to break up scar tissue and improve blood flow.

There's a decent chance he's also been injected with platelet-rich plasma, which is a newer treatment that appears to speed the healing of muscular injuries.

"It's going to take a few weeks (for Rodgers to heal)," Leach said. "The problem is, every time he gets out and pivots or pushes off or scrambles out of the pocket, he's obviously causing inflammation and slowing the healing process. He's not resting it."

Cianca uses acupuncture in his practice regularly — on a patient or two a day, he estimates. But he uses it more for wellness than acute injuries.

"I tend to try to solve problems mechanically first, meaning I try to iron out why it happened and try to correct that," he said. "Often times that's enough. But in this setting where somebody has urgency getting back, I might use (acupuncture) as an adjunct."

— pdougher@pressgazettemedia.com and follow him on Twitter @PeteDougherty.