Sports Injuries, Repetitive Strain, and Post-Surgical Pain

Sports Injuries, Repetitive Strain & Post-Surgical Pain

An injury has its own biology and its own timetable. Muscle, tendon, ligament, and bone do not heal at the same rate, and no treatment can bypass the stages through which damaged tissue must repair itself. What treatment can address is what happens around that recovery: pain, protective muscular guarding, loss of comfortable movement, and the compensations that develop elsewhere in the body while an injured area heals.

The problem is rarely confined for long to the tissue that was first injured. A painful ankle changes the way you walk; a shoulder injury alters the way the neck, upper back, and opposite arm work. Muscles tighten protectively, movement becomes cautious, and temporary adaptations can become patterns of their own.

Our aim is to address those secondary problems while respecting the healing tissue itself. Acupuncture, cupping, manual treatment, and appropriate movement are used according to the injury and its stage of recovery — initially with an emphasis on pain and excessive guarding, and later on comfortable movement, function, and return to normal activity.

Acupuncture and cupping have also become increasingly familiar in the world of sports and athletic recovery. Their popularity among athletes is not evidence in itself, but the appeal is understandable: when someone is training regularly, managing pain, maintaining comfortable movement, sleeping well, and limiting the compensatory tension that develops around an injury can all be important while the injured tissue does the slower work of healing.

For athletes, the goal may be returning to training or competition. For someone recovering from surgery, an accident, or an overuse injury, the goal is much the same: to recover with as little residual pain, stiffness, and altered movement as possible.

What we treat

• Acute soft-tissue injuries — strains, sprains, and other injuries once fracture or significant structural injury has been ruled out when appropriate
• Tendinopathy — including tennis and golfer’s elbow, Achilles, patellar, and rotator cuff-related tendon pain
• Plantar fasciitis and heel pain
• Running and training-related injuries, including IT band-related pain and shin pain
• Muscle strains and tears during recovery, including the compensatory patterns that can follow them
• Repetitive strain injuries — wrist, forearm, thumb, neck, and shoulder pain associated with keyboards, instruments, tools, and repetitive work
• Carpal tunnel syndrome and other peripheral nerve irritation
• Post-surgical pain and rehabilitation following orthopedic and other surgery
• Persistent pain and restriction associated with healed scars
• Return to activity after injury or a prolonged layoff
• Peripheral neuropathy and nerve pain, including chemotherapy-induced peripheral neuropathy and post-herpetic neuralgia

Sports injuries and repetitive strain

Sports injuries range from an acute strain or sprain to problems that develop gradually under repeated load. The stage of the injury matters.

When an injury is very recent, we may begin by treating away from the injured tissue, particularly when the area is swollen, highly sensitive, or still being medically evaluated. As healing progresses, treatment can move closer to the affected area and begin addressing the muscles and movement patterns that have been compensating for it.

Overuse injuries require a somewhat different approach. Tendinopathy, for example, is not simply an inflamed tendon that needs to be rested indefinitely. Appropriate progressive loading is an important part of rehabilitation. Acupuncture and manual treatment can be used alongside that process to address pain, surrounding muscular tension, and limitations that make rehabilitation more difficult.

We regularly work with patients who want to remain active while recovering. The question is often not simply “Can I exercise?” but which activities can continue, which need temporary modification, and how to return gradually without repeatedly aggravating the problem.

Repetitive strain and nerve compression

Not every musculoskeletal problem begins with an injury. Repeated use of a keyboard, mouse, musical instrument, tool, or other activity can produce persistent pain and tension through the hands, wrists, forearms, elbows, shoulders, and neck.

Treatment looks beyond the symptomatic area. Wrist and hand symptoms, for example, may coexist with significant tension or restriction through the forearm, shoulder girdle, or neck.

Carpal tunnel syndrome requires particular attention to neurological symptoms. Acupuncture may be used as part of conservative treatment for pain, tingling, and sensory symptoms, but progressive weakness, loss of hand function, or muscle wasting warrants medical evaluation.

What treatment looks like

Treatment changes as an injury heals. Acupuncture may initially be performed away from an acutely painful area and later include local treatment as appropriate. We also address the muscles and other tissues that have tightened or compensated around the injury.

Cupping is frequently used when muscular tension is prominent, particularly across larger muscle groups and areas that have been working differently because of an injury. Manual therapy may also be recommended when we think it will be useful as part of your overall treatment plan.

For particularly taut or overworked muscles, we may also use brief, focused needling, treating several specific areas of muscular tension one at a time. Each needle is manipulated and removed before moving to the next area. This can be useful when a muscle remains markedly tight after training or when a particular area of muscular guarding persists after the rest of the treatment.

Heat and moxibustion are used selectively according to the presentation rather than automatically for every injury.

Rehabilitation remains important. When strengthening, progressive loading, mobility work, or physical therapy is needed to restore the capacity of an injured tissue, acupuncture is used alongside that process rather than as a substitute for it.

Sports massage and recovery

We also offer stand-alone therapeutic, deep tissue, and sports massage in 30-, 60-, and 90-minute sessions. Massage can be used on its own for muscular tension and recovery, or alongside acupuncture during rehabilitation from an injury.

Athletes also come in simply for recovery — after periods of heavy training, long runs, races, or events such as the New York City Marathon. Treatment is adapted to where you are in your training or recovery rather than applying the same intensity every time. Immediately after a demanding event, the emphasis may be on gentle recovery work; at other times, deeper work can be used to address persistent muscular tension and restriction.

You do not need to be injured to benefit from treatment. For people who train regularly, massage can also be used between events or during periods of heavier training to address accumulated muscular tension and help maintain comfortable movement.

Post-surgical recovery

Surgery creates its own recovery process. Even when everything has gone exactly as planned, patients may be dealing with pain, swelling, restricted movement, muscular guarding, temporary weakness, and compensations that developed before or after the procedure.

We treat patients following orthopedic and other surgeries as part of their broader recovery. Early treatment may focus away from the surgical site. As healing progresses and the surgeon’s restrictions change, treatment can be adapted to address surrounding muscular tension, movement, and eventually the healed scar when appropriate.

We do not needle through a fresh incision or work directly over an unhealed wound. For recent surgery, we follow the surgeon’s restrictions and obtain clearance for local treatment when needed.

When post-operative swelling is a significant issue, manual lymphatic drainage may also be recommended when appropriate.

Peripheral neuropathy and nerve pain

Peripheral neuropathy deserves a somewhat different approach from a muscle or tendon injury. Symptoms may include burning, tingling, numbness, altered sensation, hypersensitivity, or pain in the hands or feet, and treatment generally requires a longer-term approach.

We see patients with several forms of nerve pain, including chemotherapy-induced peripheral neuropathy and persistent nerve pain following shingles. Acupuncture may be incorporated into supportive care with the goals of reducing symptoms and preserving comfort and function.

If you are receiving chemotherapy and beginning to develop changes in sensation, tell your oncology team as well as us. Chemotherapy-induced neuropathy can affect treatment decisions and should be medically monitored.

Working with physical therapy, sports medicine, and orthopedics

Acupuncture frequently works alongside physical therapy, sports medicine, and orthopedic care.

Pain and muscular guarding can make rehabilitation difficult, while rehabilitation provides the progressive strengthening and loading needed to restore capacity after many injuries. The two approaches can therefore serve different but complementary roles.

If you have had imaging or a surgical procedure, bring the relevant report if you have it. If your physical therapist or physician has given you specific restrictions or a rehabilitation program, tell us so that treatment can be coordinated appropriately.

A significant new injury should be medically assessed when appropriate — particularly if there was a major impact, obvious deformity, inability to bear weight, substantial swelling, a joint that gave way, or new neurological symptoms such as numbness or weakness.

Common questions

How soon after an injury can I come in?

Potentially quite early, provided a fracture or other significant injury has been ruled out when the circumstances call for it. With a very acute injury, we may begin by treating away from the injured tissue and adjust treatment as healing progresses.

Will acupuncture get me back to training faster?

We don’t promise to accelerate the biological healing time of an injured tendon, ligament, muscle, or bone. Acupuncture is used to address pain, muscular guarding, and compensatory tension while you heal and rehabilitate. Return to sport should still be based on the capacity of the injured tissue rather than pain relief alone.

How many treatments will I need for tennis elbow or Achilles tendinopathy?

Tendons generally recover more slowly than uncomplicated muscular injuries, and treatment length varies according to how long the problem has been present, its severity, and the demands you are returning to. Acupuncture works best as one part of a rehabilitation plan that includes appropriate progressive loading.

Can you treat carpal tunnel syndrome?

Yes. Acupuncture may be incorporated into conservative treatment for carpal tunnel symptoms. If there is progressive weakness, loss of hand function, or muscle wasting, we will recommend medical evaluation rather than delaying appropriate care.

Can I have acupuncture after surgery?

Yes, when appropriate. Timing and location of treatment depend on the surgery and stage of healing. We follow your surgeon’s restrictions and obtain clearance for local treatment when needed.

Do you treat chemotherapy-induced peripheral neuropathy?

Yes, as supportive care alongside oncology treatment. If you are developing new or worsening neuropathy during chemotherapy, your oncology team should also know about it.

Will I get cupping marks?

Possibly. Cupping can leave temporary circular discoloration that usually fades over several days. If you don’t want visible marks, tell us and we can use other techniques.

Does massage come with the treatment?

Manual therapy may be recommended when we think it will be useful as part of your overall treatment plan.