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Successful Return to Sport After ACL Injury with Acupuncture and Physical Therapy

12/25/2013

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According to a recent article in the Journal of Orthopedic and Sports Physical Therapy Anterior Cruciate Ligament, or ACL, rupture is “one of the most physically, financially, and emotionally devastating sport-related knee injuries,” which is something I can personally attest to.

I tore my ACL in 2003 and had reconstructive surgery because I wanted to return to sport which, at the time, was martial arts.  I had good insurance then as well so my out of pocket costs were manageable, but I remember seeing the hospital bill - $50,000.  


It took an entire year of weekly acupuncture and Physical Therapy for me to participate in my sport at the level I wanted to, and it was two years before I didn’t notice my knee feeling different during activity.  

I am proud to say, however, that one year after my surgery I successfully completed a very vigorous 24 hour martial arts test including 12 hours of continuous fighting, running and forms.  A decade later, my ACL repair is still holding strong with no concerns.

What I didn’t know until I read this article, was how rare my case is.  Only 44% of athletes successfully return to sport after an average 3-1/2 years following an ACL repair.  When quizzed about their subjective experience of performance after a successful ACL repair and return to sport, only 50% percent of high-school and college athletes indicated that they were able to perform at their pre-injury level.

Furthermore, up to 30% of athletes who return to sport after an ACL repair re-injure their ACL or tear the ACL on the opposite knee due to a number of factors, neuromuscular weakness and asymmetry primary among them.  Due in part to the increased joint laxity and increased angle between hip and knee, female athletes with previous ACL repair are 4 times more likely to re-injure their knees after returning to sport compared to their male counterparts!

My ACL repair actually puts me in the top 5% of female athletes who have an ACL repair.  I absolutely credit my success to the individualized and dynamic Physical Therapy I received along with consistent Acupuncture treatments.  I actually started acupuncture two days after my surgery and continued treatment every week for an entire year, and then every other week for 2 years thereafter.  Even my surgeon was amazed with my recovery (and he was the surgeon for the Blazers here in Portland).


Preventing an ACL Injury

So if you are engaged in sport, how do you prevent an ACL injury?  Sometimes you just can’t, life happens, but you can greatly decrease the possibility of injury with proper neuromuscular training. According to this research article, of primary importance are the following:
  • balanced strength between the quadriceps and the hamstrings
  • symmetry between right and left leg strength
  • overall balance and stability as well as stability of the knee joint in particular
  • trunk (core) strength and stability
Exercises should be specific to your strengths and weaknesses and to your sport.  Whether you continue with regular physical therapy as a preventative measure or not, seeing a Physical Therapist for a personalized exercise regime is research-proven to be effective in decreasing the instance of ACL injury by 43-73%.

Regular acupuncture is also recommended.  Acupuncture can decrease and resolve minor aches and pains, keep muscles physically loose and energetically balanced, and cause natural endorphins and anti-inflammatories to be released by the body improving performance and recovery rates for minor injuries.

Recovering from an ACL Injury

If you are unfortunate enough to experience an ACL injury or tear, there is still a lot you to can do to ensure a strong recovery and decrease your likelihood of experiencing a secondary ACL injury.

  • Get Acupuncture Right Away - the sooner you start to decrease inflammation and pain, the sooner and more successfully you will recover.
  • Get Physical Therapy Right Away & Before Surgery - the sooner you start Physical Therapy to address your injury, the stronger you will recover. The stronger you are going into surgery, the faster your recovery will be out of it.
  • Consult with a Physical Therapist about Graft Type - There are several different types of grafts available for ACL repair - patellar, hamstring, cadaver.  Depending upon your age, gender, sport and natural joint tension or laxity, different grafts may be recommended.  A PT who is familiar with the latest research on these options is best able to advise you about graft type.
  • Continue Physical Therapy and Acupuncture After Surgery - As I mentioned above, I can attest to the strength of this combination.  I know that it is the combination of these two therapies that has placed me in the top of 5% of female ACL repair recipients.
I have extensive personal and professional experience with using acupuncture to treat ACL injury and ACL surgery recovery.  I also have extensive professional experience treating general knee pain and injury, meniscus injury and surgery recovery as well as full knee replacement.  If you are looking for help treating any knee condition, I would be honored to be a partner in your care.

My go to Physical Therapist for knee injury prevention, knee injury, ACL injury and ACL surgery recovery is my husband - Brian Kitzerow, DPT at Goodell Physical Therapy.  He always keeps up on the latest research and has a thoughtful and thorough approach to every patient.

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7 Ways To Stay Healthy This Winter

12/18/2013

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PicturePortland's Park Blocks in Winter!
In Chinese Medicine Winter is dominated by the Water element which governs the Kidneys and the Bladder.  The transition from one season, or element, to the next is the most delicate time for your health and the time when the most care needs to be taken if you want stay well.  


This last week before the official start of Winter, therefore, is an especially important time to be minding your Winter health P’s and Q’s if you want to avoid winter colds and flu’s.

Fall, the season we are leaving, is dominated by the Metal element which governs the Lungs and the Large Intestine, so we are currently leaving the Metal season and moving into the Water season.  The Lungs are connected to the skin in Chinese Medicine while the Kidneys are connected to the ears.  If either organ is having trouble energetically with the seasonal change, viruses that include skin rashes and ear symptoms are more likely to be present.


Its especially important, therefore, to take care of both of these energetic systems right now, and I’m happy to provide you with some acupuncture tips on staying healthy through the change of seasons!


Acupuncture Health Tips for Staying Well into Winter

Staying well through the transition of seasons is dependent upon caring for both the Metal and Water elements in the body, primarily the Lungs and Kidneys which are the Yin or “substantive” organs in the pairs listed above.  A few simple tips can go a long way to helping you maintain the best health possible as Fall makes its final turn to Winter this week:

  1. Hydrate!  Its no surprise the Water element (Winter - Kidney) needs you to stay well hydrated for optimal function.  Ever notice how Winter weather seems to dry out your skin?  Try to drink 1/2 your body weight in ounces per day for optimal hydration.
  2. Sleep well! Sleep is your body’s natural time to rest, rejuvenate and repair.  In Chinese Medicine, it is when the Protective Qi of the Lung circulates internally to protect the organs and boost immunity.  Its especially important to pay attention to your sleep habits this time of year.  Try to be consistent about getting to bed in time for a good nights sleep.  If you’re having trouble sleeping, this is the time to see your Acupuncturist, ND or PCP to rectify it before low sleep leads to low immunity and a rough Winter season.
  1. Skin Brushing - Skin brushing is an ancient technique for health that involves brushing dry skin with a dry brush from the extremities towards the heart.  The skin is your largest detox organ - and its part of the Lung system in TCM - so keeping the skin healthy goes a long way to keeping YOU healthy.  It moves lymph, increases circulation, encourages detoxification, and strengthens the Lung meridian.  Read more here.
  2. Keep the Neck Covered Turns out mom telling you to wear a scarf if you’re going out ties in to ancient Chinese medical wisdom.  The back of the neck and the upper back area are called the “wind gate” in TCM and this is the area where colds and flu’s energetically enter the body and make you ill.  If you’re going to be exposed to cold and wind, be sure to keep these areas covered with a high neck sweater, jacket or scarf.
  3. Ban Lan Gen Chong Ji - a natural antiviral.  Ban Lan Gen is the Chinese name for Isatis Root, a general antiviral herb with many applications.  In Chinese medicine it is used for colds, flu’s and cancer interestingly enough.  Ban Lan Gen Chong Ji is a simple Isatis root combination that is powdered into an instant tea for ease of use - its an over the counter staple for kids and adults alike in Mainland China.
  4. Elderberry - Elderberry is another simple and natural antiviral herb.  Used primarily in naturopathic medicine, it is sweet and easy to find!  I use a dropperful of glycerin-based elderberry syrup for myself and my kids in the Wintertime.  Its also great - and safe - in pregnancy.
  5. Yin Qiao Jie Du Pian - Stop Colds Now! This herbal remedy is an amazing formula to stave off the early stage of a cold, especially one that starts with a sore throat.  I ALWAYS keep it at home, take it before I get on an airplane and bring it with me whenever I travel.  Feel a tickle?  Someone coughing next your desk at work?  Take a little Yin Qiao and be amazed at the results - can be used preventatively.

Remember that a little bit goes a long way.  Try to incorporate one of two of these tips into your regime the next few weeks and give yourself a great immunity boost as the weather turns.

Happy Winter Solstice!

~Rebecca

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4 Ways Acupuncture Gives You Hope for Car Accident Recovery

12/11/2013

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According to the Oregon Department of Transportation there were 49,798 car accidents reported in 2012 and 36,085 people were injured in those accidents.  That is an average of 136 crashes PER DAY in Oregon alone!  And did you know that the highest incidents of crashes occurred on Fridays and in October? [Note to self; try not to drive on Fridays in October!]

All levity aside, a car accident is no joke, as the 36,000 injured people in 2012 can attest.  The force of impact that the body is made to endure in even a minor car accident causes a ripple effect of muscular tension which can result in whiplash, headache, back pain, decreased range of motion and sciatica to name just a few.    

None of these things should be left untreated and the sooner you get in for treatment, the sooner you can head off pain and injury in the early stages and avoid major problems down the line.  Some of these effects such as whiplash are immediate, but others occur due to compensation over time and the best remedy is to get treatment early - within the first two weeks of an accident ideally.

Acupuncture for auto accident recovery is highly effective, and if you combine acupuncture with Physical Therapy and Massage your recovery is expedited even more.  

Acupuncture by itself gives great hope for recovery.  It can:
  1. Relax Muscles by relieving tension from both superficial and deep layers 
  2. Decrease Pain by causing the body to release pain relieving endorphins which also expedites healing
  3. Reduce Reliance on Pain Medication in Recovery by changing the way the brain perceives pain thereby reducing the necessity for medication.
  4. Return the Body to a Natural Pain-Free State by balancing the meridians which reminds the body of its natural, healthy, fluid and pain-free baseline

Testimonial from an Auto Accident Treatment Patient

After my auto accident, my pain levels made it hard for me to both concentrate and to physically sit long enough to do my work. My acupuncture treatments with Rebecca were and continue to be a critical part of my recovery from the accident, as they provided immediate relief for the acute pain and gave me three or four days of respite from it after treatment. Of all the healing modalities I tried - massage therapy, chiropractic treatment, physical therapy, and acupuncture - acupuncture proved to be the one that was the best at keeping pain to manageable levels, thus allowing me to get back to the work I love doing.

Charlie G, Portland, Oregon

Combining Modalities in Car Accident Treatment Gives Best Results

Massage or foot reflexology is something I add into all of my acupuncture treatments for at least 5-10 minutes, but I encourage all patients who come in for auto accident treatment to come in for 90 minute acupuncture + massage sessions so we have more time to spend on bodywork (massage).  It helps that if you have an auto accident in Oregon, acupuncture and massage are covered 100% by your auto insurance without a referral!

I often incorporate Cupping and Gua Sha - traditional Chinese myofascial release techniques to relieve pain and stagnation - into car accident treatments as well. This too, I find, helps patients recover faster after an auto accident or MVA (motor vehicle accident) by helping the body relieve tension and flush out toxins that may be associated with tense guarded muscles.

Lastly I always recommend patients see a Physical Therapist as part of their car accident treatment plan, because while acupuncture can help balance the body, reduce and often completely relieve pain from whiplash, headache, back spasm, sciatica and certainly helps to increase range of motion, it can’t assess your posture or potential repetitive motion injury sources in your daily life that could aggravate your pain and delay healing.  

In my experience as both a motor vehicle accident treatment patient AND a provider, no one is a better mechanic for the body than a Physical Therapist, and when you combine the pain relief and Qi balancing of Acupuncture and massage, with the mechanical reprogramming of physical therapy exercise, your results are quick and long lasting.

The most important message here is that no matter what you do, get treatment early.  Ideally within those first two weeks of having a car accident.  Sometimes it takes 10-14 days for the full effects of a car accident to “wear in” to the body, so if you can get in before your body really sets into the pain, you have a much better chance of heading it off and avoiding the worst effects the injury has to offer.

If you have questions please don’t hesitate to contact me via email or book a free consultation anytime.  If you’ve had a car accident and are looking for treatment, please book in for a new patient 90 minute appointment so we can assess your situation and we will take it from there!  I have excellent Physical Therapists in SW, SE and downtown that I refer to for auto accidents regularly and I would be honored to help coordinate your care.

Until next time,

~Rebecca

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How Can Acupuncture Help Me?

12/4/2013

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PictureBenefits of Acupuncture
As a Licensed Acupuncturist with a degree in Traditional Chinese Medicine, acupuncture treatment is a central focus of my practice.  One of the most common questions a new patient asks beyond “does acupuncture hurt?” and “what can acupuncture treat?” is “how can acupuncture help me?”  

This question is so common that today I’m going to do my best to answer it for some of the more common complaints I see in the treatment room.

Its important first to realize that 3,000+ years ago, acupuncture and Chinese medicine were the only medical options available in China, and therefore they were used (and still have protocols today) to treat everything from colds to acute infections, back pain, and more.  With the advent of modern medicine, it is clear that some things - especially anything that would warrant a trip to the ER - are best suited to Western medical treatment while other things are treated very successfully and naturally by Acupuncture and Traditional Chinese Medicine.

Here is a short list of some of the ailments best suited to acupuncture treatment:

  • Arthritis - Rheumatoid and Osteo 
  • Auto Accident Recovery 
  • Back Pain
  • Chronic Pain Management 
  • Common Cold and Flu 
  • Digestive Pain and issues including Irritable Bowel Syndrome 
  • Foot Pain 
  • General Fertility Support 
  • Headache 
  • Infertility 
  • Insomnia 
  • Irregular Periods 
  • Knee Pain 
  • Labor Induction 
  • Menopause Symptoms 
  • Neck Pain
  • Painful Periods 
  • PCOS 
  • PMS 
  • Poor Immunity - frequent illnesses and sinus infections
  • Post-Partum Recovery 
  • Sinus Infection 
  • STRESS
  • Surgery Recovery (such as knee surgery, back surgery, C-Section)

There’s quite a bit more, but these are most common ailments I see in my clinic.  The top two complaints I see are Pain - especially Neck, Back, Knee and Auto Accident Recovery - and Women’s Health Issues.  

How Can Acupuncture Help My Pain?

The benefits of acupuncture for pain treatment have been widely researched and show that acupuncture can cause the body to release pain-relieving endorphins and cause the brain to change the way it perceives pain by changing opiate receptor sites.  Neither of these completely explain all the benefits of acupuncture, but acupuncture has received endorsement from the National Institute of Health for pain treatment.

Acupuncture uses hair-thin needles strategically placed along meridians and around the site of pain or injury to balance the meridians.  When we balance the energetic body, the physical body follows suit finding a physical state of balance to match the energetic one and in so doing returning the body to a pain free state.  

Even when meridians, or energetic channels, are treated locally, the whole meridian from its branches connecting internal organs all the way to the skin layer are affected.  

This means that the benefits of acupuncture are widespread - not only will acupuncture treat and resolve the pain, but it will also balance the body on a deeper level in order to maintain the pain free state.  Many other things are improved as a by-product of acupuncture treatment such as enhanced immunity and stress reduction - two of the most common acupuncture side effects.

This is true for any type of pain, but is especially successful in treating auto accident recovery.  After even a minor car accident, your body is in a state of distress - whiplash, rib subluxation, back spasm.  You can also suffer from high stress associated with dealing with the aftermath of an auto accident such as managing multiple appointments and dealing with insurance claims.

Acupuncture will treat the physical pain - relaxing muscles, moving stagnation, decreasing inflammation - and also the stress and physical effects of the trauma such as insomnia and anxiety.

How Can Acupuncture Benefit Women's Health Issues?

The same is true in the treatment of Women’s Health Issues such as PMS, menopause and infertility.  Not only can acupuncture balance hormones and reduce cramping, irritability, insomnia, hot flashes etc., but it can also help reduce the stress and anxiety associated with difficult or irregular menstrual cycles.  

Indeed, I’ve seen patients with Polycystic Ovarian Syndrome who haven’t had a regular cycle or unmedicated period in a decade return to normal cycles in as little as 3 months using acupuncture and herbal treatment alone.

How Can Acupuncture Help Me?

So the short answer to the original question, “How Can Acupuncture Help Me?” is that it can help you by balancing your meridians.  This resolves both physical and energetic imbalances which can relieve pain and hormone irregularities.  Common acupuncture byproducts include stress reduction and immune enhancement so acupuncture can benefit you on many levels, even ones you may not be actively seeking assistance with.  Once balanced, acupuncture can help you maintain a healthy state for years to come.

If you have questions or want to know more please don’t hesitate to contact me or book a free consult anytime!  

~Rebecca
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    Rebecca M H Kitzerow is a Licensed Acupuncturist practicing in La Center, Washington. With over a decade of experience she has won 10 Nattie consumer choice awards from Natural Awakenings Magazine since 2014.

    Rebecca practices a variety of Acupuncture and Traditional Chinese Medicine techniques including Tan Acupuncture, Kiiko style Japanese Acupuncture, Traditional Chinese Herbal Remedies, Cosmetic Acupuncture, Foot Reflexology, Cupping and Gua Sha. Rebecca strives to help people Be Well and Stay Well in every way.

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