Acupressure is one of the Complementary and Alternative Medicine (CAM) techniques. It is simple, safe and practical technique to manage symptoms such as nausea, vomiting, anxiety and pain. Let\u2019s dive deeper into what acupressure is, where does it come from, how does it work, and when it works best according to research. Lastly, we will discuss what acupressure can do for athletes, as this was the topic of my PhD thesis. <\/p>\n\n\n\n
Acupressure is a therapeutic\ntechnique which uses pressure applied to certain points on the body. The\ntherapist applies pressure with the thumb, other finger or elbow. Acupressure\ncan also be applied with the use of devices, such as a bead or a band.\nAcupressure is quite safe as it does not cause many side effects. It can be as\ngentle as touch. If acupressure is applied to the ear, it is called auricular\nacupressure.<\/p>\n\n\n\n
Acupressure comes from\nTraditional Chinese Medicine dating as early as the second century BCE\n(Unschuld, 1999). Acupressure is closely related to acupuncture, as they both\nwork with points on the body arranged in meridians. Meridians are thought to be\nchannels through which energy flows throughout the body (look at the photo). The\nblockage of energy flow along meridians causes imbalances that can lead to diseases.\n<\/p>\n\n\n\n
There are 14 standard\nmeridians running throughout the body with around 360 acupuncture points (World Health\nOrganization, 2008). Most of acupuncture points can be used as acupressure\npoints (Zhao-Pu, 1991b), but in practice, the ones with easy access are the\nmost commonly used. <\/p>\n\n\n\n
As acupuncture is\nslowly building acceptance of its usefulness in western medicine, so is\nacupressure, its non-invasive analogue. The crucial difference between the two\nis in their method of application. Acupuncture uses needles to apply\nstimulation to the points, whereas acupressure uses pressure. This difference\nbecomes crucial when working with children and youth, people who fear or\ndislike needles or in environments where keeping skin clean may be an issue\n(e.g., road accident, sports field). <\/p>\n\n\n\n
The\nmechanism of acupressure from the Western medicine viewpoint is not fully\nunderstood and multiple mechanisms have been proposed in the literature\n(Felhendler & Lisander, 1999; Gao et al., 2012; A. D. Lee & Hsu, 2014).\nThe main mechanisms suggest that acupressure influences nervous system\n(McFadden & Hern\u00e1ndez, 2010). Other theories include stimulation resulting\nin the release of hormones known as endorphins, and changes in circulation of\nlocal bioactive substances such as cytokines (Selfridge, 2012).<\/p>\n\n\n\n
Some researchers\nsuggest that acupressure influences the autonomic nervous system. This\ninfluence is based on activation of the parasympathetic, and reduction in\nactivity of the sympathetic nervous system (McFadden & Hern\u00e1ndez, 2010). <\/p>\n\n\n\n
The sympathetic\nnervous system is responsible for a mobilisation of the body and the\nfight-and-flight response (Jansen, Van Nguyen, Karpitskiy, Mettenleiter, &\nLoewy, 1995). This change is reflected by changes in various physiological\nparameters, mainly in the cardiorespiratory system (Matsubara et al., 2011). <\/p>\n\n\n\n
However,\nresearch on the exact mechanisms underpinning acupressure still leaves some\nquestions unanswered.<\/p>\n\n\n\n
The evidence available\nin the literature is consistent in showing that acupressure and auricular\nacupressure decreases heart rate in healthy individuals (Felhendler &\nLisander, 1999; Gao et al., 2012; Litscher, 2004; Sugiura et al., 2007),\nindividuals with musculoskeletal injuries (Barker et al., 2006; Lang et al.,\n2007) and patients recovering from a stroke (McFadden & Hern\u00e1ndez, 2010).<\/p>\n\n\n\n
Acupressure\nhas been successfully used to manage pain in a range of conditions including\nheadaches (Hsieh, Liou, Lee, Chen, & Yen, 2010), painful menstruation (Cho\n& Hwang, 2010), cancer (Spross & Wolff Burke, 1995), or during labour\n(U.-L. Chung et al., 2003; E. J. Lee & Frazier, 2011; M. K. Lee, Chang, & Kang, 2004). One of the settings where\nacupressure has been effectively used as a pain management tool was during\ntransport to hospital (Barker et al., 2006; Kober et al., 2002; Lang et al.,\n2007). <\/p>\n\n\n\n
Acupressure\nhas shown to be effective in chronic musculoskeletal conditions such as chronic\nlow back pain (Hsieh et al., 2006; Hsieh et al., 2004).<\/p>\n\n\n\n
Acupressure\nhas been found to decrease the reactivity of the sympathetic nervous system\nthrough decreasing the heart rate. Inhibition of the sympathetic nervous system\nshifts autonomic activity more to the parasympathetic system with the increased\nexpression of rest-and-digest response. The \u201ccalming down\u201d effect of\nacupressure may be an origin for the effect of reducing an anxiety attributed\nto this therapy.<\/p>\n\n\n\n
Anxiety\nwas reduced in patients with minor contusions and fractures (Barker et al.,\n2006; Kober et al., 2002; Lang et al., 2007). Additionally, (Agarwal et al.,\n2005; Valiee, Bassampour, Nasrabadi, Pouresmaeil, & Mehran, 2012)\nacupressure and auricular acupressure was effective in reducing anxiety in\npre-operative patients, and auricular acupressure (Kober et al., 2003; Mora et\nal., 2007) has been successful in reducing anxiety in patients transported by\nambulance to undergo surgical procedures. Moreover, acupressure (Wang, Gaal,\nMaranets, Caldwell-Andrews, & Kain, 2005) was effective in reducing anxiety\nin parents whose children were undergoing surgery. <\/p>\n\n\n\n
Acupressure has been\nshown to be effective in decreasing symptoms such as nausea, vomiting (Norheim,\nPedersen, F\u00f8nneb\u00f8, & Berge, 2001; Shin, Song, & Seo, 2007; Werntoft\n& Dykes, 2001), fatigue (Molassiotis, Sylt, & Diggins, 2007), and pain.<\/p>\n\n\n\n
During\nchildbirth, acupressure has been shown to decrease pain intensity and shorten\nthe delivery time (Hjelmstedt et al., 2010; Kashanian & Shahali, 2010; M.\nK. Lee et al., 2004; C. A. Smith, Collins, Crowther, & Levett, 2011).\nAcupressure can also be effective in reducing nausea and vomiting in cancer\npatients receiving chemotherapy (Jang & Park, 2011).<\/p>\n\n\n\n
Unfortunately,\nathletes are a group that is at high risk of sustaining an injury. These\ninjuries will result in pain and possibly some other negative consequences like\ndecrease or loss of function. Acupressure has a potential to be applied in\nvarious sports injuries by a range of sports medicine personnel. <\/p>\n\n\n\n
Acupressure\nhas not been extensively studied in the context of sports medicine. Auricular\nacupressure was investigated during treadmill training in healthy individuals\nfor its positive influences on lactic acid levels and oxygen uptake\n(Jaung-Geng, Salahin, & Jung-Charng, 1995), and investigating pain\nthresholds during exercising (Tekeoglu, Adak, & Ercan, 1998). Further two\narticles provided an overview of positive influence of acupressure use in\nsports fatigue (Ma, 2003), and an opinion on reducing menstrual pain in\nathletes using acupressure (Martin, 1993). <\/p>\n\n\n\n
Finally,\nacupressure has been effective in reducing acute pain in athletes suffering\nfrom various musculoskeletal injuries (M\u0105cznik, 2013, M\u0105cznik, 2017). This was\nan easy 3-minute application to one acupressure point. This was the main topic\nof my PhD thesis. I will write more about it soon, so stay tuned.<\/p>\n\n\n\n
Alex<\/p>\n\n\n\n
Agarwal, A., Ranjan, R., Dhiraaj, S., Lakra, A., Kumar, M., & Singh, U. (2005). Acupressure for prevention of pre\u2010operative anxiety: A prospective, randomised, placebo controlled study. <\/a>Anaesthesia, 60<\/em>(10), 978-981.<\/p><\/p>\n\n\n\n Barker, R., Kober, A., Hoerauf, K., Latzke, D., Adel, S., Kain, Z. N., & Wang, S.-M. (2006). Out-of-hospital auricular acupressure in elder patients with hip fracture: A randomized double-blinded trial.<\/a> Academic Emergency Medicine, 13<\/em>(1), 19-23. doi: 10.1197\/j.aem.2005.07.014<\/p>\n\n\n\n Cho, S.-H., & Hwang, E.-W. (2010). Acupressure for primary dysmenorrhoea: A systematic review. <\/a>Complementary Therapies in Medicine, 18<\/em>(1), 49-56. <\/p>\n\n\n\n Chung, U.-L., Hung, L.-C., Kuo, S.-C., & Huang, C.-L. (2003). Effects of LI4 and BL 67 acupressure on labor pain and uterine contractions in the first stage of labor. <\/a>Journal of Nursing Research, 11<\/em>(4), 251-260.<\/p>\n\n\n\n Felhendler, D., & Lisander, B. (1999). Effects of non-invasive stimulation of acupoints on the cardiovascular system.<\/a> Complementary Therapies in Medicine, 7<\/em>(4), 231-234.<\/p>\n\n\n\n Gao, X.-Y., Wang, L., Gaischek, I., Michenthaler, Y., Zhu, B., & Litscher, G. (2012). Brain-modulated effects of auricular acupressure on the regulation of autonomic function in healthy volunteers.<\/a> Evidence-Based Complementary and Alternative Medicine, 2012<\/em>(Article ID 714391), 1-8.<\/p>\n\n\n\n Hjelmstedt, A., Shenoy, S. T., Stener\u2010Victorin, E., Lekander, M., Bhat, M., Balakumaran, L., & Waldenstr\u00f6m, U. (2010). Acupressure to reduce labor pain: A randomized controlled trial. <\/a>Acta Obstetricia et Gynecologica Scandinavica, 89<\/em>(11), 1453-1459.<\/p>\n\n\n\n Hsieh, L. L.-C., Liou, H.-H., Lee, L.-H., Chen, T. H.-H., & Yen, A. M.-F. (2010). Effect of acupressure and trigger points in treating headache: A randomized controlled trial. <\/a>The American Journal of Chinese Medicine, 38<\/em>(01), 1-14.<\/p>\n\n\n\n Hsieh, L. L.-C., Kuo, C.-H., Lee, L. H., Yen, A. M.-F., Chien, K.-L., & Chen, T. H.-H. (2006). Treatment of low back pain by acupressure and physical therapy: Randomised controlled trial.<\/a> BMJ, 332<\/em>(7543), 696-700.<\/p>\n\n\n\n Hsieh, L. L.-C., Kuo, C.-H., Yen, M.-F., & Chen, T. H.-H. (2004). A randomized controlled clinical trial for low back pain treated by acupressure and physical therapy. <\/a>Preventive Medicine, 39<\/em>(1), 168-176.<\/p>\n\n\n\n Jang, S. Y., & Park, J. S. (2011). The meta-analysis of the effect of acupressure for nausea and vomiting in cancer patients receiving chemotherapy.<\/a> Journal of Korean Oncology Nursing, 11<\/em>(2), 116-126.<\/p>\n\n\n\n Jansen, A. S., Van Nguyen, X., Karpitskiy, V., Mettenleiter, T. C., & Loewy, A. D. (1995). Central command neurons of the sympathetic nervous system: Basis of the fight-or-flight response. <\/a>Science, 270<\/em>(5236), 644-646.<\/p>\n\n\n\n Jaung-Geng,\nL., Salahin, H. S., & Jung-Charng, L. (1995). Investigation on the effects\nof ear acupressure on exercise-induced lactic acid levels and the implications\nfor athletic training. American Journal of Acupuncture, 23<\/em>(4), 309-313.<\/p>\n\n\n\n Kashanian, M., & Shahali, S. (2010). Effects of acupressure at the Sanyinjiao point (SP6) on the process of active phase of labor in nulliparas women.<\/a> Journal of Maternal-Fetal and Neonatal Medicine, 23<\/em>(7), 638-641.<\/p>\n\n\n\n Kober, A., Scheck, T., Greher, M., Lieba, F., Fleischhackl, R., Fleischhackl, S., . . . Hoerauf, K. (2002). Prehospital analgesia with acupressure in victims of minor trauma: A prospective, randomized, double-blinded trial. <\/a>95<\/em>(3), 723-727. doi: 10.1213\/01.ANE.0000025704.39845.61<\/p>\n\n\n\n Lang, T., Hager, H., Funovits, V., Barker, R., Steinlechner, B., Hoerauf, K., & Kober, A. (2007). Prehospital analgesia with acupressure at the Baihui and Hegu points in patients with radial fractures: A prospective, randomized, double-blind trial.<\/a> American Journal of Emergency Medicine, 25<\/em>(8), 887-893.<\/p>\n\n\n\n Lee,\nA. D., & Hsu, E. S.-Z. (2014). Mechanisms of acupuncture analgesia. In\nY.-C. Lin & E. S.-Z. Hsu (Eds.), Acupuncture for pain management <\/em>(pp.\n73-85). New York: Springer.<\/p>\n\n\n\n Lee, E. J., & Frazier, S. K. (2011). The efficacy of acupressure for symptom management: A systematic review.<\/a> Journal of Pain and Symptom Management, 42<\/em>(4), 589-603. <\/p>\n\n\n\n Lee, M. K., Chang, S. B., & Kang, D.-H. (2004). Effects of SP6 acupressure on labor pain and length of delivery time in women during labor.<\/a> Journal of Alternative and Complementary Medicine, 10<\/em>(6), 959-965.<\/p>\n\n\n\n Litscher, G. (2004). Effects of acupressure, manual acupuncture and Laserneedle\u00ae acupuncture on EEG bispectral index and spectral edge frequency in healthy volunteers. <\/a>European Journal of Anaesthesiology, 21<\/em>(01), 13-19.<\/p>\n\n\n\n Ma,\nY. N. (2003). Application of acupoint therapeutic efficacy screening in the\nrecovery from sports fatigue. Chinese Journal of Clinical Rehabilitation, 7<\/em>(21),\n3006-3007.<\/p>\n\n\n\n Macznik, A. K., Schneiders, A. G., Athens, J., & Sullivan, S. J. (2017). Does acupressure hit the Mark? A three-arm randomized placebo-controlled trial of acupressure for pain and anxiety relief in athletes with acute musculoskeletal sports injuries. <\/a>Clinical Journal of Sport Medicine, 27<\/em>(4), 338-343.<\/p>\n\n\n\n Macznik, A., Schneiders, A., Sullivan, J., & Athens, J. (2013). Management of pain associated with acute sports injuries\u2014Is acupressure a way to go?.<\/a> Journal of Science and Medicine in Sport, 16<\/em>, e8.<\/p>\n\n\n\n Martin,\nM. (1993). Acupressure technique: Menstrual pain in athletes. Int J Alternat\nComplement Med, 11<\/em>(5), 23-24.<\/p>\n\n\n\n Matsubara, T., Arai, Y.-C. P., Shiro, Y., Shimo, K., Nishihara, M., Sato, J., & Ushida, T. (2011). Comparative effects of acupressure at local and distal acupuncture points on pain conditions and autonomic function in females with chronic neck pain.<\/a> Evidence-Based Complementary and Alternative Medicine, 2011<\/em>(Article ID 543291), 1-6.<\/p>\n\n\n\n McFadden, K. L., & Hern\u00e1ndez, T. D. (2010). Cardiovascular benefits of acupressure (Jin Shin) following stroke.<\/a> Complementary Therapies in Medicine, 18<\/em>(1), 42-48.<\/p>\n\n\n\n Molassiotis, A., Sylt, P., & Diggins, H. (2007). The management of cancer-related fatigue after chemotherapy with acupuncture and acupressure: A randomised controlled trial. <\/a>Complementary Therapies in Medicine, 15<\/em>(4), 228-237.<\/p>\n\n\n\n Mora, B., Iannuzzi, M., Lang, T., Steinlechner, B., Barker, R., Dobrovits, M., . . . Kober, A. (2007). Auricular acupressure as a treatment for anxiety before extracorporeal shock wave lithotripsy in the elderly. <\/a>The Journal of urology, 178<\/em>(1), 160-164.<\/p>\n\n\n\n Norheim, A. J., Pedersen, E. J., F\u00f8nneb\u00f8, V., & Berge, L. (2001). Acupressure treatment of morning sickness in pregnancy. A randomised, double-blind, placebo-controlled study. <\/a>Scandinavian Journal of Primary Health Care, 19<\/em>(1), 43-47.<\/p>\n\n\n\n Selfridge,\nN. (2012). Acupressure: The evidence presses on. Alternative Medicine Alert,\n15<\/em>(6), 64-67.<\/p>\n\n\n\n Shin, H. S., Song, Y. A., & Seo, S. (2007). Effect of Nei\u2013Guan point (P6) acupressure on ketonuria levels, nausea and vomiting in women with hyperemesis gravidarum. <\/a>Journal of Advanced Nursing, 59<\/em>(5), 510-519.<\/p>\n\n\n\n Smith, C. A., Collins, C. T., Crowther, C. A., & Levett, K. M. (2011). Acupuncture or acupressure for pain management in labour. <\/a>Cochrane Database of Systematic Reviews, 7<\/em>.<\/p>\n\n\n\n Spross,\nJ. A., & Wolff Burke, M. (1995). Nonpharmacological management of cancer\npain. In D. B. McGuire, C. H. Yarbro & B. Ferrell (Eds.), Cancer pain\nmanagement <\/em>(pp. 159-179). London: Jones & Bartlett Learning.<\/p>\n\n\n\n Sugiura, T., Horiguchi, H., Sugahara, K., Takeda, C., Samejima, M., Fujii, A., & Okita, Y. (2007). Heart rate and electroencephalogram changes caused by finger acupressure on planta pedis.<\/a> Journal of Physiological Anthropology, 26<\/em>(2), 257-259.<\/p>\n\n\n\n Tekeoglu,\nI., Adak, B., & Ercan, M. (1998). Investigation into the possibilities of\nusing ear acupressure for increasing the pain threshold during athletic\ntraining. American Journal of Acupuncture, 26<\/em>(1), 49-52.<\/p>\n\n\n\n Unschuld, P. U. (1999). The past 1000 years of Chinese medicine.<\/a> The Lancet, 354<\/em>, siv9.<\/p>\n\n\n\n Valiee, S., Bassampour, S. S., Nasrabadi, A. N., Pouresmaeil, Z., & Mehran, A. (2012). Effect of acupressure on preoperative anxiety: A clinical trial. <\/a>Journal of PeriAnesthesia Nursing, 27<\/em>(4), 259-266.<\/p>\n\n\n\n Wang, S.-M., Gaal, D., Maranets, I., Caldwell-Andrews, A., & Kain, Z. N. (2005). Acupressure and preoperative parental anxiety: A pilot study.<\/a> Anesthesia & Analgesia, 101<\/em>(3), 666-669.<\/p>\n\n\n\n