Acupuncture as an Assessment

Acupuncture as an Assessment is a method taught in the Sports Medicine Acupuncture Certification program, though it has most likely been used by TCM practitioners for thousands of years.

Key acupuncture points can be used to reduce pain, increase range of motion, and change orthopedic evaluative and manual muscle test results. This method can greatly benefit the acupuncturist to not only determine the affected channel(s) but to refine his/her treatment protocol by testing which acupuncture points provide the greatest benefit to the patient.

Based on the patient’s complaint, the practitioner uses the appropriate orthopedic evaluative tests (OET), manual muscle tests (MMT), range of motion tests (ROM), functional tests, and palpation of pain or tension within the myofascial sinew channel.

Pain, limited range of motion, weak MMT, a positive ortho test, etc., now becomes an objective and subjective standard for the practitioner to change with acupuncture point selection.

The affected channel(s) are determined through these examinations.

For example, with a positive Ely’s Test, the Stomach sinew channel is involved due to shortening of the rectus femoris muscle. Or, for a weak supraspinatus manual muscle test, the Small Intestine channel is indicated because the supraspinatus muscle belly (contractile tissue) belongs to this channel.

The practitioner chooses from various acupuncture points located distally on the affected channel. Using jing-well, xi-cleft or luo-connecting points will often make substantial changes in the myofascial channel observed with re-evaluation of the assessment tests.

Here a couple of orthopedic assessment videos (supraspinatus manual muscle test and Ely’s test) that provide great examples of using Acupuncture as an Assessment:

Needles are inserted into the selected acupuncture point, qi is obtained, which will constantly stimulate the proprioceptive systems and promote the movement of qi and blood in the channels.

The needle is then withdrawn slightly, but not removed from the body. Withdrawing the needle to the subcutaneous tissue is recommended (jing-well points is the exception). Not only is withdrawing to this level comfortable for the patient when they perform the evaluative exam again, but there is evidence that afferent proprio­ceptive information from subcutaneous proprioceptors assists in the perception of motion. (Lephart S, 1992), (Reiman B, 2002).

In fact, it was found that patients with anterior cruciate deficient knees and osteoarthritis relied more on the subcutaneous proprioceptors for the perception of joint motion than did non-injured individuals. (Callaghan, M. J., 2012). This is important information and helps the practitioner to explain why cutaneous and subcutaneous needles can have a profound effect on movement patterns.

To determine if the acupuncture point selected was correct, again, with the needle in place, the practitioner re-tests the same physical exam for increased range of motion, decreased pain, stronger muscle with MMT, improved results of the OET, etc.

The needle at the acupuncture point(s) that made a substantial change is then withdrawn completely from the body. This point is stimulated again with acupuncture when the practitioner performs the comprehensive acupuncture treatment.

It is imperative that the practitioner reinserts a needle into the acupuncture point that made the change along with adjacent and local points to reinforce the signaling system and increase the affect. The practitioner should remember to use the channel correspondences and to assess and treat anyzang fu patterns for long-lasting results.

The Acupuncture as an Assessment Method is Simple

• Test the patient
• Apply acupuncture and retain the needle
• Retest for improved results

This method can be invaluable for the practitioner as a diagnostician and incredible for the patient to experience how quickly results can be reproduced. This is a confidence-building skill the practitioner can develop and use quickly and effectively on the patient.

Because this technique is not commonly taught in acupuncture schools or in the TCM field today, we have structured this assessment method into a into a step-by-step system for the acupuncturist to use.

Step-by-Step: Acupuncture as an Assessment Method

1. Based on the patient’s complaint, the practitioner uses the appropriate orthopedic evaluative tests (OET), manual muscle tests (MMT), range of motion tests (ROM, functional tests, and/or palpation of pain or tension within the myofascial sinew channel. This will provide a quantitative or qualitative standard.
2. The practitioner chooses from various acupuncture and/or motor points found distal on the affected channel. Using jing-well, xi-cleft or luo-connecting points will often make substantial changes to the assessment tests.
3. Needles are inserted into the acupuncture point, qi is obtained, the needle is withdrawn just enough so the patient does not have any discomfort when re-performing the examination.
4. To determine if the acupuncture point selected was correct, again, with the needle in place, the practitioner re-tests the same physical exam for increased range of motion, decreased pain, stronger muscle with MMT, improved results of the OET, etc. The needle at the acupuncture point(s) that made substantial changes is then withdrawn and applied again when the practitioner performs the comprehensive acupuncture treatment.
5. Remember to use the channel correspondences and to assess and treat the zang fu patterns for increased and long-lasting results

Callaghan, M. J., McKie, S., Richardson, P., & Oldham, J. A. (2012). Effects of patellar taping on brain activity during knee joint proprioception tests using functional magnetic resonance imaging. Physical therapy, 92(6), 821-830.

Lephart S, Kocher M, Proprioception following ACL Journal of Sport Rehabilitation. 1992; 1: 188-196.

Reiman B, Lephart S. The sensorimotor system, part I: The physiologic basis of functional joint stability. J Athl Train. 2002; 37(1): 71-79.