Sports Medicine

I have been treating both professional athletes and weekend warriors for years. I continuously take advanced doctoral-level courses in Sports Acupuncture. This ongoing training in the latest techniques for treating sports injuries sets me apart from the majority of acupuncturists in New York City. My years in the ring fighting as a full combat Muay Thai kickboxer has given me firsthand experience in breaks, fractures, tears, strains, dislocations, and other sports injuries – be it my own or those I have treated over the years.

As I have said to both my pros and amateurs, “there is nothing I am doing to you that I haven’t done to myself or have had done on me (always said with a laugh and a smile).” I offer my patients a complete treatment program from the evaluation of x-rays and MRI reports to physical assessment, evaluation, diagnosis, treatment, manual modalities and muscle retraining and reorientation in addition to acupuncture, low-level laser, photobiomodulation, and cupping.

Integrative Approach and Treatment

I work closely with many orthopedic surgeons, physiatrists, neurologists, physical therapists and osteopaths here in New York City to create an integrative approach and treatment program to ensure a complete resolution to your medical condition, which will help you to train more efficiently and effectively to optimize performance, decrease risk of injury, and accelerate your recovery time.

Some sports-related conditions I treat are:


Back Pain

There are three sections of the back: the neck (cervix), the midsection of the back (thorax) and the lower back (lumbar).  Back pain is defined based on the region of the back affected:  cervical, thoracic and lumbar.  A fourth area of pain is defined as tailbone or sacral pain (coccydynia).  In my clinic, patients present with one or multiple regions of their back affected by pain.  There are many causes of back pain and include conditions of the spine (the ‘soup bones’), the discs between the vertebrae, nerve impingement, peripheral ligaments of the spine and discs, the spinal cord, paraspinal muscles and muscles of the posterior, organs of all three major regions, and the pelvic floor.  Other causes of back pain can be pregnancy, stress, tumors, inflammation, conditions of the skin and lifestyle. Back pain that comes on suddenly and lasts no more than six weeks (acute) can be caused by a fall or heavy lifting. Back pain that lasts more than three months (chronic) is less common than acute pain.  Back pain often develops without a cause that your doctor can identify with a test or an imaging study.  A red flag and cause to seek immediate medical attention is when your back pain is alleviated by lying down (this could be a tumor).
Conditions commonly linked to back pain include:

Muscle or ligament strain:  Repeated heavy lifting or a sudden awkward movement can strain back muscles and spinal ligaments. If you’re in poor physical condition, constant strain on your back can cause painful muscle spasms.

Bulging or ruptured discs:  Discs act as cushions between the bones (vertebrae) of your spine. The soft material inside a disk can bulge or rupture and press on a nerve. Nerve impingement can lead to numbness and tingling of an extremity or lack of motility of a muscle group.  It is important to note that you can have a bulging or ruptured disk without experiencing back pain.  An x-ray and MRI can determine if a disc is bulged or ruptured.  In certain cases, the combined therapies of acupuncture and corrective postural exercises can help minimize or eliminate disc pain.

Arthritis:  Osteoarthritis can affect the any region of the back. In some cases, arthritis in the spine can lead to a narrowing of the space around the spinal cord, a condition called spinal stenosis. Regular acupuncture treatments, photobiomodulation therapy, proper diet and healthy lifestyle can help minimize the symptoms of spinal stenosis. 

Skeletal irregularities: Scoliosis is when the spine curves to one side or another.  This can lead to back pain as muscles of one side can be in a state of constant spasm, concurrently, the muscles on the opposite side of the back are in a constant state of flaccidity.  

Osteoporosis: Your spine’s vertebrae can develop compression fractures if your bones become porous and brittle.  It is important that as we age, we perform exercises and engage in activities that will help strengthen our muscles and bones.  Proper nutrition and lifestyle habits should be practiced.

Overuse Injuries: Overuse injuries are very common and typical occur when we push our bodies past their levels of training or physical abilities.  However poor form and improper training techniques (e.g.: running 22 miles to train for a half marathon, not enough time for warming-up or cooling-down) are more often the culprits causing injury.

Plantar fasciitis

is one of the most common causes of heel pain and a condition I see quite frequently in my clinic.  Plantar fasciitis develops when the plantar fascia (the thick band of tissue that runs across the bottom of your foot and connects your heel bone to your toes) becomes inflamed.  Patients complain of severe pain when they get out of bed in the morning which dissipates as the day goes on, but can return after prolonged standing or when a person stands after sitting for long periods of time.  For athletes, the pain is worse while exercising, not afterward.  Wearing high heels or shoes with inadequate support, runners, dancers, elderly and obese persons are more at risk for plantar fasciitis.  Compensating one’s gait can lead to complications of the knees, hips and low back.  I have been successfully treating plantar fasciitis for years with acupuncture and muscle re-education.

Shoulder Arm, Elbow, Wrist and Hand Injuries (upper extremity injuries)

Injuries of the upper limbs are very common in people who engage in physical activities such as tennis, volleyball, football, boxing, and mixed martial arts.  Reoccurrence of upper extremity injuries are common, simply because athletes rush back to their sport before their initial injury is completely healed.   Stress fractures, nerve impingement, rotator cuff injuries, trauma and joint degeneration all fall under upper extremity injuries. The most common elbow injury in sports is tendinopathy. Tendinopathy is an injury to a tendon that results in pain, swelling and loss of proper function.  Pain is worse with movement and better with rest.  Tendinopathies can be successfully treated with acupuncture, but it takes a treatment strategy of one to two treatments weekly for several weeks and patient compliance to rest the limb during this treatment period.

Lateral epicondylitis

(inflammation of the outside of your elbow) also known as tennis elbow, begins with mild pain that increases over time and radiates down the forearm into the wrist and hand.  Giving a handshake, picking up a bottle or glass or turning a door knob will become very difficult and painful as time progresses.  Poor technique while hitting a tennis ball or a racquet that isn’t a ‘right fit’ frequently causes this condition, hence the name.

Medial epicondylitis

(inflammation of the inside of your elbow) also known as golfer’s elbow is seen in person’s who participate in sports that require throwing movements (a hockey slap, baseball pitchers and volleyball players).

Nerve injuries

Nerves can become compressed for many different reasons.  Nerve injuries can result in pain, numbness, tingling, or decreased motility of a muscle or muscle groups.  For example, a compressed nerve in the neck can cause symptoms in the shoulder, arm, wrist and /or hand.

Wrist and hand

Injuries to the wrist and hand can be commonly caused by trauma or overuse.  In the past several years, there are more and more cases of carpal tunnel syndrome reported because of improper alignment at a computer keyboard and texting thumb (DeQuervian’s syndrome) which is inflammation of the tendon of the thumb from overuse of cellphones.

Rotator cuff injuries

These are very common injuries among sports players who throw balls, compete in MMA or box.  The rotator cuff is a group of four muscles and tendons that help to abduct, adduct, elevate, flex and rotate the shoulder. The four muscles include the supraspinatus, infraspinatus, teres minor and subscapularis.  The muscles connect the upper arm (humerus) to the shoulder blade (scapula) forming a “cuff” around the humerus. Each muscle originates on the scapula and has a tendon that attaches to the humerus. The supraspinatus tendon is the most frequently torn tendon in the shoulder.  Tears to the rotator cuff can be caused by an acute injury such as a fall, lifting or pulling, or lifting too much overhead. Chronic tears are more common in people over 40 years of age due to normal wear and tear over the years. Calcium deposits and bone spurs that build up over time within the cuff can cause a tear.  Repetitive stress to the rotator cuff in overhead sports such as swimming, baseball or volleyball, or occupational jobs (painting or hammering) can lead to tears. Shoulder dislocations and different shapes to the acromion can weaken and tear the cuff.  A red flag that a person has a rotator cuff tear is when the patient complains of pain while trying to sleep. Patients will also point to their pain and describe verbally and show with their finger how the pain radiates down their upper arm, and demonstrate the difficulty and limited ROM (range of motion) when lifting their arm to the side away from the body.    Patients may also present with muscle weakness (atrophy) and crepitus (joint noise in the shoulder).

A SLAP (superior labral tear from anterior to posterior) or SLAP lesion

is an injury to the glenoid labrum.  This is a fibrocartilaginous rim that attaches around the periphery of the glenoid cavity of the shoulder.  I see this condition in my clinic mostly with my mixed martial artists.  Surgery is typically required because these tears do not self-heal. The combined therapies of photobiomodulation and acupuncture pre- and post-surgery can help to improve blood flow the affected region, thereby accelerating the healing process.

Radiculopathies and Neuropathies

To keep it simple, conditions related to the median, radial, and ulnar nerves of the upper limbs can be an entrapment (compressed by another type of connective tissue) or be a nonentrapment condition (trauma to the nerve, infection or an inflammatory condition).   Pain, loss of dexterity of the limb, numbness, tingling or an ‘electrical’ feeling are warning signs that a person should seek medical attention.  Here at my clinic, manual muscle testing can be performed on a patient to determine the root cause of the pain, but if these tests are negative, I refer my patient to a neurologist for electrophysiologic testing or an MRI to determine the cause of the condition.  Once a clear diagnosis and root cause of the pain is determined, a treatment plan can be made that can include but not exclusive to surgery, acupuncture and occupational therapy.  In many cases, the root cause of these conditions is not at the site affected, yet commences from the neck or shoulder.

Stress Fractures and Simple Fractures

Stress fractures are tiny cracks in a bone.  This condition is seen more commonly in the lower legs and feet because they are weight-bearing.  They can be caused by increasing intensity or volume of an activity (too much too soon), before the bone can adapt to the increase in exercise or activity.  Stress fractures are commonly seen with sports that involve jumping up and down or long-distance running.  Osteoporosis can weaken bones; hence stress fractures can occur.  I see this condition quite frequently in post-menopausal women and breast cancer survivors.   Bones are like muscles:  when you exercise, tissue is destroyed and needs time to recover and rebuild (this increases bone mass).  Without sufficient time to recuperate and regenerate tissue, the bones can become weaker and become susceptible to fracture.  Stress fractures first present as a small pain or tenderness of the affected area that increases with activity but is better with rest.  Over time, there might be redness or swelling present.  People who engage in track and field, basketball, tennis, Muay Thai kickboxing, ultra-marathon running, endurance events, dance or gymnastics are susceptible for stress fractures due to the intense training regimen for these activities.  Eating disorders, lack of Vitamin D and calcium, irregular or absent menstrual cycles, and sudden spurts of physical exercise after long periods of a sedentary lifestyle can all contribute to stress fractures.  
Simple fractures are fractures of the bone only, without damage to the surrounding tissues or breaking of the skin. Sports injuries (mostly contact sports), motor vehicle accidents (MVAs), falls, certain cancers, and osteoporosis are all causes of simple fractures.  Geriatric communities must take extra precaution to avoid falls as their bones tend to be more brittle and prone to fracture during falls.  These fractures can take up to 2 months to heal depending on the severity of the fracture.  The combined therapies of infrared laser and acupuncture can help to speed up the recovery time for these patients.

Dancer’s Injuries and Hip, Leg, Knee, Lower Leg, Ankle and Foot Injuries

Ankle sprains are the number one traumatic injury in dancers. When an ankle is sprained, ligaments on the inside or outside of your foot get twisted or overstretched and in extreme cases, tears might occur.  Ankle sprains often happen when there is a misalignment of the ankles, landing on one’s feet improperly, or wearing of shoes that do not fit properly.  Ligaments are like rubber bands. When a sprain occurs, they act like rubber bands that have been overstretched and do not ‘snap back’ to their original elasticity.  For this reason, the prevalence of reoccurring sprains is high. Building up the strength of the surrounding muscles of the joint is paramount to lowering one’s risk for reinjury.  Overuse injuries of the low back, legs, hips, knees, ankles and feet are also commonly seen in dancers given their daily occupation.  Dancers are at high risk to develop osteoarthritis in the knee, hip, ankle and foot after years in their profession. 

MCL & ACL Tears

An MCL injury is a sprain or tear to the medial collateral ligament. The MCL is a band of tissue on the inside of your knee.  It connects your thighbone to the bone of your lower leg. The MCL keeps the knee from bending inward.  You can hurt your MCL during activities that involve bending, twisting, or a quick change of direction. For example, the MCL can be injured in football or soccer when the outside of the knee is hit. This type of injury can also occur during skiing and in other sports with lots of stop-and-go movements, jumping, or weaving.  Clues that you may have injured your MCL are swelling, pain that increases several hours after injury, difficulty flexing and/or extending your knee, and tenderness of the affected area.  Acupuncture can be very effective treatment for most MCL injuries along with rest, ice, and reduction of activities for several weeks.  If pain persists after 48 hours of injury, imaging might be necessary to rule out any tears or severe injury.
ACL (anterior cruciate ligament) injuries are common in sports.  Sudden changes of direction (football, soccer, tennis, rugby) can cause ACL injury, but certain daily activities can also cause injury to this ligament.  Persons who have experienced an ACL tear speak of a ‘popping’ sound at the moment of injury and severe pain.  Inability to put weight on the leg, swelling of the joint, and instability of the limb are common signs of a tear.  Minor tears might only require biweekly acupuncture treatment, physiotherapy, and sometimes a brace.  More severe tears might require surgery as this ligament receives no blood supply and a full tear will not be able to heal on its own.  

RSD

(Reflex sympathetic dystrophy syndrome)/ RND (Reflex neurovascular dystrophy), CRPS:   Complex Regional Pain Syndrome (CRPS). Both RSD/RND and CRPS are chronic conditions characterized by long-lasting and severe burning pain, most often affecting the arms, legs, hands, or feet.  This condition usually occurs after an injury, stroke, or sometimes a heart attack. Patients can experience changes in bone and skin, excessive sweating, tissue swelling and extreme sensitivity to touch.   The pain is intense and becomes worse over time.  Patients will complain of a severe burning sensation, increasing sensitivity to any type of contact with their skin, the skin of the affected limb will be blotchy, red or purplish and warmer than other body parts.  The nails and hair of the affected limb appear to be different in texture and growth and the patient will experience decreased ability to move the affected limb over time.  There is no known cause of this condition but scientists lean towards the theory that this could be a malfunction of the sympathetic nervous system.  RSD tends to occur after trauma to the extremities (physical or surgical).  Low level laser therapy is non-contact and may help to give some minor relief of pain, but it is not long-lasting.

Sprains & Strains

sprain is an injury to a ligament (tissue that connects two or more bones at a joint). When a sprain happens, one or more ligaments is stretched or torn. A strain is an injury to a muscle or tendon (fibrous cords of tissue that connect muscle to bone).  In a strain, a muscle or tendon is stretched or torn.  Sprains or strains can happen anytime to anyone whether exercising or simply twisting one’s ankle while stepping off a curb.  Symptoms of a sprain are swelling, bruising and the inability to use the affected joint.  Strains can include pain, muscles spasms, swelling and cramping and decreased mobility of the muscle.  It is important to seek medical attention for both conditions to determine the severity of the injury and course of treatment to ensure no further damage to the joint is done, and prevent repetitive injuries going forward.  Rest, ice, compression and elevation (RICE) of the injured area are important.  Acupuncture, herbal poultices and photobiomodulation therapy can help to decrease swelling, inflammation and reduce pain and muscle spasms.  A strategem consisting of treatment two to three times weekly during the acute stage of injury followed by a combined program of acupuncture and physiotherapy can help prevent stiffness, increase strength, and help to completely heal the injured joint.  Patience is important; if a patient goes back to normal activity too soon after a sprain or strain, re-injury can occur.

Ligamentous Tears

Tears to ligaments commonly occur when a joint experiences tremendous blunt force.  Typically, this happens with a fall or during high-impact sports. Ankles, knees, wrists, thumbs, the neck or back are sites of injury we see more often with ligamentous tears. Ligaments are like strong rubber bands that connect bones to bones.  They possess a certain amount of flexibility that allows movement between the bones (bending your fingers/flexing your toes).  When these ‘rubber bands’ are overstretched, a tear can occur.  There are three grades of ligamentous tears:  Grade 1 is mild, Grade 2 is a moderate tear, and Grade 3 is a complete tear (rupture) that often requires surgery.  Both Grades 1 and 2 can be treated during the acute stage with combined therapies of acupuncture and photobiomodulation and poultice wraps.  RICE (rest, ice, compression, elevation) is also highly recommended.  If pain and swelling do not improve within 24 to 72 hours post initial injury, seek the counsel of your medical professional.

Treating Patellofemoral Syndrome with Photobiomodulation Therapy

Patellofemoral syndrome is a very painful knee condition that can limit the quality of a person’s life. The video you see here is a non-invasive, 20-minute outpatient treatment -when performed 2 to 3 times weekly this therapy can reduce inflammation, relieve pain, increase collagen production and blood circulation to the affected tissues and structures. Greater range of motion, reduction of swelling and improved quality of life and activities are gained with this type of treatment. Additional modality of acupuncture amplifies results significantly.