Acupuncture: where does it fit in with injury, pain and physiotherapy?

When we are injured or in pain we want to reduce the time out of their chosen sport injured as much as possible optimising recovery time and reducing the risk of re-injury. Acupuncture is just one of the many tools that physiotherapists can employ (if qualified) alongside their other skills to optimise recovery and rehabilitation. In my opinion it’s a useful additional skill to have when working with patients.

You may or may not be aware that acupuncture is a treatment option that some physiotherapists off

er as part of an integrated approach to the management of pain, inflammation and injury.  At First Physio both Jo and Toby are qualified in acupuncture.

Acupuncture into Achilles tendon

Acupuncture into Achilles tendon

What is acupuncture?


Herringbone technique on Achilles tendon pain and injury

Herringbone technique on Achilles tendon pain and injury

Acupuncture can reduce pain by stimulating the brain and spinal cord to produce natural pain-relieving chemicals such as endorphins, melatonin (which promotes sleep) and serotonin (to promote well-being), to

name but a few. These chemicals assist the body's healing processes and offer pain relief as a precursor to other treatments such as manual therapy or exercise in order to aid recovery. Acupuncture can used to target specific tight areas in muscles and other soft tissues too.

Acupuncture forms part of traditional Chinese medicine (TCM). This ancient system of medicine dates back as far as 1000 years BC and is based on a holistic concept of treatment which regards ill health as a manifestation of imbalance in the body’s energy. Physiotherapy combines TCM principles with scientific evidence as a means of reducing pain and promoting healing, always with the aim of enhancing physiotherapy treatments such as exercise and rehabilitation techniques to promote recovery and improve quality of life.


Why may acupuncture be worth considering if you are injured or in pain?

Acupuncture can target the management of pain on a number of physiological levels: locally in the tissue where the needle is placed, spinally through the neural pathways to the spinal cord and continuing to the brain via these neural pathways impacting on pain perception. Pain will change the way we move and therefore even just a short-term episode of pain lasting only a few minutes can have a marked impact on normal movement and feedback to the brain. This then can have a direct impact on the recovery from an injury and performance.

Acupuncture can also have a more global influence on digestion, sleep, and the stress hormone cortisol. Athletes commonly now take various supplements or influence their diet with the aim of improving their training and performance. Digestion of such food products or supplements is clearly therefore important. Sleep is very well documented to be crucial in recovery and repair for all of us, athlete or not. The stress hormone cortisol can affect both short and long-term physiology and psychology. Hence the impact of acupuncture on the more global bodily function should not be ignored as it impacts on sports performance, decision making and injury risk to name a few.

How is acupuncture done?


Acupunture technique for pain and bruising

Acupuncture technique for pain and bruising

Conventional acupuncture involves the use of single-use, pre-sterilised disposable needles of varying widths, lengths and materials that pierce the skin at the acupuncture points. The physiotherapist will determine the locations of these points on the basis of a normal physiotherapy assessment. A number of needles may be used during each treatment, and these are left in position for a varying amount of time. The acupuncture is used to compliment other treatment techniques and rehabilitation as part of your comprehensive physiotherapy assessment and treatment.

Many athletes have tight areas in the muscles which are very normal; some however may become more sore or problematic and be defined more as trigger points. Trigger points are just taut tight bands of muscle fibres within a muscle, normally sore and tight to touch and can refer pain away from the trigger point itself. There are specific patterns we would expect to have reported for it to be a true active trigger point. Trigger point acupuncture can be very effective at removing these quickly and with perhaps less discomfort than a large elbow being put in the tight muscle! Trigger point acupuncture may also be used to facilitate relaxation in specific muscles following traumas, for longer-term unresolved muscle pain, or as a means of increasing muscle length in order to aid stretch and rehabilitation. It is important to remember that it still only makes up a small part of treatment and must be accompanied with specific exercises or stretching for example to stop the trigger points or pain returning.

Physiotherapists are in a unique position to combine acupuncture with other treatment methods, such as:

  • Exercise
  • Manipulation
  • Muscle re-education
  • Joint mobilisation
  • Relaxation
  • Electrotherapy
  • Sports rehabilitation
  • Ergonomic assessments


Why being members of AACP (Acupuncture Association of Chartered Physiotherapists) matters?

Chartered physiotherapists are bound by a strict professional and ethical code of practice. The Acupuncture Association of Chartered Physiotherapists (AACP) requires its members to undergo a minimum of 300 nominal hours of acupuncture training.

Members of AACP are required to keep up with a stated minimum number of hours of continuing professional development each year in order to remain on the register. Find the register at: Accupuncture Association of Chartered Physiotherapists

The supervision of the education register enables AACP, together with the Chartered Society of Physiotherapy (CSP) and the Health and Care Professions Council (HCPC), to maintain the necessary high standards of practice.

All AACP members are covered by comprehensive professional liability insurance.


Jo Avery

Chartered Physiotherapist MSc, BSc (Hons), MCSP, MHCPC

Owner First Physio


Disclaimer: The opinions expressed are those of First Physio only and do not constitute medical advice.