Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture in Tempe Arizona and a leading expert on Cold Laser Therapy.

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A SLAP tear in the shoulder is defined as a Superior Labrum Anterior-to-Posterior tear. This is due to separation of the labrum or the cartilage that lines the “ball-and-socket joint” of the shoulder. A type 2 version is where part of the cartilage and the biceps tendon separates from the joint. It usually requires surgery to re-attach. I mention this because we had a young golfer come in with a grade-2 SLAP tear and couldn’t lift is arm much less swing a golf club. Even I was skeptical how much we could help him. After about 8 treatments of acupuncture and cold-laser therapy and some physical therapy, he claims he’s hit 320 yard drives. Yes, that’s super far… No, he’s not just pulling my leg. Acupuncture and laser therapy are amazing!

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Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture in Tempe Arizona and a leading expert on Cold Laser Therapy.

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While most of my patients come in for acupuncture for back/pain, sports injuries, sinus problems, depression, I will occasionally come across a case that makes me really smile and reminds me why I switched from engineering to acupuncture. A 9 year old little girl comes into clinic experiencing “Absence” seizures averaging 12-15 times per day. Each seizure only lasts 5-6 seconds. After her second acupuncture treatment, she had 6 continuous days where she averaged between 0 and 1 seizure per day. Even “I” was pleasantly surprised how awesome she’s doing.

 

Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture in Tempe Arizona and a leading expert on Cold Laser Therapy.

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When told that our cartilage is worn out or our meniscus is torn, we usually assume that reconstruction (or in-action) is the only option. Some recent articles reinforce our claim at ‪#‎HiddenRhythmAcupuncture‬ that our Cold Laser therapy can induce cartilage repair and regrowth. We’ve seen it in our clinic, and now you can read more about it here if you’ve interested.

Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture in Tempe Arizona and a leading expert on Cold Laser Therapy.

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Cartilage Degradation

Aside from traumatic injuries such as ligament and cartilage tears, knees are also prone to simply “wearing out”. The articular cartilage lining the head of the femur begins to thin over time, and the surface can become rough, uneven, and ultimately degrade to the point where it is no longer there. This condition can be collectively labelled Osteoarthritis or OA (6).

As a result of this thinning and irritation of the area, a full inflammatory process can take place including extra fluid in the joint capsule, thickening of the synovium also known as the lining of the joint capsule surrounding the knee, thickening of the surrounding bone into spurs called osteophytes, and extra swelling around the joint leading to contracting of the surrounding ligaments .

Sometimes this inflammatory process can indeed lead to tissue repair and decrease in pain. Other times, however, it can lead to further damage because of increased instability and other parts of the joint attempting to carry the load.

Prolonged pain and swelling can lead to weakening of the surrounding ligaments and muscles leading to further instability and increased risk of further degradation. Left unchecked, the downward spiral can continue until permanent damage will result.

Osteoarthritis can be caused by several factors(4):

Gender – Women are 50% more likely to experience OA (osteoarthritis) than men.

Age – As we get older, our internal repair processes slow down, and by our mid-to-late 40’s, OA becomes more prevalent. The connection between “getting old” and OA isn’t so clear cut, however. As we age, things do indeed tend to wear down a bit, but increasing evidence shows that OA is not simply caused by regular activity or exercise in our 40’s. It is now suggested that INACTIVITY can contribute to osteoarthritis. To be specific, there is an optimum amount of “recovery time” suggested after noted cartilage damage. Intense exercise too soon after damage has been shown to increase injury. It was surprising to note, however, that prolonged immobility can also accelerate cartilage damage.(5) Research suggests that activity (especially low-impact movement like elliptical training ) can stimulate cartilage growth resulting in increased cartilage health. By the time many people reach 40 or older, a shift to sedentary lifestyles is common…increasing chances of immobility, thus reinforcing the perception that getting older leads to OA.

Obesity – Being overweight can vastly increase the chance of OA in the knees. The extra load on the knees coupled with likely inactivity can accelerate cartilage damage.

Injuries – Other knee related injuries such as torn meniscus or ligament tears can lead to joint instability and cause uneven loading and uneven wear on the cartilage leading to damage.

Genetics – Yes, a genetic connection can increase your chance to developing OA if you have other family members suffering from OA.

Smoking – It is common knowledge how toxic cigarettes are for virtually every organ of the body. While some early research suggested that nicotine might even have a protective effect on OA, more recent and thorough studies confirmed that smoking does speed up cartilage loss and disorder cells that can rebuild cartilage.(7)

Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture in Tempe Arizona and a leading expert on Cold Laser Therapy.

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We’ll begin this series of posts by giving an introduction  and overview in knee anatomy.

It’s not the years, it’s the mileage”….one of my favorite quotes from Indiana Jones in “Raiders of the Lost Ark”

Some of the most common medical conditions among active adults are knee problems. Reported knee injuries and knee degeneration just in the United Sates number in the millions per year. If we just look at reported ACL tears, for example, between 250,000 and 300,000 ACL injuries are reported each year. Most are attributed to athletes.(1) Keep in mind this is only one of the common knee injuries.

In this article we will briefly describe common knee problems including both ligament damage and cartilage degeneration and discuss the advantages of using acupuncture and cold laser therapy (low level laser therapy or LLLT) to not only decrease pain, but also accelerate the healing of these injuries.

A Quick Overview of the Knee Anatomy.

The joint is considered a “hinge” type of synovial joint that allows basically two directions of movement; flexion (bending) and extension (straightening). Yes, there is a small amount of flexibility allowing for some rotating and bending side-to-side, but only a little. The repeated load that the knees sustain during movement, and the relatively limited direction of the motion allowed by the knee leave it vulnerable to some unique risks and injuries. Shown below is a diagram showing the basic parts of the knee. Most knee injuries occur in either the ligaments (cruciate or collateral) or the meniscus (cartilage pads that help cushion the load of the knee joint when weight is applied). Degeneration of the knee is usually more attributed to a thinning and eventual loss of the cartilage (either the meniscus or the articular cartilage lining the femur) commonly referred to as “osteoarthritis”.

Let’s discuss some of the more common injuries in a little bit more detail. In a normally functioning knee joint, flexion and extension (bending and straightening) occur without any drama… it sustains the weight of the body through standing, walking, running, sprinting, and side-to-side movements. It will sustain a small amount of side-to-side bending or rotation. It is essentially a hinge joint. Ask the knee to do much more than that, and injuries will result, most often in the form of ligament tears.

Most athletic injuries result from asking the knee to rotate or flex further than it is designed. They can result from impact of another person, or rotating the body while the foot is planted and cannot rotate.

ACL Tear

The anterior cruciate ligament (ACL) tear can result from rapid changes of direction, improper landing from a jump, or impact.(2) It is often accompanied by damage to other parts of the knee. There are of course varying degrees of damage to the ACL. Grade 1 and 2 sprains describe just over “stretching” or even partial tear of the ligament while a grade 3 sprain indicates a complete tear with full separation. Grade 1 and 2 sprains can indeed resolve themselves without surgery. Grade 3 complete tears, however, will require a surgical repair (usually a graft) to regain full function and stability of the knee.

PCL Tear

Posterior cruciate ligament (PCL) tears usually result from front impacts while the knee is bent. These are much less common than ACL tears and can often resolve without surgery.

MCL and LCL Tear

Damage to the collateral ligaments, either medial (MCL) or lateral (LCL) sides of the knee are often the result of side impacts to the knee. While it obviously depends on the degree of damage, collateral ligament damage can often be resolved without surgery.

Meniscal Tear

The meniscus are vulnerable to tearing during impact with sudden twisting and are more common in older patients. The need for treatment of meniscal tears depends on the type and severity. Flap tears occur where portion of the meniscus tears and can fold underneath itself. The knee will suddenly lock up with severe pain. In contrast, degenerative tears will result in gradually increasing pain, swelling, and stiffness.
Tendon Tears

Patellar tendon tears occur in the tendon connecting the kneecap (patella) to the tibia (shinbone) while quadriceps tendon tears occur between the quadricep (thigh) and the patella. These type of tears can occur from landing from a jump and are more common with increasing age. The need for surgery (like ligament tears) is largely dependent on the degree of tear.(2)

Bursitis of the Knee

Bursa are fluid filled sacs that help relieve pressure and reduce friction around the knee between tendons/ligaments and the bone. 11 such bursa exist around the knee. Bursitis can be caused during repeated injury or overuse such as prolonged kneeling or pressure on the knees. It is characterized by pain, swelling, and warmth. Bursa can also become infected. X-ray, MRI, and ultra-sound imaging is often used to differentiate bursitis from other common knee problems. Conventional therapy can include cortisone injections, aspiration (draining of the fluid) and even removal of the bursa.(3)

Keep in mind that these are not ALL of the injuries that can occur in the knee, just some of the more common ones.

Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture in Tempe Arizona and a leading expert on Cold Laser Therapy.

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In past articles I’ve already shown strong evidence how acupuncture can improve insulin sensitivity for people with Type-2 diabetes.  More recent studies however, showed  how the success of acupuncture in the treatment of diabetes is largely dependent on point selection.    Three groups of obese women were treated with acupuncture with the purpose of lowering glucose fasting levels.  Each group was treated with a different style of acupuncture.  Group 1 was treated with points on the arms and legs.  Group 2 was treated on the mid/low back.  Group 3 was treated with points in the ears that supposedly were designed to address blood sugar.    After just 1 thirty-minute session, glucose fasting levels were measured.  Both body and back acupuncture groups showed significant decreases in blood sugar levels while the ear-acupuncture group showed no change with a  suggestion of a small increase.

While the study as fairly small, it further reinforced that acupuncture with proper point selection can be an important tool in the successful treatment of Type-2 Diabetes.

 

Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture in Tempe Arizona and a leading expert on Cold Laser Therapy.

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Besides having a good acupuncturist at your disposal, something else that EVERYBODY should have in their medicine kit is Tea Tree Oil. Also known as oil of Melaleuca alternifolia…. a tree native to Australia. Why? It is probably one of the most potent topical antiseptic currently known.  Current research reveals it’s potent properties as an antibacterial, antiviral, and antifungal.  Some studies even suggest it as an effective treatment against MRSA. (see Melaleuca alternifolia (Tea Tree) Oil: a Review of Antimicrobial and Other Medicinal Properties, C. F. Carson1, K. A. Hammer1 and T. V. Riley1,2,*)   As a fairly clumsy guy fully involved in high-risk and contact sports, I’ve used raw Tea-Tree Oil and Tea-Tree Oil based products to treat skin wounds with overwhelming success.    The classic “Neosporin” or similar products no longer hold a place in my house.  Both personal experience and clinical research are overwhelming in their evidence in it’s success.

Craig Amrine is the owner and operator of Hidden Rhythm Acupuncture in Tempe, Arizona and a leading expert in  cold laser therapy.

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The Wisdom of Mom – She may have been right after all.

“Put a coat and scarf on or you’ll catch cold”! How many times have we heard this from our parents? Most of us grew up thinking that catching a cold resulted from prolonged exposure to cold weather.

As most of us grew up however, we learned that that colds were due to viruses, such as the rhino-virus. Colds and flus are actually caused by a variety of virus strains. So the question came up as to why do most people get sick in colder weather? The common answer was that during cold weather, people tended to gather in close quarters more often, increasing the chance of transmission. The stresses caused by feeling “cold” could also lower the immune system and increase chance of transmission.

So Mom’s advice was wrong. You can just as easily get a “cold” in the summer as you can in the winter. Right?

Not so fast.

Recent studies show that flu and cold viruses thrive better in cold weather. In fact, the viruses seem to form a protective barrier in cold weather that enables them to survive until they can find a warmer environment. Once inside the body, that protective barrier melts away allowing the virus to spread and infect the host. (http://www.webmd.com/cold-and-flu/news/20080303/why-flu-virus-thrives-in-winter)

Further research also suggested humidity also plays a role and that a cold and drippy nose is the IDEAL temperature for some of these viruses to thrive. (http://scienceline.org/2015/01/cold-viruses-thrive-in-cold-noses/). In the other extreme, very low humidity such as in heated house in the winter also increases the virus survival rate.

The cold nose model also explains that it’s more difficult for the nose to release certain infectious fighting agents in colder temperatures. (http://newyork.cbslocal.com/2015/01/06/study-cold-weather-may-be-linked-to-common-cold-after-all/)

So, bundling up when you go out on a cold day may indeed help you in the fight against catching a cold, so Mom may be right after all. Of course, the jury is still out on medicinal effects of chicken soup.

Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture, the premier acupuncture clinic in Tempe, AZ and is the leading authority of Cold Laser Therapy in the Phoenix

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I’ve been using cold-laser therapy in my clinics for the past 6 years and truly believe it achieves amazing results. Based on my own clinic experience as well as an overwhelming amount of scientific studies, cold-laser therapy or low-level laser therapy has been proven to both accelerate tissue (bone, ligament, muscle, skin) repair and as well as reduce inflammation.

Due to a recent tear of my medial collateral ligament in my knee, I took a more concerted effort in examining the research that’s been conducted on laser treatment of ligament damage. Specifically, I was looking for studies involving laser treatment of knee damage due to ligament or cartilage tears. I did in fact find several studies that showed how laser treatments help ligament repair. Specifically, both fibril diameter and tensile strength of the medial collateral ligaments in damaged rats were measured before and after several weeks of laser treatment. The results showed overwhelmingly that ligaments that were exposed to laser therapy showed a significant increase in both fibril diameter and tensile strength as compared to untreated subjects. The abstracts for these studies can be found here, here, and here. Further research here also revealed that laser therapy and also indeed help in cartilage regeneration.

This data simply further supports my enthusiasm in using cold laser therapy along with acupuncture in my clinic and helps explain my success rate in treating people with these kinds of injuries.

Craig Amrine, L.Ac. is the owner and operator of Hidden Rhythm Acupuncture in Tempe, Arizona and a leading authority on cold-laser therapy.

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Several of my past articles and blog posts have been aimed at explaining how acupuncture works in effectively treating complex conditions including migraine headaches, Type2 Diabetes, menopause symptoms, and inflammation.  In this post, however I’d like to highlight a recent study showing the effect of a specific acupuncture point (Liver 3 or Taichong) on specific regions of the brain.

In Traditional Chinese Medicine (TCM), acupoint Liver 3 is a very popular point that I use in many applications including:

– Blurred vision and eye problems

– Muscle tightness, contraction, muscle movement.

-Menstrual disorders

-Emotional problems including irritability and depression

A recent study found HERE examined the effects of stimulating Liver 3  using functional MRI analysis.  Specifically, they compared MRI results from stimulation Liver 3 with real acupuncture  versus sham acupuncture.  In this case, sham acupuncture was defined as using a dull stimulation at the Liver 3 location but without piercing the skin.   The patient was completely shielded  from knowing which point was the real treatment and which point was the sham treatment.  In this case, we can define this experiment as a SINGLE-blind study.

The first interesting result was that specific differences were noticed between real and sham acupuncture.  While sham acupuncture did stimulate some changes, they were vey different than changes induced by real acupuncture.   This difference was noticed when comparing the two different analysis techniques used during the MRI analysis.  Specifically, one of the two analysis techniques only noticed brain activity changes during real acupuncture in comparison to the sham acupuncture.

The other set of results showed a fascination correlation between a real acupuncture and marked excitation or inhibition in areas of the brain associated with vision, movement and muscle contraction, and emotion; associations that have been connected with Liver 3 according to traditional texts.

This study is exciting in that it shows the connection between traditional functions of Liver 3 and it’s modern correlation with MRI analysis.  A modern look at traditional acupuncture is an increasing trend among forward-thinking scientists.  Several acupuncture points including  Large Intestine 4, Spleen 6, Stomach 36, Du 20, and now Liver 3 are undergoing increasing scrutiny to get a better understanding not only if they indeed work, but, HOW they work.  With the increasing data, a fascinating confirmation is growing between traditional functions and modern analysis of these points.