Athletes and Overtraining: A Traditional Chinese Medicine Perspective

Athletes and Overtraining: A Traditional Chinese Medicine Perspective Overtraining affects athletes at all levels, as it impairs athletic performance and creates injuries. Proper training is vital to the athlete's performance in competition within his or her particular individual or team sport. Integrating Oriental medicine and strength and conditioning can be invaluable for an athlete's optimum performance level during training sessions, thus minimizing overtraining and potential injury.

Overtraining can also affect various organs and channels, depending upon pre-existing conditions. Today, many athletes train year-round (between playing in-season and participating within club sports during the so-called "off-season"). These athletes ultimately end up having no recovery time and rest. This leads to muscle weakness, and is associated with the spleen functions, according to Chinese medicine. Many of these athletes need to not only practice strategy for their particular sport, but they also need to maintain strength, so the athletes practice in the afternoon and work out with their coaches in the morning. If there is not enough recovery, then working out in the weight room damages the kidney's functions. With continuous training, weaknesses occur within the muscles, which chronically affect the tendons. This leads to liver imbalance, specifically the liver blood and/or yin, which can potentially progress to liver wind, due to liver blood deficiency.

Spleen qi deficiency is one of the most common types of deficiency among athletics and the general population. The spleen/stomach is the origin of qi and blood because it is the root of the post-heaven/natal qi. If the spleen/stomach become impaired, these organs cannot perform their functions of transportation and transformation. One must also remember that (grade-school through college-level) athletes tend to eat fast food most of the time, while they keep up with their school work; train and make practices for their sport; and also hold down a job. One can understand why spleen qi deficiency is so common. The liver is another organ that is commonly affected by athletic performance. The liver blood can be affected from pre-existing liver qi stagnation or vice-versa. It can also be a result of pre-existing spleen qi deficiency. Liver yin supports the liver blood as it is the yin part of the liver. If the blood becomes deficient and is not counterbalanced, then the yin becomes affected; conversely, if the athlete has pre-existing liver yin deficiency due to kidney yin deficiency, it can affect the liver blood.

Yet another organ that is affected by overtraining is the kidney. Kidney yin and yang deficiency are pre-existing conditions that develop over prolonged periods of time. The kidney is the origin of the yin and yang energies of the entire body. Once either one of these have been affected due to irregular diet; long study hours; long training sessions; irregular work schedules; and/or a great deal of performance anxiety, this hectic lifestyle will, over time, deplete the yin and/or yang. Chronically deficient yang usually involves deficiency of the spleen yang as well, because the spleen and kidneys are closely interrelated with transformation, excretion and movement of the body fluids.

In all of these cases, rest regenerates both qi and blood. However, rest will not necessarily get rid of the fatigue associated with overtraining. An athlete's regular diet should include decreasing his or her consumption of greasy and fatty foods, sweets, alcohol and caffeine, as these deplete the spleen's ability to function. The next step would be to tonify the spleen qi using acupuncture points as ST 36, R 12 and SP 3. As for the kidney, one would want to not only tonify the kidney yang, but the yin as well, as they support one another. Acupuncture points such as R 4, ST 36 and K3 are for kidney qi deficiency; R 6, R 4, K 2, K 7 and ST 36 are for kidney yang deficiency; and ST 36, K 6 and R4 are for kidney yin. If the liver blood became deficient, one would tonify the blood using acupuncture points ST 36, SP 6, LI 4, LV 3, LV 8 and D 20. In the case of liver yin deficiency, one would tonify the liver yin using the acupuncture point LV 8.

All of these zang fu organ patterns can be treated and prevented by using appropriate acupuncture points and herbal formulas with modification for combined conditions or preexisting conditions, all of which are based on the Eastern philosophy of counterbalancing TCM diagnostic principles. This diagnostic methodology can be used to offset limitations within Western medical protocols, adding more specific training parameters to prevent overtraining and provide a more consistent optimal training environment.

Current Trends in the Use of Oriental Medicine Within Strength and Conditioning
Unfortunately, the strength and conditioning profession really does not recognize Oriental medicine as a modality for training athletes.

The accepted method for an athlete to get an "edge" over other athletes is the use of many different over-the-counter nutritional supplements that may help him or her train longer without muscle fatigue, based on what he or she hears from "buddies" about a particular product. The Westernized community mindset likes the concept of the "magic bullet," which translates to pills, shots, and the easy way to achieve a goal, as seen within the multibilliondollar weight loss and performance enhancement industry. An example of this mentality is the use of the Chinese herb ma huang (ephedra). This concept bears the closest relationship to Oriental medicine because it is classified as a Chinese herb, nothing more. Most of the profession views this particular herb as a Western-termed "stimulant," rather than a "release exterior" herb within traditional Chinese medicine (TCM) philosophy. This profession uses ma huang to stimulate the nervous and circulatory systems, improve performance, and promote performance enhancement and weight loss. However, there are major flaws within its use in this Westernized context. According to TCM, ephedra whole herb (in context to organic form) is purely useful for (generally) the common cold and certain asthma cases, and is always combined with other herbs in a balanced formula. Much of the research that has been (and is being) published addresses the effects of the drug ephedrine, the synthetic form (isolated components identified to be the active ingredient; that active ingredient is then replicated in the lab) originally derived from the leaf of the ephedra plant and a great deal more concentrated. This synthetic derivative combined with caffeine, is sold over-the-counter as a nutritional supplement to "increase energy."

The reality is medical practitioners (NDs, LAcs, OMDs and botanists) educated within Oriental medicine and medicinal herbology would not even consider using a "release exterior" herb for weight loss and/or performance enhancement, as it does not even treat the right TCM zang/fu organ pattern differentiation.

Because of this mindset, the United States tends to skew the basic concept and perception of Oriental medicine. Using herbs out of context creates for a very misinformed population and academic and medical communities, due to lack of research (not just implementing scientific method protocols within single variable use), understanding and knowledge of use within different cultures.

In conclusion, athletes have a tendency to overtrain by nature of necessity. Integrating exercise physiological components in conjunction with Oriental medicine philosophy prevents overtraining and potentially related overuse neuromuscular injuries. The Oriental medicine profession can be a valuable diagnostic modality, as presented within this article, not only within sports medicine, but also within strength and conditioning.

It is also imperative that athletes be educated in seeking information about over-the-counter supplements containing herbs, by those trained in medicinal herbology, prior to use. This is not understood within the Western community, in general. Most herbs, as explained above, are implemented from the Western indications and symptom-based approach. As we have seen, this is a dangerous and very irresponsible policy used by health care providers, nutritional supplement distributors and manufacturers. Another problem is with the marketing of buzzwords termed "natural" and "energy," as they create misinformed consumers. This bottom-line issue needs to be addressed seriously, and the application of Oriental medicine should be used by those trained within this field, not through weekend seminars or short courses, or by distributors trying to sell their products. Again, an issue that plagues this industry, in general, is the capitalistic ideal of quantity over quality.

This concept presented embraces prevention, which far surpasses current training methodologies and trends to increase muscle endurance. Every athlete should be re-evaluated daily as to needs assessments and training regiment from the collaboration of both the strength and conditioning coach and acupuncturist. This multispecialty training provides depth and conceptual training parameters that enhance athletic performance and prevent overtraining and potential injuries.

References

1. Baechle. Essentials of Strength Training and Conditioning, NSCA, Human Kinetics, 1994. 2. Enqin, Zhang. Basic Theory of Traditional Chinese Medicine, Publishing House of Shanghai College of Traditional Chinese Medicine, 1990. 3. Power, Howley. Exercise Physiology, Brown, Benchmark, 1997. 4. Prentice WE. Rehabilitation Techniques in Sports Medicine, 3rd ed., WCB Saunders,

1999. 5. Prentice WE. Therapeutic Modalities in Sports Medicine, 4th ed., WCB Saunders, 1999. 6. Bensky D, Barolet R. Chinese Herbal Medicine: Formulas & Strategies, Eastland Press, Seattle, 1990. Ronda Wimmer, PhD, MS, LAc, ATC, CSCS, CSMS, SPS, L/CMT Costa Mesa, California

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Athletic Performance & Acupuncture

Using Eastern Philosophy t Optimize Sports Performance, in "Western" Terms

By Ronda Wimmer, PhD, MS, LAc, ATC, CSCS, CSMS, SPS

The use of biorhythms or circadian rhythms is categorized as chronobiology within the Western scientific community. Chronobiology is defined as "the study of rhythm patterns in biological phenomena."1 In Eastern philosophy, yin and yang aspects of the circadian clock represent an extremely important external synchronizer. This is based upon the transitional yin and yang rhythms of yin (nighttime/the sun going down) passing into yang (daytime/the sun coming up). These transitional rhythms are broken down into four quadrants within a 24-hour period. This clock gets even more specific, and also represents the times at which qi and blood are at their peak within each respective zang/fu organ. Each organ has a two-hour window that represents one organ entering the next, in a clockwise order of progression. Chronobiology identifies the nature of these biorhythm patterns within the German model, zeitgeber, meaning time-givers, and biorhythms are considered external environmental cues. These external cues affect the athlete's ability to adjust to seasons, time zone changes and daylight. According to Eastern philosophy, qi and blood represent the energetic or bioelectric and/or biomagnetic influence upon the body - an underlying influence upon all bodily functions that is difficult to tangibly quantify within the Western scientific community. The fact that it does exist makes it a possibility for improved performance. Thus, these biorhythms; circadian rhythms; energies; and bioelectric and/or biomagnetic fields also have significant influence upon psychomotor; physiological; cognitive; and psycho-emotional functions within sports

performance. By truly understanding Eastern philosophy patterns of qi, blood and body fluids, one can identify specific predisposing/pre-existing factors that may inhibit an athlete's optimal performance. Integrating traditional Chinese medicine (TCM) individually, we can identify and prevent the athlete's anticipated potential to develop dysfunctions that inhibit optimal athletic performance. Therefore, highly specialized education in multiple arenas, including sports medicine; exercise physiology; sports performance; and Oriental medicine need to be fully understood to effectively use this method for optimal training of athletes. The integration of the Oriental medicine perspective can significantly influence sports performance and assist in injury prevention by understanding how it can be incorporated into an athlete's training regimen, cycle and/or environmental pattern, and is an important variable to be considered within a sports performance consultation.
Scientific Basis

The scientific community looks at biorhythms as geophysical phenomena associated with the 24-hour rhythmic rotation of the earth on its axis and the transition from dawn to dusk.2 Scientists explain that the human biological clock is located within the hypothalamus, specifically in the suprachiasmatic nucleus (SCN). This accepted theory explains that light stimuli activate the SCN through the process of phototransduction (the transformation by photo receptors) of light changed into an electrical potential. The brain orchestrates communication among numerous nerve fiber pathways. Once the electrical impulse is communicated from the SCN to these nerve fibers, the influence upon athletic performance varies to include sleep; activity; rest; adjusting the core body temperature; hormone secretion; melatonin levels (melatonin is inhibited by light and causes drowsiness); biological drive; and emotional/psychological behaviors and processes.3,4 The release of neurotransmitters is involved with the mechanism of circadian rhythms. It is speculated that the SCN is densely innervated by serotonergic fibers.3,4 Acupuncture can significantly influence neurotransmitter firing; the synchronization of neurotransmitters is important to athletic performance.
Biorhythms and Their Effects on Sports Performance Definitional rhythms associated with human performance:

Psychomotor rhythms influence performance through synchronization of neurotransmitters and motor neuron synthesis for reaction time and coordination. Physiological rhythms influence performance through synchronization of neurotransmitters; ATP-PC availability; lactic acid tolerance for speed; and the elasticity of muscle fibers for flexibility. They also influence the recruitment and growth of sarcomeres and ability to tolerate lactic acid for strength and power, and the ability of the athlete to create ATP and stress the heart to pump as efficiently and effectively as possible for endurance. Cognitive rhythms influence performance through memory, attention and assimilation. Psycho-emotional rhythms influence performance through experiential interactions, developing mental focus and concentration levels to include competitive pressures.

Many individual variables affect biorhythms, including lifestyle; behaviors; stress; eating habits; overtraining; chronological age; and genetic predisposition. These differences account for the athlete's individual peak performance that needs to be at a consistent level for elite athletic performance. Many athletes who tend to "get tired" during practice or training sessions are experiencing the effect of the mind and body naturally wanting to shut down to rest. This ultimately affects their quality of psychomotor; physiological; cognitive; and/or psycho-emotional rhythms. Therefore, this affects the athlete's potential for optimal performance, both individually and for overall team efforts. Thus, practices and training times need to be varied and/or held at multiple times throughout the day. Many elite athletes train multiple times a day for maximal recovery and training efficiency, which enables them to perform at a high level on a continual basis.
Correlation of Biorhythms and Enhanced Human Performance

An athlete's recovery time is extremely important, and sleep is his/her sanctuary. However, biorhythm synchronization can have the most influence during our waking time.2 There are two classifications associated with optimal performance:
1. yang within yin risers (early risers) just as yang is moving into yin; 2. yang within yang risers (late risers), i.e. "night-owls." (Note that there is a third classification: those who fall in between. These individuals have adaptability. Therefore, I am focusing on the first two classifications.)

These two classifications are important to sports performance because they can identify "peak" training times according to an athlete's energy level; mood; metabolism; concentration; and hunger levels, as they tend to be fairly consistent in experiencing individual highs and lows. These highs and lows influence the athlete's psychomotor; physiological; cognitive; and psycho-emotional functions of athletic performance. Athletic peak time presents when the athlete experiences his/her most efficient performance during training, while the lows present when the athlete experiences inadequate or decreased performance during training. Thus, yang within yin (early) risers experience their peak performance window when their natural cycles of metabolic, physical and mental alertness are all at their highest point in the yang within yin morning. These athletes wake up enthusiastic and full of energy. Conversely, the yang within yang (late) risers tend to experience their peak performance window (with peak metabolic, physical and mental alertness in their highest points) in the late afternoon, or yin within yang, aspect. These athletes tend to stay up late in the evening; are slow to wake in the morning; and take a few hours to get functioning and feel alert.
Biorhythms Imbalanced

All athletes experience "feeling off" when their performance lacks typical consistency. Their biorhythms are imbalanced. The following factors tend to affect athletic performance and individual biorhythms: emotional and mental stressors; extended travel across multiple time zones; extreme environmental changes; injury; and illness. When this happens, we can adjust the athlete's biorhythms by re-synchronizing them. Mental imagery can be used to counterbalance mental, emotional and physical "out-of-sync"

biorhythms. This technique is used as the athlete rests and shuts down for recovery. It is a very effective method used within sports performance. We can also re-synchronize biorhythms by changing and/or developing consistent waking habits (waking at the same time every day).5,6 These are triggered by steady bedtime habits. Another technique is using an alarm clock and bright lights to control wakeup times that correlate with anticipated time zone daylight times, two to three days before traveling.6 Acupuncture and Chinese medicinal herbs are extremely effective for counterbalancing the jet lag many athletes experience when traveling to and from competitions, which is associated with imbalanced biorhythms.
Summary

Influence of biorhythms within the sports performance arena can impact optimal training performance from two perspectives: first, the influence of optimal training performance to prepare athletes for high-level competition; second, to anticipate and prevent potential injuries. This correlates directly into competition. For many track athletes, a difference of between 1/100 - 1/1000 of a second can be the difference between qualifying times and/or gold, silver or bronze medals. By integrating the awareness of biorhythms and the concepts of the Eastern philosophies of qi, blood, body fluids and peak training times on an individual basis, we can maximize training quality and efficiency more consistently. Synchronizing the training schedules of the athletes with their natural rhythms to enhance overall sports performance adds another variable that truly influences optimal result-oriented outcomes in the long term. In turn, this will facilitate athletic precision through the achievement of more frequent ideal performance states and long-term injury prevention.
Wimmer, Ronda. "Using Eastern Philosophy to Optimize Sports Performance, in "Western" Terms." Acupuncture Today. Jan. 2003. 9 Aug. 2007 <http://www.acupuncturetoday.com/mpacms/at/article.php?id=28136&MERCURYSID=3fe609ac d594d6386 References 1. Manfredini R, Manfredini F, Fersini C, et al. Circadian rhythms, athletic performance and jet lag. British Journal of Sports Medicine 1998;32:101-106. 2. Murphy PJ, Cambell SS. Physiology of the circadian system in animals and humans. J Clinical Neuophysiology 1996;13:2-16.