When your lower back or glutes flare up painfully after going too hard trail running over the weekend, your default instinct might be to add some extra stretching to your routine or schedule some time with your massage therapist or chiropractor.Ěý If the pain is excruciating, you might even consult with a sports medicine doctor.

But there’s another accessible and effective treatment option for aches and pains. One that has only limited side effects and that’s been practiced for thousands of years.

It’s acupuncture. And although the mechanisms through which acupuncture works in the body aren’t fully understood, and there may be a placebo effect in play, research repeatedly indicates that acupuncture is effective at treating various forms of pain, including those related to , the back, and .

Here’s what you need to know about acupuncture’s potential role in treating sports injuries.Ěý

Acupuncture and Sports Medicine

is a practice in Traditional Chinese Medicine (TCM) that involves inserting small, thin needles through the skin and often into the superficial layers of the muscle to relieve pain and address health conditions like menstrual cramps, , and arthritis. The points where needles are inserted are pathways, each corresponding to a particular organ or system, along which energy, or qi, is believed to travel. According to TCM, the needle helps unblock meridians.Ěý

From a Western medicine perspective, it’s believed that the needles stimulate the body’s muscles, connective tissue, and central nervous system, which can help with recovery from illnesses and pain. “Basically, what we’re doing with acupuncture is we’re using your body’s inherent means of healing itself,” says , DO, who is a primary care and sports medicine physician and licensed acupuncturist at Houston Methodist.Ěý

Sports medicine acupuncturists specifically treat sports injuries using the same foundations of TCM, but also incorporate functional anatomy, muscle testing, and range of motion testing. “Using this approach, I can precisely identify complex injuries and their sources, especially when checking for posture issues during various movements,” explains sports medicine acupuncturist .Ěý

a doctor of Chinese Medicine and licensed acupuncturist who works with the Minnesota Vikings, believes combining TCM and sports medicine really helps nudge the body along on the path to healing. “The body wants to be in harmony, it wants to be balanced, it wants to be functional,” she says. “But sometimes it has to be told what to do because it’s gotten out of alignment.”

Acupuncture is used to treat all sorts of sports injuries, including joint problems, muscle sprains and strains, tight muscles and trigger points, lower back pain, cervical and lumbar herniations, and many other conditions. “It’s just so incredibly helpful because we can treat the whole body effectively in that one treatment,” Patzer says. “Those needles are like little magic wands.”

This broad approach means that when treating something like a quadriceps strain, an acupuncturist will also assess and potentially address other muscles around that injury that may be compromised or compensating. “If you don’t treat anything around [the injury], they’re going to continue to have that quad injury and it’s not going to heal nearly as fast as if you treat upstream and downstream as well,” Patzer explains.

How Acupuncture Helps Sports Injuries

Here are a few ways that acupuncture can be useful when treating sports injuries, according to the experts: 

1. Reduces Pain

Acupuncture is frequently used to of pain and is increasingly recognized as a non-drug alternative to painkillers. One reason for acupuncture’s pain relieving effect is that it’s known to , which can help decrease pain and lift your mood. “By boosting the production of endorphins, acupuncture directly counters pain, a primary concern with sports-related injuries,” Menard says.Ěý

2. Decreases Inflammation

Acupuncturists commonly use the practice to reduce inflammation following injuries. Menard explains that acupuncture improves to targeted muscles, fascia, tendons, and ligaments, which helps reduce swelling and repair injured tissues.

A recent published in the journal Nature found that acupuncture can trigger an anti-inflammatory response and suppress inflammation through the involvement of a nerve pathway between the vagus nerve and the adrenals called the vagal-adrenal axis. Other show similar findings, with acupuncture reducing or controlling inflammation by stimulating various pathways that connect the nervous and immune systems, both of which are known to play a role in the body’s inflammatory response. It’s important to note that these studies were conducted on mice, which isn’t always an exact predictor of human response.

Another found that acupuncture may reduce inflammation by stimulating the vagus nerve, which is part of the parasympathetic nervous system and plays a large role in the body’s stress response.

3. Corrects Muscle Imbalances

Acupuncture can enhance proprioception—meaning the body’s sense of its position and movement—by addressing trigger points and knots in the muscle tissue, Menard says. For athletes, proprioception is really important because it plays a role in balance, coordinating movements, and adjusting muscle activity. When proprioception is low, sports injuries may be to occur

“These knots, if untreated, can hinder muscles and their counterparts from functioning correctly, leading to imbalances and further complications,” Menard explains. “Acupuncture’s ability to identify and treat these points can provide immediate relief, helping athletes regain their proper form and function.”

Patzer compares muscle functioning to a slinky—when a muscle is functioning properly it opens and closes like a spring, and that’s a good thing. But if it’s pulled too long or locked up too tight, it may not perform at its best. Left untreated, this can sometimes lead to problems with nearby muscles, tendons, and joints. “With acupuncture, I’m able to help the muscle get that kind of proper movement and function back,” Patzer says.Ěý

Do All Acupuncturists Treat Sports Injuries?

Many acupuncturists may be able to help someone with a sports injury, but if you’re an athlete and experiencing pain, Patzer says it’s best to see someone who specializes or is certified in sports medicine acupuncture. If you have an X-ray or MRI results, bring a copy to your appointment to help inform treatment. “It’s essential to accurately diagnose each condition to tailor the most effective acupuncture treatment to the patient’s specific needs,” Menard says.

Keep in mind that acupuncture likely isn’t going to be a one-stop cure for any sports injury that arises, and it’s often most effective when used in conjunction with other types of treatment. Acupuncturists will even refer patients to other care facilities or professionals, like hospitals, chiropractors, physical therapists, and massage therapists. “We work in tandem, ensuring every patient gets the holistic care they need,”Menard says.

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At age 18, Kate Badgett was your typical young runner. She clocked about 20 miles a week, usually on the road, and took spin classes and did basic core work to cross-train. However, like other dedicated athletes, she soon experienced a femoral stress fracture, a hairline fracture of the thigh bone.

This type of injury is typically the result of overuse, but Badgett’s weekly mileage didn’t seem high enough for the two to be correlated. She started experiencing other pain, including partial dislocations of her shoulder. Badgett’s case suddenly felt anything but typical. Her physical therapist began to wonder if joint hypermobility, a greater-than-average range of motion in your joints, was at the root of the problem. Turns out, he was right.

Badgett has hypermobile joints due to , a connective tissue disorder that causes the ligaments to become looser and stretchier. She experienced two more femoral stress fractures over the next six years. (She later discovered that they were caused by extensive hypermobility and instability through her feet and ankles that placed too much pressure and strain on her bones.)

Research shows that some people with joint hypermobility may be more at risk of things like injuries, , and knee and shoulder dislocations. Badgett’s still able to run these days, but she had to change the way she trains. She goes to physical therapy regularly, cross-trains, runs on trails more than she used to, and does a specific yoga practice that’s designed to help the body rewire more effective movement patterns.

What Is Hypermobility?

Normally, your ligaments help keep your joints stable. But if you have joint hypermobility, your ligaments and other connective tissue can be loose, so your body has to work harder to keep the joints stable. As a result, the joints of hypermobile people may frequently subluxate or dislocate, says , MD, an integrated medicine physician at .

“Hypermobility is really common, and it’s a different body type that requires a lot of maintenance—and if treated well, will perform well,” explains , MD, a sports medicine physician and medical director of the and the Tulane Fascia Institute and Treatment Center.

Doctors measure joint hypermobility using a screening test called the , which looks at the range of motion of various joints, including your spine, thumbs, elbows, and knees. The higher the score, the more likely someone has joint hypermobility. But physicians also look at other factors, like how flexible or hypermobile someone may have been in the past. Some people with hypermobility can become more stiff as they age, due to arthritis and other physical changes.

Joint hypermobility occurs on a spectrum and can manifest in different ways. Some people may only have one hypermobile joint in their body, whereas others, like Badgett, may experience hypermobility as one symptom of a broader genetic connective tissue disorder. And hypermobility doesn’t always equal flexibility. If you’re hypermobile, your body may compensate for joints that move past the normal range of motion by tightening muscles around the joint to hold it in place. In these cases, you may feel stiff and inflexible.

How Might Hypermobility Affect Someone Who Lives an Active Lifestyle?

Having hypermobile joints definitely doesn’t mean you need to ditch your active lifestyle. In fact, it may work to your advantage in your athletic pursuits. For a swimmer, spine and shoulder hypermobility can offer increased range of motion, torque, and efficiency. And a hypermobile pitcher may have greater range of motion in their shoulders or elbows that allows them to throw a faster and more forceful pitch.

“In general, hypermobility probably offers a mechanical advantage when it comes to cycling, running, and hiking, and it certainly offers a mechanical advantage with anyone who throws anything, like pitchers, javelin, and quarterbacks,” Courseault says.

But hypermobility can also be problematic in some cases. “For people who have problems with their kneecap tracking, hiking can actually be really tough and so can bicycling,” says , MD, a board-certified physician and founder of P.R.I.S.M. Spine and Joint, a clinic that treats patients with hypermobility and connective tissue disorders. “When you have kneecap tracking problems, that midrange of knee mobility is actually where you have the most pressure on your kneecap.”

For someone with a hypermobile spine or shoulders, she says, cycling may put a lot of pressure on the thoracic spine or overstretch the muscles in your back, causing pain.

Does Hypermobility Lead to More Injuries?

Not necessarily. show that hypermobility doesn’t always lead to more injuries. In fact, many high-performing and even professional athletes are hypermobile, Courseault says. But the care and maintenance required to keep a hypermobile body well-functioning and injury-free through things like strength and balance work is a bit higher than for someone without hypermobility.

For example, a strong, hypermobile climber who has well-supported joints may actually benefit from increased range of motion in her joints that allows her to move her body in ways that makes it easier to reach and grab holds. “You can make the argument that hypermobile bodies are less prone to injury because they can stretch in ways that a non-hyper mobile body can’t,” Courseault says.

But if an athlete’s joints become too loose, they could get injured in settings where others wouldn’t. People who are hypermobile are more likely to dislocate a joint, as well as get tendinopathies, tendonitis, and tendinosis, Bluestein says. It also may take them longer to recover from these injuries.

How to Deal With Hypermobility

If you’re hypermobile, the most critical thing you can do is listen to the signals your body sends your way—and respect that your anatomy may change over time. Some people with hypermobility can engage in all the activities they love without any issues. But if you’re experiencing a lot of injuries, Bluestein recommends taking a close look at what activities you can participate in without problem (green light activities), which cause your symptoms to flare up a bit (yellow light activities), and which cause lots of pain and injuries (red light activities).

“Over the course of your lifetime, those things are of course going to change, but you want to get to where you’re as active as you can be, but in a zone that is appropriate for your body at that point in time,” she says.

Here are some ways to manage hypermobility—but keep in mind that managing hypermobility is highly individual.

11 Ways to Manage Hypermobility

1. Wear supportive shoes that offer .
2. Work with a physical therapist who is knowledgeable about hypermobility.
3. Strengthen your body with isometric exercises and Pilates.
4. Work on stabilizing exercises that maintain space in the joints.
5. Move your body and exercise regularly, but stick to activities that don’t cause pain.
6. Avoid repetitive physical activities if they cause pain or irritation.
7. Keep proper form and biomechanics when engaging in physical activities.
8. Try to maintain correct posture and alignment in your body, even when you’re not being physically active.
9. Stay hydrated, including with electrolyte drinks.
10. See a doctor who specializes in or is knowledgeable about hypermobility.
11. Speak with your doctor about the benefits of prolotherapy and other forms of regenerative injections.

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