We were thrilled to have Dr Isagani Leal visit from Manilla, Philippines. Dr Leal completed his residency training in Tel Aviv, Israel and specializes in non-surgical orthopaedics utilizing musculoskeletal ultrasound. Of great interest, Dr Leal is the first Dr that I am aware of who utilizes ultrasound guided acupuncture known as “Intramuscular stimulation.” Developed by Dr Chan Gun, this practice emphasizes that tendon injuries are a result of shortened & contracted muscles. For example if someone has achilles tendon pain, the shortened muscles of the calf & tibialis posterior must be relaxed. Dr Leal palpates the shortened muscle and marks a spot that reproduces pain in the patient. Afterwards Dr Leal uses ultrasound to look into the muscle & inserts an acupuncture like needle into the muscle belly & illicits a “twitch.” The patient perceives a brief pulse known as “Qi (chi)” The needle is left in for 3 minutes then removed & heat is provided with ultrasound. According to Dr Leal patients need 2 treatments one wk apart & may have tremendous relief.
I must admit the idea is interesting having an acupuncture background myself. However this theory may influence us to consider injecting not only the tendon that is damaged but simultaneously relaxing the affected muscle. This phenomenon may also explain why some tendon injuries don’t respond appropriately when treated.
We may have learned more from Dr Leal than he from us! Many thanks to our kind patients who allowed Dr Leal to observe various procedures for the week! We hope to collaborate with Dr Leal in PRP research together.