TO STUDY THE EFFECTIVENESS OF SEDATING LI-2 (LARGE INTESTINE) MERIDIAN POINT WITH MICRO CURRENT STIMULATION, IN INHIBITING HAMSTRING OVER ACTIVITY & IMPROVING HAMSTRING FLEXIBILITY IN ATHLETES : Gagandeep Arora *

Abstract
Background: Changes in apparent leg length”(leg retraction) have been used by many as a means of locating subluxation in various Joints. The leg assessment is based on the assumption that unequal muscular contraction (e.g. hyper irritable muscles) about the spine and pelvis have the ability to retract one leg relative to the other.
Method: Subjects were assessed for hamstring overactivity with the help of isolation test for hamstring muscle in prone leg length testing according to inclusion criteria Also subjects were screened for hamstring tightness with the help of measuring hip R.O.M by goniometer. They were evaluated quantitatively for hamstring overactivity by measuring R.M.Pof hamstring muscle through EMG.
The selected subjects were then given microcurrent stimulation on Li-2 (large intestine) meridian point for 30 seconds three times with 3 seconds rest period in between. After intervention the two things were tested RMP of hamstring muscle and ROM of hip joint.
Results: The results of the study suggest that t-value for Hamstring tightness is 1.130 which corresponds to p-value >0.01. It means results are significant at more than 10%, which is non-significant and t-value for Hamstring overactivity is 13.97 which corresponds to p-value <0.0005. It means results are significant at less than .05%, which is highly significant.
Conclusion: Inhibition of hamstring muscle occur by the stimulation of Li-2 meridian point but there is no improvement in hamstring flexibility.

Introduction
Janda suggested that a normal of activation during prone hip extension is the hamstrings followed by the gluteus maximus followed by the contralateral erector spinae followed by the ipsilateral erector spinae.
The most common sign of a faulty movement pattern is over activation of the hamstrings and erector spinae and delayed or absent contraction of the gluteus maximus3.
Dominance or hypertrophy of the hamstrings usually is associated with hypotrophy or inhibition of the gluteus maximus on the ipsilateral side and hypertrophy of the thoracolumbar paraspinals.The hamstring muscles function synergistically with the gluteus maximus to produce hip extension.When there is gluteus maximus inhibition, the hamstrings substitutewith hip extension during gait propulsion; therefore, gluteal atrophy often is associatedwith hypertrophy of the hamstrings on the ipsilateral side2
Large intestine meridian point :The large intestine meridian is one of the biggest energy channels in the body. Another name for this meridian is the Hand Yang Ming meridian. Its partner is The Foot Yang Ming, better known as the stomach meridian. This implies an inner relationship between the stomach and the large intestines Once the energy in the body moves through the large intestine meridian, it then moves into the stomach meridian. The large intestine meridian runs from the tip of the finger (LI-1) to the corner of the nose (LI-20).
Location of Li-1 meridian point
Chinese Name: Shangyang (English translation: Metal Yang)
Location : On the radial end of the distal phalanx of the index finger, .1cun (finger cun) distance from the corner of the nail.
Location of Li-2 meridian point.
Li-2 meridian point is located On the radial side of the index finger distal to the 2nd metacarpophalangeal joint in a depression at the border of the red and white skin.
The body’s electrical capabilities were studied at least as early as 1830, when the Italian Carlo Matteucci is credited as being one of the first to measure the electrical current in injured tissue. Bioelectricity received less attention after the discovery of penicillin, when the focus of medical research and treatments turned toward the body’s chemical processes7.
The timer-relay system allows the practitioner to read out the meridian condition, deliver a burst of current to tonify or sedate, and then immediately read out the change produced in that meridian on the Meter. Thus the entire principal meridian system can potentially be assessed and brought into balance in a few minutes. Tonificationand sedation is chosen through the current Polarity control, and selection of proper frequency.
Electroaccupuncture and manual accupressure seems to stimulate different areas of brain. In studying the both on Li-4, Kong etal (2002) found that electroaccupuncture mainly produce fMRI signals increase in precentralgyrus, the post central gyrus/ inferior parietal lobule and putamen; in contrast manual needle manipulation produced decrease in fMRI signals. In the posterior cingulated gyrus, the superior temporal gyrus and the putamen8.
A Microcurrent Electrical Neuromuscular Stimulator or MENS (also microamperage electrical neuromuscular stimulator) is a device used to send weak electrical signals into the body. Such devices apply extremely small (less than 1 milliampere) electrical currents to nerves using electrodes placed on the skin. One microampere (uA) is 1 millionth of an ampere and the uses of MENS are distinct from those of “TENS” which runs at one milliamp(mA) or one thousandth of an ampere9.

Aim Of Study:
To study the effectiveness of sedating Li-2 (Large Intestine) meridian point with microcurrent stimulation , in inhibiting hamstring overactivity and improving hamstring flexibility in athletes.

Methodology
All Sportspersons of different sport academies from Dehradun who had history of hamstring related problems. For taking Sample size a list was made by total of 218 individuals, were found to match the inclusion and exclusion criteria, 30 athletes were randomly selected by Lottery method for intervention through random sampling of Quasi-Experimental design.
U’r Physiotherapy, fitness and sports medicine clinic, B-10 , janpath, Dehradun was the place of study. Inclusion Criteria included individuals of age between 18years to 35 years, Either gender male or female, athletes with a history of hamstring or back of thigh problem, athletes with suspected hamstring overactivity primary or secondary to gluteus weakness, posterior kinetic chain dysfunction ,S.I. joint strain and athletes with Hamstring Tightness i.e Hip R.O.M. < 800.
Exclusion criteria excluded athletes with acute hamstring muscle strain ,hamstring overactivity other than musculoskeletal dysfunction like spasticity, failure to show Hamstring isolation test i.e. on isometric contraction, hamstring showing negative leg length, athletes with normal Hamstring Flexibility i.e Hip ROM >800.
Microcurrent stimulation of Li-2 meridian point was Independent variable and Hamstring overactivity and Hamstring Flexibility were Dependent variable. Tools used for research were Microcurrent Equipment, Electromyography Equipment, Goniometer and Stopwatch.

Results:
For both the groups , Group A (pre-experimental) and Group B (post-experimental), the mean & SD values are calculated for both components i.e Hamstring overactivity and tightness.
The results of the study suggest that t-value for Hamstring tightness is 1.130 which corresponds to pvalue >0.01. It means results are significant at more than 10%, which is non-significant.
The t-value for Hamstring overactivity is 13.97 which corresponds to p-value <0.0005. It means results are significant at less than .05%, which is highly significant.

Table 1:comparison of mean values of group A and group B for hamstring flexibility.

Hamstring resting Membrane potential (microvolts)

Table 2:comparison of mean values of group A and group B for hamstring Resting Membrane Potential.

Graphical Representation of Hamstring Activity i .e. Resting Membrane Potential (µV)

Discussion:
The stimulation of the Li-2 meridian point leads to decrease in hamstring muscle activity. Previously it was considered that muscle tone is regulated by propioceptors or mechanoreceptors present in the muscle , ligament and tendons and Fascia was considered mainly a mechanical structure. But recent research by Michell and schmid 1977, cottingham 1985, on Fascial Plasticity, described that fascia is richly innervated by sensory receptors ( Type 3 and Type 4 ) which originate from free nerve endings called interstitial myofascial tissue receptors.
Most of these receptors are unmyelinated and thinly mylienated , hence are slower than Type 1 and Type 2 which are known to originate in muscle spindles. These fascial receptors have two type of fibre, Low threshold pressure unit and High threshold pressure Unit .
Accupuncture meridian points are the areas of the skin with low threshold units, stimulation of these points by microcurrents cause the activation of these low threshold pressure unit of the interstitial myofascial tissue receptors which inturn cause the development of action potential in them. This action potential travels through a different pathway to Central Nervous system. In response to these afferent stimuli the C.N.S responds by powerfully changing the gamma motor neuron activity and weak effect in alpha motor neurons which causes the reduction of excess muscle tone and activity.
While discussing any changes in motor organization, it is important to realize that the central nervous system does not operate ‘in muscles’ but as a motor unit . so the regulation of the gamma motor system by C.N.S. will influence thae activity of related motor unit not only the isolated muscle.
When a muscle is sedated and relaxed, electrical energy along its meridian is decreased , on the other hand if we tone a muscle and cause it to contract, energy along the muscle meridian is increased22. Similarly when a muscle is overactive or overdominated , electrical energy along its meridian is overfacilitated because not the individual muscle is involved but whole motor unit is involved, so if we try to inhibit a muscle ( which in turn will be inhibited by whole motor unit ) and it will be relaxed after meridian balancing.
The effect of sedation of a muscle can be due to some inhibitory reflex , but long lasting effect can be achieved by balancing these meridians. Hamstring muscle spasm overactivity leads to blockage of energy flow along the meridian will cause it overcongested, and the adjacent meridian to whom it supply it will be deplected or drained. So by electroaccupuncture the overstimulated merdian need to be sedated and adjacent meridian need to be supplied energy by tonification.
The diminution of RMP amplitude value measured during sedation of hamstring muscle support the notion of change in the quality of resistance. Caruso Leisman described the muscle activity tests as one that evaluates a transitory state named quality of resistance.
While the mechanism of efficacy are not well established , a few studies have shown that there may be correlation between the traditional Chinese medical system of acupuncture and microcurrents. A study published in 1975 by Reichmanis , marino and becker concluded in part that At most accupunture points on most subjects there was greater electrical conductance maxims than at control sites . The theory elaborated by Pierre Mathieu a Victoria biomechanics specialist and TCM practitioner was that the MENS is running one order of amplitude closer to the bodys actual currents of only a few picoamp which are one millionth of a microamp itself . The stimulation therefore is more in coherence with the body own circuitry.
Unlike TENS , Microcurrents electrical stimulation is usually administered through hand held probes positioned so that current flows between them through the painful area for10secs . The vast majority of pain problems can be treated with <10 applications of 10secs probe treatment . many patients are free of pain in < 2mins and there is generally a significant residual effect often las
Ting from at les 8 hours to as long as 3 weeks or more, so this is very less duration of time needed for the treatment outcomes can reduce the duration of rehabilitation in chronic cases.

Conclusion :
Inhibition of hamstring muscle occur by the stimulation of Li-2 meridian point but there is no improvement in hamstring flexibity.

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