Sprain, Strain, and Other Physical Trauma Treatment

Anyone can suffer from an unexpected joint sprain (i.e., injury of the ligament) or muscle/tendon strain while playing sports or lifting heavy objects. While most cases are 1st- or 2nd-degree damage that doesn’t involve a completely torn tissue (3rd-degree), they can still take a long time to heal if they are just left alone without proactive treatments.

When the micro blood vessels surrounding the joints or supplying the muscle fibres rupture due to trauma (referring to a physical injury as opposed to an emotionally distressing experience in this case), the area becomes swollen and painful and develops a bruise which limits the motion of the affected joint or the activity of the affected muscle. The area may also become swollen not only due to ruptured blood vessels but also because white blood cells get called to the site of injury when our body recognizes damaged and dying cells or other chemical messengers released from disrupted cells. This results in inflammation at the site of injury which can trap the blood locally. This phenomenon is what we call Blood Stasis in TCM. Such Blood Stasis not only creates pain and limits the range of motion at the time of the injury, but it can also cause a recurrence of pain or susceptibility to injury at the same site because unresolved Blood Stasis can inhibit the active blood circulation to the injured site. This is a natural cause and effect - as a result of remnant Blood Stasis, injured tissue does not get a proper removal of the wasted and useless blood and supply of fresh and rejuvenating blood, and so they become weak and stiff. Blood circulation is necessary for repairing tissues and therefore the recovery of their function.

So how do we treat this Blood Stasis and effectively treat and recover from trauma? The first thing we should do after an injury is stabilizing and icing the affected region as we make our way to the clinic at the earliest convenience. The TCM treatment will then involve promoting blood circulation and resolving Blood Stasis from the hemorrhage in the local tissues using modalities like wet cupping, acupuncture, and herbal medicine. The wet cupping part is especially important in the extraction of the local Blood Stasis which will then allay the swelling and the pain. Acupuncture will aid in circulating Qi and Blood locally and systemically, and the local effect is more important in that it reduces the inflammation at the site by attracting white blood cells (leukocytes). Herbal medicine will circulate them systemically. Although we said that icing should be done immediately after the injury, we need to use hot packs to keep the injured area warm after receiving treatment. This is to enhance blood circulation which is essential for the healing of the tissue.

Western medicine does not use methods to remove the stagnant blood unless it is a severe condition which affects the function of internal organs and the vitals of the patient, such as hemorrhage of the brain, hemothorax, etc. The conventional routine is inquiry, visualizing the affected region using X-ray or ultrasound only if the pain is severe and the muscle or joint is completely dysfunctional, and prescribing anti-inflammatory & analgesics (painkillers) such as NSAIDs to alleviate the inflammation and pain resulting from the tissue damage & bleeding, in addition to recommending rest, icing, compression, and elevation of the affected region if the patient came immediately after the trauma. If there is a bone fracture upon X-ray, the area will be stabilized using a cast. However, these methods are insufficient to effectively heal the tissues. When joint sprain, muscle strain, or bone fracture in youth heals incompletely, it tends to develop into a chronic condition as we age, and we get recurrent sprain or pain in the same area. When we keep using analgesics to appease this chronic pain as opposed to completely getting rid of the Blood Stasis, the affected region can develop blue-blackish discolouration and severe pain in the worst-case scenario. By then, we would have to consume a large dosage of analgesics or receive a regular steroid injection which brings their own side effects.  

Even in Canada where TCM is viewed as complementary/alternative medicine, the greatest proportion of cases we see is ankle/wrist/lower back sprain and strain. If these patients visited us as their first contact of care, they have already received TCM treatment in the past, they have been recommended by their acquaintance who has experience with TCM trauma treatment, or they are Korean/Chinese people who are familiar with TCM. The other patient group consists of those who do not know about the effects or even the existence of acupuncture, cupping, moxibustion or other types of alternative medical treatment, or those who went to their family doctor to be prescribed anti-inflammatory & analgesic medications due to lower financial burden even when they knew about the option of alternative medicine. This second group of people finds us after suffering from long-term pain which does not get better even with the medication or after suffering from recurrent exacerbations of the pain.

There are also foods that we can take to help the treatment of trauma. In the initial stage of treatment when the swelling and pain are severe, foods such as chives, canola leaves & stems (Yu Choy), peach, lotus root, and hawthorn berries are good. If there is a bone fracture, goji berry tea and Eucommia bark tea can be consumed to help bond the bones once swelling and pain become manageable. In patients with low bone density which increases the risk of recurrent bone fractures and slow healing, foods like black bean, longan fruit, soup stock from fish bones, and soup stock from meat bones should be consumed as they supplement the calcium levels.

Although we talked about circulating blood with respect to trauma, Qi and Blood circulation are also of the foremost importance in the prevention of geriatric diseases such as stroke, dementia, and cardiovascular conditions as well as for a long and healthy life. In the next post, we will discuss life cultivation methods to facilitate Qi and Blood circulation.