Dealing With An Injury?

Written by: Karen Moreland L.Ac. Generations Acupuncture LLC

During this time of year everyone is getting out and enjoying the outdoors. If you injure yourself somehow while playing sports, climbing, running, or cycling keep several things in mind.

First, to help you learn about the way injuries work, there are four stages of tissue damage. The First stage is called the Acute Stage. It lasts 0-3 days after an injury has occurred and includes inflammation, swelling, and bruising at the injury site. The second stage is called the Sub-acute Stage; it lasts 4-14 days after an injury. During this time there is less inflammation and pain, but more stiffness as the muscles contract to immobilize the injury. Also, adhesions may form in the muscles, called Trigger Points. The third stage of healing is called the Healing Stage. This begins about 14 days after an injury, although more severe injuries may take 6-8 weeks to get to this stage. During this time pain, stiffness, and bruising reduce, and function is better. With some injuries exercise can be resumed slowly now. The fourth stage is the chronic stage and starts at 3-4 months after an injury. Not all injuries reach this stage, but they can if there was improper treatment of the injury, not enough rest, not enough movement, constitutional weakness already present in the body, older age, improper nutrition, and excessive application of cold and compression. This stage includes overstretched ligaments, adhesions in the muscles, scaring, impaired circulation, and nodules or grinding in joints. If this stage is not treated properly it can lead to more severe problems.

Western medical doctors usually recommend a treatment protocol called RICE (Rest, Ice Compression, Elevation) for injuries. This is now beginning to change. Too much ice, compression, and elevation, after the first 3 days of an injury, are often counterproductive to healing. I often see people using too much ice or compression for too long, or going back to activity too soon and re-injuring themselves and making it worse. These people end up spending many months or years getting back on their feet.

In Oriental medicine the goal for the Acute Stage is to reduce swelling and stimulate circulation with acupuncture, cupping, bleeding techniques, herbal plasters, very light movement, and ice applied for no more than 15 minutes at a time. During the Sub-Acute Stage the goal is to improve circulation and move swelling out so the body can bring healing nutrients in. Treatment includes acupuncture, cupping, tui na (Chinese medical massage), gentle movement (but avoid anything vigorous), compresses, soaks, moxibustion (a heat therapy), and herbal formulas. At this time ice is counterproductive to healing, unless you have a prior medical condition, like Gout, that brings lots of chronic heat and swelling to injuries. During the Healing Stage there is still some potential for re-injury so it is important to resume exercise very slowly. If your injury is more severe (including injuries to tendons, bones and/or ligaments) it will be longer before you can start to slowly resume exercise. If you resume exercise too soon you will re-injure the area and have to start over again with healing. In Oriental medicine the goal during the Healing Stage is the same as the Sub-Acute Stage and treatment continues. It may also be the time to start to apply strengthening exercises, and to include tonic herbal formulas to help promote sinew and bone repair.

Cupping, just like what was recently seen in the Olympic Games, is very effective in treating sports injuries. Cupping pulls the lactic acid and other toxins in the deeper tissues (like muscle) to the surface of the body where circulation is better. This allows the body to remove the toxins easier and faster. It also pulls blood and nutrients into the area. This improves and speeds up healing time for people and athletes after workouts or injury.

If your injury has reached the chronic stage and beyond, it is best to stop using ice and compression and come for regular Oriental medical treatments right away. We want to help improve healing and circulation, this will help prevent development more serious conditions like Compartmental Syndrome, which can be very painful and scary.

Depending on the severity of your injury you may need more serious medical intervention like diagnostic imaging and possibly surgery. In that case coming in for regular Oriental medical treatments will still help you to speed up healing and get back on your feet. The results of using Oriental medicine for healing injuries after surgery can be profound.

For at home treatment, until you can get in to see your licensed acupuncturist, I recommend using the RICE treatment for only the first 2-3 days after an injury occurs. This protocol is to keep too much swelling from moving to the injury, but after the acute stage of an injury your body will not be swelling as much anymore. After 48-72 hours you want to improve circulation to the area so the body can bring resources in for healing. To improve circulation you use heat, Epsom salt soaks, gentle massage, warming herbal rubs, and gentle movement. Be careful not to go back out and start exercising again too soon. If you do you can re-injure the area and greatly increase the time needed for healing.

This information is not intended to over-ride the recommendations of your doctor. If you have been injured please go and see your doctor first.

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Written by: Karen Moreland L.Ac. Generations Acupuncture LLC