Chinese Sports Medicine VS. Western Sports Medicine

Chinese Sports Medicine VS. Western Sports Medicine

In injury comparison between the Eastern world and Western world and examination of the healing process, an ankle sprain seems to be the perfect model. Ankle sprains are not unique to sport-related incidents, as they can happen during most any everyday activity. Just stepping off a curb on your way to work can result in an ankle sprain. And, the principles used in treating ankle sprains are also often applicable to tendon, joint, and muscle injures too.

Those that have personally experienced a sprained ankle can attest that the pain is nothing to be taken lightly. They may also be very slow to heal and interfere or prevent exercise, athletic activities, and/or daily activities for sometime after the injury occurred.

Western Medicine

Inflammation usually shortly follows a sprain. Blood will flow into the area of injury and cause it to fill with blood and other bodily fluids. The injured area will also feel hot or warm to the touch and be red and painful.

The warmth and redness around the injured area is caused by the small blood vessels, such as arterioles, dilating and increased vascular permeability causing an increase in how much blood is brought to the injured area. When a tendon or ligament is stretched or torn, the blood from the ruptured blood vessels and other fluids clog or back up around the injured tissue and become trapped, thereby causing the area to swell. There are white blood cells in the blood that serve to fight off possible infections and clean up the injured tissue that’s dead. There’s also nutrient building blocks that serve to jump start the healing process by rebuilding broken blood vessels.

The above inflammatory response is a natural process that the body uses to splint the injured area and protect itself against additional trauma. While this inflammatory response is an important step in the body trying to heal itself, it can also be problematic since the splint (blockage) of blood and other fluids typically prevents normal movement and circulation. It can also cause friction among tissues that don’t normally have contact with each other, leading to added inflammation and tissue irritation. So, to prevent further inflammation and irritation and quickly begin rehabilitating a strain, sprain, or fracture, it’s vital to get the swelling under control as soon as possible.

Another complication that’s common in sprain injuries is bones being slightly displaced. Take an ankle sprain as an example. When the ligaments and tendons stretch, it can move the talus bone from its natural alignment. If it doesn’t return to a normal position when tension is released, it may remain slightly out of alignment. This misalignment is often so slight that it isn’t detected on MRI’s or X-rays, yet is substantial enough to cause ankle pain and weakness long after the inflammation has subsided.

Most people that have had to cast a broken leg or arm will find that their extremity looks very frail and emaciated when the cast is removed after about six weeks. However, this isn’t necessarily from six weeks of immobility, as muscle atrophy can begin after just a couple of days of immobility or restricted movement. The less atrophy that an injury causes now… the less weakness the person will experience later, and the less likely they are to suffer a future re-injury. All too often it’s the secondary weakness that is preventing an athlete from resuming their sport or a person from resuming their normal activities of daily living. It’s easy for these injuries to become a brutal rotation of pain, chronic inflammation, atrophy, weakness, and re-injury, especially if treatment is delayed or neglected.

When the muscles, tendons and ligaments are set in motion by body movement, it can reduce weakness and joint stiffness. Motion also helps to increase blood circulating to the injured tissue. As blood circulates through the damaged tissues, it sweeps away the dead tissue cells, thereby reducing swelling and spurring the area to heal. Movement, specifically stretching and strength exercises, also help to correct muscle imbalances that might have caused the injury or leave the already injured area more susceptible to future re-injury.

In the Western world, the most commonly accepted treatment for reducing inflammation is rest, ice, compression, and elevation steps, also known by the acronym RICE. RICE should begin in the initial twenty-four hours following the injury and is comprised of the following steps:

1. Rest

As inferred, the person shouldn’t continue activity, as this may further irritate, inflame, or otherwise harm the already injured area.

2. Ice

Unlike Chinese medicine, where ice is rarely used because the cold is believed to cause muscle contraction and the congealing or freezing of fluids and be the culprit of improperly healing joint injuries, Western medicine commonly recommends ice for any number of inflammatory responses, including that of an acute or chronic injury.

This step involves icing down or applying an ice pack to the injured area. Ice will contract the blood vessels in the injured area and cool it off, thereby reducing swelling, pain, and the heat from inflammation.

3. Compression

Unlike Chinese medicine, where constriction is thought to contribute to blood stagnating and congealing around the injury and the slowing of the fluids from being reabsorbed into the blood stream, Western medicine commonly recommends compressing an injured area to limit the swelling in the area.

Compression usually involves wrapping the injured area with an elastic bandage that will compress the tissue and limit blood flowing into the area.

4. Elevation

Finally, a step employed in Western medicine and Chinese medicine. The injured area is basically raised above heart level. This allows gravity assisted drainage of excess fluids.

Treatment is focused on mild movement and exercise to achieve circulation restoration to the affected area once swelling and inflammation has been reduced. After swelling has become stable, contrast baths may be recommended following the initial 24 to 48 hours of RICE. Contrast baths are alternating hot and cold baths. While one bath causes the blood vessels in the injured area to dilate, the other bath causes the blood vessels to contract. This helps to steadily pump fluids and blood to the injured area and regain normal circulation.

The Western approach to treat and diagnose sprains is useful and actually has elements that are congruent with the Chinese medicine approach. However, the Western approach often ends with RICE and doesn’t provide very many paths to actually rehabilitate the injury. Unfortunately for those injured, this often leaves them with multiple unanswered questions, mainly:

* why is it that some sprains heal and some don’t?
* how can the same injury result in brutal cycle of re-injury and chronic pain in some , but quick and complete healing in others?
* why do certain injuries, such as sprains and fractures, cause more pain in cold or damp weather conditions?
* why does arthritis develop in some injuries, but not others?

Eastern Medicine

Fortunately, those that are seeking more information can often find very comprehensible and concise information about the above questions and various injuries and treatments through Chinese medicine philosophy. The approach used by Western and Chinese medicine to examine a sports injury, such as with a sprain or strain, may appear very much alike on the surface, but when carefully looked at, they are actually very different.

The flow of vital energy (qi) and blood in a local area is affected by some force or impact acting upon the body. The force may be in the form of a twisting or wrenching force, such as that of a sprain; a comprehensive force, such as what the body receives during a fall; or a whiplash force, such as the tissues within the body stretching and then suddenly snapping back into place. In any event, a great enough force or impact can affect the area where the it’s applied, as well as distant areas.

After the force or impact, blood, qi, and other fluids stagnate in the affected area, thereby blocking circulation. This results in swelling and pain. While this process may sound simple enough, the consequences can be profound. You really must understand the relationship of blood and qi to fully comprehend the these consequences.

Qi is the internal vital force (energy) that makes all movement in the body possible. Blood that circulates in the blood vessels, fluids that move through tissues, digestive movement, respiratory movements, hormone production and release, activity on the cellular level, and so forth all depend on this vital force. Much like the blood system, qi flows through complex networks in the skin, flesh, tendons, and muscles. It brings blood and fluids to all the tissues of the body. It also moisturizes and nourishes the tissues, providing skin with a shining and vitalized appearance and muscles and tendons with the ability to contract and move smoothly and coordinately. Qi also has a role in how the body adapts to changes in temperature, as it controls pores closing and opening and warms the exterior of the body. The blood and qi relationship can most simply be described as blood being the mother of qi and qi being the commander of blood, meaning that blood can’t move without qi driving it and qi is relying on the organs producing it to be adequately nourished by the blood.

Stagnated qi, as well as the blood and fluids moved by qi, are what cause swelling and pain after a force or impact is applied to the body. In Chinese sports medicine, pain is attributed to qi not freely flowing (stagnation). Imagine the qi acting like a dam, blocking fluids and blood back from the rest of the body. As the fluid accumulates behind the dam, it causes a lump or swelling to form and pain. The accumulation of qi also causes the injured area to become warm or hot due to its warming action.

Ever wonder why you have an unconscious urge to rub an injured area? This is a natural reaction to try to restart circulation by pushing the accumulation of qi, blood, and other fluids through the area, thereby breaking the metaphorical dam; restoring the free flow of blood, fluids, and energy throughout the body; and decreasing the swelling and pain.

In more severe injuries like torn ligaments or muscles and broken bones, there’s usually structural damage and/or ruptured blood vessels. Of course, circulation disruption and the amount of stagnated blood and qi is even greater in these cases, thereby causing a greater degree of swelling, heat, and pain. Bruising will also be visually apparent fairly quickly in injures that involve ruptured blood vessels.

There’s a tendency for stagnant blood to get lodged between tissue layers. In doing so, it will congeal there and glue the tissues around it together. This is called an adhesion, and it results in the previously smoothly sliding tissues now sticking or catching on each other. Adhesions can cause pain as it interferes with normal functioning and movement.

The affected area will not have as much vital energy if the stagnant fluid, blood, and qi aren’t cleared so that normal circulation can return. The area will become sort of like a dead zone that just never quite feels right. It will take much more energy for the body to push circulation around and through the area, even after the inflammation and swelling has subsided. Due in part to this inadequate circulation, the area can eventually grow very sensitive to damp and cold weather, have occasional periods of swelling, and feel numb. Other factors that decrease the body’s energy, such as being stressed, tired, or sick, can cause existing pain to increase and subsided pain to return.

At this point, the injury is called bi syndrome, meaning that the injured area has a chronic energy obstruction. While bi syndrome may affect the muscles, it most often occurs in the joints. This is because the thick fibrous tissues making up the joint capsule can so easily limit the circulation to the capsule interior. Since the interior layer is mostly cartilage and doesn’t have a direct supply of blood, it takes a greater time to heal. Now, you don’t have to wonder why injuries such as torn meniscus (knee cartilage) often take so long to heal?

The chronic energy obstruction that’s described above can be the result of repetitive cold and dampness exposure or exposing an already weakened area to dampness and cold. In either case, the exposure works against the body’s effort to protect and warm itself.

Many that fail to understand the complete relationship between blood and qi and the actions of each during injury will often dismiss the above explanation as unscientific, this despite it thoroughly answering the question, “Why do certain injuries, such as sprains and fractures, cause more pain in cold or damp weather conditions?” Yet, countless people using over-the-counter or prescription strength painkiller still have recurring or worsening pain upon the weather changing.

Injured tissue must regenerate to properly heal. This occurs from the damaged tissue being replaced with normal, functioning, and healthy tissue. It’s impossible for this to occur if there isn’t restored normal circulation and an energy and nutrient supply reaching the injured area. If there is chronic inflammation and repeated re-injury, then the injured area may be replaced with scar or thick fibrous tissue instead of normal tissue. Prolonged inflammation can result in the muscles, joints, and tendons being unnaturally deposited with calcium, which only creates more inflammation. So, it’s easy to see how affected areas can get into this perpetuated cycle of injury, stagnation, inflammation, pain, re-injury, an so on.

Minor sprains, bruises, and such are often easily dismissed as something that will heal without intervention. But, by just looking at how an acute injury progresses to a chronic injury, it’s easy to deduct the vital importance of treating even the most minor injury as soon as possible. That is, if you want to avoid a chronic obstruction, break the cycle of injury, and return to focusing on your daily activities or sport.

Another question that isn’t answered by Western medicine is why nothing more than a little rest can cause some injures to subside, but others develop into chronic conditions? Like our other question, the answer to this one, vital energy, is also often dismissed as unscientific by Western medicine.

While the specific term “vital energy” is dismissed, many in Western cultures will often refer to someone with the “will to live” or being more resilient or resistant from disease. The idea is somewhat alike. It’s common knowledge that the same treatment, for the same illness, and with the exact same circumstances will often not have the exact same result. This is due to varying amounts of vital energy from one person to another, and the same can be said of healing. Those with different amounts of vital energy don’t heal at the same rate.

Of course, severe injuries that have substantial structural damage are going to be complicated and be difficult for normal function to be restored. That said, slow healing or injuries that simply will not heal are often that way because the vital energy or qi is compromised. This compromise can occur from many things, but is most often due to stress. Aside from trying to minimize stress, it’s important to get rest, eat a balanced diet, and get fresh air so that the body can direct its full arsenal of resources toward the repair process.

The modernity of life today means that we work and play more, while resting less. This is even true in injury, as far too often there is a monetary need, employer pressure, and so on to return to work immediately after injury, surgery, or illness. There’s also the frequent desire to immediately resume a previously stressful personal lifestyle after an injury, even if the body isn’t yet equipped to handle that stress. Then, there’s the issue of poor nutrition, often from eating processed and otherwise non-nutritious foods. We also often fail to take the time to get outdoors for fresh air. All of these elements combine to exhaust the body and starve it of the nutrients and resources it needs to repair the injured area.

Sadly, age is also a healing factor. There is a surplus of vital energy in youth; just think of the bursting energy and constant running and jumping exhibited by young children. While more fragile than their adult counterparts in some ways, children generally bounce back and heal from an injury quicker. They are also less susceptible to injury since their muscles and bones are still pliable. Even the above stressors will often be overcome by the extra vital energy of youth, thereby helping them to recover more quickly.

It’s understandable to want to resume activity or sport as soon as possible. It’s difficult to take the necessary time to allow healing in today‘s society. As soon as pain subsides, most people try to resume wherever they left off. But, just because you think you’re ready, doesn’t mean that your sprained ankle is actually ready. The torn or overstretched ligaments in the sprained ankle need you to slow down and allow them the time they need to return to normal. As pain and swelling subside, movement may increase. The next step is to walk without limping and without assistance Now, you can add flexibility and strengthening exercises, gradually increasing the intensity. Do remember to continue rehabilitation and therapy until their isn’t any pain during sport or regular activities. If the pain continues, you should consult with a medical professional.