Acupuncture and Chinese Medicine for Sports Injuries

Acupuncture and Chinese Medicine: A Historical Perspective on Sports Injuries

For over two millennia, acupuncture and Chinese medicine have played a crucial role as primary healthcare systems for billions of people in Asia. Long before modern Western medicine arrived in China, practitioners of Chinese medicine treated traumatic injuries ranging from fractures to sprains and strains to infected wounds, utilizing these ancient practices on battlefields throughout history.

I recall my own experience years ago while living in China. After a severe foot sprain during a mountain hike, my father-in-law took me to a Chinese Medicine Traumatology hospital. They realigned the bones in my foot and ankle, providing herbal remedies that alleviated pain and swelling. Remarkably, I was back on my feet within days, which sparked my interest in treating sports injuries. I found that patients often respond quickly to treatment, and timely, proper care can prevent the development of chronic pain.  Since then I have been happy to work on sports injuries in my acupuncture practice.  First in Rego Park and now in Mamaroneck.  All times of sprains and strains, severe brusing, etc.

Typical Treatment for Sports Injuries

Many individuals suffer from sports-related soft tissue injuries, characterized by pain and swelling in the affected areas. Traditionally, the RICE method—Rest, Ice, Compression, and Elevation—has been the go-to approach. This method involves resting the injured area, frequently icing to reduce swelling, and applying compression and elevation.

However, recent studies suggest that complete rest and prolonged icing may hinder recovery. Dr. David Mirkin, who introduced the RICE method in 1978, has revised his stance based on new evidence. Before I found Chinese medicine and acupuncture I followed this method without question, but I have since learned that excessive icing can prolong healing and even increase the risk of chronic pain. It can restrict blood flow, depriving surrounding tissues of oxygen and potentially leading to long-term complications. Chinese medicine offers a more nuanced and effective approach to managing sports injuries.

Summary of Sports Injuries and Their Treatment

Sports injuries, often referred to as sinew or soft tissue injuries, are prevalent among individuals engaged in competitive sports and repetitive tasks like typing or gardening. These injuries can also occur from actions like twisting an ankle while walking down the street. Sinews include soft tissues such as muscles, tendons, and ligaments that connect and support joints. These tissues experience significant strain during physical activities, which can lead to a range of issues.

Types of Sinew Injuries

• Mild Strain/Sprain: Involves microscopic tears in tendons and ligaments, typically healing within a week with proper treatment.
• Severe Sprain: Characterized by complete tears causing joint instability, requiring further medical evaluation.

At any time while reading the next section you come to a description of a treatment you are unclear about please follow these links.

The Three Stages of Sports Injury Recovery

Stage 1: Acute

This stage starts at the moment of the injury: a jammed finger, twisted ankle, twisted knee, or tripping on ice and injuring your hip. This stage is characterized by pain, bruising, swelling, and inflammation. This is the perfect time to treat with Chinese medicine to speed recovery. In China, this often includes fractures. In this country, if there is a fracture, patients are advised to go to the emergency room first. Once cleared, Chinese Medicine treatment can be applied to speed recovery.

Overview of Stage 1:

• Timing: This stage starts immediately after an injury and can last up tp 7 days.
• Symptoms: Swelling, redness, pain, and possible heat from inflammation.
• Treatment: Focus is on restoring circulation, reducing swelling and inflammation, and enhancing joint mobility. Application of heat should be avoided to prevent worsening inflammation.

Treatment Principles:

• Normalize Circulation: Reduce swelling and inflammation to restore blood flow.
• Promote Qi and Blood Flow: Alleviate pain and improve mobility.
• Encourage Movement: Strengthen the area to prevent re-injury while enhancing circulation.

Stage 1 Treatments:

• • Herbal Poultices and Plasters: Effective in reducing swelling, pain, and inflammation, serving as an alternative to ice.
  • Bleeding and Cupping: Techniques to eliminate stagnant blood and fluids, restoring Qi flow.
  • Acupuncture and Massage: Stimulate movement of stagnant fluids.
  • Trauma Liniment: Applied externally for soft-tissue injuries, typically three times daily. 
  • Internal Herbal Medicine: Used to complement external herbal medicine treatments.  Used to increase blood and fluid circulation and to stop pain.
  • Movement & Exercise: Gentle exercises to maintain range of motion and prevent muscle atrophy.

Case Study: Recently, a patient came into the acupuncture office in Mamaroneck with a twisted ankle she sustained during a volleyball match.  She could not walk on her own and needed crutches.   The ankle was swollen, bruised, and felt warm to the touch. The night before, she visited the emergency room, and it turned out there was no fracture. Acupuncture and bodywork were administered above and below the injured area to encourage circulation and reduce swelling. A poultice of powdered herbal medicine mixed with water was applied to the injury and wrapped in gauze. The patient was advised to leave the poultice on for 6 hours and then remove it. An herbal liniment was applied three times a day for one day, and she returned for treatment the following day. Forty-eight hours after the initial sprain, she was able to walk around with minimal pain. Swelling was greatly reduced, and the inflammation was gone. (Case continued below in Stage 2)

If treated properly at the outset, you may not experience Stage 2 symptoms and can quickly return to normal activities. However, if the injury was severe or Stage 1 issues persist, Stage 2 treatment may be necessary for complete recovery.

Overview of Stage 2

• Timing: Begins within a week post-injury and can last up to three weeks.
• Symptoms: Reduced swelling and pain, possible residual swelling, and stiffness from tendon spasms.
• Treatment: More direct and aggressive than Stage 1, utilizing warming herbal medicines and vigorous bodywork.

Stage 2 Treatments:

• • • Massage, Acu-Pressure, & Liniments: Employment of deep massage techniques and appropriate liniments to relieve blood stasis and pain.
    • Acupuncture: More targeted interventions to address swelling and stasis.
    • Stage 2 Poultices: Helpful in dispersing residual swelling.
    • Herbal Soaks: Soaking the affected area in herbal solutions to aid recovery.
    • Movement and Exercise: Focus on range of motion and strengthening exercises while avoiding vigorous activities.

Case Study (continued): As mentioned above, the patient returned to the acupuncture office in Mamaroneck with significantly reduced swelling, decreased pain, and no more heat coming from the injury. She still had restrictions in movement and stiffness. Due to the stiffness, the patient was given an herbal soak to boil and soak her foot in twice a day for two weeks. She can come in twice a week for acupuncture and bodywork. After each treatment, an herbal poultice was applied, and the ankle was wrapped. Liniments were rubbed into the joint three times a day. After two weeks, the ankle was back to normal as if nothing had happened.

Overview of Stage 3

• Timing: Typically 3-4 weeks after injury but can last up to 6-8 weeks for tendon and joint injuries.
• Symptoms:  Swelling and inflammation has typically decreased.  Stiffness and discomfort may persist.  Often the area will feel cold to the touch or is sensitive to cold, humidity or weather changes.  
• Treatment:  Treatment is given to strongly warm the injured area and drive out cold with moxa, warming soaks and liniments.

Stage 3 Treatments:

• • • Massage, Acu-Pressure, & Liniments: Utilizing warming liniments to alleviate blood stasis and pain.
    • Acupuncture: Focused on addressing swelling and stasis.
    • Stage 3 Poultices: Effective for dispersing residual swelling.
    • Herbal Soaks: Promotes recovery, using warming solutions.
    • Moxibustion: Used to heat painful areas, particularly effective for discomfort worsened by cold.
    • Cupping and Gua Sha: to pull fresh blood into the area, relax stiffness and to warm the tissues.
    • Internal Herbal Medicine: Aimed at enhancing circulation and nourishing damaged tissues.

Most patients who end up in the acupuncture clinic for pain come with injuries and pain conditions that would be considered stage 3. This can include arthritis in the hip, chronic knee pain that worsens with weather changes, and lower back pain from a car accident five years ago that never fully healed, among others. A combination of all the above treatments will greatly speed recovery.

Case Study: Recently, a patient came in with neck pain that has persisted for ten years. The patient was in a car accident ten years ago. He initially iced the area, and the pain went away. Over the years, the area has become stiffer. When it’s cold outside, the area feels tighter, and he experiences a sharp pain that radiates across his back. Acupuncture, bodywork, and moxibustion were applied three times a week for three months. During that time, cupping was performed three times. Internal herbs were given to address his digestion, sleep, and neck stiffness. An herbal ointment was applied twice a day, and at night, a sticky herbal plaster was placed on the neck. Exercises were prescribed to be performed daily to increase movement of neck.  After three months, the pain and stiffness were completely gone, and he returned to all his normal activities.