Sprains and strains occur when the musculoskeletal system is stressed beyond capacity, tearing fibres. A strain indicates a muscle or tendon is torn. A sprain indicates a ligament is torn. Normally, a greater force is required to tear a ligament than a muscle, though sprains and strains often occur simultaneously.

Muscle Strains and Ligament Sprains

The Symptoms

With soft tissue injuries, people normally experience pain that is worse with movement. The pain is normally achy or sharp in character. In more severe cases, weakness or instability can occur. If there is a shooting or electrical sensation that means a nerve has been affected.

When the body experiences a sprain/strain it tries to protect the area by tightening the surrounding musculature. This is a compensation mechanism termed “splinting”. It can change the way a person walks, affect posture or result in muscle spasm that limits movement. Continuing to participate in activities that stress the area through compensation can be a recipe for re-injury.

Severity of Injury

The amount of tearing will be a key factor in the speed of recovery. The greater restriction in range of motion, severity of pain, and inability to bear weight will lengthen recovery time. A qualified acupuncturist or physician trained in sports medicine will be able to diagnose the injury. An X-ray can show injury or misalignment of bones. An MRI can be used in severe cases to demonstrate the extent of injury to the entire musculoskeletal system including soft tissue (muscles, tendons, and ligaments), severity of swelling, scarring, and when the injury occurred.

The Healing Process

The body will begin the inflammation process immediately after injury. Following is the restorative phase when the body begins to lay down new tissue. Depending on the success of phase II, the body may or may not go into the final phase of healing which can last weeks to months with negative effects lasting permanently in some cases. Rest, Ice, Compression and Elevation (R.I.C.E.) is the mainstay of early treatment. Acupuncture, light stretching, and herbal therapies can speed up the healing process and limit the possibility of permanent damage.

Stage 1- Inflammatory (1-7 days)

  • Calor- Hot
  • Tumour- Swollen
  • Rubor- Red
  • Dolor- Painful

Care: If the area is hot to the touch then ice it. People usually do not ice enough. 5 times per day is adequate for 10 to 15 minute increments. The skin over the injured area should be numb to the touch after icing. Use a towel as a barrier to protect from skin damage. Acupuncture benefits microcirculation in the area, reduces swelling and relaxes muscles in spasm. Chinese herbal therapy is a crucial component during this initial phase to reduce swelling, clear heat and break up stasis.

Stage II- Proliferative (1-3 weeks)

  • Soreness
  • Swelling
  • Stiff muscles
  • Limited movement

Care: Use a mixture of ice and heat, alternating between the two. This will decrease swelling but still allow adequate circulation. Heat can relax stiff muscles and benefit microcirculation which speeds up healing. Do not use heat if the area is hot to the touch or heat aggravates the condition. A Chinese herbal compress neutral in nature can balance these affects for your particular condition, whether you have more swelling, heat, tightness, soreness, or bruising. Acupuncture is optimal in this phase because it relaxes the muscles and increases range of motion as the injury is repaired with increased circulation. Acupuncture will also prevent chronic injury due to compensation mechanisms or inadequate tissue recovery.

Stage III – Restorative (3 weeks – months)

  • Achiness aggravated by cold
  • Limited movement
  • Weather changes may aggravate
  • Wind may aggravate
  • Limited or no swelling

Care: Use predominately heat. Do not ice unless there is an exacerbation or reinjury. As a rule, do not ice unless the area is warm to the touch or swollen for any condition. Inadequate care or multiple reinjuries will perpetuate this phase, sometimes for a year or longer. Think of grandpa’s old football injury telling him that a storm is coming. Stiffness and limited movement are uncomfortable. But not only that, they make surrounding tissue more susceptible to damage in the future because they require more work and flexibility from surrounding joints. Poor posture and changes in gait, or the way people walk, are an indication that this scenario has taken hold. Treatment at this stage focuses on increasing circulation to the injured area, relaxing stiff muscles, breaking up scar tissue, and resetting compensation mechanisms. An integrative approach including acupuncture, liniments and plasters, physical therapy, and, in more severe cases, conventional prescriptions such as injections or may be necessary.

When should I seek the care of a physician?

  • If a bone break is suspected
  • If you hear an audible “popping” sound at the time of injury
  • If there is fever or open wounds

Most physicians will use physical exam and imaging (X-ray, MRI, etc) to diagnose the injury and provide medication to stop the inflammatory process and relax the musculature. If warranted, they will refer out to an orthopedist or neurologist for additional treatment including injections and surgery.

When should I seek the care of an acupuncturist?

Acupuncture should be sought for moderate to severe cases. Chinese medicine, specifically the martial arts tradition, has extensive experience remitting swelling, heat, and pain in the initial stages as well as tissue repair, increased strength and movement in the later stages of healing. Sprains and strains are common, and have been common through the 3000-5000 year history of acupuncture, acting as a mainstay of treatment for the rich military and martial arts traditions in China, Korea, Japan, and Mongolia throughout history.

Treatment methods have been continually refined during this time. They include acupuncture, plasters, liniments, specific massage techniques called tui na, exercises called qi gong, and a host of adjunctive therapies. With the integration of Chinese Medicine into the Western Medical system, anatomical and physiological advancements have propelled a renaissance in the growth of Chinese medicine and the effectiveness of care. Chinese medicine is a conservative approach with limited side effects that can cut recovery time tremendously.

 

Muscle Strains and Ligament Sprains
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