Photo by: Caleb Oquendo
From Kung Fu Medicine to Chinese Sports Medicine
Injury recovery has been a part of Chinese Medicine since the beginning of martial arts. Teachers with amazing fighting skills were also the very same teachers who had abilities to heal the sick and injured. Kung Fu Medicine evolved into Chinese Sports Medicine which combined acupuncture, herbs, moxabustion, massage, exercise and nutrition. Using the right treatment at the right time makes all the difference and plays a crucial role in preventing a minor injury from becoming a chronic injury. In order to understand the timing of the treatments, one must understand the stages of an injury.
The Three Stages of Injury
Stage 1
This stage starts at the moment of injury and generally last 1-7 days. There will be a combination of symptoms including swelling, bruising, inflammation and/or pain. Sometimes this stage only lasts a few days but for some, it can last for an entire week.
Stage 2
This stage starts within a week after the injury and can last up to 3 weeks. The swelling begins to settle, the heat and inflammation is greatly reduced, and the pain is improving. Stiffness and soreness increases. Symptoms often shift a lot during this time as inflammation comes and goes. The pain and stiffness fluctuates from day to day.
Stage 3
This stage starts around 3-4 weeks after the injury. The swelling and inflammation have dissipated but the stiffness and soreness increases. There is restricted range of motion. Ligaments and tendons take much longer to heal than muscles due to their limited blood supply. They make take up to 6-8 weeks to heal completely. In more severe sprains, it may take even longer. This is also the stage where injuries can linger and become chronic. The pain may continue to come and go with occasional swelling and inflammation.
Treatment Plans for the Three Stages of Injury
Stage 1
This is the only time that we recommend ice in Chinese Medicine. As the saying goes, “Ice is for dead people”. In Traditional Chinese Medicine, it’s important to maintain blood flow and circulation, especially in ligaments and tendons that have less blood supply than muscles. Using ice beyond the initial 24 hours of injury will further impede blood flow and cause the blood to stagnate. The lack of blood flow will further slow down the muscle recovery. The influx of blood brings the necessary white blood cells to heal the tissue. If ice is necessary due to high pain levels, alternate the ice with heat to continue supplying the injury with blood. It is a balancing act to reduce the pain by reducing inflammation while still keep the blood flow moving. There are acupuncture points to reduce heat and inflammation as well as herbs to use topically to clear heat without blocking the blood flow and reduce pain levels. NSAIDs can be a great tool to reduce inflammation but they are also known to interfere with muscle recovery.
Stage 2
During this stage, treatments can be more localized, focusing more on the site of injury instead of the area around it. As I mentioned previously, this stage brings a wide variation so the treatment plan may vary from week to week. On the days where inflammation is high, the focus is on reducing the swelling, heat, and inflammation. As the stiffness settles in, the treatment plan will include points to increase blood flow. This is also the time to use moxibustion as well as topicals which have more herbs to increase the circulation.
Stage 3
Treatment for this stage is focused on increasing poor local circulation and tonifying Qi and blood to aid in recovery. Wind, damp, and cold are elements in Chinese Medicine that can exacerbate symptoms and prevent proper healing. Applying topicals are still important during this phase but it may be more important to use internal herbs to address more systemic blood flow and nourishment to the connective tissue.
Topicals to use for Each Stage
Stage 1
A famous kung fu teacher known as “Magic Hands”, Hsu Hong-chi was treating an ankle sprain when his student Tom Bisio suggested using ice to help reduce the swelling. He responded with the statement, “Ice is for dead people.” *This story is taken from a wonderful book called A Tooth from the Tiger’s Mouth by Tom Bisio*. In Chinese Medicine, ice is used in the first 24 hours of an injury but after that, heat is preferred to increase blood flow and healing.
- One of the best herbal formulas to use during Stage 1 after the first 24 hrs is a topical called “Herbal Ice”, or San Huang San. Here are a few brands that I recommend:
- There is also a classic trauma liniment called Die Da Jiu, also known as Dit Da Jow, that has been used for centuries in martial arts. It is translated as “fall and hit wine” even though this wine is for external use only, never internally. It is a classic formula to strengthen sinews and relieves pain in muscles & joints. It’s great for aches and pains but especially good for any injury to muscles, joints, and bones. Liniments are easy to use by just applying directly onto the injured area. They are cleaner than a more oil based topical because they evaporate quickly due to the alcohol. The disadvantage of the evaporation is that they need to be applied often to be effective. There are many variations of this topical that I use in my clinic and at home:
- White Flower Oil is a combination of essential oils like eucalyptus, lavender, menthol, wintergreen, peppermint and camphor to help relieve pain and inflammation.
Stage 2
Treatment can be stronger and more direct. Applying wet heat, like hydrocollator packs and hot towels, and herbals soaks are now recommended to move stagnation in the tissues to help increase range of motion and movement. Herbal soaks are made by cooking herbs in a pot of water and placing the injured body part in the liquid after the herbs are removed. If the soft tissue injury is not an extremity, soak towels in the herbal soak and place or wrap the injured area.
- My favorite herbal soak, created by one of my brilliant former professors, is available by prescription at AOMA herbal pharmacy. It is based on the formula Hai Tong Pi Tang. Please reach out to me for more information!
- Dr. Bob’s Medicated Oil by Blue Poppy. This potent topical is a variation of the classic marital arts formula called Po Sum On. It’s a well-balanced massage oil to increase circulation, warm the muscles, and reduce inflammation and pain with the addition of peppermint oil. A little goes a long way. Add a few drops to a neutral massage lotion and apply to a large area or just use a drop on a cotton ball and apply to the affected area.
- Wu Yang Pain- Relieving Plasters This plaster can be cut to fit the size of the injury and left on for several hours. It is also helpful for more chronic injuries in Stage 3 like tendonitis as well as sprains, strains, and torn or pulled muscles with swelling, heat and inflammation.
Stage 3
This chronic stage may require the use of topicals from Stage 1 and 2 depending on the level of inflammation and swelling. It is also a great time to use internal herbs. Moxa sticks are also great to help increase blood flow, especially for ligament injuries and joint pain where cold causes more pain and blood flow is typically less than in muscles.
In conclusion, the most important aspect of understanding these stages is to move through them properly in order to prevent acute injuries from becoming chronic. Inflammation causes pain but it is also the mechanism that brings healing to the tissues. The ideal is to have enough inflammation to bring healing to the tissues but not enough to cause pain. I have spent 20 years trying to improve upon that balance. May these topicals help you in whatever stage of healing you find yourself.