Positive Health Online

Say ‘Chinese Medicine’ and, more likely than not, the first thing that comes to your mind is Acupuncture. Though acupuncture is a vital and integral part of Chinese Medicine, it is only one of several sub-modalities that comprises this ancient healing tradition.

Acupuncture is one of the primary alternative treatment and rehabilitation modalities in sports medicine today. But it is by far not the only one. All of the other modalities available in Chinese Medicine, including Physical Therapy, Tui Na Massage, Qi Gong energy movement therapy, Diet therapy, and last but not least, Herbal therapy, is available for the treatment of sports injuries. In fact, Chinese Medicine emphasizes a multi-treatment approach to healing both acute and chronic sports related injuries, where many of these sub-modalities are combined as appropriate.

Herbal medicine forms a very early basis in the treatment of illness in many cultures, but its use in China represents the longest unbroken herbal tradition extant today, thousands of years old.

History of Sports Medicine

Historically, the treatment of ‘sports’ injuries evolved from both martial arts practice and the treatment of battle injuries. Sprains, strains, bruises, fractures, sore and aching muscles, even wounds, were part and parcel to training in the martial ways and a result of war. It led to the common saying that ‘to learn to injure (or kill) means also to learn to heal’.

Concurrent with the evolution of what has come to be known as ‘Traditional Chinese Medicine’ (TCM) evolved a tradition known as ‘Kung Fu medicine’ or ‘Martial Arts medicine’. The famous Shaolin Buddhist Temple became the repository for this rich tradition of Chinese Medicine, and to which the monks added significantly.

This is not to suggest in any way that the tradition of Chinese Medicine-herbal or otherwise – should be designated as ‘folk medicine’. Elements of this tradition go back over 5,000 years. It has, therefore, withstood the critical test – the test of TIME! It is well understood that if something works, it is passed on through the generations, often refined, while what is ineffective falls by the wayside. This is more so the case when it comes to treating battle injuries!

As is typical in Chinese Medicine regardless of tradition, prevention of injury is in the forefront. Tai Chi or Qi Gong for example, are a series of deliberate movements that stretch the tendons, ligaments and muscles while massaging the internal organs. But most importantly, they circulate the ‘vital energy’ which the Chinese call ‘qi’ (pronounced ‘chee’).

The concept of qi is fundamental to Chinese medicine. It is the vitalizing principle of life itself, the proverbial ‘life-force.’ As it is common to all life, Man is, therefore, also related to all things!

Advances in biolectromagnetic medicine are beginning to substantiate the basic principles of qi as bioelectric current, not only of the nervous system but even from the cells themselves. These bioelectric currents are an entirely new approach to healing that provide a scientific basis to knowledge and techniques already known and understood thousands of years ago!

Treatment Approaches

Treatment approaches used in Chinese herbal sports medicine are quite sophisticated. They employ strategies to kill pain, reduce inflammation and swelling, stop infection and help in tissue regeneration.

While the aim is the same as in conventional medicine, the approach can be very different. For example, in conventional, allopathic medicine, a sprain is treated according to the RICE standard. That is, Rest, Ice, Compression and Elevation, to be initiated within the first 24 hours of the injury.

While Chinese Medicine would also advocate rest (initially), the use of ice and compression is completely contrary to its principles, especially the use of ice. Inflammation and swelling must be checked, but it is done so with a herbal application externally, for example, and herbal pills or teas taken internally.

Swelling is the body’s attempt to ‘splint’ the injury, causing the stagnation of blood, fluids and qi energy. The use of ice serves to reinforce such stagnation, instead of increasing their circulation in order to remove damaged cells and tissue, debris, metabolic wastes, etc. Such stagnation leads to pain, in turn leading to adhesions of tissues that restrict movement, causing stiffness and more pain!

In Chinese Medicine swelling is reduced, while simultaneously, the treatment increases circulation, thereby aiding to restore normal movement and function more quickly, reducing both pain and stiffness.

Contrast soaking or baths, i.e. alternating hot and cold soaks or baths, one to two days after initial treatment is recommended by both conventional medicine and Chinese Medicine. The alternating contraction and dilation of blood vessels increases both circulation and fluid absorption while continuing to limit swelling.

Herbal Remedies

A staple of Chinese herbal sports medicine is the herb formula San Huang San (Three Yellow Powder), and is probably the single most useful herbal formulation for acute injury. It is used instead of ice to reduce swelling and limit inflammation, as three ‘cooling’ herbs in this combination increase circulation and help break up stasis of blood and qi. In fact, it is frequently referred to as ‘herbal ice’ because it mirrors all the good points of ice without any of the negatives!

San Huang San is especially effective in sprains, strains, muscle pulls – even contusions and internal bruising. Some insist the formula is also effective for simple fractures that do not break the skin!

Another external formulation is Dit Da Jou (Hit-Fall Wine) commonly called Trauma Medicine. While there are herbs in common, there are many, many formulations of Dit Da Jou. It seems every martial arts master has his own formula handed down through the generations and kept secret.

Its action is similar to San Huang San, in that it breaks up blood, fluid and qi stasis. However, it also tonifies the qi energy and reduces pain. My own formulation is actually a combination of several different formulas that I have adapted and use in my own clinical practice.

Plasters and poultices are another treatment approach. They are also used to relieve pain and stiffness, and to increase circulation or promote healing as above. But, they are also very effective in chronic conditions like arthritis and rheumatism.

Dit (or Die or Tieh) Da Wan (Trauma Medicine Pills) are herbs taken internally, in combination with external treatments like San Huang San or Dit Da Jou outlined above. Taken within the first 24-36 hours of injury, Dit Da Wan, works from the inside out, helping to heal the injury from depths where the liniment can’t reach. It helps normalize circulation in the injured area and promotes healing.

Cuts and lacerations are less common sports injuries today (with the exception of fighting related sports, i.e. boxing), but they do occur in almost all sports at one time or another. The single, most useful herb in stopping bleeding is Tien Chi (Gymnura pinatifida), also known as noto-ginseng or pseudo-ginseng. Used externally as a powder, it is poured directly onto the wound. It stops bleeding and speeds up healing. It is also used internally for internal bleeding as well as assisting in the healing of external wounds.

But the formulation Yunan Paiyao, which includes Tien Chi, is by far the best in treating bleeding of all kinds. It is extremely effective in stemming major and minor wounds and preventing infection, both internal and external. The story goes that the formula was one Chinese family’s secret, passed on from generation to generation, until Mao’s government forced the family to divulge the secret formula. It is available in both pill and plaster forms. It even helps reduce scarring!

Probably the most common complaint amongst sportsmen – amateur, professional and especially the occasional athlete – is sore muscles. While many reach for commercial muscle rubs, I still prefer the Chinese herbal preparations like Tiger Balm or Heavenly Balm, especially since it is so easy to make yourself. Sore muscles are due to slight tears in the muscle tissue. In my experience, the Chinese herbal balms seem to go deeper and aid in healing as well as offering relief from muscle pain and stiffness.

How Sports Medicine Works

As in any treatment approach, the distinction between acute and chronic conditions must be made. Left untreated or improperly treated, an acute injury, even a relatively minor one, can lead to chronic conditions, including localized weakness or even disease processes like arthritis.

One of the ways Chinese Medicine addresses this issue is by understanding that the internal organs are connected to the ‘exterior’ – skin, sensory organs, muscles, tendons, ligaments and bones. As a result, if an athlete continually suffers injuries to the tendons and ligaments, in addition to treating the specific injury itself, the liver would be strengthened and reinforced too, as this is the organ associated with the sinews of the body.

What I especially like about Chinese herbal sports medicine is that the body seems to take what it needs from the herbal formulation. Because, in any Chinese herb formula, there is a balance between the herbs themselves, there is a harmonization between the injury and the treatment, which is the reason a single formula can be applied to more than one type of injury.

The body has its own hierarchy of healing needs, based on the healing capacities of the individual. Unlike synthetic drugs, herbs have their own inherent buffering systems. There isn’t the extreme impact on the body with herbs as with drugs – nor the side-effects! Also, herbs are more easily metabolized, allowing the body to more easily use what it needs as it needs it and eliminating the rest.

As with all sports medicine approaches, the bottom line in injury treatment is the ‘bounce-back period’ – to return to play in the shortest, fully-recovered, time possible. The real advantage with the Chinese herbal approach is not only a short and full-recovery period, but also a decrease in re-injury or conversion to chronic injury forms, which is really at the heart of injury management.

Recipes

Most of the herbs listed are available in Chinese herbal pharmacies or by mail-order from firms specializing in Chinese herbs. An abundance of such firms can be found on the internet.

Please note that almost every formulation that ‘moves blood to breakup stagnation’, including those mentioned in this article, are contra-indicated in pregnant women as they can lead to miscarriage.

Further Information

This article is derived from his recently published book Chinese Herbal Sports Medicine by Lev G Fedyniak, MD, due to be released in April, 2007. For more information about the book please go to www.EndsPubl.com/SportsMed.htm

Tiger Balm FOR EXETERNAL USE ONLY Ingredients: (% by weight) Menthol crystals 20% Camphor blocks 32% Bees wax 20% Petroleum jelly 4% Oil of clove 8% Oil of cajuput 8% Oil of cinnamon 8% Procedure: Grate or chop camphor blocks into small pieces. Melt beeswax and petroleum jelly in a glass or enamel pot until completely liquefied. Remove from heat and stir in camphor blocks. Add remainder of ingredients one at a time, stirring constantly, until camphor has melted. Pour into jar and let set. Note: To make Red Tiger Balm, stir in cayenne pepper. Go easy though, as it will significantly increase the heating sensation of the balm!

San Huang San FOR EXETERNAL USE ONLY Da huang    Rhizoma rhei    Chinese Rhubarb    0.5 ozs. Huang qin   Radix Scutellaria baicalensis    Skullcap root    0.5 ozs. Huang bai    Cortex phellodendri    Phellodendron bark    0.5 ozs. Pu Gong ying    Herba taraxaci mongolici    Dandelion    0.5 ozs. Zhi zi    Fructus gardenia jasmonoidis    Gardenia    0.5 ozs. Hong hua    Flos carthami tinctorii    Safflower     0.5 ozs. Each herb should be finely ground. They can be well mixed with mediums such as petroleum jelly, lanolin or even beeswax, and stored in an air-tight container until needed. Dit Da Jou FOR EXETERNAL USE ONLY This formulation is effective for sprains, strains, contusions and bruising. Kuei pi chih         Cinamonium cassia    Cinnamon twigs    1 oz. Sheng di huang   Rehmannia glutinosa     Rehmannia    1 oz. Lien to                Nelumbo nucifera    Lotus root    1 oz. Tien chi              Gymnura pinatifida    Noto ginseng    1 oz. Huang qin           Scutellaria baicalensis    Skullcap root    1 oz. Hong hua            Carthamus tinctorus    Safflower    1 oz. Ru hsiang           Boswellia glabra    Frankincense    1 oz. Mo yao              Commiphora malmal    Myrrh    1 oz. Chuan xiong       Ligusticum lucidum    River parsley    1 oz. Gan sao            Glycyrrhizae glabra    Licorice root    1 oz. Dong quai          Angelica sinensis    Dong quai    1 oz. Pai shi              Paonia albiflora    White peony root    1 oz. Zhi zi                Fructus gardenia jasminoidis    Gardenia    1 oz. Huang bai         Cortex phellodendri    Phellodendron bark    1 oz. Da huang          Rhizoma rhei    Chinese Rhubarb    1 oz Each herb should be coarsely crushed but not powdered. Place into a large glass container or crock. Add one-half gallon of ethyl alcohol (NOT methyl or isopropyl alcohols) and one-half gallon of distilled water. As an alternative use a gallon of 90 proof (45%) vodka. This will allow both the herbs dissolve in water or alcohol to enter into solution. Stir two or three times per day for the first several days and then once every several days for the next for four to six weeks, storing in a dark, cool place. Decant, wringing out the herbs to squeeze out every drop of fluid possible. Cover and store the tincture in a cool, dark place.