In part one of this article we featured an introduction to western and traditional Chinese medicine philosophies of treating sports injuries. Here we look at specific injuries and how two treat the same injury using either method of western medicine or TCM.
We speak to two Beijing-based practitioners, Dr. Derric Wang from Horizon Sports Medicine Clinic and Dr. Zhang Muchuan from Beijing Dongwen TCM Clinic, about how they would treat four common types of sports injuries.
Dr. Wang has a degree in Physical Therapy from the University of Alabama. An orthopedic certified specialist and athlete trainer, he has practiced at sports medicine clinics in the US working with colleges and semi-professional athletes. Dr. Zhang mainly treats soft tissue injuries caused by sports, incorrect postures caused by everyday life, and internal diseases. In the table on the next page, Dr. Wang represents western medicine views while Dr. Zhang represents TCM views.
Type of Injury
Ankle Sprain
An ankle sprain refers to an injury of the soft tissues – usually the ligaments of the ankle – that typically occurs when the foot is accidentally turned inwards, stretching or tearing the relatively weak ligaments on the outside of the ankle.
Ankle sprains are almost inevitable in sports that involve jumping, running and turning quickly – all movements that can easily lead to ankle sprains. These movements are common in soccer, hockey, basketball, and volleyball.
Western Medicine
Treatment Methods
• Full assessment to determine the severity of the injury
• Immobilizing or taping of the ankle to decrease swelling
• Ultrasounds for pain management
• Basic physiotherapy exercises to regain flexibility and range of motion
• Functional exercises for strengthening muscles
• Observation of knees and hips to ensure that the entire muscle chain is working
correctly, and that the patient maintains good posture
• Re-introduce physical activity towards the end of the treatment to ensure a safe return to the sport
TCM Treatment Methods
Acute period (within three hours of injury):
• Acupuncture or acupressure on the opposing ankle
• Acupuncture on the tibialis anterior muscle (located near the shin)
• Herbs to prevent blood stagnation, such as anti-bruising powder 七厘散 (qili san). Contains Daemonorops draco (a type of rattan palm), frankincense, myrrh, black catechu (extracted from Acacia), and borneol.
After acute period:
• Acupuncture on the tibialis anterior muscle
• Acupuncture or bone setting manipulation on the ankle
• Massage and moxibustion on the calf
• Herbal drinks to improve blood circulation, such as a circulation decoction 血府逐瘀汤 (xuefu zhuyi tang) containing Chinese thorax root, immature orange fruit, white peony root, licorice, Angelica sinensis, and chuan xiong (a herb commonly used to relieve pain and improve circulation).
Type of Injury
Pulled Hamstring
Three muscles in the back of the thigh form the hamstring; injuries happen when these muscles are stretched too far. Sprinting and other sports that put a lot of stress on the legs increase the risk of pulled hamstrings. Running, jumping, and kicking sports cause the most hamstring injuries.
Pulled hamstrings can vary greatly in severity, from muscle pulls (Grade 1 injuries) to complete hamstring tears (Grade 3).
Western Medicine
Treatment Methods
This injury is difficult to treat, as the hamstring is a muscle that powers your legs to run and provides flexibility for kicking. The treatment plan must ensure that both strength and flexibility are regained.
It’s vital to treat first-time injuries properly or future pulls could lead to calcification of the hamstring muscle or tendon. Treatment methods include:
• Compression bandages to keep swelling under control
• Ultrasounds for managing pain
• Stretching exercises once the pain has subsided
• Regaining strength through appropriate exercises
• Checking flexibility and ensuring that everything is balanced with the hip flex
and quads (this trio is referred to as the “powerhouse”)
• Taping to decrease swelling
• Basic exercises to regain flexibility and range of motion
TCM Treatment Methods
Acute period (within three hours of injury):
• Put ice on the injury in the first 30 minutes and stop moving
• Massage the calf and buttocks
• Herbs to prevent further blood stagnation
After acute period:
• Acupuncture on the buttocks and pressure points near the injury
• Massage, manipulation, and moxibustion on the hamstring
• Herbal drinks to improve blood circulation
Type of Injury
Knee Injury
Many knee problems are grouped into the category of “runner’s knee,” which includes a variety of aches and pains related to the kneecap. Runner’s knee (patella tendonitis) is often caused by increasing your running speed or the distance you run too quickly and not allowing your body to get used to the change.
Severe knee injuries can involve damage or bruising to cartilage or ligaments. The four major ligaments in the knee that are most frequently injured are the posterior cruciate ligament (PCL), the medial collateral ligament (MCL), anterior cruciate ligament (ACL), and the lateral collateral ligament (LCL).
Runners are not the only victims of knee injuries, however; they also commonly strike cyclists, basketball players, and soccer players.
Western Medicine
Treatment Methods
Tight quads can occur as the body reacts to injured knees. The physician will observe your running pattern to see whether this is causing undue stress on your kneecaps and tendons. Heel striking puts stress on the knee, so it’s important to try striking with the ball of the foot.
If ligaments such as the ACL are damaged, the injury typically requires surgery and it can take 9-12 months for the patient to return to sports.
TCM Treatment Methods
Acute period (within three hours of the injury):
• Put ice on the injury in the first 30 minutes and stop moving
• Acupuncture on the opposite knee
• Soft massage on the thigh
• Herbs to prevent further blood stagnation
After acute period:
• Deep massage and acupuncture on the thigh
• Herbal drinks to improve blood circulation
Type of Injury
Shoulder Injury
Shoulder injuries include dislocations, sprains, and strains.
These problems are generally caused by overuse, which loosens the rotator cuff – the group of tendons and muscles surrounding the shoulder. Symptoms include pain, stiffness, weakness, and slipping in the shoulder.
Shoulder injuries are most common in tennis, swimming, badminton, and
volleyball – any sport that involves a lot of overhead movement.
Western Medicine
Treatment Methods
With injuries such as shoulder impingement syndrome and tendonitis, it’s important to stop playing the sport immediately to avoid further damage to the rotator cuff.
• Ultrasounds on the small stabilizer muscles
• Sports massages to relax the associated muscles
• Exercises to strengthen the upper back muscles and pull the shoulders back
• Exercises to stretch the chest muscles in order to open up the shoulder and create space so tendons aren’t rubbing on bone
• Rehabilitation program to address any muscle imbalances and issues with posture
TCM Treatment Methods
Acute period (within three hours of injury):
• Put ice on the injury within 30 minutes or less
• Acupuncture on the arm and the neck
• Massage along the upper spine
• Herbs to prevent further blood stagnation
After acute period:
• Acupuncture on the shoulder and the arm
• Massage and moxibustion on the shoulder
• Chiropractic adjustments
• Herbal drinks to improve blood circulation
Resources
Horizon Sports Medicine Clinic 北京弘道运动医学诊所
Horizon Sports Medicine Clinic provides outpatient physical therapy, sports medicine, pediatric sports related injuries, and post-operative rehabilitation.
Mon-Fri 9.30am-6.30pm. 4/F, Bldg A, 40 Xingfu Er Cun, Chaoyang District (8438 9966, clinic@winbright.cc) www.horizon-clinic.cc
朝阳区幸福二村40号A座4层
Beijing Dongwen TCM Clinic 北京东文中医诊所
Beijing Dongwen TCM Clinic takes a holistic approach to health. They offer TCM procedures like acupuncture, massage, moxibustion, Chinese herbal medicine, bagua, and more.
Mon-Fri 9am-5.30pm, Sat-Sun 9am-8pm. Rm 107, 8 Xiaoyunli, Chaoyang District (5613 7619, dywjmedical@gmail.com) www.dywjmed.com 朝阳区霄云里8号107室
This article originally appeared on p26-27 of the September 2014 issue of beijingkids. To view it online for free, click here.To find out how you can obtain your own copy, email distribution@truerun.com.
Photos: Courtesy of Dongwen