The Athlete’s Nemesis: Muscle Pulls, Strains, and Tears, by Tom Bisio

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Muscle injuries are very common complaints in orthopedic practice, occurring both among athletes and among non-athletes We regularly read about top athletes in almost any sport who are sidelined for weeks due to a strained, pulled or torn muscle. Although these kinds of injuries may seem minor, compared to a broken bone or torn ligaments, they present a challenge due to the slow recovery time, during which athletes and exercise buffs are unable to take part in training or competitions. And these injuries have tendency to recur, sidelining the athlete yet again. Muscles crossing two joints are more prone to a muscle pull because they are more often subject to acceleration and deceleration forces. Bruises generally affect the muscle belly, while strain-type injuries more often occur at the muscle-tendon junction, closer to a joint.

Preventative measures can be taken to reduce the likelihood of strains and tears, but when bruising, strains, and sprains occur, treatment should take place as soon after the injury as possible, and should follow correct treatment principles. Traditional Chinese medicine actually does quite well with these kinds of injuries, often much better than Western medicine. This is largely due to the fact that in Chinese medicine, we take advantage of the inflammation response rather than attempting to suppress it with ice and anti-inflammatories. The evidence against the use of RICE (Rest, Ice, Elevation, Compression) in Sports injuries is virtually overwhelming, so much so that one of the creators of this protocol has since disavowed it. Ice and anti-inflammatories actually interfere with tissue healing, and therefore can keep you on the bench longer.

In Chinese medicine, the first step in a muscle injury is to restore free-flow of the local circulation, which aids in flushing out the dead cells and debris that are stuck in local area of the injury, while simultaneously bringing in cell building blocks and fibroblasts, which create new tissue. Restoring free-flow of circulation also reduces pain, because it is precisely the lack of free-flow that creates the pain. Restoring free-flow is best achieved by a multi-modal approach.

In the case of pulled muscle (which means that there are torn muscle fibers), direct application of Extra Strength Trauma Liniment (Qiang Li Die Da Jiu) helps to kill pain and restore free-flow. If muscle fibers have rolled up or bunched up to a hard knot, they should be ironed out with techniques like Pushing (Tui Fa) and Round Rubbing (Mo Fa) as the muscle is stretched. In the case of hamstring pull, this means extending the leg to its maximum as you literally “iron out” and realign the muscle fibers manually.

If the muscle has extensive bruising apply a thick layer of Herbal Ice: (San Huang San Gao) or Stage 1 Trauma Ointment (Die Da Gao Yi Bu) over the inured and discolored area, cover with a bandage and leave overnight or for 24 hours. This kind of injury occurs more often at the belly of the muscle, because this part of the muscle is highly vascularized. The blood vessels, can rupture with an impact or severe torsional force.

With both tears and bruises, it is often useful to also approach the problem form the inside out with a trauma formula like the Blood Stasis Trauma Pill (Huo Xue Die Da Wan). Generations of martial arts practitioners have used the Blood Stasis Trauma Pill (Die Da Wan) to clear blockages of Qi, blood and fluids that have accumulated at the site of an injury. This trauma pill is carefully formulated to prevent blood from congealing in the tissues of the injured area, and to address “dead blood” before it can develop.

Later when the initial heat and pain are gone, herbal soaks can be applied by immersing towels in the liquid of the soak, and then applying them as warm compresses to the local area. A key soak for this purpose is Extra Strength Tendon Relaxing Soak (Shu Jin Huo Xue Jin Ji). Extra Strength Tendon Relaxing Soak is very effective in the treatment of strains and sprains and muscle pulls. This soak relieves spasm, relaxes sinews, kills pain and moves stasis. It can be used in conjunction with Tui Na massage methods. Compresses can be applied for 15 minutes twice a day.

If the muscle pull or tear is at the tendinous portion of the muscle near the joint, after the initial pain and swelling are dissipated by the methods described a above small amounts of Dragon's Blood Tendon Lotion (Xue Jie Shu Jin Lu) can be massaged into the local area several times a day.

In a chronic injury where, the muscles are tighter in cold weather or feel cold, warming liniments like Dragon's Blood Tendon Lotion (Xue Jie Shu Jin Lu) can be used. Massage can also be performed with Tiger's U-I Oil (Hu Biao Ru Yi You).  For cold in the muscles, Tiger’s Yu-Yi Oil can be soaked into cloths or paper towels which are placed over the local area in conjunction with wet heat (hydroculator), a hot water bottle or even a heat lamp. In more severe instances of cold penetrating into the muscles, or lack of circulation with a feeling of cold in the local area, one can use the Warming Soak (Wen Jing Huo Luo Jin Ji).

The following chart shows the various factors that can set up, complicate or compound an injury to the muscles.

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Strengthening weak muscles is important in order to prevent muscle strains and tears, but more recent studies seem to indicate that it is more important to correct muscle imbalances, between the two sides of the body or imbalances within a grouping of agonist and antagonist muscles like the quadriceps and hamstrings.

Making sure muscles are flexible can also be important in preventing injury. This means undertaking a program of intelligent flexibility exercises that engage breathing and relaxation in order to lengthen the muscles and increase their suppleness. Flexibility and stretching routines can be enhanced by applying Yoga Stretching Oil (Yoga Shen Jin You) before and after stretching. Yoga stretching oil is specifically formulated to help the muscles and sinews lengthen and relax.

If you are doing everything right and a muscular injury simply won’t heal, consider life style factors - are you eating well and getting enough rest? And sometimes the body just needs a boost to help it heal damaged tissue. In these cases a formula like Strengthen Sinew Pills (Bu Jin Wan), that nourishes the blood and the liver and kidneys in order to strengthen and heal the muscles, tendons and ligaments, can be an important addition to treatment.

By: Tom Bisio

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Tom Bisio is a world-renowned martial artist and a licensed practitioner of Chinese medicine. He heads a clinic in New York City where his unique background in Western and Eastern approaches to healing has helped him create and implement effective rehabilitation program