Physical Injury and Chinese Medicine



In the US most people experience acupuncture after an injury. My first acupuncture treatment was indeed after a knee injury due to a twisted kung fu jump kick in my twenties! Chinese culture has such a long history of Martial Arts that having to deal with physical injuries are a big part of its medicine. From massage, cupping, scraping or gua sha, to bone setting and topical herbal liniments and finally acupuncture. This is a rich culture with lot's of resources on how to heal injuries.

In my case after one year of practicing qi gong I realized I could not proceed with my kung fu practice, and with much grief I turned to yoga and running. Most people have a story of injury and how they had to modify their lifestyle. In very rare cases athletes are able to perform at their previous level after spending time healing an injury. The question is how to find the most balanced way of going through that transition. There are certain principles that relate to injury in Chinese Medicine. I'm going to go over them here and I hope there will be something practical to take home for you.

First what is pain in Chinese medicine perspective? Pain is what we feel when something obstructs the flow of energy or if there is not enough of it in the acupuncture channels or meridians. These Meridians start at the tip of fingers and toes and cover the whole body, converge in the chest and head and go deeper into the body organs. Most of them are traversing the body vertically except one that is like a belt going around the waist. This meridian is important when injury is caused due to fall or accident where one side of the body is affected. As if the belt has gotten loose or too tight. So addressing the belt meridian is important when there is one sided pain anywhere in the body. The main principle in addressing pain is creating flow of energy either by removing obstruction or by nourishing the scarcity.

In addition to the primary meridians there are also sinew channels which cover a large area of the body along the muscles and tendons parallel to the primary channels. The point that affects the sinews most importantly is usually the tip of fingers and toes. Addressing this point will help relax the whole channel and also help get the pathology out of the channel if something is stuck there.

Most of the time when we have pain the idea is that we need to rest and prevent movements that create the pain. However we don't want to be completely immobile either. Usually gentle movements to create flow of energy and blood to the area is helpful as long as it is not causing pain.

The problem with using pain medication is that if it numbs us we are not able to gage if we are actually injuring it further with our movements. I've seen people with back pain whose only goal was to be able to run the way they used to. So they would take NSAIDs to go for a run. That's another big part of the picture: What we were able to do prior to the injury and how we need to shift our life style to meet the new body. Most people take that as a sign of aging and have so much grief and fear about losing their past habits. They push their bodies into acting the way they used to before getting injured and, in this way, injure themselves more.

In addition, some procedures such as surgery can introduce cold or scar tissue into the channels which will prevent further healing of the body. In those cases applying Moxa along with acupuncture is the best option for reintroducing yang and warmth to heal.

Another problem that usually makes the healing process lengthy is the compensation by the opposite side. So if one knee is in pain one puts most of the weight on the opposite side and ends up with an imbalance that further prevents the healing and brings the problem deeper into other parts of the body. That's why the main way we treat pain is by looking at opposites in the body. Opposite of elbows are knees, opposite of wrists are ankles, opposite of shoulders are hips, opposite of the back is the chest and abdomen. That's how we can bring ourselves back to a state of balanced flow. So if you have pain in your right hip pay attention to your left shoulder and try to relax that shoulder. Also look at how you hold what is below and above it. For example if you have pain in your knee pay attention to your hip and ankle and see if you are tensing those areas and preventing the flow to get to your knee.

Another question that I usually encounter is the use of steroids. Steroids are the “miracle” drugs of the 20th century. However that comes with a cost. They steal from the body's inner most resources to cover up any problem temporarily. If you are debilitated with pain go to them for a few days until you get passed your emergency. But staying on them long term is living in denial of the root cause. And that also includes topical steroid creams. Something is causing the problem and you haven't dug deep enough to get to the truth; you are using the easy way out. A short term solution that will cause more problems along the way . Pain is the body's signal that something needs to be changed. Either a posture, a movement, an obsession with a stretch that does more harm, too much sitting, not enough sleep, a relationship or food that's not right for you at this moment, etc. Instead of listening to the signal that is loud and painful, we chose to muffle it with the use of steroids.

Last point is about use of ice for pain. In Chinese Medicine ice congeals and prevents the flow of energy and blood and fluids. Immediately after injury when the area is swollen and hot, it's ok to use ice temporarily to prevent the swelling from getting larger and putting more pressure on the surrounding tissue. However using it after the initial injury will prevent healing and will introduce cold into the channels, thus congealing the flow of energy.

So what is an example of how pain is addressed with acupuncture and herbs in my practice:

I palpate the location of the pain, and the rest of the body. I find the opposite tender spots. I find out what channels are mainly affected and are in the line of the pain. I open the channels, by using the end points, I use the specific points that deal with pain in those channels, I use tender points near the injury and farther from the injury along the channels and their opposites. If there is palpable muscle tension I check if the points that I'm using are helping the muscle to relax. If there is limited range of motion due to pain, I check if the points are helping with that. I use heat, moxa, and if needed, an external poultice of herbs to cover the injury and help bring more blood flow and warmth to the area. I also advise some movement or basic qi gong exercises that would support, strengthen, or help create more flow in the body. Lastly I address the feelings that come with injury. The feelings of fear, grief, denial, anger all hold tension around the injury and becoming aware of them or releasing those emotions help the healing process.

My personal belief is that every accident happens for a reason. If we are given crutches, we were going too fast. We need to learn a lesson from walking slow. If we talk to our body the way we talk to a beloved child, asking what is wrong, trying to find out what the subconscious message is that our body is trying to convey to our consciousness, then modifying our behavior to bring healing becomes discovery of ourselves. I wish that everyone turns their pain into a healing that will let them learn and grow.

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