Injury Anatomy - East & West

Inflammation and Swelling

When a sprain occurs there is usually inflammation. Blood flows into the injured area and it swells with blood and tissue fluid. The result is redness, swelling, heat, and pain. The sensation of heat are caused by the dilation of small blood vessels and greater vascular permeability. Blood and fluid backs up in the tissue causing swelling. Blood brings white blood ells to clean up dead tissue. Nuturient building blocks are also brought in where they attempt to initiate the leaking process and rebuild damaged tissue.

Inflammation is an important part of the healing process. It is also the body's attempt to "splint" the injury thereby protecting it from further trauma. The problem is that this splinting with blood and fluid blocks normal circulation and prevents movement. It also causes tissues that were not normally in contact with one another to rub together. This can lead to further irritation.

The Western treatment for reducing inflammation from sprain is known as RICE (Rest; Ice; Compression; Elevation).

Ice is very useful for preserving things in a static state. It slows the decay of food and dead bodies. It does not help damaged tissue repair itself. It reduces pain and initial swelling at a cost, contracting blood vessels & tissues inhibiting the restoration.

It is not uncommon to see a sprained ankle that was iced still slightly swollen more than a year after the original injury.

In Chinese medicine there is an idea that cold and damp can penetrate into areas of the body where the vital energy has been compromised. This can lead to an arthritic type of pain which often increases whether changes and it is difficult treat. I still rue the day I iced my fractured patella. It has taken years of treatment.

Beyond RICE, Western medicine's mechanical approach does not give athletes many tools to work with for recovery, and leaves many questions unanswered: Why some sprains heal while others don't ? ; Why some athlete get caught in a cycle of chronic pain and re-injury ?; Why do some sprains/fractures hurt more in damp or cold weather? ; Why do some injuries become arthritic in later life?

The questions can be answered when the relationship of Qi and blood is understood. Qi flows in a capillary-like network through the skin and the flesh, muscles and the tendons. It brings blood and fluid to these tissues, nourishing and moistening them. The relationship of Qi and blood is summed up as follows: "Qi is the commander of the blood. Blood is the mother of Qi" This means that blood cannot move without the action of the Qi. In turn, the organs that produce and nurture the Qi are dependent on the nourishment of the blood.

Organs of digestion such as the spleen, pancreas, stomach, and intestines break down food and transform into sugars like glucose that provide fuel for muscle. These unconscious metabolic activities are visible manifestations of the unseen vital force. Qi is constantly coalescing and transforming into blood and in then blood transforms into Qi. They are like two sides of the same coin.

In more superficial layers of the body Qi travels in a network of tiny vessels. Deeper in the body it travels in more discrete pathways called meridians that connect with the internal organs, sensory organs, and the brain.

Swelling is the result of Qi stagnating (and therefore the blood & fluid it moves also stagnate). The stagnation of Qi acts like a dam. Blood & fluid backs up behind the dam, causing swelling. The sensation of heat is due to warming action of the Qi overheating the area as it backs up and accumulates.

The impulse to rub an injured area is a natural unconscious attempt to push the circulation through, breaking the dam, restoring free-flow of Qi and blood.

Pain = stagnation of Qi

Stagnant blood tend to lodge in the spaces between tissue layers. As it congeals, it glues these tissues together. Layers of tissues that slid smoothly now stick together. This is called adhesion. They interfere with nomad sliding movement. This restriction of movement cases pain. If stagnant blood & fluid are not cleared it becomes kind of a "dead zone" that never feels quite right.

Even after swelling and inflammation are gone, it takes more of the body's energy to push circulation through around that area. Over time the area becomes sensitive to cold or damp weather, in part due to the diminished circulation. It may occasionally swell or feel numb. The pain can return when the body's energy is depleted.

I remember a woman who ran the New York City Marathon inappropriately dressed for the day that turned unexpectedly cold and wet. After the race her legs became heavy, painful, and numb. Weather changes made the condition worse. Use of warming liniments, moxabustion (heating the injured area by burning herbs over acu-points), and herbal formula helped to drive out the cold, and restored normal circulation. She is still running today.

When already weakened area is repeatedly exposed to cold and damp climate, the injury becomes chronic (called Bi syndrome). Bi syndrome occurs in joints and muscles. To heal properly, damaged tissue must be replaced by healthy functional tissue. If it is left unrestored and the body does not have the energy and nutrients to do this, adhesion forms causing low-level inflammation.

In cases where there repeated re-injury, normal tissue can be replaced with thick fibrous tissue. This is scar tissue. Continued inflammation can cause calcium to be deposited, restricting movement further, creating more inflammation thereby perpetuating the cycle.

It is easy to understand the importance of treating minor injuries as soon as possible to prevent from developing into chronic obstructions. It is too easy to dismiss a bruise or sprain as "nothing" (a mistake I made many times). If treated the right way, it really will be nothing and you can simply focus on plying your sport.