Relief of Chronic Pain Caused by Sports Injury

Relief of Chronic Pain Caused by Sports Injury: An Alternative Strategy of Traditional Chinese Tui Na and Related Techniques

Dr. Zhidao Xia, Associated Professor of Orthopaedics and Traumatology from China. Graduated from Institute of Orthopaedics and Traumatology, China Academy of Traditional Chinese Medicine as a M.D. in 1991. Graduated in Hubei Traditional Chinese Medical College in 1984. 11 years experience as an orthopaedic surgeon in both Western Medicine and Traditional Chinese Medicine. Currently works as a research assistant in the Nuffield Orthopaedic Centre, Nuffield Department of Orthopaedic Surgery, the University of Oxford.

Personal Contact:

Dr. Zhidao Xia, 6 Observatory Street, Oxford, OX2 6EW

Tel. 01865 227964 (day), 01865 514172 (night)

Email. Zhidao.xia@ndos.ox.ac.uk

Sports injuries can be divided into two groups, acute injuries and chronic injuries. Impact, twisting, friction, shearing or stretching forces may inflict the injuries. With proper management, the majority of injuries recover completely, and the athlete returns to full activity. If injuries are not managed appropriately, they may become chronic with deleterious long-term changes in the tissues which may cause prolonged pain and even disability. Not only the individual’s sporting prowess, but also the quality of life may be affected by these changes.

Due to the advancement of sports medicine, most acute sports injuries can be treated by specialists in Sports Injury Clinics and managed properly. However, if chronic injuries do happen, it may take a long time to fully recover.

The significant symptom of chronic injuries is pain. The mechanism of chronic pain is very complicated, and the treatments are less effective. Even a slight pain can severely affect the skill of the athletes, so effective relief chronic pain is the target for most physiotherapists and sport medical specialists.

Tui Na, or Chinese massotherapy is a technique originally from China that combines skills of massage, frictions, manipulation and passive stretching etc. to relieve pain and treat internal organ disorders. It was developed by ancient traditional doctors and martial arts masters and eventually became a discipline of Traditional Chinese Medicine (TCM). Some herbal medicine and special devices like cupping jar (cupping therapy), wooden or bamboo stick, and health hammer might be used with Tui Na to promote the effects.

Tui Na concentrates painful points regardless of the reason and location of the chronic injuries. Actually for whatever reasons cause the chronic injuries, the local pathological changes are very similar. The process of Tui Na is normally to find the painful points first. Then a series of manoeuvres are employed to increase the blood flow locally, disperse oedematous fluid, break down fibrinous adhesions, reduce local muscle spasm and tension, relieve muscle stiffness and soreness, improve the orientation and extension of chronic scar tissue and replace any slight dislocation or adhesion of the joint.

During this therapy, as the therapists deeply touch, rub and press the surface of the injured tissue, some inflammatory factors that cause pain will be pushed out and move into the local tissue. This helps to relieve pain in the injured tissue but might result in a large area of diffusive pain afterwards. However, as the blood supply improves, the inflammatory factors will be diluted and eliminated in several hours or even a few days. Massage cream or gel contains painkillers or herbal medicines are recommended for this kind of pain. The cupping jar therapy can suck inflammatory factors, oedema fluid or even hematoma to the subcutaneous space where they have a better blood supply to eliminate them and can promote the effect of Tui Na.

There is one more factor that is very easily ignored, the mechanical signals supplied by the therapists. To maintain normal function, human tissues, bone, cartilage, tendon, ligament, skin etc. all need correct biophysical signals, stress/strain (compress, extension, shear), ions flow in tissue and cells, vibration from muscle contractions etc. In the injured tissue, the local environment has completely changed. The normal cell communication and physical signals are disturbed by the injury and the balance is broken down. Immobilisation due to pain or fixation treatments causes further lack of these signals.

As a therapist who manages to offer the Tui Na, he must have enough healthily muscle to exercise this particularly labour intensive job. The biophysical signals from a health therapist will stimulate cell receptors, recall the physiological arrangement of biomechanical sensations, drive the ion flow and rebuild the balance in the tissue and cells. It might be the main difference between a human therapist and a massage device.

If the Tui Na and related therapy is going to work, a significant improvement can be noticed in less than three treatments, even if the injury is more than 10 years old. Some multiple chronic injuries or severe injuries may take much longer to recover, but improvement can be seen at every treatment. However, if there is not any change after three treatments, it is recommended to try other treatments, as this therapy will not be effective.

This alternative therapy aims to relieve chronic pain for sport injuries only. For acute injuries, fractures, full rehabilitation and return to a normal sports career, please consult a medical sports expert and physiotherapist.

Reference:

1. Andrews JR, Harrelson GL and Wil KE. (1998) Physical Rehabilitation of the Injured Athlete. 2nd ed. W.B. Daunders Company.

2. Read MTF. (2000)A Practical Guide to Sports Injures. 1st ed. Butterworth Heinemann.

3. Lachmann S. (1988) Soft Tissue Injuries in Sport. 1st ed. Blackwell Scientific Publications