Chinese Sports Medicine: Anatomy of a Compound Tibial Fracture

Chinese Sports Medicine: Anatomy of a Compound Tibial Fracture

Today I want to discuss how Chinese medicine can greatly improve the recovery from a compound tibial fracture. If anyone saw the Louisville vs. Duke basketball game last night, you know exactly what kind of sports injury this is. While it's rare to see it occur during a basketball game, it's not uncommon for football and soccer players to break the tibia.

Whereas with a soft tissue injury we can begin acupuncture treatments immediately, a fractured bone needs to be set by an MD before we can go to work. Compound fractures involve the broken bone protruding from the skin and are thus a more serious injury that require surgery.

I discussed how the injury is considered damage to the Meridians, as well as the local tissue and bone, in the last blog: Anatomy of an Ankle Sprain (http://meridianlouisville.blogspot.com/2013/03/chinese-sports-medicine-anatomy-of.html). There is severe stagnation of Qi and Blood, impeding free flow, so there is pain and inhibited ability to heal the damage. The same principles apply here, though with a broken bone the treatment is altered slightly. With a compound tibial fracture, the Foot Yang Ming Meridian will be especially traumatized. The Yang Ming channels are said to be the most exuberantly full (of Qi and Blood) of all the Meridians. Imagine how abundant the Yang Ming of an athlete is! On the one hand, the nature of the injury is considered very serious because that Meridian is involved, but on the other hand, acupuncture can significantly hasten recovery time since this channel, when properly repaired and utilized, can bring a lot of much-needed nourishment to the injured area.

Treatment:

Normally with an orthopedic/sports injury, we would needle at the site of the trauma to break up static Blood that is clumping in the area; however, broken bones are usually set with casts, and so we are only able to needle distal to the injured area. Fortunately, the Meridian system connects the body so thoroughly that invigorating one part of a Meridian increases circulation in the whole Meridian. Assuming the broken leg is casted from below the knee down to the foot, we are able to use points on the thigh and near the toes. If the whole leg is covered, we are able to work with the affected Meridians on the opposite leg or paired Meridians on the arms. Also, in addition to the points we use that are aimed at conditions specifically affecting the lower extremities, treatments would include points indicated for bone conditions. These are points that have been shown to increase osteoblastogenesis, meaning increasing the rate at which new bone cells are created. The Kidney governs the bone, according to Chinese medicine, so strengthening the Kidney Qi also increases osteoblastic activity to help bones grow and heal quicker.

Herbal Treatment:

Taking an herbal formula becomes much more important with a bone injury due to the severity of the injury and the likelihood that the immediate area of trauma will be inaccessible and immobilized. The treatment principles remain the same as with acupuncture: Invigorate Qi and Blood in the affected Meridians to alleviate pain and restore proper flow, promote healing of the damaged tissues, and specifically mend bone. It is vitally important to understand the timeline of recovery - immediately after surgery you cannot invigorate Blood! The focus should first be on healing the blood vessels and recovering from surgery, holding off on the Blood-moving herbs and using herbs that generate flesh, instead (San Qi, Dang Gui, Rou Gui). Once swelling goes down, you can proceed.

As always, the specific formula will need to be custom-tailored to the individual and their injury, but the base formula will be geared towards strongly promoting circulation. Qi-strengthening and Blood-nourishing herbs are usually added to address the blood loss during injury and surgery, and warming herbs may be added if Cold has entered the Meridians, either from immediate icing of the injury or during surgery, since Cold is another cause of stagnation (see the last blog!). Finally, herbs that tonify the Kidney Yang are added to promote bone growth. These herbs can also be taken to treat and prevent stress fractures by strengthening bone.

Here are a few herbs that specifically strengthen and mend bone:

Du Zhong (Eucommiae Cortex):
- Tonifes the Liver and Kidney, strengthens the sinews and bones
-Aides in the smooth flow of Qi and Blood: used to promote circulation, especially in those with weakness of the sinews and bones

Gou Ji (Cibotii Rhizoma):
- Tonifes the Liver and Kidney, strengthens the sinews and bones
- Expels Wind-Cold-Dampness to relieve painful obstruction

Xu Duan (Dipsaci Radix):
- Tonifes the Liver and Kidney, strengthens the sinews and bones: especially good for tonifying without causing stagnation
- Promotes the movement of blood, alleviates pain, and reconnects the sinews and bones: often used for trauma, and especially good for pain and swelling in the limbs from trauma.

Gu Sui Bu (Drynariae Rhizoma):
- Tonifes the Liver and Kidney, strengthens the sinews and bones
- Promotes mending of the sinews and bones: for traumatic injuries such as falls, fractures, contusions, and sprains. Especially good for ligamentous injuries and fractures

Chinese medicine is amazing for treating sports injuries! If there is a specific condition you'd like to learn about, let us know, and we'll blog about how we treat it!