Strains and Sprains in Chinese Medicine

Few of us have escaped the nagging pain of a twisted ankle, pulled hamstring or a jammed toe. These injuries are so commonplace that we often just walk them off or wait them out.

These bumps, pulls and twists can often continue to nag us or even return to cause discomfort years later, seemingly out of nowhere.

Before there was transit, email and delivery services, an injury such as a twisted ankle had much more of an impact on daily life. An out-of-commission ankle meant no work. And no work meant no food on the table.

Over many generations and observations, Traditional Chinese Medicine (T.C.M.) has used Acupuncture, massage and herbs to effectively treat injuries and get people moving again. According to T.C.M. the earlier we treat these injuries, the fewer problems we’ll have later.

In this article we will look at how T.C.M views and treats stains and sprains and give you some simple tips about management and prevention.

Some points before we start

A sprain generally refers to an injury to a ligament; a strain refers to muscle injury. Sprains and strains often occur together in or near a joint, since joints absorb the stress of movement and are vulnerable to be being twisted or wrenched.

In T.C.M., Qi and Blood are two important concepts involved in the injury and healing.

From a T.C.M. perspective, Blood does more than run through our veins and oxygenate cells. It ensures we have nourishment and moisture for the entire body. Blood keeps our tendons, skin and hair healthy, strong and flexible. It lubricates joints and allows for smooth movement.

Qi is the vital force that is responsible for movement. Qi moves Blood and fluid evenly throughout the body nourishing each organ and tissue. Qi also warms the body’s exterior.

Qi and Blood are mutually dependent. The organs that produce Qi are dependent on the nourishment of the Blood and Blood cannot move without the force of Qi.

An injury and a traffic jam

Acute stage

Imagine you are walking by a traffic jam on a summer day and there is a fender bender up ahead. All the congestion and idling engines will produce more heat and exhaust on that block than if traffic were running smoothly.

In any strain or sprain a mechanical force disrupts and blocks the movement of Qi and Blood. Pain, swelling and heat are the result of Qi Blood and fluid stagnation. When Qi stagnates it can no longer move Blood and fluids. Heat has accumulated in the area because Qi, which is inherently warm, accumulated in the local area.

If the fender bender is severe enough, traffic will not move at all and people will be forced to get out of their cars. Similarly, within your body, if the sprain is severe enough, blood will forced to break out of the vessels and pool around the injured area which creates dark-blue or black swelling.

Post-acute stage

Once the accident is cleared and one lane is open, most of the traffic and congestion will start moving. However, at this point, all the roads in the neighbourhood will be moving slowly. Traffic will move past the accident site but at a much slower pace.

In a post-acute stage all the surrounding muscle and tendons will contract to protect the vulnerable area. The free flow of Qi and Blood is restricted in the local area.

Chronic stage

If Blood and fluids are not properly cleared they congeal and stagnate and glue the tissues together which causes adhesions. This restricts the tissues from evenly and smoothly sliding over each other.

Because of these restrictions it takes more energy for Qi and Blood to push though this area. The area can become devitalized, numb and more sensitive to cold and damp. The pain will increase when we are low in energy, under stress or have a cold or flu.

Gradually drivers avoid the slow moving intersection and take other routes.

In the post acute stage, muscles surrounding the area contract to protect the surrounding area. In chronic cases these muscles compensate and take on the work of the damaged area – – a job they are not designed to do.

Treatment and management of sprains – self help tips

Acute stage

How you treat an injury in the beginning sets the stage for the rest of the recovery. The goals are to:

Reduce swelling

• Stimulate local circulation

• Reduce heat in the local area


No additional force should be applied on the site of the injury. Keep all movement to a minimum.


Ice should be applied immediately to the sprain to minimize swelling and ease pain. It can be applied for 10-15 minutes at a time, 3-4 times a day. Ice can be combined with a wrapping to minimize swelling and provide support. Avoid heat at this stage.


Dressings, bandages, or ACE wraps should be used to immobilize the sprain and provide support.


Keeping the sprained joint elevated above heart level will also help to minimize swelling.


Simple range-of-motion exercises that do not aggravate the injury help to stimulate circulation and reduce swelling and blood stagnation.


In T.C.M., foods are classified into energetic categories. The nature of cold is to contract. Consuming cold slows down the circulation of Qi and Blood and thus the healing process.  The following foods should be avoided in the initial stage of an injury:

  • Cold foods – iced drinks, beer, ice cream
  • Raw fruits and vegetables
  • Tomatoes
  • Dairy
  • Soy
  • Shellfish

Chinese herbs, ointment and plasters

Cooling herbs, ointment and plasters can be taken internally or externally to reduce pain, bruising and swelling. Talk to your acupuncturist for more details.

Acupuncture and Shiatsu

Acupuncture and Shiatsu stimulate circulation and reduce swelling and blood stagnation. After an injury our entire body tightens up. Shiatsu and Acupuncture can reverse this situation and reduce immediate pain quite dramatically.


If a sprain is treated correctly in the beginning, most of the pain and swelling are gone. There will likely be stiffness in the surrounding tendons from protecting the vulnerable area. In this stage of treatment the goals are to:

• Restore normal range of motion

• Remove any leftover stagnant Blood

• Revitalize the area


Reestablishing correct movement is the most important activity at this stage. Injuries are often not integrated with the body as a whole. We tend to “walk them off” or block them out. Lack of treatment will eventually lead to the area “never feeling quite right.”

Try range of motion stretches and strengthen the surrounding area with light weight-bearing actives. Be aware of any compensation you might have developed while healing.

Once the pain is gone you may have an impulse to get back on your bike or head to that yoga class you’ve had to miss. Remember that the area is still weak and can easily be injured again. Be sure to stretch and massage the area before you start any activity. Stop when you feel any discomfort and return to stretching and massaging the area. The better you take care of yourself at this stage the less likely it is that the injury will come back.


In the early stage of an injury, ice removes the heat and swelling. When these have disappeared it is essential to increase the circulation of Qi and Blood in the local area using heat. A simple heating pad or water bottle will do the trick.

Shiatsu and Acupuncture

Deep and more direct techniques are used to increase range-of-motion and circulation to the injured area. This type of therapy can also address any compensation the area may have developed after the injury.  Self-shiatsu techniques can be learned to move Blood and Qi and keep the healing momentum between treatments.


There are many cases in which pain and stiffness might stick around. This can be frustrating but there are things you can do to manage, prevent and heal the injury.


In chronic injuries local circulation is poor. Because of this, cold and damp conditions are better able to penetrate into the soft tissue or joint. For this reason you may feel achy or sore on cold, damp or rainy days.

To manage this:

• Always keep the area covered or wrapped when in cold/damp environments

• Soak the area and use hot packs.

• Moxibustion is a therapy that involves burning a dried herb on acupuncture point to produce a penetrating heat. It is simple to use and can be extremely effective for drying up dampness, clearing out coldness and revitalizing the injury. Your acupuncturist can teach you a simple and safe self -care regimen.

Self Massage and Acupressure

If stagnant Qi, Blood and fluids have not dispersed, you might feel hard nodules or scar tissue around the area. Continue stretching daily. Massage and use deep acupressure in the local area. Ask your therapist to show you how.

Herbs, Shiatsu and Acupuncture

In T.C.M, injuries are considered in relation to the way the whole body is functioning. Healing may be slow due to other more systemic patterns of disharmony or lifestyle factors. For example you may be more susceptible to tendon injuries, bruising, or be working in an environment that predisposes you to this type of injuries. By addressing diet, using herbs, receiving regular Acupuncture and Shiatsu treatments, you can address these underlying imbalances and get moving again.



This articles is not a substitute for medical advice and must not be used for self-diagnosis or treatment. We urge you to seek medical advice for any healthcare issues.