Tuesday, January 10, 2012

chiro, physio, acupuncture or massage?

Which is better for rehab after sports injury? Chiro, physio, acupuncture, or massage?
It really depends on the nature of injury... if there are broken bones (fracture), torn ligaments (ankle, knee, shoulder),  or torn tendon (shoulder rotator cuff), then it's wise to let the orthopedic specialists examine first.
Every healthcare professional holds a piece of the puzzle for better rehab after an injury...

Let me share a few key principles with you.


1. Reduce PAIN - many ways to achieve this... Painkillers block the pain signals and anti-inflammatory drugs can reduce the swelling (bengkak). Cold pack or ice wrapped in cloth can also be applied on the area provided there are no cuts or open wounds. TCM practitioners may prescribe some herbal recipe to boil and drink, while bone-setters (titda) may wrap the injured area with Chinese herbs to reduce the swelling (provided there are no cuts or open wounds).
You can read some guy's blog about his visit to a semi-traditional Chinese medicine centre...  http://www.shaolintiger.com/2008/08/09/osso-bone-care-fix-your-joints-bones-general-pains/
Granted, it is difficult to find an experienced bone-setter nowadays but there are some around. Do e-mail me for more info (info@everhealth.asia)

2. Gradually increase MOBILITY (range of motion). Two ways to achieve it - via exercise and treatment. Here is where physio and chiro may excel because physiotherapists and chiropractors have knowledge about what exercises to recommend for *gradual* improvement. Skip the over-enthusiastic gym trainers for the time being!!

Treatment to increase mobility - acupuncture can be used to decrease pain, increase circulation to the injured area and some TCM practitioners may also add some massage (eg, tuina), pulling movements, etc.



Physio may use certain stretching techniques, etc to increase mobility while chiro may adjust the joints if necessary.

3. Improve strength and coordination. Depending on the nature and severity of injury, you may sometimes not be able to re-gain the level of strength and coordination as prior to your injury... but at least you will have a better quality of life and can get back to activities of daily living (walking, lifting, reaching, etc) with minimal pain.

 As I have mentioned before, skip the over-enthusiastic gym trainers for the time being!! Knee, shoulder and back injuries can take a long time to heal... so you definitely don't want to go back to square one by doing exercises that you are not ready for. For example, jogging or doing full range squats when your knee is not ready for it.



What if you have a chronic sports injury (eg, six months up to several years)? Chronic injury usually leads to scar tissue  or knots and relevant muscles will not work properly. For example, if you have an injured rotator cuff (assuming nothing is torn) for many months or years, you may not be able to move in certain directions such as reaching upwards. Hence, other muscles have to substitute to help you reach upwards... and over time you may find that you feel tight below the neck area.

For treatment of such chronic problems, you need a combination of deep massage and perhaps ultrasound (which on its own provides rather slow progress) to remove the scar tissue. Physiotherapists, massage therapists, and Rolfers would be able to help in this respect. Tuina or some bone-setters also know how to massage but since your problem is chronic, you need to bear in mind that the area that requires massage may be *more* than just the originally affected area (eg, shoulder). Hence, physiotherapists, massage therapists, and Rolfers may be more experienced in this aspect.
To find more about ultrasound, you can read here http://www.pthealth.ca/therapy_services.php?services=6


Finally, you also need to re-educate the brain (nerves) on how to move and use the proper muscles. In this aspect, physio is a good bet.