Repairing Soft-Tissue Damage with Some Common Herbs
NUTRITIONAL ALTERNATIVES
Steven R. Frank
Proper chiropractic manipulation can collect problems of use. Massage can release residual trauma and support proper muscle balance. However, often with repetitive-use injuries and strains or sprains, the ligaments and tendons need help too. Tendonitis, fasciitis, and microtears in ligaments aie conditions that happen all too often in the aging population. As a chiropractor, you need to address the healing of these issues in order to offer a complete return to health.
Our bodies aie primarily made up of various combinations of collagen, and the inability to produce enough of this vital material results hi weaknesses and insufficient healing of damaged tissue. Unlike other proteins, collagen is comprised of only two amino acids—glycine and hydroxyproline. Vitamin C is critical in the reactions that produce collagen and is, in fact, destroyed in the process.1 Since humans aie not able to synthesize vitamin C, we tend to operate our bodies in a state where sufficient collagen cannot be produced. Since much of processed food and “pickedgreen” fruit is devoid of this valuable nutrient, supplementing with vitamin C is critical to maintaining good health, and especially important during periods of tissue repair.2
Our livers produce an enzyme that controls the quiescent level of fibroblast activity. As we age, the liver’s ability to produce this enzyme is reduced. Chinese medicine has acknowledged the connection between the health of connective tissue and liver
Since much of processed food and “picked-green” fruit is devoid of this valuable nutrient, supplementing with vitamin C is critical to maintaining good health, and especially important during periods of tissue repair. 5 5
function for thousands of years. While a base-metabolic test may show “normal” liver function, “normal” for those over 50 is insufficient to maintain sound connective tissue health. Since the fibroblasts aie responsible for producing the reparative collagen, a debilitated liver can leave one susceptible to tendon, ligament, and fascia degradation or damage.3,4 Supporting liver health with restorative herbs is quite advantageous as we age.
As we age, the microvasculature within the ligaments and tendons can become blocked with plaques. Soft tissue trauma can leave blockages due to microclots. This restricts and inhibits the movement of the semi-motile fibroblasts and the nutrient supply that they rely upon. This diminution of mobility and nutrient flow in an injured region reduces the ability of the fibroblasts to apply reparative collagen over areas of damage and microtears.5
So we can see that insufficient supplies from which to make
collagen, reduced activity of the fibroblasts, and unpaired circulation all contribute to the weakened state of connective tissues as we age. In fact, this weakened state allows repetitive-use injuries and strains to become a major health issue in our older years. It so happens that with a little simple dietary and herbal therapy, we can correct this problem.
Chiropractic manipulation can reestablish proper skeletal functionality and even maintain balanced blood flow. Therapeutic massage can improve muscle body function, break up local fixations, and promote load sharing while relieving blockages of circulatory and lymphatic flow. These are all valuable and effective means of treating sprained ankles, rotator cuff issues, epicondylitis, and other common injuries. Yet there is more that can be done to support a complete return to health for the patient. This is where herbology becomes a valuable ancillary therapy to the
‘* Although the pain is undesirable, it is an important part of the healing process and it should be blocked without stopping the inflammation. NS AIDs are a reasonable alternative. From an herbal standpoint, arnica contains prostaglandin-blocking constituents and willow bark contains salix. Both of these (applied topically) will relieve pain without interfering with the healing process. ï Ï
musculoskeletal work of chiropractic and therapeutic massage.
Injury and chronic repetitive use usually result in chronic and often acute pain. Anti-inflammatory painkillers or cortisone shots stop the inflammation reaction and can hinder the healing process.9 The inflammation reaction serves as the signal to the brain to sustain the repair cycle. The brain signals the liver to produce more of the enzyme that increases the level of fibroblast activity and thereby causes more reparative collagen to be applied to the damaged area. Although the pain is undesirable, it is an important part of the healing process and it should be blocked without stopping the inflammation. NS AIDs are a reasonable alternative. From an herbal standpoint, amica contains prostaglandin-blocking constituents and willow bark contains salix. Both of these (applied topically) will relieve pain without interfering with the healing process.
Additionally, amica has been shown to break up the microclots that appear as bruising, and this facilitates the return of circulation to the area of damage. This is a wonderful contribution to the healing process. 8
■ ■ Since the fibroblasts are responsible for producing the reparative collagen, a debilitated liver can leave one susceptible to tendon, ligament, and fascia degradation or damage. 55
For thousands of years, broken bones and soft-tissue damage were handled by macerating comfrey and/or plantain and applying it directly to the site of injury as a poultice. Comfrey’s common name is “knitbone” for its ability to facilitate the rejoining of broken bones by accelerating the production of collagen. As it turns out, these two valuable herbs do this because they contain a substance known as allantoin, which increases fibroblast activity. This is an invaluable tool for repairing soft-tissue damage.7
All injuries produce some muscular fixation (residual trauma). This can cause poor load sharing within the muscle group and reduced circulation. Poor load sharing can cause joint misuse and microtears in adjacent portions of the tendons. Rosemary and thyme increase lymphatic and vascular circulation when applied topically. Witch hazel improves muscle fiber flexibility and lubricity, thus encouraging better load sharing.6 Better load sharing and increased flexibility are important to keep from disturbing the area under repair.
All of the valuable constituents of these herbs can be extracted with a simple low-temperature water decoction. One simply makes a tea of them
while being careful not to use water that is hotter than 150 degrees Fahrenheit. The decoction can then be applied directly to the skin over the injury where it will be readily absorbed. Soaking a cloth in the decoction and then tying it around the injured area may not be as convenient and socially accepted as it was in the 1800s. Today, one can achieve the same results by gelling the decoction and simply applying it to the skin. This decoction or gel should be reapplied three times per day. It is important to note that supporting the body internally with vitamins A, C, D, and E will provide it with the constituents necessary to rebuild healthy tissue with reduced scarring.
In fact, clinical and field testing of this sort of bruise, strain, and tear repair gel have demonstrated dramatically reduced recovery times and improved healing outcomes. In younger athletes and animals, the repair times were as much as 50% shorter. With older patients and recalcitrant injuries, complete healing was observed in four to six weeks. By complete healing, we are presenting that return to service did not produce a reinjury.
The beauty of this technique to assist the patient in his or her return to health is that, as long as this herbal gel is applied, the area will continue to be stimulated to maintain the repair. While the pain-relieving analgesics and prostaglandin blockers of the willow bark and arnica will relieve the pain right away, it is important to continue to apply this decoction several times per day for four to six weeks to make sure that the healing is complete. Patients will be tempted to stop applying it after a few days because the pain will be gone and use will have returned. As we age, though, it takes longer for a complete repair to be accomplished.
In the case of back trauma and damage, the local fixation can prevent an adjustment from holding. Each week, the patient returns with the same level of pain and in need of corrective manipulation. Concurrent use of this herbal gel has demonstrated the ability to relax the local fixation and facilitate repair so that
adjustments hold for longer and longer periods. The pain level steadily recedes and a complete repair is achieved.
When procured commercially, an herbal gel of this sort is a very simple and tremendously valuable tool for the chiropractor to deal with patient injuries in a more wholistic manner. Wholistic meaning to deal with all of the aspects that the body needs to produce a complete return to health. Chiropractors can do more than adjust the musculoskeletal system without being herbalists by utilizing the carefully engineered support tools that are offered by the natural health industry.
References:
1. [Myllyla et al, “Ascorbate is Consumed Stoichiometrically in the Uncoupled Reactions Catalyzed by Prolyl--(-Hydroxylase and Lysyl Hydroxylase. Journal of Biological Chemistry 259:5403-5405. 1984]
2. Roger J. Williams, Nutrition Against Disease, 1971. Pg 85-86 (paperback)
3. JClin Gastroenterol. 2002 Oct;35(4):345-9. Connective tissue diseases and the liver. Youssef Wíl, Tavill AS.
4. BestPractRes Clin Gastroenterol. 2013 Aug;27(4):543-51. doi: 10.1016/j.bpg.2013.06.016. Liver abnormalities in connective tissue diseases. De Santis Ml, Crotti C, Selmi C.
5. J Orthop Surg. 2008; 3:18. Published online 2008Apr 30. doi: 10.1186/1749-799X-3-18 PMCID: PMC2397381 ggstThe role of tendon microcirculation in Achilles andpatellar tendinopathy Karsten Knobloch
6. The Holistic Herbal Directory. Penelopy Ody 2001 The Ivy Press Limited. ISBN: 0-7858-1351-9. Pg 155
7. Modern Encyclopedia of Herbs. Joseph M. Kadans, N.D., Ph.D. Parker Publishing Company, Inc. 1970, Catalog Card Number 72-124345, pp 97-103
8. Evid Based Complement Alternat Med. 2011; 2011: 917541. Published online 2011 Jan 19. doi: 10.1155/2011/917541 PMCID: PMC3035003 Inflammatory Process Modulation by Homeopathic Arnica montana 6CH: The Role of Individual Variation Ana Paula Kawakami, 1 Cesar Sato, 1 Thayna Neves Cardoso, 1 and Leoni Villano Bonamini, 2
9. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Brooke K Coombes, MPhty, Leanne Bisset, PhD, Prof Bill Vicenzino, PhD Published Online: 22 October 2010 DOI: http://dx.doi.org/10.1016/S01406736(10)61160-9
Mr. Frank started his career designing modern medical equipment for large corporations. He then transitioned into developing specialty experimental equipment for medical researchers. After many years of working with allopathic medicine, Mr. Frank found his way into herbal medicine. Studying with herbalists, physicians, chiropractors and physical therapists led Mr. Frank to the development of a number of products for the treatment of common physical injuries and maladies utilizing natural medical techniques. Steven Frank can be reachedfor comment at: Nature ’s Rite 1 800 991 7088 stevefcjnaturesriteremedies.com
