• Bruises, Contusion, Injuries, Joint Injuries, Ligament Injuries, Muscle Injuries, Sports Injuries, Sports and Fitness Support: Minor Sports Injuries, Sprains, Strains
• ]]>Proteolytic Enzymes]]>
• ]]>Homeopathic]]> Arnica , ]]>Bioflavonoids]]> (Citrus Bioflavonoids and ]]>Oxerutins]]> ) , ]]>Calcium]]> and ]]>Vitamin D]]>, ]]>Comfrey]]> (Topical Only) , ]]>Creatine]]>, ]]>Glucosamine]]>, ]]>Horse Chestnut]]>, ]]>Oligomeric Proanthocyanidins (OPCs)]]>, ]]>Vitamin C]]>
This article addresses injuries such as bruises, minor fractures, and sprains. Other forms of minor injury such as ]]>minor burns]]> , ]]>minor wounds]]> , ]]>back pain]]> , and more chronic ]]>soft tissue injuries]]> are discussed in their own articles.
Unless you never leave your couch, you are likely to injure yourself sometime. Although minor injuries such as bruises and sprains will heal without treatment, they can be quite unpleasant.
Conventional treatment for minor sprains and strains involves anti-inflammatory drugs, icing, and, in some cases, physical therapy. Bruises are sometimes treated with ultrasound, although there is no meaningful evidence that it really helps.
Principal Proposed Natural Treatments
Proteolytic enzymes]]> help you digest the proteins in food. Your pancreas produces the proteolytic enzymes trypsin and chymotrypsin, and others, such as papain and ]]>bromelain]]> , are found in foods. Proteolytic enzymes are primarily used as digestive aids for people who have trouble digesting proteins. When taken by mouth, proteolytic enzymes appear to be absorbed internally to a certain extent, and they might reduce inflammation and swelling. Several small studies have found proteolytic enzyme combinations helpful for the treatment of minor injuries. However, the best and largest trial failed to find benefit.
Most studies involved proteolytic enzymes combined with ]]>citrus bioflavonoids]]> , which are also thought to decrease swelling.
A ]]>double-blind, placebo-controlled]]> study of 44 individuals with sports-related ankle injuries found that treatment with a proteolytic enzyme and bioflavonoid combination resulted in faster healing and reduced the time away from training by about 50%. ]]>1]]> Based on these and other results, a very large (721-participant) double-blind, placebo-controlled trial of people with an ankle sprain was undertaken. ]]>19]]> It compared placebo against bromelain, trypsin, or rutin (a bioflavonoid), separately or in combination. None of the treatments alone or together proved more effective than placebo.
Three other small, double-blind studies, involving a total of about 80 athletes, found that treatment with proteolytic enzymes significantly speeded healing of bruises and other mild athletic injuries as compared to placebo. ]]>2,3,4]]> In another double-blind trial, 100 people were given an injection of their own blood under the skin to simulate bruising following an injury. Researchers found that treatment with a proteolytic enzyme combination significantly speeded recovery. ]]>5]]> However, most of these studies were performed decades ago and fall beneath modern standards in design and reporting.
Other Proposed Natural Treatments
Oligomeric proanthocyanidins (OPCs)]]> , substances found in grape seed and pine bark, have shown promise for the treatment of minor injuries. A 10-day, double-blind, placebo-controlled study enrolling 50 participants found that OPCs improved the rate at which edema disappeared following sports injuries. ]]>8]]> It is also relevant that a double-blind, placebo-controlled study of 63 women with breast cancer found that 600 mg of OPCs daily for 6 months reduced postoperative edema and pain. ]]>9]]> Similarly, in a double-blind, placebo-controlled study of 32 people who had cosmetic surgery on the face, swelling disappeared much faster in the treated group. ]]>10]]>
Preliminary evidence from a somewhat poorly reported double-blind trial of 40 college football players suggests that a combination of ]]>vitamin C]]> and ]]>citrus bioflavonoids]]> taken before practice can reduce the severity of athletic injuries. ]]>12]]>
Another small placebo-controlled study suggests that an oral combination product containing ]]>vitamin C]]> , ]]>calcium]]> , ]]>potassium]]> , ]]>proteolytic]]> enzymes, ]]>rutin]]> , and ]]>OPCs]]> can slightly accelerate healing of skin wounds. ]]>20]]>
The herb ]]>horse chestnut]]> is thought to have properties similar to those of citrus bioflavonoids. The active ingredient in horse chestnut is a substance called aescin. One double-blind study of 70 people found that about 10 g of 2% aescin gel, applied externally to bruises in a single dose 5 minutes after the bruises were induced, reduced their tenderness. ]]>11]]>
The herb ]]>comfrey]]> is unsafe for internal use due to the presence of liver-toxic pyrrolizidine alkaloids. However, topical use is believed to be safe. In a double-blind, placebo-controlled study of 142 people suffering from an ankle sprain, use of comfrey gel resulted in more rapid recovery than placebo gel, according to measurements of pain, swelling, and mobility. ]]>21]]>
The supplement ]]>creatine]]> has shown some promise for preventing the muscle weakness that commonly occurs when a limb is immobilized following injury or surgery. ]]>14,15]]> However, one study failed to find creatine helpful for restoring strength following arthroscopic knee surgery. ]]>22]]>
The supplement ]]>glucosamine]]> might be helpful for people who experience knee pain due to cartilage injury. ]]>17]]> In addition, one study found somewhat inconsistent evidence hinting that glucosamine might aid recovery from acute knee injuries experienced by competitive athletes. ]]>28]]>
A small double-blind, placebo-controlled study suggests that use of ]]>calcium]]> (1 g daily) plus ]]>vitamin D]]> (800 IU daily) may speed bone healing after fracture in people with ]]>osteoporosis]]> . ]]>23]]>
One study failed to find that onion extract can help reduce scarring in the skin. ]]>27]]>
]]>Homeopathic]]> forms of the herb arnica are popular as a treatment for injuries, but studies suggest they are no more effective than placebo. ]]>16,24-26]]> Other homeopathic treatments are discussed in the homeopathy section of this database, under the titles ]]>Bruises]]> and ]]>Sports-related Injuries]]> .
1. Baumuller M. The application of hydrolytic enzymes in blunt wounds to the soft tissue and distortion of the ankle joint—a double-blind clinical trial [in German]. Allgemeinmedizin. 1990;19:178-182.
11. Calabrese C, Preston P. Report of the results of a double-blind, randomized, single-dose trial of a topical 2% escin gel versus placebo in the acute treatment of experimentally-induced hematoma in volunteers. Planta Med . 1993;59:394-397.
14. Hespel P, Eijnde BO, Van Leemputte M, et al. Oral creatine supplementation facilitates the rehabilitation of disuse atrophy and alters the expression of muscle myogenic factors in humans. J Physiol. 2001;536:625-633.
19. Kerkhoffs GM, Struijs PA, De Wit C, et al. A double blind, randomised, parallel group study on the efficacy and safety of treating acute lateral ankle sprain with oral hydrolytic enzymes. Br J Sports Med . 2004;38:431-435.
20. Brown SA, Coimbra M, Coberly DM, et al. Oral nutritional supplementation accelerates skin wound healing: a randomized, placebo-controlled, double-arm, crossover study. Plast Reconstr Surg . 2004;114:237-244.
21. Koll R, Buhr M, Dieter R, et al. Efficacy and tolerance of a comfrey root extract (Extr. Rad. Symphyti) in the treatment of ankle distorsions: results of a multicenter, randomized, placebo-controlled, double-blind study. Phytomedicine . 2004;11:470-477.
22. Tyler TF, Nicholas SJ, Hershman EB, et al. The effect of creatine supplementation on strength recovery after anterior cruciate ligament (ACL) reconstruction: a randomized, placebo-controlled, double-blind trial. Am JSports Med . 2004;32:383-388.
23. Doetsch AM, Faber J, Lynnerup N, et al. The effect of calcium and vitamin D(3) supplementation on the healing of the proximal humerus fracture: a randomized placebo-controlled study. Calcif Tissue Int . 2004 May 27. [Epub ahead of print]
Last reviewed April 2009 by EBSCO CAM Review Board]]>
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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