Dr.Jason Wang Surrey Acupuncture and Chinese Medicine in Surrey

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Acute Shoulder Injury & Fracture

A relative of mine was recently injured in a fall, tripping over an unevenly cracked concrete sidewalk while walking to work. When she fell over she tried to use one arm to support herself from falling directly against the ground.

After this unfortunate incident the arm that was used to support herself in that sudden instant became stiff and unable to raise in any direction. Other parts of her body sustained minor scrape injuries. Immediately afterwards she went to the family doctor to see if she could get an X-ray done.

About a week afterwards the results came back and reported the injured right shoulder has sustained an undisplaced fracture on the greater tuberosity of the humerus. The family doctor advised the patient to go to the ER immediately. The patient told me about this and I told her that since it is undisplaced I don't believe there is anything to panic about.

(When it comes to bone injuries, displacement, whether the bone has completely separated or not, is the most important to thing to consider first.) The most they will do once admitted to the hospital is apply some kind of support for the arm, some painkillers, and really nothing much else.

Physiotherapy will begin only after many many weeks afterwards. I decided to treat the patient myself, knowing the most modern medicine can do in this situation is give some kind of shoulder support which in my opinion are only necessary to fixate any type of displaced fractures. Since there is no displacement the support is unwarranted in my view.

In fact, by using shoulder support, it will make the shoulder even more immobile and will likely result in adhesions down the road, which makes physiotherapy pointless. Of course I have doubts about physiotherapy anyway from what I hear from my patients but that's another story.

From the viewpoint of Chinese Medicine, fractures involve many things. First, it is a damage to the bone, the blood vessels, and even the nerves sometimes. The second thing of interest is damage to the tendons and other soft tissues around the bone or those directly joined to the bone.

We often call this "stagnation in the meridians". There is local congestion of the injury site and inflammation essentially. However this congestion cannot be completely suppressed forcibly by drugs because the inflammation is actually required for recovery.

So instead it needs to be smoothened out in order for the bone to mend and for the damaged tendons to rejoin properly, from which pain will truly decrease and range of motion can be gradually regained. In other words, simply leaving an injured arm in a sling not only does absolutely nothing to the shoulder but really makes things worse, as it makes the area even more restricted and thus prolonging(or even aggravating) the congestion and inflammation.

Thus, thinking injuries will heal themselves simply by leaving it immobilized for so and so weeks, almost as if for granted, is really a pipe dream. And popping painkillers and anti-inflammatories in this regard does nothing because it doesn't help the body actually repair the tissues, since as said before the inflammation is part of the recovery process.

I used a combination of Chinese Medicine and Acupuncture to deal with this injury, at the same time told the patient to continue regular walks so that the arm is still kept at a level of movement so as to not make the injury worse but enough to maintain some degree of local circulation. The patient started from 24/7 soreness and immobility to now being able to raise the arm with little difficulty in most directions and having no obvious soreness anymore. This was all in just a little over a month.

Recently I heard about a friend of a friend who also apparently had sustained a shoulder injury in the recent past. It was not even a bone injury, but a simple tendon stress injury from lifting something heavy. It was likely a tear injury from the sound of it.

This apparently lasted 8 months and now the problem isn't even completely gone yet, while the person is still doing physiotherapy. On this subject I should also point out that my patient's family doctor was very confused as to why she did not choose to go to ER. He told her if she ends up having "compartment syndrome" then it's her "loss".

For those who don't know what compartment syndrome is, this is a severe complication of traumatic injuries where the inflammation and swelling gets so severe that circulation below and away from the injury gets impaired, leading to other potentially worse conditions. I only have to say, this won't happen since we know how to prevent it through Chinese Medicine and Acupuncture. Leave it to conventional methods then it's anybody's guess.