Sprains and Strains (Holistic)
About This Condition
- Control swelling and pain
Use the R.I.C.E treatment: Rest the body part, Ice it every hour, Compress it with elastic bandages, tape, or a brace, and Elevate it above your heart
- Control inflammation with enzyme preparations
Take 4 to 8 tablets a day of proteolytic enzymes containing trypsin, chymotrypsin, and/or bromelain for inflammation
- Take a multivitamin
Extra vitamins and minerals during recovery can help insure against deficiencies that slow the healing process
- Get help for serious injuries
Also, see a doctor if you cannot move or put weight on the body part, if the part looks crooked, if pain or tenderness is severe, if there is numbness or redness in the area, or if you have any other concerns about your injury
About This Condition
Sprains and strains are types of minor injuries to the soft tissues and connective tissues of the musculoskeletal system. Sprains usually refer to injuries to ligaments, but sometimes to other connective tissues, such as tendons and the capsules surrounding joints. Strains usually refer to injuries to muscles or to the areas where muscles become tendons.
Sprains and strains may occur together, and occasionally are quite severe, requiring immobilization of the body part in a rigid cast for weeks, long-term rehabilitation programs, and sometimes surgery.
Symptoms
The most common type of sprain is the ankle sprain. Ankle sprains have differing degrees of severity. Mild or minimal sprains with no tear of the ligament usually produce mild tenderness and some swelling. Moderate sprains, in which the ligament has been partially ruptured, produce obvious swelling, bruising, significant tenderness, and difficulty walking. Severe sprains, as when the ligament is completely torn from the bone (called avulsion), make walking impossible and produce marked swelling, internal bleeding and joint instability.
Symptoms of strains include muscle soreness, muscle spasm, pain, and possibly swelling or warmth over the involved muscle.
Holistic Options
Spinal manipulation is used by chiropractors, licensed naturopathic doctors, and some osteopathic doctors to relieve pain and improve healing of sprains and strains. One preliminary trial tested a combination of chiropractic manipulation, muscle stretching, and special exercises known as “proprioceptive neurofacilitation” to people who had sprain/strain neck injuries that had not resolved with other treatment.1 Treatment was reported to help the majority of people, and over one-third reported that their symptoms were completely gone or only mildly bothersome. In a larger preliminary trial,2 people who were still suffering neck pain a year after whiplash-type accidents were treated with spinal manipulation for an average of four months. At the end of the treatments, 72% reported at least some benefit and nearly half reported significant benefit or complete recovery, but people with the most severe symptoms derived little benefit.
The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.
| Recommendation | Why |
|---|---|
| Major injuries can use protein | People hospitalized for major injuries may benefit from a diet high in protein and adequate in calories, to help the body repair damaged connective tissues. Good protein sources include fish, chicken, and soy products. Adequate amounts of calories and protein are required for the body to repair damaged connective tissue. While major injuries requiring hospitalization raise protein and calorie requirements significantly, minor sprains and strains do not require changes from a typical, healthful diet. |
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
| Supplement | Why |
|---|---|
3 Stars Bromelain 4 to 8 tablets a day of bromelain | Bromelain, a proteolytic enzyme, may be helpful in healing sprains and strains because it is anti-inflammatory and appears to promote tissue healing. Several preliminary trials have reported reduced pain and swelling, and/or faster healing in people with a variety of conditions using either bromelain, papain from papaya, or a combination of trypsin and chymotrypsin. Double-blind trials have reported faster recovery from athletic injuries, including sprains and strains, and earlier return to activity using eight tablets daily of trypsin/chymotrypsin, four to eight tablets daily of papain, eight tablets of bromelain (single-blind only), or a combination of these enzymes. However, one double-blind trial using eight tablets per day of trypsin/chymotrypsin to treat sprained ankles found no significant effect on swelling, bruising, or overall function. Bromelain is measured in MCUs (milk clotting units) or GDUs (gelatin dissolving units). One GDU equals 1.5 MCU. Strong products contain at least 2,000 MCU (1,333 GDU) per gram (1,000 mg). A supplement containing 500 mg labeled “2,000 MCU per gram” would have 1,000 MCU of activity, because 500 mg is half a gram. Some doctors recommend 3,000 MCU taken three times per day for several days, followed by 2,000 MCU three times per day. Some of the research, however, uses smaller amounts, such as 2,000 MCU taken in divided amounts in the course of a day (500 MCU taken four times per day). |
3 Stars Proteolytic Enzymes 4 to 8 tablets a day of proteolytic enzymes containing trypsin, chymotrypsin, and/or bromelain | Proteolytic enzymes, including bromelain, may be helpful in healing sprains and strains because they are anti-inflammatory and appear to promote tissue healing. Several preliminary trials have reported reduced pain and swelling, and/or faster healing in people with a variety of conditions using either bromelain, papain from papaya, or a combination of trypsin and chymotrypsin. Double-blind trials have reported faster recovery from athletic injuries, including sprains and strains, and earlier return to activity using eight tablets daily of trypsin/chymotrypsin, four to eight tablets daily of papain, eight tablets of bromelain (single-blind only), or a combination of these enzymes. However, one double-blind trial using eight tablets per day of trypsin/chymotrypsin to treat sprained ankles found no significant effect on swelling, bruising, or overall function. Bromelain is measured in MCUs (milk clotting units) or GDUs (gelatin dissolving units). One GDU equals 1.5 MCU. Strong products contain at least 2,000 MCU (1,333 GDU) per gram (1,000 mg). A supplement containing 500 mg labeled “2,000 MCU per gram” would have 1,000 MCU of activity, because 500 mg is half a gram. Some doctors recommend 3,000 MCU taken three times per day for several days, followed by 2,000 MCU three times per day. Some of the research, however, uses smaller amounts, such as 2,000 MCU taken in divided amounts in the course of a day (500 MCU taken four times per day). Other enzyme preparations, such as trypsin/chymotrypsin, have different measuring units. Recommended use is typically two tablets four times per day on an empty stomach, but as with bromelain, the strength of trypsin/chymotrypsin tablets can vary significantly from product to product. |
2 Stars Comfrey Apply an ointment containing 35% herbal extract | Comfrey is widely used in traditional medicine as a topical application to help heal wounds. Comfrey is also widely used in traditional medicine as a topical application to help heal wounds. In a study of people with acute ankle sprains, topical application of an ointment four times a day containing a comfrey extract was at least as effective as, and possibly more effective than, a topically applied anti-inflammatory drug (diclofenac). The comfrey ointment was a proprietary product that contained 35% comfrey extract. |
2 Stars Horse Chestnut Apply a 2% gel every two hours | Horse chestnut contains a compound called aescin that acts as an anti-inflammatory and reduces edema (swelling with fluid) following injuries. Horse chestnut contains a compound called aescin that acts as an anti-inflammatory and reduces edema (swelling with fluid) following trauma, particularly sports injuries, surgery, and head injury. A topical gel containing 2% of the compound aescin found in horse chestnut is widely used in Germany to treat minor sports injuries, including sprains and strains. The gel is typically applied to affected area every two hours until swelling begins to subside. |
2 Stars L-Carnitine (Exercise-Related Muscle Injury) 3 grams per day | One trial showed that people who take L-carnitine for three weeks before engaging in an exercise regimen are less likely to experience muscle soreness. One controlled trial showed that people who supplement with 3 grams per day L-carnitine for three weeks before engaging in an exercise regimen are less likely to experience muscle soreness. |
2 Stars Tart Cherry (Exercise-Related Muscle Injury) 80 mg anthocyanins, the equivalent of approximately 100–120 cherries, 16–24 ounces tart cherry juice blend, 1 ounce of liquid concentrate, or 400 mg of concentrate in tablets or capsules | Some studies indicate that supplementing with tart cherry may support muscle strength recovery and reduce pain, especially after exercise. An animal study found reduced blood measures of muscle damage after strenuous exercise when the animals were fed tart cherry juice prior to exercise. In a small, double-blind study, young men drank 12 ounces twice daily of tart cherry juice blended with apple juice, [note: ratio not given] equivalent to 80 mg per day of anthocyanins or 100-120 cherries per day. After eight days the men performed intense elbow flexion exercises, and after drinking tart cherry juice this exercise resulted in less muscle pain and loss of strength compared to after drinking a placebo juice. In a small double-blind study, trained athletes took about one ounce twice daily of a tart cherry juice concentrate, containing about 550 mg per day of anthocyanin, for ten days beginning seven days before an intense session of weight-training leg exercises. Compared to when they took a placebo concentrate, taking tart cherry concentrate resulted in faster recovery of leg muscle strength after the exercise. Two double-blind trials investigated the effects of tart cherry juice in long distance runners. In one small double-blind trial, drinking eight ounces twice daily of tart cherry juice blended with apple juice, [note: ratio not given] equivalent to 80 mg per day of anthocyanins or 100-120 cherries per day, for eight days beginning five days before a marathon resulted in faster recovery of leg muscle strength and smaller elevations in post-race blood measures of inflammation. However, there was no difference in muscle soreness or in post-race blood measures of muscle damage. In another, larger double-blind trial, long distance runners who drank 10.5 ounces twice daily of tart cherry juice blended with apple juice, [note: ratio not given] equivalent to 80 mg per day of anthocyanins or 100-120 cherries per day, for eight days beginning one week before the race reported only one-third as much post-race muscle pain compared to those who used a placebo juice. |
2 Stars Vitamin C 250 to 500 mg with meals and at bedtime | Vitamin C is needed to make collagen, the “glue” that strengthens connective tissue. Vitamin C supplementation can speed healing of various types of trauma. Antioxidant supplements, including vitamin C and vitamin E, may help prevent exercise-related muscle injuries by neutralizing free radicals produced during strenuous activities. Controlled research, some of it double-blind, has shown that 400–3,000 mg per day of vitamin C may reduce pain and speed up muscle strength recovery after intense exercise. Reductions in blood indicators of muscle damage and free radical activity have also been reported for supplementation with 400–1,200 IU per day of vitamin E in most studies, but no measurable benefits in exercise recovery have been reported. A combination of 90 mg per day of coenzyme Q10 and a very small amount of vitamin E did not produce any protective effects in one double-blind trial. Vitamin C is needed to make collagen, the “glue” that strengthens connective tissue. Injury, at least when severe, appears to increase vitamin C requirements, and vitamin C deficiency causes delayed healing from injury. Preliminary human studies have suggested that vitamin C supplementation in non-deficient people can speed healing of various types of trauma, including musculoskeletal injuries, but double-blind research has not confirmed these effects for athletic injuries, which included sprains and strains. |
2 Stars Zinc Take under medical supervision: 25 to 50 mg daily ( plus 1 to 3 mg of copper daily, to prevent depletion) | Zinc helps with healing. Even a mild deficiency can interfere with optimal recovery from everyday tissue damage and more serious trauma. Zinc is a component of many enzymes, including some that are needed to repair wounds. Even a mild deficiency of zinc can interfere with optimal recovery from everyday tissue damage as well as from more serious trauma. Trace minerals, such as manganese, copper, and silicon are also known to be important in the biochemistry of tissue healing. However, there have been no controlled studies of people with sprains or strains to explore the effect of deficiency of these minerals, or of oral supplementation, on the rate of healing. |
1 Star Arnica 2,000 to 9,000 mcu per day | Arnica is considered by some practitioners to be among the most effective wound-healing herbs available. Arnica is considered by some practitioners to be among the most effective wound-healing herbs available. As a homeopathic remedy, arnica is often recommended as both an internal and topical mean to treat minor injuries. Some healthcare practitioners recommend mixing 1 tablespoon of arnica tincture in 500 ml water, then soaking thin cloth or gauze in the liquid and applying it to the injured area for at least 15 minutes four to five times per day. |
1 Star Chondroitin Sulfate Refer to label instructions | Chondroitin sulfate may promote wound healing by providing the raw material needed by the body to manufacture molecules found in skin, tendons, ligaments, and joints. Glucosamine sulfate and chondroitin sulfate may both play a role in wound healing by providing the raw material needed by the body to manufacture molecules called glycosaminoglycans found in skin, tendons, ligaments, and joints. Test tube and animal studies have found that these substances, and others like them, can promote improved tissue healing. Injectable forms of chondroitin sulfate have been used in Europe for various types of sports-related injuries to tendons and joints, and one preliminary trial reported reduced pain and good healing in young athletes with chondromalacia patella (cartilage softening in the knee) who were given 750–1,500 mg per day of oral glucosamine sulfate. However, specific human trials of glucosamine and chondroitin sulfate for healing sprains and strains are lacking. |
1 Star Copper Refer to label instructions | Trace minerals, such as copper, are known to be important in the biochemistry of tissue healing. Zinc is a component of many enzymes, including some that are needed to repair wounds. Even a mild deficiency of zinc can interfere with optimal recovery from everyday tissue damage as well as from more serious trauma. Trace minerals, such as manganese, copper, and silicon are also known to be important in the biochemistry of tissue healing. However, there have been no controlled studies of people with sprains or strains to explore the effect of deficiency of these minerals, or of oral supplementation, on the rate of healing. |
1 Star DMSO Refer to label instructions | DMSO has anti-inflammatory properties and may inhibit the transmission of pain messages by nerves. Supplementing with it may ease the pain of minor injuries. The use of DMSO, a colorless, oily liquid primarily used as an industrial solvent, for therapeutic applications is controversial. However, some evidence indicates that dilutions, when applied directly to the skin, have anti-inflammatory properties and inhibit the transmission of pain messages by nerves, and in this way might ease the pain of minor injuries such as sprains and strains. However no controlled research exists to confirm these effects in sprains and strains. DMSO comes in different strengths and different degrees of purity. In addition, certain precautions must be taken when applying DMSO. For those reasons, DMSO should be used only with the supervision of a doctor. |
1 Star Glucosamine Refer to label instructions | Glucosamine sulfate may promote healing after injury by providing the raw material needed by the body to manufacture molecules found in skin, tendons, ligaments, and joints. Glucosamine sulfate and chondroitin sulfate may both play a role in wound healing by providing the raw material needed by the body to manufacture molecules called glycosaminoglycans found in skin, tendons, ligaments, and joints. Test tube and animal studies have found that these substances, and others like them, can promote improved tissue healing. Injectable forms of chondroitin sulfate have been used in Europe for various types of sports-related injuries to tendons and joints, and one preliminary trial reported reduced pain and good healing in young athletes with chondromalacia patella (cartilage softening in the knee) who were given 750–1,500 mg per day of oral glucosamine sulfate. However, specific human trials of glucosamine and chondroitin sulfate for healing sprains and strains are lacking. |
1 Star Manganese Refer to label instructions | Trace minerals, such as manganese, are known to be important in the biochemistry of tissue healing. Zinc is a component of many enzymes, including some that are needed to repair wounds. Even a mild deficiency of zinc can interfere with optimal recovery from everyday tissue damage as well as from more serious trauma. Trace minerals, such as manganese, copper, and silicon are also known to be important in the biochemistry of tissue healing. However, there have been no controlled studies of people with sprains or strains to explore the effect of deficiency of these minerals, or of oral supplementation, on the rate of healing. |
1 Star Multivitamin Refer to label instructions | Taking a multivitamin-mineral supplement can help insure against deficiencies that slow the healing process. Many vitamins and minerals have essential roles in tissue repair, and deficiencies of one or more of these nutrients have been demonstrated in animal studies to impair the healing process. This could argue for the use of multiple vitamin-mineral supplements by people with minor injuries who might have deficiencies due to poor diets or other problems, but controlled human research is lacking to support this. |
1 Star Silicon Refer to label instructions | Trace minerals, such as silicon are known to be important in the biochemistry of tissue healing. Zinc is a component of many enzymes, including some that are needed to repair wounds. Even a mild deficiency of zinc can interfere with optimal recovery from everyday tissue damage as well as from more serious trauma. Trace minerals, such as manganese, copper, and silicon are also known to be important in the biochemistry of tissue healing. However, there have been no controlled studies of people with sprains or strains to explore the effect of deficiency of these minerals, or of oral supplementation, on the rate of healing. |
1 Star Vitamin E (Exercise-Related Muscle Injury) Refer to label instructions | Antioxidant supplements, including vitamin E, may help prevent exercise-related muscle injuries by neutralizing free radicals produced during strenuous activities. Antioxidant supplements, including vitamin C and vitamin E, may help prevent exercise-related muscle injuries by neutralizing free radicals produced during strenuous activities. Controlled research, some of it double-blind, has shown that 400–3,000 mg per day of vitamin C may reduce pain and speed up muscle strength recovery after intense exercise. Reductions in blood indicators of muscle damage and free radical activity have also been reported for supplementation with 400–1,200 IU per day of vitamin E in most studies, but no measurable benefits in exercise recovery have been reported. A combination of 90 mg per day of coenzyme Q10 and a very small amount of vitamin E did not produce any protective effects in one double-blind trial. |
1. Woodward MN, Cook JC, Gargan MF, Bannister GC. Chiropractic treatment of chronic “whiplash” injuries. Injury 1996;27:643-5.
2. Khan S, Cook J, Gargan M, Bannister G. A symptomatic classification of whiplash injury and the implications for treatment. J Orthop Med 1999;21:22-5.
Last Review: 06-04-2015
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