Injury Management Naturopathic Protocol
Injury Management Naturopathic Protocol
This Injury Management Naturopathic Protocol is provided as information for patients of HealthMasters Naturopath Kevin Tresize ND as part of a treatment plan to assist patients with understanding of their treatment plan and should not be substituted for medical advice, diagnosis or treatment. It is important to note that this is a summary only and is intended to assist discussion between practitioner and patient as part of consultations. This Injury Management Naturopathic Protocol may be changed to suit the individual requirements of the patient and should not be substituted for medical advice, diagnosis or treatment.
HealthMasters Naturopath Kevin Tresize ND
An acute injury is a recent injury, often associated with inflammation and pain, to joints, muscles and connective tissues. Whatever the injury (e.g., cut, strain, sprain or fracture), many of the underlying inflammatory and healing processes are the same. The aim of acute injury treatment is ensuring these processes occur in a timely, appropriate and healthy manner. How acute injuries are managed is important, however, as it makes a difference to future function. A poorly healed injury can restrict functional ability or result in long term pain. Before going ahead with management it is important to exclude serious diagnoses which need medical attention. Symptoms to be wary of include:
- Sudden and severe pain and swelling which does not ease with time
- Deformity/misalignment of the injured part
- Strong guarding of the part, or unusual movement
- Grating or crunching at the site of injury
A chronic injury may occur from the cumulative effects of repeated exposure to an injurious force not sufficient to cause acute injury. It may also result from an acute injury that, for whatever reason, does not recover as expected. Examples include stress fractures, Osgood-Schlatter Disease, tendonitis (e.g. tennis elbow) or Repetitive Strain Injury (RSI).
2. Aetiology / Risk factors
Factors that increase the risks for having an injury:
- Alcohol and recreational drug abuse
- Sports – all types
- Age: 16-19 years have the highest risk of motor vehicle accidents
- Age: 50 years and older have the highest risk of injury after falls
3. Signs and Symptoms
Common signs and symptoms of an acute injury are:
- Common signs and symptoms of acute soft tissue injury include pain, redness, heat, swelling, bruising, muscle spasm, instability of a joint, inability to use part normally.
- Abdominal or thoracic injury could cause chest or abdominal pain, shortness of breath or blood in the urine.
- Airway obstruction could cause choking, gasping or wheezing, collapse and respiratory arrest.
- Fractures or dislocations may be present where there is severe pain, deformity of a limb or inability to use a part of the body.
- Head injuries may show up as confusion, head pain, loss of consciousness, disorientation or aggression.
- Nerve injuries may show up as weakness, numbness, pins and needles and inability to use part of the body, perhaps without significant pain.
- Spinal injuries must always be considered when any significant force is involved in the trauma, with neck or back injuries resulting in pain and perhaps inability to use a part of the body.
- Vascular injury can result in loss of normal pulses, a change in colour or temperature of a limb or a drop in blood pressure as bleeding occurs inside the body.
Common signs and symptoms of a chronic injury include:
- Pain when performing activities
- Dull ache at injury site when at rest
- Swelling at the site
4. ACUTE INJURY TREATMENT
First 1 – 4 weeks, depending on injury after First Aid is administered
4.1 Manage inflammation, swelling and trauma
High Potency Anti-inflammatory Herbs - 2 tablets up to three times daily
4.2 Manage pain
Meta Mag Magnesium Bisglycinate, Corydalis and California Poppy for Pain - 1 serve twice daily
4.3 Initiate healing and repair, connective tissue support
High Bioavailability Zinc with Vitamin C - 1 serve 2-4 times daily
4.4 Manage shock or stress
Herbal Support for Hyper HPA and Stress - 1-2 three times daily, as required
5. CHRONIC INJURY TREATMENT
Recovery 1 – 6 months, depending on injury
5.1 Chronic management of inflammation and pain
BCM – 95 Turmeric and Devil’s Claw to Treat Chronic Inflammation - 3 capsules twice daily
Specialised Pro-Resolving Mediators[*] - 1 capsule twice daily
Highly Bioavailable Palmitoylethanolamide (PEA) With Endocannabinoid Action - 1 capsule twice daily
5.2 Nutrients to repair connective tissues
Nutritional Support for Connective Tissue Strength and Repair - 1 tablet three times daily
High Bioavailability Zinc with Vitamin C - 1 serves times daily, as required
5.3 Support lymphatic drainage to manage swelling around inflamed joints
Blood and Lymphatic Detoxification - 1 tablet twice daily
5.4 If joint injury
Gelatin Complete Joint Restore Powder - 1 serve daily
5.5 If with broken bones
Hydroxyapatite and Soy for Osteoporosis - 2 tablets twice daily or 1 serve twice daily
High Bioavailability Magnesium Powder with active Bs - 1 serve twice daily
5.6 If with nerve damage
Lipids and Tocotrienols for Healthy Cell Membranes and Cognition - 1 serve twice daily
Alpha Lipoic Acid for Antioxidant Support - 1 tablet daily
5.7 If required antibiotic therapy or if with ongoing gut-derived inflammation
5.8 Support psychological wellbeing for patients with severe or long term physical injury
Assess neurobiology using the Mood and Stress Questionnaire (MSQ)
5.9 Achieve or maintain a healthy body composition with an anti-inflammatory diet and lifestyle
If overweight or obese
Wellness and Healthy Ageing Program
6. Alphabetical Reference of Nutritional
|Formula Catch Phrase||Key Benefits|
|Alpha Lipoic Acid for Antioxidant Support||Alpha-lipoic acid (ALA) supports nerve health and function, being a useful antioxidant in the management of neuropathy.|
|BCM – 95 Turmeric and Devil’s Claw to Treat Chronic Inflammation||A combination of herbs to provide powerful synergistic anti-inflammatory and analgesic effects by inhibiting RAGE, COX-2 expression, TNF-α and NFkB. This herbal combination is safe for long-term use.|
|Blood and Lymphatic Detoxification||Cleavers, burdock, nettle, blue flag and danshen blended with essential oils helps to reduce inflammation and support lymphatic drainage to reduce pain and swelling.|
|Gelatin Complete Joint Restore Powder||This blend of glucosamine, MSM and gelatin with nutritional co-factors is shown reduce musculoskeletal pain and inflammation and promote the healing of joint tissues.|
|Herbal Support for Hyper HPA and Stress||An herbal blend that rapidly relieves anxiety and tension. Including zizyphus and magnolia which interacts with calming dopamine, serotonin and GABA benzodiazepine receptors to manage pain and anxiety.|
|High Bioavailability Zinc with Vitamin C||Poor wound healing is a symptom of zinc deficiency. Replenishing zinc speeds recovery and vitamin C is necessary for connective tissue formation.|
|Highly Bioavailable Palmitoylethanolamide (PEA) With Endocannabinoid Action||PEA is a bioactive lipid that directly modulates endocannabinoid signalling, indirectly increasing cannabinoid receptor activity throughout the nervous system, including microglial cells and astrocytes, as well as receptor activity in immune cells. PEA’s actions enhance anti-neuroinflammatory, analgesic and neuroprotective pathways, benefiting chronic pain, including neuropathic pain, in addition to neurodegenerative conditions.|
|High Potency Anti-inflammatory Herbs||Helpful for acute pain management with powerful anti-inflammatory standardised extracts including BCM-95 turmeric, BosPure Boswellia, willow bark, ginger and quercetin to rapidly reduce inflammation|
|High Bioavailability Magnesium Powder with active Bs||Magnesium is an important bone nutrient, as well as helping to relieve muscular cramps and spasms, all helpful for injury management, as well as the beneficial nervous system support to help manage the stress of injury.|
|Hydroxyapatite and Soy for Osteoporosis||An advanced bone strengthening combination of microcrystalline hydroxyapatite bone extract with an isolflavone-rich extract of soy plus synergistic nutrients, blended to support bone strength and to support growth, repair and recovery of bone injuries.|
|Lipids and Tocotrienols for Healthy Cell Membranes and Cognition||Vitamin D, tocotrienols, omega 3 EFAs and phospholipids effectively protect and replace damaged lipids and support cellular and mitochondrial structure, function and numbers.|
|Low Carb Protein Powder for Fat Loss||Delivering 20 g protein (soy and whey) and 2.3 - 2.9 g carbohydrates. Due to the different digestion rates of whey and soy, this blend prolongs amino acid delivery to tissues to support optimal muscle synthesis and mass and supports healthy immunity and healing.|
|Meta Mag Magnesium Bisglycinate, Corydalis and California Poppy for Pain||A magnesium and herbal formula for acute or chronic pain management. Magnesium has been shown to block glutamate via inhibition of the NMDA receptor, thereby reducing excitatory neurotransmission. Corydalis is an effective analgesic in both inflammatory and neuropathic pain.|
|Nutritional Support for Connective Tissue Strength and Repair||Vegetarian-friendly nutrients such as silica, magnesium, lysine vitamin C and manganese are required for connective tissue strength and repair.|
|Specialised Pro-Resolving Mediators||SPMs are lipid mediators that promote resolution, reduce pain, encourage clearance of pathogens and mitigate pathological inflammation, without immunosuppression. SPMs regulate macrophage polarisation; triggering the switch from M1 (proinflammatory) to the M2 (anti-inflammatory) phenotype, therefore promoting resolution.|
|Undenatured Whey Protein Isolate||A low reactive whey protein powder, providing the necessary amino acids for tissue repair.|
7. Supportive Lifestyle Programs
|Shake It Practitioner Weight Management Program||There is growing evidence that obesity is a disorder of energy homeostasis, and that the metabolic set-point for overweight individuals is set to a higher level. The Shake It Practitioner Weight Management Program is a novel 3 phase program structure designed to prevent metabolic adaptation, reset the patient’s metabolic set point, and provide regular psychological breaks from active dieting to achieve sustained weight loss. The program provides supportive materials in order to implement behavioural change techniques and two diet options: Ketogenic (low carbohydrate, high fat), or low fat (low fat, liberal carbohydrate). The ketogenic diet is advised to optimally address insulin resistance.|
|Wellness and Healthy Ageing Program||This program recommends a low glycaemic load diet with lifestyle recommendations for exercise, relaxation, intellectual stimulation and effective stress management – all factors associated with healthy ageing and chronic disease prevention.|
|Gut Pathogen Elimination Program||Neurological and gut health is highly dependent on effective liver and bowel detoxification and clearance of endogenous and environmental toxins. The Gut Pathogen Elimination Program is specially created for those who experience ongoing or extensive digestive symptoms, or who have been identified with an imbalance in their gut flora, which can negatively impact health and wellbeing. This program helps to restore healthy gastrointestinal function and rebuild a healthy intestinal microbial balance.|
8. Diet and Lifestyle
Dietary and lifestyle guidelines may assist in management of acute and chronic injuries:
- Consume an anti-inflammatory low reactive diet, with adequate protein and essential fatty acids and low in starchy carbohydrates, as outlined in the Wellness and Healthy Ageing Program.
- Adjunctive soft tissue therapy treatment such as massage, physiotherapy, cranio-sacral therapy and/or Bowen therapy may be recommended.
- Acupuncture has been shown to assist in management of some acute injuries.
Plus chronic injuries:
- Stretching and guided physical therapy is often recommended to prevent adhesions.
- Electrotherapy, cryotherapy and/or thermotherapy are also used in chronic injury management.
9. Pathology Tests
|X-Ray||X-rays are especially useful in the detection of injury of the skeleton and some soft tissue injuries.|
|Ultrasound||Ultrasound performed diagnostically may reveal inflammation and/or chronic injury.|
|MRI / CT scan||CT scan is best for viewing bone injuries, whereas MRI may be used to examine soft tissue in ligament and tendon injuries or spinal cord injuries.|
|Omega-3 Index Test||A validated test that measures red-blood cell (RBC) EPA and DHA status to personalise supplemental and diet prescriptions, as well as identifying those at risk of health conditions associated with omega-3 deficiency. An Omega-3 Index in the desirable range of 8%-12% is an indicator of better overall health.|
10. Pharmaceutical Treatments
[*] Ensuring patients maintain an omega 3 index above 8% is essential to SPM production. Omega-3 status can be evaluated/monitored using the Omega-3 Index Test (refer to pathology testing section). In the instance of deficiency, consider co-prescribing an omega-3 essential fatty acid supplement.