Notes from Zheng Gu Tui Na Martial Arts/Sports Medicine Workshop

Soft Tissue Injuries

Bruise color determines the level of damage:

Black is bone level (KD)

Green is tendon level (LV)
Yellow is muscle level (SP)

Stage 1 (Acute) 1-7 Days

Characteristics: Heat, Qi and/or Blood Stasis, Fluid Accumulation

Treatment Principles: Clear Heat, Move Stasis, Stop Pain, Course Qi/Blood, Reduce Swelling
Ice is Contraindicated!

Treatment Strategies:
Injury is a break of flow of the Wei Qi so the area is exposed to external pathogens. We need to
restore the free flow of Qi.

Restoring the free flow will accelerate healing.

Massage around a sprain and away. Push fluid toward heart and toward limb/fingers/toes
Use a linament that is not too warming (because of presence of heat)
Can needle the sprain if swelling is not so bad that you can’t see bony landmarks
Needle in points above and below to draw Qi there
Bleed Jing Wells (like letting out steam in the channel, not necessary to get a lot of blood)
Cupping and Bleeding (remove blood to relieve pressure. not necessary to get a lot of blood.
just to relieve pressure in the superficial tissue)
Poulices can have miraculous affect on swollen joints (left overnight)
San Huang San Gao. Pack it on and leave is for 24 hours. Cover with saran wrap and a
bandage (lightly. don’t restrict blood flow or you may do more damage)
Guide herbs can be added to cool or warm depending.
A Hit Pill can be taken. Or Resinall K.
A purgative formula to draw blood away from injury is often given. for stasis. usually a laxative
i.e. Da Huang.

Resinall K- Qi Li San Herbal Supplement

For the treatment of pain and swelling due to traumatic injuries-sprains, strains, contusions, fractures,
broken bones, torn sinews, bleeding, bruising, lacerations. Treats some skin disorders topically fungal
infections (ringworm, athlete's foot), bacterial infections (impetigo, carbuncles, furuncles, periodontal
disease), eczema and dermal ulcers. Treats chronic pain, use with tonic formula. Made in the U.S.A.
by Health Concerns Ingredients: Proprietary Blend of resin Xue Jie, San Qi, Er Cha, Yan Hu Suo,
Hong Hua, Mo Yao, Ru Xiang, Bing Pian, Alcohol, Glycerin. *Do Not Use if pregnant or nursing The
statements regarding this product have not been evaluated by the Food and Drug Administration. In case
of emergency contact your healthcare provider immediately.

San Huang San ("Herbal Ice”) is the premiere external gao for 1st stage sinew and bone injuries
with swelling, pain and redness (heat). In Chinese medicine, it is the alternative to using ice, reducing
inflammation while simultaneously reducing swelling and removing stasis. San Huang San can also be
used to treat extensive bruising of large muscle areas. Preparation is available premixed with beeswax
and sesame oil for immediate use (Net Wt. 2oz)

Ingredients: da huang, huang qin, huang bai, pu gong ying, zhi zi.

San Huang San/ Powder

can be mixed with different media for different effects.

GAO MEDIUMS (applies to all Gao):
Vaseline, Green Tea, Egg Whites, Vinegar, Liquor, Turpentine, Chrysanthemum Juice, Ginger
Juice, Honey, Sesame Oil, Beeswax & Sesame Oil, Pine Resin, Water, Clay

Gao External Guide Herbs

Bo He Bing: mint crystals (very very warming) Bing Pian: penetrates muscle level Borneal
Crystals, She Xiang: muscle/bone level Extremely Warming!, Zhang Nao: camphor - warming

Do not apply Gao to open wounds, cuts, abrasions, nor with pregnancy
Soft Tissue Injuries (continued)

Stage 2 (sub-acute) 3-20 Days

Characteristics: Perhaps Heat or Cold, Qi and/or Blood Stasis (if there’s pain, there’s stasis),
Minor Fluid Accumulation

Treatment Principles: Move Stasis, Stop Pain (by moving stasis), Relax Sinews (restore some
flexibility), Course Qi/Blood, Reduce Swelling (if present), Restore Normal Function

Treatment Strategies:
Moving away from heat clearing, more moving of qi and damp accumulation (pathological
water), spasm, relax tendons

More Soaks are used in this phase (Soaks are too damp for stage 1)
Acupuncture 2” needle from GB40 toward KD6 threading (for ankle)
On lower leg do Tui Na to work on separating interossious membranes
Look one joint up and one joint down (always) for joint pain. Knee pain is rarely just knee.
(there’s a hip and ankle issue possible and one can cause the other)

Gua Sha - dredging, bursting superficial network so it can rebuild

Cupping (either with bleeding or with liniment possible) If there is stagnant blood, bleeding with
cupping is great.

Soaks: Boil for 20 minutes, steam the injury while on the stove (if possible) and then soak the
limb. If necessary, use towels. One soaking in the herbs while using the other and then switch
when it gets cool. Herbal soak can be kept for 4-5 days but must not be boiled a second time.
Just rewarm.

No soaks for bone fractures! (soaks are too expanding. bone fractures need a contracting
formula)

Ru Yi Jin Huang Gao is a good Gao for 2nd Stage Sinew Injuries

Leave on for 24 hours

Ru Yi Jin Huang San/ Powder

 Jin Huang Gao is generally used for 2nd stage sinew injuries or in late 1st stage
injuries where redness and heat are not present, but there is stagnation of fluids and
blood with swelling. The presence of more warming damp dispelling ingredients helps to
prevent Bi (obstruction) syndrome from developing and helps to dispel stagnant fluids.
Available in powder form (Net Wt. 100g).

Ingredients: da huang, huang bai, jiang huang, bai zhi, sheng tian nan xing, chen
pi, cang zhu, hou po, gan cao, tian hua fen. External use only.

Stage 3 (Chronic) note: This is where most patients are by the time they come to the clinic

If something is chronic there is deficiency and stasis.

14-20 Days - Present

Characteristics: Heat or Cold, Unresolved Qi and/or Blood Stasis, Minor Fluid Accumulation,
Accomodating/Adaptive Dysfunctions (people learn to move differently and this causes
misalignment that also causes problems which need to be addressed). This is where Qi Gong
and Tai Ji can play a role in the patient’s recovery.

Treatment Strategies:

When there are still Pathogens like Cold, Heat, Damp, you need to go back to the 1st Stage
treatments. Bleed Jing Wells, Cupping, Resinall K, Poultices, San Huang San (if there is heat).

Osseous Injuries
Stage 1 (Acute)
When a bone breaks, it breaks soft tissue, flow of meridian, qi, blood and fluids causing stasis,
blood accumulation, marrow possibly.

Treatment for 1-7 Days after bone break

The order of magnitude of debris in the surrounding tissue is beyond what Gua Sha can do.
Gua Sha breaks capillaries and works on superficial and muscle level tissue. When it’s down to
the bone, it is not a good strategy for clearing out the debris.
Take Hit Pills, Use San Huang San Gao
Use Acupoints above and below break
Maybe Tui Na above and below
Possibly Cupping (only above and below, NOT if it’s possible you will be moving the bone out of
place)
NO SOAKS

Stage 2 7-14 Days

Treatment Strategy:
Early Stage Bone Knitting Formula

Bone Knitting Formula - Early Stage

This formula focuses more on cleaning stasis in order to promote fracture healing, and so is
appropriate in the early stages of fracture healing (the first 2 weeks), when there is still swelling, bruishing,
and signs of blood stasis.

Ingredients: Gu Sui Bu, Lu Lu Tong, Zi Pan Tong, Dang Gui, Tu Bie Chong, Hong Hua, Mo Yao,
Ru Xiang, Tao Ren, San Qi, Gui Ji, Chi Shao.

Contains: 15 units, each 0.33oz.

Stage 3: 14-28 Days

E-Stim through area with needles at both ends. Must wait until bone is set. Don’t make muscles
twitch. They may spasm.

Bone Knitting Formula - Late Stage

Bone Knitting Formula--Late Stage

This formula continues to clear stasis while strongly tonifying the blood and strengthen bones and
sinews. It should be used in the 3rd to 5th weeks following a fracture.

Ingredients: Shu Di Huang; Chuan Xiong; Bai Shao; Dang Gui; Du Zhong; Wu Jia Pi; Gui Zhi; Gu
Sui Bu; San Qi; Lu Jin; Bu Gu Zhi; Tu Si Zi; Dang Shen; Mu Gu; Huang Qi; Tu Bie Chong; Liu Jin Nu; Xu
Duan.

Stage 4 4-5 weeks

Treatment Strategies:

Late-Stage Bone Knitting Formula

If not healing, check diet. Too much raw food or cold foods cut back on healing
May need to temporarily use a Yang Tonic
3 Whip Pills (temporarily, not for long-term)

ZHI BAO SAN BIAN JING

English name for this formula
Priceless Treasure Three Whip Extract

Symptoms related to Zhi Bao San Bian Jing

Asthenia (elderly people); Impotence; Intellectual asthenia; Memory loss; Night sweating; Pain
in the lower back; Premature ejaculation; Sexual asthenia; Spermatorrhea; Weakness of lower
back; Weakness of the knees; Chronic asthma; Insomnia; Weakness of the muscles; Weak
pulse (Ruo); ...

Ancillary Technique - GuaSha

Sha which literally means “sand” is a result of abnormal or restricted circulation

to determine if there is sha, press the area
if it remains white for more than 2-3 seconds, there is sha
instuct patient to avoid starch, roasted or deep fried foods, and cold food and drink for 24 hours
after guasha.
Guasha reformats network vessels: It also dredges stagnant blood, fluid and phlegm from
channels and collaterals

Indications:
Pain, stiffness, immobility in muscles
Cold
Sore muscles, as in early onset of fever, common cold, or Cold pathogen
Sunstroke, Heat exposure, Fever

Contraindication:
Varicose veins
Skin infections
Boils or abscess
Weak or thin skin (i.e. elderly)

Treaments
Cold
Guasha along sides of cervical and thoracic vertebrae and along trapezius muscle

Headache:
Guasha back of neck and Taiyang

Cough/Asthma:
Guasha anterior midline of sternum
Guasha upper back and intercostal areas
Fever:
Guasha on both sides of spine

Sore Throat:
Guasha sides of neck, SCM muscle and down both sides of spine (avoid carotid artery by staing
on the posteror half of SCM)

Mild Sunstroke:
Guasha neck and Taiyang
Guasha both sides of spine and intercostal spaces
Guasha back of knee, cubital crease and armpit