utitiona otocos o otTissue nuies an oint Heath


by: Robert G. Silverman, DC, DACBN, DCBCN, MS, CCN, CNS, CSCS, CIISN, CKTP, CES, HKC, SASTM


When an individual gets inured, the typical treatment response does not include proper supplementation necessary to help the body heal itself. In the times of physiological stress or inury, diet alone may not meet the body’s nutritional needs. The use of nutritional sup- plements in addition to a proper diet creates a physiological environment for healing. Therefore, understanding the role and use of micronutrients can improve the uality of your practice.


micronutrients and how they can promote inury healing. The following article will talk about


A continually contracting muscle reuires specic nu- trients and oxygen. A lack of nutrient supply to a muscle/ tendon region will lead to overuse; soft-tissue inuries. Therefore, let’s ensure that patients get a healthy nutrient supply to the body through proper diet and supplementation that will assist the body with its natural function and repair processes.


The initial inury stage is called the acute phase, char- acteried by visual swelling, inammation, and spasm in the surrounding tissues. Typically, there is limited range of motion and potential loss of function. The obective of nutritional supplements in this phase should be to aid in managing pain, reducing swelling and relaxing tight muscles.


Tissue trauma causes an inammatory process, which releases certain inammatory response mediators called cytokines and chemokines. These chemicals release PLA and arachidonic acid, which then stimulate prostaglandins and thromboxanes. These hormones signal pain and in- duce rapid inammation.


Management of the Acute Phase: Reducing Pain, 


The typical acute phase lasts for three days. Effective treatment begins immediately with nutritional supp- lementation. utrients to address swelling such as tryp- sin, chymotrypsin, bromelain (also called proteolytic en- ymes) can help aid to reduce pain and inammation. In fact, it is evidenced that patients experience faster recovery rates with proteolytic enymes. These enymes must be consumed on an empty stomach for full effectiveness. umerous studies conclude that both ginger and turmeric (curcumin) inhibit inammation by moderating excessive cyclooxygenase and lipoxygenase response. Turmeric stimulates muscle tissue repair and is an F-k inhibitor. oswelia serrata has been found to specically inhibit the powerful pro-inammatory enyme, -lipoxygenase. The


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obective of taking these nutrients is to reduce pain and modulate inammation.


Muscle Tissue Repair


Calcium and magnesium are excellent additions to assist muscle tissue relaxation; calcium acts via pre-synaptic inhibition at neuromuscular unctions to reduce spasm, while magnesium promotes muscle relaxation. In a typical multivitamin/mineral, calcium to magnesium is taken in a 1 ratio. However, for muscle inury, they should be consumed at a 1 ratio for purposes of muscle relaxation.


Sub-Acute Healing: Repair and Remodeling Phase The second phase starts at day four and includes up to approximately eight weeks, during which repair and remodeling of soft tissue takes place.


 Range of motion possibly compromised  Tissue repair and remodeling have begun


Patient Symptoms  Continued oint or muscle pain  Palpable inammation surrounding inury may still be present


 Aid in connective tissue remodeling  Reduce risk of re-inury and degeneration 


Therapeutic Objectives for the Repair/Remodeling Phase  Provide repairative nutrients that may help minimie formation of scar tissue


 Continue controlling pain and inammation


Initiate soft-tissue (extracellular matrix) support by modulating matrix metalloproteinases


Nutritional Protocol for Sub-Acute Healing An inured site never achieves the original histologic or mechanical features of a healthy, uninured tendon with rest alone., but chiropractors can make a real difference in the healing of a tendon. Chiropractic treatment including, low-level laser therapy, exercise, manipulation, and crucial nutritional supplements aid in the healing process. Matrix metalloproteinase (MMP) enymes are released at the time of inury. nfortunately, excessive release of MMP’s can damage healthy tendon, collagen and connective tissue in the inured area. At this point, with elevated MMP’s release, the body goes from an inammatory process into a degenerative state, accelerating from “itis” to “osis.” The goal at this point is to modulate the explosion of these enymes.


Certain compounds, iso-alpha-acids such as ThiAA, signal inhibition and stimulate positive messages into the cell. erberine, selenium and folic acid are nutrients that also positively impact MMP’s. These nutrients are critical elements in a soft tissue nutritional formula. Support the growth and construction of connective tissue with the following combined nutrients  lycine, proline, lysine, vitamin C, 6, , L-taurine, and silica


 lucosamine/chondroitin sulfate/MSM should be consumed concurrently as well to aid in oint stability


Wellness and Prevention Phase The goal in this nal phase is to achieve optimal tissue


THE ORIGINAL INTERNIST MARCH 01 (Continued on next page)


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