Hi Card Fam! I’m Colby Helton, and I’ll be providing injury reports on our fallen Cardinal team members this basketball season. Hopefully we won’t have to catalog too many entries in this article series, but it’s my goal to provide a little more insight into the nature of the injuries and their treatments. In addition to being a huge Louisville fan, I am also an acupuncturist by trade, so I will be offering my alternative approach to treating sports injuries as well as the usual standard of care procedures.

Injury

Ryan McMahon collided with a player during Louisville’s intrasquad Red-White scrimmage on Oct .13, injuring his ribs and causing him not to return to the game.

Diagnosis

Originally McMahon was said to have bruised his ribs, though later tests revealed he had at least one hairline fracture. Which rib or ribs are affected is unknown. Diagnosis is typically done by physical exam or X-ray.

Symptoms and Anatomy

Symptoms of fractured rib bones are typically pain on palpation of the area, during movement of the upper torso, and when taking a deep breath. The small muscles in between the ribs are called the intercostal muscles. The intercostals are considered secondary muscles of respiration, meaning they aid in breathing by helping to expand the ribcage as the lungs fill with air upon inhalation. Often with broken ribs due to trauma, there is significant bruising or tearing of the nearby intercostals, resulting in more pain in the area and during breathing. This certainly makes high-intensity athletic activity extremely uncomfortable, to say nothing of the risk for further injury or pain upon impact in practice.

Standard Treatment

Typical treatment is usually rest and medication to manage pain and discomfort. Stretches and breathing exercises are often recommended to help with deep breathing to avoid respiratory complications. Some doctors may wrap the chest to immobilize the area of the fracture, but this is not always the case as that can impair breathing. With a hairline fracture, this is typically sufficient. Obviously, if there ribs are broken in multiple places or fragmented, that increases healing time and the likelihood of requiring surgery.

Dr. Colby’s Treatment

As an acupuncturist, my approach to sports injuries is pretty straightforward: increase circulation to promoting healing of the injured tissues. In Traditional Chinese Medicine (of which acupuncture is one part) there is a saying: “Tong zhi bu tong; Bu tong zhi tong,” meaning “Where there is free flow, there is no pain; where there is pain, there is no free flow”. This applies to all types of pain, but certainly traumatic injury. If you think about a bruise, what is it really but damaged tissue and stuck blood? It’s painful, and you have the mark to prove it. As the bruise fades, so does the pain. Acupuncture speeds up that process.

For a hairline fracture of the rib and bruised intercostals, I would use acupuncture at the site of the pain, needling directly into the muscles between the ribs. Now this is where six years of needling technique training come in: the ribs are designed to protect your vital organs from sharp things, so the depth and angle of insertion here are incredibly important! Needling the tissue obliquely helps to stimulate blood flow locally, moving out congestion, dead blood cells, and alleviating pain and inflammation. The specific area of the injury also determines where else on the body acupuncture is done. Several acupuncture meridians (the lines on which all the acupuncture points are) run through the chest and ribcage area, so to increase circulation along that pathway, I would also needle somewhere else farther down the line, usually on the foot or leg. Additionally, there are general pain relief points that work by releasing dopamine and other neurotransmitters in the brain that help stop pain and increase blood flow. There are also acupuncture points that literally help to mend broken bones, having been shown clinically to increase osteoblast production, creating new bone cells.

Herbal medicine has a role to play, too. There is a formula called “Bone Knitting Powder” that I use frequently for broken ribs and other bones among my patients. I typically prepare it as a tea, though it can be used externally, as well. The strategy is the same, however, and the ingredients include natural medicinals whose functions include invigorating blood flow, stopping pain, regenerating tissue, and mending bones.

The breathing exercises and stretches are really important because they also help to keep things flowing. Chinese medicine differs from western medicine in that we don’t like to use ice to stop swelling and numb pain. If the creek is frozen, it is not flowing freely and steadily. Heat is almost always better.

Prognosis

Standard recovery time is usually about a month, give or take a week or two. Avoiding ice and including acupuncture in the treatment regiment will typically shave at least a week off recovery time in otherwise healthy individuals.

Ryan, we wish you well on your continued recovery and hope to see you sinking 3-pointers against Omaha next week!

Go Cards!

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Colby Helton is a Louisville native who pronounces it "Louie-ville." He has lived in Chicago, Germany, China, and San Diego, but people don't watch college basketball in those places, so he moved home. He did his undergraduate studies at Northwestern University and has a Master's of Science in Traditional Oriental Medicine and a Doctorate of Acupuncture and Oriental Medicine from the Pacific College of Oriental Medicine. Colby is also co-owner of AcuBalance Acupuncture & Integrative Medicine in Middletown. He is passionate about UofL basketball, bourbon, and enjoying the two together.

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