Zippelius Asa 2014

Rasche Heilung nach Knieverletzungen
Dr. med. Karl Zippelius - ÖISM/ Wien - Praxis Florenz
ASA Kongress - Solothurn 04.12.2014
www.drzippelius.com
Montag, 8. Dezember 14
Family HE - Chengdu
Er Renfu (1895 ─ 1969) 4. generation
Bayi Orthopedic Military Hospital Chengdu
He Tianzuo, (Februar 1941)
Chengdu Orthopaedic Hospital
Prof. Yang learned from

Master Yuankong , an
elder of Buddhist
monastery from Shaolin
Temple, who was 120
years old then. Master
Yuankong taught him the
Longevity Gong and
Methods of Chinese
M e d i c i n e N o u ri s h i n g .
P ro f . Ya n g p ra c t i c e d
Orthopedics of TCM for
more than 80 years.
Prof. Yang Tianpeng

(Mai 1902 -2005 am 26. August)
(Cruciate) Ligament injuries
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Pathology of trauma
Acute traumatic event
„slightly“ „strong“
Qi - Stagnation
Qi - Stagnation Blood - Stasis
Injured tissue
TUI NA
Acupuncture Therapy?
other qi moving therapies
Restitutio ad integrum post-traumatic and late Restitutio ad integrum

stage symptoms
Qi - Stagnation
Blood - Stasis
Injured tissue
 Anatomical dislocation/axis/ alignment Surgery

Scar tissue + „disorder“ of tissue
Immobilization
Orthopedic Implants And Instruments like
screws, plates, implants (espec. made of metal) Acupuncture/ Qi Gong
external a. internal pathogenic factors TUI NA
chinese Pharmacology
Physiotherapy
Free flow of Qi and blood is obstructed
Restitutio ad integrum
Incomplete healing
“meteoropathy” = sensitive against external path.
factors (Wei Qi↓)
Chronic pain syndroms
Post-traumatic Arthrosis/ degenerative processes
Spontaneous Healing of a Tear of the Anterior Cruciate Ligament. A
Report of Two Cases*
MASAHIRO KUROSAKA, M.D.; SHINICHI YOSHIYA, M.D.; TOSHIYUKI MIZUNO, M.D.; KOSAKU
MIZUNO, M.D., KOBE, JAPAN
The Journal of Bone and Joint Surgery, 1998 Aug 01;80(8):1200-3
A seventeen-year-old high-school student sustained an injury to

the left knee while he was playing American football.
Arthroscopy, performed eight days after the injury, revealed

complete detachment of the proximal portion of the anterior
cruciate ligament.
Fig. 2-C Four
months after the
Fig. 2-A:
injury:
Palpation with a
The mid-portion of
probe showed
the ligament was
detachment of
intact, and no
the proximal
bleeding or
end
laceration was
noted.
Fig. 2-D Six months after

the injury, a 30-degree
arthroscope was
Fig. 2-B The introduced from the
denuded anteromedial portal to
original femoral allow visualization of the
insertion (arrow) entire anterior cruciate
could be ligament. The vascularity
identified by and tension of the
additional ligament were good, and
probing the detached proximal end
was firmly attached to the
lateral femoral condyle
(the anatomical insertion).
(Cruciate) Ligament injuries - case history
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Knee examination for diagnosis
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Soccer player - multiple knee injury
- at least subtotaly ruptured PCL

- grade I sprain of ACL
- bone bruise + microfracture of tibial epiphysis
- tear of medial meniscus posterior horn
subtle energy = yang
condensed energy
= matter = „Yin“)
3 phases of trauma
• Absorption phase (acut)
topical application of herbal remedies accelerates hematoma absorption
and reduction of swelling
• Reconstruction phase (subacute)

- acupuncture triggers healing program
- early mobilization regulates repair processes
• Rehabilitation phase (chronic)

- acupuncture for pain reduction
- „tui na“ massage to soften hardness
- physiotherapy to regain range of motion
TCM: acting on hardware (Yin) software (Yang)
Herbal paste
shorten absorption phase
Acupuncture
early mobilization
trigger „healing program“
Tui Na techniques
soften hardness
Hemarthrosis - delay of healing?
In a recent study, Tang et al. concluded, although the regular wound-healing mechanism
also occurs after ACL injury, accumulation of matrix metalloproteinase activity in the
synovial fluids due to all the intra-articular tissues may be at least one of the important
reasons why an injured ACL cannot be repaired.
Tang Z, Yang L, Wang Y, Xue R, Zhang J, Huang W, Chen PC, Sung KL. Contributions of different intraarticular tissues to the
acute phase elevation of synovial fluid MMP-2 following rat ACL rupture. J Orthop Res. 2009;27:243–248
In vitro & in vivo assessment of a herbal formula used
topically for bone fracture treatment
Li Hua Peng et al, Journal Ethnopharmacology, 131(2): p. 282-289, 2010 Sep 15
Sambucus Williamsii Ram. jie gu mu 接骨木 30 g
Dipsaci Radix xu duan 續斷 15 g
Notoginseng Rx. et Rh. san qi 三七 9g
Carthami Flos hong hua 紅花 9g
Rhei Rx. et Rh. da huang 大黃 30 g
Gardeniae Fructus zhi zi 梔子 9g
Effect on callus formation after 2 weeks of treatment
Over 8 weeks: FH paste significantly improved the bone healing in the rabbit fracture
model, as was indicated by the increases in callus size at weeks 2-5
External application - Qu Yu Xiao Zhong Gao
(Paste, to eliminate blood stasis and swelling)
Daemonoropis Resina Xue Jie 9 g Preparation: Mix powdered

herbs with honey to get a paste
Catechu Er Cha 6 g Application: Put the paste on
the affected area. cover with
Myrrha Mo Yao 9 g waxpaper and fix it with elastic
bendage. Keep it up to 12 hours
Olibanum Ru Xiang 9 g
Function: stops pain, reduce
Corydalis Rz Yan Hu Suo 12 g swelling, move blood, eliminate
blood stasis
Zanthoxyli Pericarpium Hua Jiao 6 g Indication: injury in acute
stage
(Moschus* She Xiang 1,5 g)
Borneolum Bing Pian 1,5 g
Phaseoli Sm. Chi Xiao Dou 30 g
Pheretima Di Long 30 g
* substitute with Borneol
External application - Zi Jin Jiu (precious medical wine) (Source: Treatment of
Bone and Articulation Injury by Traditional Chinese Medicine combined with Western Medicine)
Draconis Resina Xue Jie 6g

Carthami Flos Hong Hua 6g
Preparation. Suck the
Camphora Zhang Nao 3g powdered herbs for at least
Alpiniae Officinari Rhizoma Gao Liang Jiang 12g 10 days in 500 ml ethanol
(40–50°), filter it to get the
Piperis Longi Fructus Bi Ba 9g tincture
Application: rub the
Asari Herba Xi Xin 6g affected part every hour
Sinapis Albae Semen Bai Jie Zi 6g Function: pain killing,
reduce swelling, move blood
Borneolum Bing Pian 3g eliminate blood stasis
Indication: Acute injury
Rehmanniae Radix Sheng di Huang 6g
with swellimg, hematoma,
Centipedae Herba Shi Hu Sui 9g pain
Olibani Resina Ru Xiang 4,5g
Myrrha Mo Yao 4,5g
Bicycle accident - metacarpal V fracture
Hier Film 2
„ Fraktur 9 Tage“ einfügen
8.11.2010 16.11.2010
single - Therapy: topical application of chinese herbs
Final functional and radiological result
09.02.2011 – 3 month
Movement - Physiotherapy
move Qi and trigger healing processes
www.drzippelius.com
Piezoelectric Effect and Growth Control in Bone
ANDREW A. MARINO & ROBERT O. BECKER
Veterans Administration Hospital, and Department of Orthopedic Surgery, Upstate
Medical Center, Syracuse, New York.
The adaptability of bone under impressed mechanical forces has been

known since the time of Wolff
1. A possible control mechanism for the process became apparent with
the discovery of the piezoelectric effect in bone
2. In theory the effect could translate an environmental stimulus into

a biologically recognizable signal controlling growth or resorptive
processes. It has been recognized that the action of the piezoelectric
signal may be to alter the chemistry of pertinent macromolecules
such as collagen, or to influence cellular activity directly
3. Of the two possibilities, evidence tends to rule out the importance of

the former and we consider here only the latter
Mobility after 4-5 weeks
Mobility after 5 - 6 weeks
Mobility after 5 - 6 weeks
Mobility after 2 month
Follow up:
3 month after injury: 10 days mountain trekking without problems
19
Mobility after 2 month
Follow up:
3 month after injury: 10 days mountain trekking without problems
19
Acupuncture - Stimulate Energy („Qi“) flow
Pain reduction & Trigger healing program
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The effect of acupuncture therapy on the repair of the
calcaneal tendon (tendo calcaneus communis) in dogs
D. SHARIFI, F. SASANI, J. BAKHTIARI, T. REZAEI
Turk. J. Vet. Anim. Sci.; 2009; 33(3): 181-184
Principles: improve flow of qi (and blood) in the meridians and in general.
unblock meridians to reduce pain, relax muscles and tendons.
Stimulation:
Neutral acupuncture of beginning and end point of meridian
+ stimulate Xi-point to activate flow of qi in meridian
+ combine with:
Ashi-point and
Le 3 (Taichong), Di 4 (Hegu), Gb 34 (Yanglingquan), SP 10 (Xuehai), (UB 17 (Geshu)).
Xi-Points in case of knee injury:

Patella: St 34
Inner Meniscus and medial ligament: Sp 8, LV 6
External meniscus and lateral ligament: Gb 36
Cruciate ligament: UB 63, Kd 5,
Qi of meridian accumulates there = useful point to move qi in meridian and reduce pain.
TUI Na - Stimulate Energy („Qi“) flow, soften hardness
and „order“ tissues
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Dispel accumulated liquids and blood:
If blood and liquids after an injury is not eliminated quickly, due to rising heat from stasis, it will
cause chronic, inflammatory processes. As a consequence the tissue loses its elasticity and it
comes to scar tissue and adhesions. The mobility and function is permanently impaired.
That is why you should start early start with (circular) rubbing and pushing to dispel blood and
liquids and move it out of joints. Thus absorption can be facilitated and accelerated.
Passive movements: relax muscles and avoid adhesion („was sich bewegt, rostet nicht“ „A
rolling stone gathers no moss“).
Manuel Reposition/ rearrange/ „order“ tissues : subluxation of joints, fibers of

connecting tissue, muscles etc in disorder, impingement of tissue (meniscus, synovial membrane
etc.) . „Disordered tissues“ blocks free flow of qi
Acupoint and meridian stimulation: in addition or substitution of acupuncture treatment

More forceful techniques in late phase of trauma: traction, shaking, press, pull etc.
(see video) to recover mobility, elasticity of tissue, soften hardness of tissue and move qi to reduce
pain
Moxibustion - move Qi by warming, tonify Yang,
eliminate damp, cold, wind
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Moxibustion
Not most important treatment method in acute and subacute phase but
very helpful in rehabilitation phase to eliminate cold and damp from meridians to
treat persistent pain and stiffness:
- whole injury area

- warm up meridian (direct moxa on UB 40 in case of swelling)
- warm up kidney (UB 23) to increase yang and tonify spleen to transform
dampness
Herbal treatment in reparation or proliferation stage
Treatment principle: „move and reconstruct“: normalize movement of qi and
blood, stimulate/ trigger healing of tissue
www.drzippelius.com
External application - soft tissue:
like acute phase: Zi Jin Jiu and Qu Yu Xiao Zhong Gao
External application - fracture

like acute phase: Zi Jin Jiu and Qu Yu Xiao Zhong Gao
or
Jie Gu Gao (Paste, to bend bone after fracture)
Preparation: Mix powdered
Acanthopanacis Cx. (Wu Jia Pi) 2 Parte,
herbs with honey to get a paste
Pheretima (Di Long) 2 Parts
Application: Put the paste on
Olibanum (Ru Xiang) 1 Part
the affected area. cover with
Myrrha (Mo Yao) 1 Part,
waxpaper and fix it with elastic
Eupolyphaga/Stelophaga (Tu Bie Chong) 1 Part,
bendage. Keep it up to 12 hours
Drynariae Rz. (Gu Sui Bu) 1 Part
Indication: fracture in
Bletillae Rz. (Bai Ji) 1 Part
subacute stage
Internal application - soft tissue injury Internal application - fracture
Huo Xue Qu Yu Tang Xu Gu Huo Xue Tang
Angelicae sinensis Rx. (Dang Gui) 15 g Angelicae sinensis Rx. (Dang Gui) 12 g,
Carthami Fl. (Hong Hua) 6 g Carthami Fl. (Hong Hua) 6 g,
Eupolyphaga/Stelophaga (Tu Bie Chong) 9 g Eupolyphaga/Stelophaga (Tu Bie Chong) 6 g
Pyritum (Zi Ran Tong) 9 g Pyritum praep. (Zi Ran Tong [Duan]) 10 g
Cibotii Rz. (Gou Ji) 9 g (arthralgy wind damp),
Drynariae Rz. (Gu Sui Bu) 15 g Drynariae Rz. (Gu Sui Bu) 12 g
Myrrha (Mo Yao) 6 g Myrrha (Mo Yao) 6 g
Olibanum (Ru Xiang) 6 g Olibanum (Ru Xiang) 6 g
Liquidambaris Fr. (Lu Lu Tong) 6 g Centellae Hb. (Ji Xue Cao) 10 g
(Dispels Wind and invigorates the collaterals) (Clear heat, resolve swelling)
Notoginseng Rx. (San Qi) 3 g Paeoniae Rx. rubra (Chi Shao) 10 g
Persicae Sm. (Tao Ren) 9 g Rehmanniae Rx. (Sheng Di Huang) 15 g
Paeoniae Rx. alba (Bai Shao) 10 g
Dipsaci Rx. (Xu Duan) 12 g
Preparation: Decoction in water Preparation: Decoction in water
Herbal treatment in riabilitation and remodelling stage
Treatment principle: open meridians, recover function, soften hardness, expell
pathogenic factors
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Acupuncture and Chinese Medicinal Wash
Luo Xiang-jun adopted this method to treat 98 R A patients
Acupuncture:
....................
Chinese medicinal wash:
The formula for the medicinal wash consisted of sheng chuan wu (raw Radix Aconiti), sheng cao wu
(raw Radix Aconiti Kusnezoffii), sheng nan xing (raw Rhizoma Arisaematis), sheng ban xia (raw
Rhizoma Pinelliae), xi xin (Radix et Rhizoma Asari), ru xiang (Olibanum), mo yao (Myrrha), qing feng
teng (Caulis Sinomenii), ku fan (Alumen Dehydratum), and ping pian (Borneolum Syntheticum).
All the medicinals, except for ping pian, were soaked in water for l hour and then decocted. After
boiling for 15 minutes, the bing pian was added, and the decoction was boiled for another minute. The
patients in the treatment group were instructed to steam the affected areas of the body with the hot
decoction, and then to wash the affected areas with the decoction once it has cooled down to a
tolerable temperature. Each treatment Session lasted 30-40 minutes. Treatment was given once a day
The patients in the control group were only given acupuncture. The total efficacy of the treatment
group was 88.73%, while that of the control group was 54% (P<0.01).
External application
Gushang Waixi Yijang — No. l Lotion Recipe for Bone Injury
Cissi caulis (Kuan Jin Teng) 30g

Uncariae Ra. cum Uncis (Gou Teng) 30g
Lonicerae Caulis (Ren Dong Teng) 30g
Vaccariae Sm. (Wang Bu Liu Xing) 30g
Artemisiae anomalae Hb. (Liu Ji Nu) 15g
Saposhnikoviae Rx. (Fang Feng) 15g
Rhei Rx. et Rz. (Da Huang) 15g
Schizonepetae Hb. (Jing Jie) 10g
Efficacy and indications.

Promoting blood circulation to remove obstruction in the channels and relieving rigidity of
muscles to ease pain; effective for clonic spasm of muscles, undesirable articular function,
aching and numbness resulting from trauma, or pain due to exopathogenic wind-dampness,
Indication: used at late stages of a complicated fracture or when the external fixation is
removed and the patient can do functional exercises, after an orthopedic Operation.
Preparation and administration Boil the drugs in water for a lotion to be used for
fumigating and bathing the diseased part.
Huajian Gao — Tissue-softening Plaster
(A proved recipe from Textbook on Traumatology of Traditional Chinese Medicine )
Indication: used to relieve sclerosis or adhesion of soft tissues at the late stage of a traumatic injury.
white mustard seed (Semen Sinapis)!2 portions

kansui root (Radix Euphorbiae Kansui)! 2 portions
earthworm (Lumbricus)! 2 portions
clematis root (Radix Clematidis) ! 2. 5 portions
garden baisam seed (Semen Impatientis)! 2. 5 portions
tuberculate speranskia(Herba Speranskiae Tuberculatae)! 2 portions
hemp root (Radix Cinnabis)! 3 portions
asarum herb (Herba Asari) ! 3 portions
black plum (Fructus Mume)! 4 portions
pangolin scale (Aquama Manitis)! 4 portions
carbonized hair (Crinis Carbonisatus ) !l portion
croton seed (Fructus Crotonis)! l portion
scorpion (Scorpio) ! l portion
ledebouriella root (Radix Ledebouriellae)! l portion
wild aconite root (Radix Aconiti Kusnezoffii) ! l portion
purplish sal ammoniac(Sal Ammoniaci Purpurati)! 0. 5 portion
sesame oil (Oleum Sesami)! 80 portions
red lead (Minium)! 40 portions
Efficacy and indications: Expelling wind and removing blood stasis ; Preparation and administration: Boil all the drugs in the
sesame oil till the drugs are exhausted, filter to collect the oil, which is then boiled and concentrated. Then add in red lead,
churn till no smoke, add in purplish sal ammoniac and churn thoroughly
Dieda Yangying Tang — Nutrition-increasing Decoction for Traumatic Injuries
(from Lin Rugao's Clinical Experience of Bone Setting)
Panacis Quinquefolii Radix! Xi Yang Shen!3g

Astragali seu Hedysari Radix! Huang Qi! 9g
Angelicae Sinensis Radix! Dang Gui! 6g
Ligustici Chuanxiong Rhizoma! Chuan Xiong! 4,5g
Rehmanniae Radix ! Shu Di Huang!15g
Paeoniae Alba Radix! Bai Shao!9g
Lycii Fructus! Gou Qi Zi! 15g
Dicscoreae Rhizoma! Bei Xie! 15g
Dipsaci Radix!Xu Duan!9g
Amomi Fructus! Sha Ren!3g
Notoginseng Radix! San Qi! 4,5g
Psoraleae Fructus!Bu Gu Zhi! 9g
Drynariae Rhizoma! Gu Sui Bu! 9g
Chaenomelis Fructus! Mu Gua! 9g
Glycyrrhizae Radix!Gan Cao!3g
Efficacy and indications: Replenishing qi and blood, tonifying the liver and kidney and
strengthening muscles and bones; used at the middle and late stages of bone fractures.
Preparation and administration: Boil the drugs in water for an oral decoction.
Shujin Huoxue Tang — Decoction for Relaxing Muscles and Promoting Blood Circulation
(from Supplement to Traumatology)
Notopterygii Rz. seu Rx. (Qiang Huo) 6 g

Saposhnikoviae Rx. (Fang Feng) 9 g
Schizonepetae Hb. (Jing Jie) 6 g
Angelicae pubescentis Rx. (Du Huo) 9 g
Angelicae sinensis Rx. (Dang Gui) 12 g
Dipsaci Rx. (Xu Duan) 12 g
Citri reticulatae viride Pericarpium (Qing Pi) 5 g
Achyranthis Rx. (Niu Xi) 9 g
Acanthopanacis Cx. (Wu Jia Pi) 9 g
Eucommiae Cx. (Du Zhong) 9 g
Carthami Fl. (Hong Hua) 6 g
Aurantii Fr. (Zhi Ke) 6 g
Efficacy and indications: Relaxing muscles and tendons and activating the flow of qi and
blood in the channels and collaterals;
Indications: used to treat clonic spasm of muscles and pain at the late stage of soft tissues
injury, bone fracture and dislocation.
Preparation and administration: Boil the drugs in water for an oral decoction.
Yangxue Zhitong W an — Pill Tonifying Blood to Relieve Pain
(from A Concise Manual for Bone Setting)
Paeoniae Rx. alba (Bai Shao) 21 g,
Salviae miltorrhizae Rx. (Dan Shen) 21 g,
Spatholobi Caulis (Ji Xue Teng) 30 g,
Gentianae macrophyllae Rx. (Qin Jiao) 12 g,
Cinnamomi Ra. (Gui Zhi) 9 g,
Rehmanniae Rx. (Sheng Di Huang) 18 g,
Clematidis Rx. (et Rz.) (Wei Ling Xian) 24 g,
Cyperi Rz. (Xiang Fu) 12 g,
Linderae Rx. (Wu Yao) 9 g,
Cyathulae Rx. (Chuan Niu Xi) 15 g,
Glycyrrhizae Rx. (et Rz.) (Gan Cao) 6 g.
Efficacy and indications: Tonifying blood, promoting blood circulation and easing the
movement of joints;
indications: used for blood stasis due to deficiency of blood at the late stage of an injury
with dysfunction of the injured limb.
Preparation and administration: All the drugs are ground together into fine powder which
is mixed with water to make pills. Take the pills with boiled water, 6g a time. 2 times a day.
Treatment - Reflect on standard western therapy
www.drzippelius.com
- Therapy with ice?
- Pain killers?
- Surgery or conservative treatment?
- Manual therapy at which stage?
- Movement or rest/ immobilization?
RICE - STANDARD WESTERN THERAPY
• Rest
• Ice
• Compression
• Elevation
Acta Orthop. 2005 Aug;76(4):470-4.
Cyclooxygenase-2 inhibitor delays fracture healing in rats.

Endo K, Sairyo K, Komatsubara S, Sasa T, Egawa H, Ogawa T, Yonekura D, Murakami R, Yasui N.
Source
Department of Orthopedics, The University of Tokushima, Japan. endoken@clin.tokushima-u.ac.jp
Abstract
BACKGROUND:
Cyclooxigenase-2 (COX-2) inhibitors have been reported to delay fracture healing. To investigate the major inhibitory period of COX-2 inhibitors in
fracture healing, we administrated etodolac, a COX-2-specific inhibitor, to a rat fracture model by altering the period of administration from early to late.
METHOD:
After closed fractures had been created at the middle of the femoral shafts in 12-week-old Wister rats, a standardized dose of etodolac was administrated
in three ways: group I received it for 3 weeks, group II for just the first week after operation, and group III for just the third (final) week. Group IV was
the vehicle control group. Bone maturation was estimated by radiographic scoring system, and mechanically by a three-point bending test.
RESULTS AND INTERPRETATION:
In both the radiographic and mechanical studies, groups I and II showed lower scores than group IV, indicating that even a short period of administration
of a COX-2-specific inhibitor in the early phase of fracture healing creates a risk of delayed healing. blacksquare, square, filled.
PMID:
16195060
[PubMed - indexed for MEDLINE]
Immobilization versus movement
• Physical movement moves Qi (in meridians)

• Contralateral exercises/treatment and silent qi gong (without macroscopic movement)
• Treat soft tissues (move qi and blood) for better nutrition of tissues
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Rasche Heilung nach Knieverletzungen

Dr. med. Karl Zippelius - ÖISM/ Wien - Praxis Florenz

ASA Kongress - Solothurn 04.12.2014

Er Renfu (1895 ─ 1969) 4. generation

He Tianzuo, (Februar 1941)

Prof. Yang learned from

Prof. Yang Tianpeng

Acute traumatic event

Restitutio ad integrum post-traumatic and late Restitutio ad integrum

 Anatomical dislocation/axis/ alignment Surgery

Free flow of Qi and blood is obstructed

The Journal of Bone and Joint Surgery, 1998 Aug 01;80(8):1200-3

A seventeen-year-old high-school student sustained an injury to

Arthroscopy, performed eight days after the injury, revealed

Fig. 2-D Six months after

- at least subtotaly ruptured PCL

• Reconstruction phase (subacute)

• Rehabilitation phase (chronic)

shorten absorption phase

trigger „healing program“

Sambucus Williamsii Ram. jie gu mu 接骨木 30 g

Dipsaci Radix xu duan 續斷 15 g

Notoginseng Rx. et Rh. san qi 三七 9g

Carthami Flos hong hua 紅花 9g

Rhei Rx. et Rh. da huang 大黃 30 g

Gardeniae Fructus zhi zi 梔子 9g

Daemonoropis Resina Xue Jie 9 g Preparation: Mix powdered

Borneolum Bing Pian 1,5 g

Phaseoli Sm. Chi Xiao Dou 30 g

Pheretima Di Long 30 g

* substitute with Borneol

Draconis Resina Xue Jie 6g

Olibani Resina Ru Xiang 4,5g

Myrrha Mo Yao 4,5g

single - Therapy: topical application of chinese herbs

The adaptability of bone under impressed mechanical forces has been

2. In theory the effect could translate an environmental stimulus into

3. Of the two possibilities, evidence tends to rule out the importance of

Xi-Points in case of knee injury:

Manuel Reposition/ rearrange/ „order“ tissues : subluxation of joints, fibers of

Acupoint and meridian stimulation: in addition or substitution of acupuncture treatment

- whole injury area

External application - fracture

Preparation: Decoction in water Preparation: Decoction in water

Cissi caulis (Kuan Jin Teng) 30g

Efficacy and indications.

white mustard seed (Semen Sinapis)!2 portions

Panacis Quinquefolii Radix! Xi Yang Shen!3g

Notopterygii Rz. seu Rx. (Qiang Huo) 6 g

- Surgery or conservative treatment?

- Manual therapy at which stage?

- Movement or rest/ immobilization?

Cyclooxygenase-2 inhibitor delays fracture healing in rats.

Department of Orthopedics, The University of Tokushima, Japan. endoken@clin.tokushima-u.ac.jp

RESULTS AND INTERPRETATION:

• Physical movement moves Qi (in meridians)

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