Generally speaking, in Chinese medicine's five-phase theory the bones and ligaments are governed by kidney energy, the tendons and sinews are ruled by the liver energy, while the flesh and muscles by spleen energy. When an acute trauma occurs due to a fall, improper mechanics when lifting /twisting, or an impact of some kind- traumatic energy enters the body disrupting normal energy flow and blood circulation. Depending on the nature and depth of the trauma, various degrees of tissue damage occurs. This early stage of trauma is marked by pain, heat and swelling.

Most often, the body's first line of defense to trauma is to stabilize the impact by sending fluids to the area. These fluids are fortified with immune-rich cells  to help address any infection, and decrease further trauma to the area by immobilizing the affected site. The increased fluid accumulation also results in stagnation (qi and/or blood) and increased pain signals. It is at this time (within 24-48 hours of the injury) that proper treatment can be most effective in aiding healing and speeding up recovery. This is also where Chinese medicine differs most from western protocol. Whereas RICE (rest, ice, compress, elevate) is the token guidance for a moderate musculo-skeletal injury in Western medicine, in Chinese medicine clearing heat/resolving toxins, and decreasing swelling by enhancing circulation through liniments, herbs, moxa, and acupuncture treatments is the primary approach.  

Once a trauma moves out of its initial stage of pain and inflammation (typically 1-3 days), secondary symptoms begin to root. Redness and heat become less prevalent, but fluid stasis lingers resulting in pain and stiffness. Whereas the swelling is a healing response in the beginning stages of trauma, it becomes pathogenic if not cleared in a timely manner because it prevents fresh blood and qi from bathing the traumatized area and peripheral tissues. Applying ice can help with the initial pain and swelling, by contracting vessels, and decreasing inflammation. However, in the secondary stages, ice often will interfere with circulation, leading to further blood stasis. As long as no signs of infection are present, and redness/heat have subsided, it is common to use moxa and "moving" herbs and liniments during this stage of healing to help facilitate blood circulation.

Most people consider themselves healed once pain has subsided, and relatively full range of motion has been restored to the injured area. However, it is very common to have an underlying weakness in the structure, (and meridians) making the area susceptible to re-injury. Structurally speaking, this is especially true with injuries that impact ligaments. Whenever ligaments are overstretched, or inherently lax, the area is prone to re-injury due to a lack of structural integrity. In this case, one is likely to be plagued by  repeated episodes of pain such as an SI joint that keeps "going out", or an ankle that gets sprained over and over. Healing this level of imbalance requires patience, and usually responds best to a multi-dimensional treatment approach including nutritional support, gentle, progressive strengthening as well as acupuncture treatments to fortify kidney qi.

Emotional distress is another element of injury that can linger once physical pain has subsided. This is especially true if the injury was accompanied by shock or heightened emotions such as fear or anger. Many energetic-based healing methods understand that the emotionally traumatic energy accompanying an injury can get lodged in ones tissues (and heart-mind), continuing to re-create the energetic patterns surrounding the event. Until this energy is recognized and properly liberated, it has a tendency to reverberate through the body, sapping one's vital energy. Acupuncture and moxibustion can be masterful modalities for exorcising these subtle, yet pervasive patterns, allowing healing energy to flourish once again.