In over twenty years of teaching kung fu, Sifu Wing Lam of Sunnyvale, California has seen, and suffered, his share of injuries. A small, but steady stream of students come to him with complaints ranging from joints that feel "sore", to definite sprains and muscle tears, to dislocations, to broken bones, to victims of over-enthusiastic partners during two-man weapons forms.

Lam has also seen his share of treatment methodologies for martial arts injuries. For purposes of discussion, he classifies them into three major methods of treatment: the first based on Western medicine, the second based on modern Chinese medicine, and the third based on the traditional practices he learned from both his Northern Sil Lum and his Hung Gar sifus, and which he uses to treat his students and himself.

Western treatments for sports injuries often consist of little more than "letting nature take its course," says Lam. Use ice to reduce swelling, restrict the motion of the affected tissue, completely immobilize it if the injury is serious enough, and wait for it to "heal naturally." After the tissue heals (taking anywhere from a few weeks to several months), begin a program of physical therapy to strengthen the muscle and regain range of motion, if necessary.

Lam finds this method too passive. "It's okay to let (an injury) heal, but it's not complete healing," he says. Scar tissue can form on muscles, tendons, and ligaments; calluses can deform bones. All these weaken the tissue and make it prone to re-injury.

Both modern and traditional Chinese treatments address this problem, using a three-pronged attack of herbal medicines, pressure point therapy, and massage. To understand why this works, says Lam, one must first understand what happens when tissue is injured.

When a muscle is torn or a bone is broken, there is often ancillary damage to the surrounding tissue. Small blood vessels often rupture. Blood and body fluids rush in to fill the gaps in the muscle, the break in the bone. The afflicted area swells, restricting movement and preventing further damage.

In the case of a minor injury, all the extra blood and fluid is "washed away" by the circulatory system. But, if the injury is bad enough, "The body can't take care of it by itself," says Lam. Blood coagulates, forming calluses, and cannot be washed away.

The objective of all three treatments--medicine, massage, and pressure point therapy--is to get rid of this "dead blood". The herbal medicines are applied to the skin over the injury (generally in either paste or lineament form), to draw the dead blood away from the injury. Massage improves the circulation to the affected area, and pressure point therapy works to both improve circulation and to "signal" the body to continue the healing process on its own, says Lam.

Both modern and traditional Chinese medicine use these methods of treatment, says Lam, with some differences, even among traditionalists. Modern Chinese medicine has adopted the ice bag, something not used in olden days simply because it didn't exist. Lam's Northern Sil Lum instructor favored pressure points and light massage--a more "gentle" approach than that taken by his Hung Gar sifu, who used deep tissue massage. This was a method that often cut recovery time but could also be quite painful. That sifu, says Lam, "always had someone to hold onto the patient."

Lam also opts for the gentler approach. "I hate to hear people screaming," he says.