Vitamins that may be helpful
Proteolytic enzymes, including bromelain,
papain, trypsin, and chymotrypsin, may be helpful in healing minor injuries such as sprains
and strains because they have anti-inflammatory activity and appear to promote tissue
healing.2 3 4
Several preliminary trials have reported reduced pain and swelling, and/or faster healing
in people with a variety of conditions using either bromelain,5 papain from papaya,
6 7 or a combination of trypsin and chymotrypsin.8
Double-blind trials have reported faster recovery from athletic injuries, including sprains
and strains, and earlier return to activity using eight tablets daily of
trypsin/chymotrypsin,9 10 11 12 four to eight
tablets daily of papain,13 eight tablets of bromelain (single-blind
only),14 or a combination of these enzymes.15 However, one double-blind
trial using eight tablets per day of trypsin/chymotrypsin to treat sprained ankles found no
significant effect on swelling, bruising, or
Bromelain is measured in MCUs (milk
clotting units) or GDUs (gelatin dissolving units). One GDU equals 1.5 MCU. Strong products
contain at least 2,000 MCU (1,333 GDU) per gram (1,000 mg). A supplement containing 500 mg
labeled “2,000 MCU per gram” would have 1,000 MCU of activity, because 500 mg is
half a gram. Some doctors recommend 3,000 MCU taken three times per day for several days,
followed by 2,000 MCU three times per day. Some of the research, however, uses smaller
amounts, such as 2,000 MCU taken in divided amounts in the course of a day (500 MCU taken four
times per day). Other enzyme preparations, such as trypsin/chymotrypsin, have different
measuring units. Recommended use is typically two tablets four times per day on an empty
stomach, but as with bromelain, the strength of trypsin/chymotrypsin tablets can vary
significantly from product to product.
One controlled trial showed that people who supplement with 3 grams per day L-carnitine for three weeks before engaging in an
exercise regimen are less likely to experience muscle soreness.17
Antioxidant supplements, including vitamin C and vitamin E, may help prevent exercise-related muscle
injuries by neutralizing free radicals produced during strenuous activities.18
Controlled research, some of it double-blind, has shown that 400–3,000 mg per day of
vitamin C may reduce pain and speed up muscle strength recovery after intense
exercise.19 20 Reductions in blood indicators of muscle damage and free
radical activity have also been reported for supplementation with 400–1,200 IU per day
of vitamin E in most studies,21 22 23 but no measurable
benefits in exercise recovery have been reported.24 A combination of 90 mg per day
of coenzyme Q10 and a very small amount of
vitamin E did not produce any protective effects in one double-blind trial.25
Vitamin C is needed to make collagen, the
“glue” that strengthens connective tissue. Injury, at least when severe, appears
to increase vitamin C requirements,26 and vitamin C deficiency causes delayed
healing from injury.27 Preliminary human studies have suggested that vitamin C
supplementation in non-deficient people can speed healing of various types of trauma,
including musculoskeletal injuries,28 29 but double-blind research has
not confirmed these effects for athletic injuries, which included sprains and
Zinc is a component of many enzymes,
including some that are needed to repair wounds. Even a mild deficiency of zinc can interfere
with optimal recovery from everyday tissue damage as well as from more serious
trauma.31 Trace minerals, such as
manganese, copper, and silicon are also known to be important in the
biochemistry of tissue healing.32 33 34 35
However, there have been no controlled studies of people with sprains or strains to explore
the effect of deficiency of these minerals, or of oral supplementation, on the rate of
Many vitamins and minerals have essential roles in tissue repair, and deficiencies of one
or more of these nutrients have been demonstrated in animal studies to impair the healing
process.36 This could argue for the use of multiple vitamin-mineral supplements by people with
minor injuries who might have deficiencies due to poor diets or other problems, but controlled
human research is lacking to support this.
Glucosamine sulfate and chondroitin sulfate may both play a role in wound healing by providing the raw material needed by
the body to manufacture molecules called glycosaminoglycans found in skin, tendons, ligaments,
and joints.37 Test tube and animal studies have found that these substances, and
others like them, can promote improved tissue healing.38 39
40 41 Injectable forms of chondroitin sulfate have been used in Europe for
various types of sports-related injuries to tendons and joints,42 43
44 45 and one preliminary trial reported reduced pain and good healing
in young athletes with chondromalacia patella (cartilage softening in the knee) who were given
750–1,500 mg per day of oral glucosamine sulfate.46 However, specific human
trials of glucosamine and chondroitin sulfate for healing sprains and strains are lacking.
The use of DMSO, a colorless, oily liquid
primarily used as an industrial solvent, for therapeutic applications is controversial.
However, some evidence indicates that dilutions, when applied directly to the skin, have
anti-inflammatory properties and inhibit the transmission of pain messages by nerves, and in
this way might ease the pain of minor injuries such as sprains and strains.47
48 49 However no controlled research exists to confirm these effects in
sprains and strains. DMSO comes in different strengths and different degrees of purity. In
addition, certain precautions must be taken when applying DMSO. For those reasons, DMSO should
be used only with the supervision of a doctor.
Are there any side effects or interactions?
Refer to the individual supplement for information about any side effects or interactions.
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