This article addresses injuries such as bruises, minor fractures, and sprains. Other forms of minor injury such as minor burns, minor wounds, back pain, and more chronic soft tissue injuries are discussed in their own articles.

Unless you never leave your couch, you are likely to injure yourself sometime. Although minor injuries such as bruises and sprains will heal without treatment, they can be quite unpleasant.

Conventional treatment for minor sprains and strains involves anti-inflammatory drugs, icing, and, in some cases, physical therapy. Bruises are sometimes treated with ultrasound, although there is no meaningful evidence that it really helps.

Proteolytic Enzymes

Proteolytic enzymes help you digest the proteins in food. Your pancreas produces the proteolytic enzymes trypsin and chymotrypsin, and others, such as papain and bromelain, are found in foods. Proteolytic enzymes are primarily used as digestive aids for people who have trouble digesting proteins. When taken by mouth, proteolytic enzymes appear to be absorbed internally to a certain extent, and they might reduce inflammation and swelling. Several small studies have found proteolytic enzyme combinations helpful for the treatment of minor injuries. However, the best and largest trial failed to find benefit.

Most studies involved proteolytic enzymes combined with citrus bioflavonoids, which are also thought to decrease swelling.

A double-blind, placebo-controlledstudy of 44 individuals with sports-related ankle injuries found that treatment with a proteolytic enzyme and bioflavonoid combination resulted in faster healing and reduced the time away from training by about 50%.1Based on these and other results, a very large (721-participant) double-blind, placebo-controlled trial of people with an ankle sprain was undertaken.19 It compared placebo against bromelain, trypsin, or rutin (a bioflavonoid), separately or in combination. None of the treatments alone or together proved more effective than placebo.

Three other small, double-blind studies, involving a total of about 80 athletes, found that treatment with proteolytic enzymes significantly speeded healing of bruises and other mild athletic injuries as compared to placebo.2,3,4In another double-blind trial, 100 people were given an injection of their own blood under the skin to simulate bruising following an injury. Researchers found that treatment with a proteolytic enzyme combination significantly speeded recovery.5 However, most of these studies were performed decades ago and fall beneath modern standards in design and reporting.

For more information, including dosage and safety issues, see the full articles on Proteolytic Enzymes and Bromelain.