Flex (TMX)™

TCM herbal formula for trauma, sports injuries, bruises, sprains, bone fractures, and post-surgical recovery — analgesic; anti-inflammatory; antispasmodic; hemostatic; invigorates blood circulation; removes blood stagnation; facilitates healing and tissue regeneration; prevents adhesion and scar tissue formation

⚠️ Contraindicated during pregnancy and nursing. In cases of concussion, send the patient to the hospital immediately — do not use Flex (TMX) until the condition is stabilized (usually 7–10 days). Do not use if the patient has serious internal hemorrhage — this formula contains herbs that activate blood circulation and may delay coagulation. Not designed for long-term use — use only during the acute phases of injury and discontinue when desired effects are achieved. Contains Dang Gui Wei (Extremitas Radix Angelicae Sinensis) — patients on anticoagulant or antiplatelet therapies such as Coumadin (warfarin) should use with caution or not at all due to higher risk of bleeding and bruising. May cause mild gastrointestinal discomfort — minimize by taking with food or decreasing dosage. California Prop 65 notice: this product contains Da Huang (Radix et Rhizoma Rhei) — do not use if you have or develop diarrhea, loose stools, or abdominal pain, as Da Huang may worsen these conditions.

CLINICAL APPLICATIONS

* Traumatic injuries — external and physical injuries with bruises, contusions, and sprains

* Broken bones or fractures with severe pain, inflammation, and swelling

* Post-surgical recovery — prevents adhesion and scar tissue formation

Background: Musculoskeletal and connective tissue injuries lead to over 10 million clinic visits per year in the United States. Causes may be external (sports injuries, car accidents, trauma), internal (chronic wear and tear; bones weakened by osteoporosis), or both. Acute injuries are characterized by severe pain, swelling, inflammation, and in some cases internal bleeding — treatment focuses on relieving pain, reducing swelling and inflammation, and stopping bleeding. Chronic injuries are characterized by dull pain, stiffness, numbness, and decreased muscle mass and strength — treatment focuses on pain relief and restoration of physical and physiological function.

Historical note: Flex (TMX) is an herbal formula originally used by kung fu [gong fu] masters and monks in the Shaolin temple to treat various internal and external injuries. It has excellent functions to relieve pain, treat soft tissue injuries, and facilitate the healing of broken bones and bone fractures.

Post-surgical recovery protocol: Take Flex (TMX) for 5–10 days after surgery to facilitate immediate wound healing. Continue with Flex (MLT) and Osteo 8 for one month to facilitate healing and recovery of soft tissues and bones respectively.

Key herb-level clinical data:

— Yan Hu Suo (Rhizoma Corydalis / Corydalis): one of the strongest analgesic herbs — analgesic potency comparable to morphine; satisfactory anesthetic effect in 98 of 105 patients (93.4%) undergoing surgery; analgesic effect significantly potentiated with concurrent electro-acupuncture; anti-inflammatory — inhibits histamine and pro-inflammatory mediators; safer than morphine — fewer side effects, less risk of tolerance, no physical dependence even with long-term use

— Ru Xiang (Gummi Olibanum / Frankincense / Boswellia): analgesic and anti-inflammatory — relieves pain and reduces swelling; facilitates wound healing by stimulating maturation and differentiation of white blood cells; clinically effective for pain from trauma and external injuries

— Mo Yao (Myrrha / Myrrh): analgesic and anti-inflammatory — relieves pain and reduces swelling; facilitates wound healing; clinically effective for pain from trauma and external injuries

— Bai Shao (Radix Paeoniae Alba / White Peony): analgesic, antispasmodic, and anti-inflammatory — relaxes both smooth and skeletal muscles; combined with Gan Cao: clinically effective for leg cramps, muscle cramps in hemodialysis, restless leg syndrome, intestinal spasm, facial spasms and twitching, menstrual cramps, neck pain, back pain, heel pain, sciatica, neuralgia, and trigeminal neuralgia; analgesic effect significantly increased with concurrent acupuncture

— Gan Cao (Radix et Rhizoma Glycyrrhizae / Licorice Root): analgesic, anti-inflammatory, and antispasmodic — relaxes tendons and muscles; harmonizes the formula; enhances glucocorticoid effect (glycyrrhizin and glycyrrhetinic acid); anti-inflammatory potency vs. cortisone approximately 10:1; clinical applications include pain, inflammation, edema, arthritis, spasms, and cramps

— Dang Gui Wei (Extremitas Radix Angelicae Sinensis / Angelica Sinensis Tail): invigorates blood circulation; promotes wound healing; analgesic and anti-inflammatory — inhibits NO and PGE2; anti-inflammatory 1.1× stronger than aspirin; analgesic 1.7× stronger than aspirin; osteogenic — stimulates type I collagen synthesis and proliferation of osteoprecursor cells

— Er Cha (Catechu / Acacia Catechu): anti-inflammatory — reduces swelling; drains dampness; absorbs seepage from sores and wounds; dual inhibition of COX and 5-lipoxygenase — reduces pro-inflammatory eicosanoids and attenuates edema

— Mu Dan Pi (Cortex Moutan / Moutan / Peony Bark): anti-inflammatory — clears heat; inhibits prostaglandin synthesis; decreases blood vessel permeability

— Chuan Mu Xiang (Radix Vladimiriae / Vladimiria): anti-inflammatory — inhibits INF-γ-induced nitric oxide production (sesquiterpenes)

— Su Mu (Lignum Sappan / Sappan / Caesalpinia): dispels blood stasis; anti-inflammatory and antiarthritic — inhibits NO and COX-2; suppresses NF-κB, IL-1β, IL-6, TNF-α, and PGE2; attenuates collagen-induced arthritis

— Hong Hua (Flos Carthami / Safflower / Carthamus): invigorates blood circulation; facilitates healing — clinical study of 775 cases of swelling and subcutaneous hemorrhage from acute sprains: improved or cured within 3–5 days

— Tao Ren (Semen Persicae / Peach Kernel): invigorates blood circulation; facilitates healing

— Da Huang (Radix et Rhizoma Rhei / Rhubarb): hemostatic — shortens coagulation time and stops bleeding when taken internally; treats traumatic hemorrhage when applied externally as powder or paste with no adverse reactions or side effects

— Fu Ling (Poria / Poria Cocos): tonifies the Spleen; indirectly promotes regeneration of muscles

WESTERN THERAPEUTIC ACTIONS

* Analgesic — Yan Hu Suo (morphine-comparable, 93.4% surgical anesthesia, electro-acupuncture potentiated); Ru Xiang + Mo Yao (trauma and external injuries); Bai Shao + Gan Cao (pain, neuralgia, neck, back, heel, sciatica, dysmenorrhea); Dang Gui Wei (1.7× aspirin)

* Anti-inflammatory — Er Cha (COX↓, 5-LO↓, eicosanoids↓, edema↓); Mu Dan Pi (prostaglandin synthesis↓, vessel permeability↓); Chuan Mu Xiang (INF-γ NO↓); Su Mu (NO↓, COX-2↓, NF-κB↓, IL-1β↓, IL-6↓, TNF-α↓, PGE2↓); Gan Cao (glucocorticoid↑, cortisone 10:1); Dang Gui Wei (NO↓, PGE2↓, 1.1× aspirin)

* Antispasmodic — Bai Shao + Gan Cao (smooth and skeletal muscle relaxation — leg cramps, hemodialysis cramps, restless leg, intestinal spasm, facial spasms, menstrual cramps)

* Hemostatic — Da Huang (coagulation time↓, traumatic hemorrhage — internal and external)

* Circulatory / wound healing — Hong Hua (775 cases acute sprains, 3–5 days); Ru Xiang + Mo Yao (WBC maturation↑, differentiation↑); Dang Gui Wei (osteogenic — type I collagen↑, osteoprecursor cells↑)

CHINESE THERAPEUTIC ACTIONS

* Invigorates blood circulation; removes blood stagnation (Dang Gui Wei, Hong Hua, Tao Ren, Su Mu)

* Dispels blood stasis; alleviates pain (Yan Hu Suo, Su Mu)

* Reduces swelling; drains dampness (Er Cha, Mu Dan Pi)

* Clears heat; reduces inflammation (Mu Dan Pi, Da Huang)

* Relaxes tendons and muscles; antispasmodic (Bai Shao, Gan Cao)

* Tonifies Spleen; promotes muscle regeneration (Fu Ling)

* Harmonizes formula (Gan Cao)

DOSAGE

Acute/initial stage: 5–6 capsules every 6 hours. After stabilization: 3–4 capsules three times daily on an empty stomach with warm water. Take with food if stomach discomfort occurs.

Supplementary formulas: Stop bleeding — add Notoginseng 9. Severe pain — use with Herbal ANG. Severe inflammation — combine with Astringent Complex. Headache — use with Corydalin (AC) or Corydalin (CR). Neck and shoulder pain — add Neck & Shoulder (AC) or Neck & Shoulder (CR). Lower back pain — combine with Back Support (AC) or Back Support (CR). Arm pain (shoulder, elbow, wrist, hand) — add Arm Support. Herniated disk — add Back Support (HD). Knee injuries — add Knee & Ankle (AC) or Knee & Ankle (CR). Chronic soft tissue damage — add Flex (MLT). Muscle spasms and cramps — combine with Flex (SC). Chronic cold arthritis — combine with Flex (CD). Joint inflammation with redness and swelling — use Flex (Heat) instead. Bone spurs — use with Flex (SPR). External injury with open wound or infection — use with Herbal ABX. Bone fracture recovery — use with Osteo 8. Post-surgical constipation — add Gentle Lax (Deficient). Severe blood stagnation and bruising — add Circulation (SJ). Excess fire signs — add Gardenia Complex.

Nutrition: Eat half a fresh pineapple on an empty stomach daily — rich in bromelain, reduces swelling and inflammation. Patients with broken bones or fractures should consume adequate calcium during recovery. Avoid foods with preservatives — phosphorus in preservatives can lead to bone loss. Avoid cold food and drinks (causes stagnation) and spicy food (aggravates inflammation).

Lifestyle: Avoid exercise with high risk of injury, especially during recovery. For external injuries with open wounds, clean the affected area thoroughly to prevent infection. Apply vitamin E oil to minimize scarring — apply only after open wounds have closed or healed.

CASE STUDIES

— 45-year-old female (A.S.): Right lateral ankle sprain 3 days prior; purplish color and swelling; local blood stagnation. Flex (TMX) + Knee & Ankle (AC). Result: 50% better after 3 days; discontinued Flex (TMX) after 8 days at 90% improvement; continued Knee & Ankle (CR) for 1 additional week — 100% recovery.

— 59-year-old male (D.G.): Acute left ankle sprain from fall; swelling, black and blue coloring, abrasions; qi and blood stagnation. Flex (TMX) 3 capsules 3x/day. Result: swelling resolved in 4 days; bruising resolved in 1 week; pain decreased within 2 days.

— 32-year-old male (S.P.): Neck and back pain from workout injury; qi and blood stagnation. Flex (TMX) 4 capsules 3x/day + Neck & Shoulder (AC) 6 capsules 3x/day. Result: immediate decrease in pain; discontinued Flex (TMX) after 2 weeks; continued Neck & Shoulder (AC) for 4 more weeks until pain resolved.

— 12-year-old male (C.K.): Painful swollen elbow with bruises from go-cart accident (pinned under roll bar). Flex (TMX) 3 capsules 4x/day with food + Po Sum On topical tincture + acupuncture + massage + homeopathic remedies. Result: accident on Thursday — 100% recovery by Monday; no stomach upset.

— 41-year-old nurse (D.D.): Severe back pain from fall while lifting patient; popping sound in back; MRI confirmed herniated lumbar disc; 9 weeks post-injury; BP 140/80, HR 80; qi and blood stagnation, soft tissue damage. Back Support (AC) + Flex (SC) + Flex (TMX) 3 capsules each 3x/day. Result: Vicodin use reduced from 2 to 0.5 tablets/day (none on some days); BP normalized from 170/110 to normal; no additional physical therapy — "remarkably well in a short period of time."

— 18-year-old male chef: Neck and shoulder pain from skateboard fall; diminished cervical curvature and hypokyphotic curve T2–T3; cervical sprain/strain. Neck & Shoulder (AC) + Flex (TMX). Result: reduction in pain; took herbs with food to avoid stomach discomfort.

— 36-year-old female massage therapist (J.M.): Pain from automobile accident (2nd in 6 months) — neck, back, arm, and leg pain; airbags bent right thumb; herniation and soft tissue damage; muscle spasms; hot trigger points; decreased ROM neck and trunk; BP 120/70, HR 72. Flex (TMX) + Neck & Shoulder (AC) + Back Support (AC) 2 capsules each 3x/day + acupuncture. Result: pain levels reduced by half in a short period of time.

— 77-year-old female (L.P.): Severe left wrist and right rib cage pain after fall; wrist and palm numbness; bruises on right eye; tender right subclavicular area; qi and blood stagnation with soft tissue damage. Flex (TMX) + Neck & Shoulder (AC) + Flex (SC) 2 capsules each 3x/day. Result: daily lowering of pain; numbness reduced to light tingling after 2 days; continuous steady improvement; referred to chiropractor for cervical and occipital adjustments after swelling reduced.

Related Reading

Also see: Osteo 8 – for bone fracture recovery and osteoporosis | Flex (MLT) – for chronic soft tissue damage | Flex (SC) – for muscle spasms and cramps | Back Support (AC) – for acute back pain | Back Support (HD) – for herniated disc | Neck & Shoulder (AC) – for acute neck and shoulder pain | Knee & Ankle (AC) – for acute knee and ankle injuries | Herbal ANG – to enhance analgesia | Notoginseng 9 – to stop bleeding | Circulation (SJ) – for severe blood stagnation and bruising | Herbal ABX – for open wound infection | Astringent Complex – for severe inflammation | Pain Relief & Musculoskeletal Support Collection.