Serine proteinases (also called serine proteases), such as trypsin, chymotrypsin, and serratiopeptidase, are sometimes used as adjunct therapies to support the healing of musculoskeletal injuries, including sprains, strains, and soft tissue trauma. The rationale is based on their enzymatic ability to reduce inflammation and edema by breaking down inflammatory mediators and proteinaceous debris at injury sites, thereby potentially accelerating the resolution of swelling and supporting tissue repair.

Scientific evidence for their efficacy is mixed and generally of low to moderate quality. Several small clinical trials—primarily from Europe and Asia—suggest that oral serine protease supplements may reduce swelling, pain, and recovery time in patients with acute injuries (e.g., ankle sprains, post-operative swelling). For example, studies on serratiopeptidase and trypsin-chymotrypsin combinations have shown modest reductions in edema and improved mobility compared to placebo or standard care. However, these studies often suffer from methodological limitations, such as small sample sizes, short durations, and lack of rigorous blinding.

Systematic reviews and meta-analyses generally conclude that while there is some evidence of benefit, the overall quality is insufficient to draw firm conclusions, and more robust, large-scale trials are needed. The use of serine proteinases for injury support is not a standard recommendation in major clinical guidelines, and their use remains somewhat controversial in mainstream medicine.