Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Endo-peptidases, such as bromelain (from pineapple) and serratiopeptidase, are proteolytic enzymes that have been investigated for their potential to support the healing of sprains and other soft tissue injuries. The rationale for their use is based on their ability to break down protein-based debris at sites of injury, which may help reduce inflammation and edema associated with tissue trauma. Several clinical studies, particularly from Europe and Asia, have examined the effects of these enzymes in patients with acute musculoskeletal injuries like sprains.

For example, a number of randomized controlled trials have reported that bromelain and serratiopeptidase may reduce swelling, pain, and recovery time when compared to placebo, and in some cases, their effects were found to be comparable to standard non-steroidal anti-inflammatory drugs (NSAIDs). However, these studies often have methodological limitations, such as small sample sizes, lack of blinding, or inconsistent outcome measures. A few systematic reviews exist, but most conclude that while there is some evidence of benefit, it is not robust or consistent enough to recommend routine use, and more high-quality research is needed.

Overall, the scientific evidence supporting the use of endo-peptidase for sprains is promising but not definitive. The mechanism—reduction of inflammatory mediators and edema—is biologically plausible, but the clinical evidence rates at about a 2 on a 0-5 scale, indicating weak to moderate support. Use should be considered adjunctive and not a replacement for standard care.

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