Acupuncture for a sprained ankle
To review, a sprain is when a ligament (those cartilage bands that hold each bone to another) becomes injured. Well, technically torn… There are different grades of tear or sprain. From very mild to a complete ‘avulsion’ when it has been completely torn in two.
A tendon, is the attachment of the muscle to the bone, and many times those are injured as well. It is a reflex of the area that is injured to tighten to naturally splint the area. This is why you would have tightness of the shin and calf muscles when you sprain an ankle.
Most ankle sprains are what are called inversion sprains, they are when you roll an ankle on a hole or rock or something. This can tear a set of ligaments on the outside of the ankle called the deltoid ligaments or the talo-calcaneal or talo-navicular ligaments. Of course, there are many ways to injure the ankle and many structures that can become damaged, but these are the most common that I have seen.
To make sure it is not a fracture is also very useful. The gold standard of course is an x-ray of the ankle, but palpation (feeling) and mobilization (by a professional, skilled practitioner) is useful. Another way to do this is with a tuning fork, which I did a video on my channel ‘Thenaturalbodyworks’ on YouTube.
RICE and self-care: The sprain tears the ligament, this causes bleeding because you have also torn blood vessels. That is where that wonderful bruise under your ankle bone is from. Also in the area is a whole system of inflammation which would include; warming up or heat, redness and bruising, pain and soreness, and swelling. All of this is normal for an injury and it is trying to help you. The body is trying to stabilize the area as well as increase action of the white blood cells and repair cells. The pain is to keep you from injuring it again. The idea is to rest and let it heal. This is the crux of the typical treatment of ‘R.I.C.E’ or Rest, Ice packs which help with pain and out of control swelling that can further damage tissues, Compression, to keep it from swelling more and to support the ankle if you have to move at all, and Elevation to reduce throbbing and pooling of blood in the lower area.
Contrast bath: I only have people use ice for the first couple days maximum. Once the bruising starts to show and change color is the time to bring in some intermittent heat. This all of course depends on what it looks like. I have patients use ice for ten minutes, nothing for ten minutes then some mild heat for ten… then repeat. It is called contrast and it gets the fluids and blood to wash out quicker.
Acupuncture: As for acupuncture it can and should be used on acute (immediate injuries, that are less than a few days old) to sub-acute (from a few days to a couple weeks) then for chronic injuries, those that have lasted over a couple weeks. Each part is unique and take different care programs which I will not go into here. The points used are general on the meridians that cross the ankle, the liver, bladder, kidney, spleen, gallbladder and stomach. WOW so many! But knowing which ligament is sprained and which points to use is essential and what an experienced acupuncture practitioner would use.
Electrical Acupuncture uses small needles to be placed in specific areas to enhance the healing capabilities and actions of the body. There are also (as shown in the picture) electrical therapy that can speed up the process even more. Electrical acupuncture can help with swelling, congestion in the area, muscle spasm and pain. I prefer to use it rather than take all kinds of over the counter medications because the medications go all over the body, when we really want the action in the ankle.
Treatment could take from 20 to 40 minutes depending on what else is going on. Home care as above is essential. For acupuncture, I have patients come in daily for three days then every other day for a week or two. Then we go to rehabilitating the ankle.
Rehabilitation is a part of the total healing of the ankle and begins with simple movement in the pain free ranges. Doing the alphabet in the air with the big toe as a pointer is useful. It helps regain some range of motion, reduce swelling and scar tissue buildup and begins to loosen the muscles. Later, weight bearing and special exercises like walking on the tip toes or heels or outer edge of the ankle is helpful and will strengthen the ankle again and prevent more injuries. Finally I do and suggest manipulations of the ankle, knee, hip and lower back to make sure it is all aligned properly and has a good range of motion that will allow you to adapt better and completely heal without weakness of the ankles or other areas which will predispose to other injuries.
Frequently these injuries become very stubbornly chronic and some have to wear a brace to help the weakened muscles, tendons and ligaments. They should be getting routine adjustments and follow up treatments to help them adapt and understand the new limitation. No sprain is ever 100% healed, there will be scar tissue no matter what you do, and the idea is to reduce it as much as possible and strengthen and build adaptability in the rest of the body.
Finally we have to also look at the emotional component of an injury if we hope to be holistic about it. The ankles and feet are our foundation, our connection with the Earth itself. In acupuncture philosophy the human is the in-between of the Earth and the Heavens. It is important to consider. Other ideas related to the ankle are the ability to stand up for one’s self, standing steady, pushing off, stepping forward, stepping up, and holding your ground. Simply put, ‘standing on your own two feet’ is a common idea. Although many ankle injuries are simply a miss-hap, a lack of attention or an accident. When they are continual or chronic we have to look elsewhere. Following the ‘kinetic chain’ from the spine all the way to the foot is essential and can really open up some good possibilities of healing other areas of the body and mind.
Trying to treat just the ankle is short changing the patient and not looking at the person as a whole process of being. The body is not like a car, you cannot easily just replace parts and have it work exactly the same. It does not work like that, never has, never will. Think holistically, look at the whole person. It does not have to be an exhaustive exploration of all the physical alignments, strengths and weaknesses, chemical insufficiencies and emotional components, but it helps to keep that idea of the whole person in the mind with any issue.
Dr. Sean H. Thompson is a chiropractor and acupuncturist in Parker Colorado. He has been treating ankle injuries for over 20 years and presents his work and findings both online and in person. https://www.youtube.com/c/thenaturalbodyworks