Ankle pain, sprains and strains
Ankle sprains are the most common cause of visits to the emergency room in the U.S.! Acute ankle injuries happen in contact, running, and jumping sports, and in accidents that can occur when someone mis-steps or falls on an unstable or uneven surface and “rolls” their ankle. Ankle sprains range from mild, with no brusing, swelling, or damage to ligaments and joints, to severe, reuslting in fractures and total disruption of ligaments and joints.
Any significant swelling or bruising following an ankle injury deserves prompt medical attention.
Swelling can mask a complete ligament tear or fracture, either of which require the care of an orthopedic physician (I”ve had several patients walk into my office on ankles which turned out to be fractured when we were able to obtain x-ray imaging!).
Even milder ankle sprains benefit from immediate “RICES” care (Rest, Ice, Compression, Elevation, Support) for at least 72 hours, including wearing a lateral stabilization brace, splint, or functional orthotic if the ankle is at all swollen or unstable. Prompt and aggressive control of swelling is key because the swelling can cause more damage than the original injury by trapping blood and inflammatory substances in the injury site, and obstructing the drainage of waste and debris out through the lymphatic and venous return systems. RICES therapy, acupuncture, lymphatic drainage massage, and ankle mobilization exercises can all help to drain swelling from a sprained ankle.
Follow-up treatment for ankle sprains is also important, because ankle sprains can fail to heal fully on their own. Sprained, stretched out or weak ankle ligaments de-stabilize the ankle joint, which can lead to more sprains and become a vicious cycle of instability, injury, and joint degeneration and eventual osteo-arthrosis (arthritis).
Chronic alteration of normal ankle joint function (either hyper- or hypo-mobility) can also lead to gait problems that cause pain, tendonitis and joint degeneration up and down the foot, knee, leg, and even hip, pelvis and back.
In my experience, acupuncture can be very helpful in reducing acute swelling and pain and facilitating re-mobilization of a sprained ankle (as long as there is no complete ligament tear, fracture or joint derangement, which require orthopedic physician care). The sooner acupuncture is applied after the injury, the better. Electro-stimulation of the acupuncture needles (electro-acupuncture) is also often helpful.
Additional modalities of cross-fiber acupressure at points such as UB 62, K 6 and GB 40, as well as rehabilitative calf-strengthening and stretching exercises, are also important. Acupuncture/electro-acupuncture can also treat chronic pain from an incompletely healed ankle sprain or ankle joint degeneration.