Sprained Ankle/Foot

It's common knowledge that sprained ankles take a while to heal, and that they are very vulnerable to re-spraining after the initial injury. Sometime this is called a weak ankle.

What most don't know, even most professionals (even doctors), is that the bones of the ankle can actually be knocked out of alignment by the forces acting on it during the injury. The natural arches of the foot are formed by the 7 bones of the ankle and the metatarsals of the foot. The arches formed are similar to classic stone arches - each piece of the top of the arch fitting against each other in wedge shapes. When disturbed out of their normal alignment, one or more of these bones can then stick out and not be able to fall back in due to the nature of the other bones wedging it out. This is like a stone arch with one of it's pieces sticking out too high: the integrity and strength of the structure is phenomenal when all are in line, but very vulnerable when out of line.

This is why a sprain can re-occur over and over again. The tendons and ligaments were stretched in the first injury, the bones were quite possibly out of line, and then the same movement happens and the bones cannot support the healing soft tissue. The re-injury isn't always a new sprain, usually it's the old one not fixed.

The bones sometimes work themselves back into alignment again on their own, but that's not always the case. I have worked on many ankles that chronically hold some misalignment. When asked, the patient reports a "weak ankle," an ankle that is prone to re-injury. Which of course is no suprise.

I have received continuing education in Chinese medical massage, Tuina. Tuina includes techniques for bone alignment. Not all acupuncturists are trained in these more advanced massage/manipulation techniques, even if they studied Tuina in school.

Tuina training combined with acupuncture is the best remedy for sprains. The basic method is to first soften all the tension in the tendons and ligaments. This is done with soothing massage and acupuncture. After the initial warming up of at least 25-35 minutes (including time with needles), the ankle can be moved through normal range of motion, and stretched to make space in the tightly wedged bones. When the arch of the bones is opened, the bone(s) that we squeezed out can slip back into place. The difference can be seen and felt immediately, and the pain much improved right away.

Most sprains occur on the outer side of the ankle or foot. The most interesting sprained ankle I have run across was across the inner aspect of the foot. The patient had sprained it 7 weeks ago, and she observed "swelling" of the inner foot. Besides it being rare to sprain the inner main arch, when I saw the foot, it was not swelling at all. The bones were so out of line over the top of the foot that they had crushed inward, raising the top of the foot. Amazing to see, and yet my training covered this contingency.

I got to work, and after each session I could see that the raised parts of the foot were indeed flattening immediately. It was not an overnight cure, but it is a real treatment. Not just pain medication, and not just exercises to get the foot "stronger" - this was actually treating the source of the problem so that the foot can be as good as new, not just functional.

The patient had to go out of town after 2 sessions. While she was gone, she went to a doctor. The only thing the doctor could say was that it was unusual! This is true, it was unusual. He immediately was jumping to arthritis or bone spur. This is completely incorrect! The doctor wanted to do a CT scan, then MRI. What is a machine taking a picture going to show that I can't see with my own eyes, feel with my own hands, and treat right in my own clinic? And what is a doctor going to do to align  the bones? They don't have it in their vocabulary. For doctors, bones don't move. How shortsighted and mistaken that point of view is!

Even the typical chiropractor, who works with bone alignment, seems to have a limited view. Somehow, they believe that the problem is about getting the bones in the right place and the rest will follow. Well, just forcing the bones back into alignment does not address what caused the bones to be out of alignment in the first place, and what will most likely cause it to go back out of alignment.

Chinese medicine states to obvious: bones are moved by muscles, attached to each other by tendons. Bones are hinged together by ligaments. If bones are out of place, it is because the muscles/tendons/ligaments are either pulling on them too hard (too tight) or failing to properly support them (too loose). But the problem is in the soft tissue. Once the soft tissue is addressed, the bones can be moved through normal range of motion, and they will simply fall back into their normal place. No cranking necessary. And the results are lasting because the solution addresses the real problem, not just a secondary manifestation. Treat the root, not the branch!