Acute ankle sprain is one of the most common musculoskeletal injuries in people of all ages, athletes and couch potatoes alike. It involves stretching or tearing of the ankle ligaments, often seen on the outside of the ankle. Being so common in our daily lives, many people often brush the injuries aside and do not seek proper treatment. However, this could eventually result in chronic ankle pain and instability, increasing the chances of repeated injuries.
Based on the duration from injury onset, ankle sprain can be broadly categorized into 2 stages – acute and recovery phase. Acute phase refers to the first 48 hours of injury. Within the period, proper first aid management and treatment are critical to subsequent recovery. A management regime, known as RICE, is commonly applied.
Rest: Stop activity as soon as possible and avoid putting weight on the injured area to prevent further damage.
Ice: Apply an ice pack (wrapped in a towel; avoid direct contact) to the injured area for 10-20 minutes several times a day. Repeated cold application will reduce pain and swelling. Contrary to popular belief, massaging is not advisable as it may aggravate bleeding and increase swelling.
Compression: Wrap the injured area with an elastic medical bandage. Bandage should be snug but not too tight. Loosen the bandage if the area turns blue, or feels numb, tingling or cold.
Elevation: Raise the injured part to or above heart level, whenever possible.
In fact, this RICE regime is not restricted to ankle sprains and can be used for most soft-tissue injuries. However, if you have difficulty bearing weight, or experience tenderness in the bones of the foot and ankle, you may need additional tests to rule out a fracture.
After the first 48 hours, the injury enters the recovery phase. During this period, warm compression is preferred as it improves blood circulation and promotes recovery. Patients are also advised to start their ankle rehabilitation exercises 3 days after injury, if it is not too severe. Proper rehabilitation is important to regain range of joint motion, strengthen surrounding muscles, and prevent future injuries. However, remember to start slow and listen to your body. If you feel pain during exercise, slow down or stop when necessary, and seek professional help from physiotherapists.
A general public consensus would agree that TCM treatment is highly effective in the management of acute ankle sprains. In fact, many people, even today, opt for TCM treatment when faced with such injuries. Some common treatment modes include acupuncture and bone setting. Acupuncture has been proven to effectively reduce pain and swelling, promoting faster recovery. Bone setting might be applied when there are minor ligament or bone displacements, and once set back in place, pain can be significantly reduced almost instantly. However, do note that bone setting is a special set of skills that requires years of training and practice, and therefore it is important to seek a professional practitioner.
And just a little tidbit about acupuncture. Have you ever been puzzled by how different acupoints are chosen for treatment? And why practitioners apply acupuncture to distant areas unaffected by the injury?
One common theory is meridian differentiation. Different meridians run through different parts of our body. Based on the location of the injury, the injured meridian can be determined. TCM believes that Qi of meridians with corresponding names are interconnected, and therefore acupuncture treatment on another meridian on a distant part of the body will help to improve Qi and blood flow of the injured meridian.
During the acute phase of ankle sprain, physicians tend to avoid excessive acupuncture on the injured area to prevent secondary bleeding. In turn, they opt to perform acupuncture on corresponding meridians of the healthy ankle or even the wrist. For example, if the injury is located along the Shaoyang channel of foot (as commonly seen on outer ankle sprains), acupoints on the Shaoyang channel of the other foot or wrist can be used. In contrast, during the recovery phase, physicians tend to focus on the local pain points of the injured ankle. Local acupuncture helps to improve blood circulation, thereby reducing pain and swelling.
It is important to note that there are many other concepts and theories behind the use of acupuncture. Meridian differentiation is just one of the many. Therefore, different physicians can have different treatment plans, each with their rationale and basis. Do consult your attending physician if you have any questions about the treatment plan.
In conclusion, ankle sprain injury, despite being common, can lead to debilitating consequences if not managed properly. It is important to apply proper first aid treatment as soon as possible to minimize damage, and to seek professional help to promote faster recovery. Lastly, rehabilitation exercises are very crucial to regain range of motion and to prevent repeated injuries.
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