7 methods to treat a severe ankle sprain
What is an ankle sprain?
-partial or complete tear of ligaments (soft tissue connecting bone to bone)
-FYI a “strain” is tearing or pulling of a tendon (soft tissue connecting muscle to bone), aka “pulled muscle”
-inversion is the most common type of sprain, that is rolling to the outside of the foot (eversion is the less common kind, rolling to the inside of the foot)
-there are 3 grades of ankle sprain severity:
Grade 1 is mild pulling or minute tearing of ligaments, minor swelling, still able to walk
Grade 2 is moderate tearing of the ligaments accompanied by swelling, bruising , and pain but still able to bear weight on the ankle
Grade 3 is severe tearing of ligaments, audible pops at the time of impact, lots of swelling, bruising, pain, instability of ankle and unable to bear any weight at all for 3-7 days
-if you have a severe ankle sprain, you may need to get X-rays to find out if you have fractured a bone
How I treated my ankle…
Here is how I treated my own ankle sprain, in a time progression describing the different phases of the soft tissue. Timing of various healing methods is just as important as the methods themselves.
Moment of impact
Rolled my ankle laterally (to the outside) while doing Parkour. I was pushing off of a wall and then landing with both feet on a surface a few feet below me, must have landed a bit off and suddenly my ankle rolled with a lot of downward force following through the tibia. I heard a series of pops as it happened, (tearing of ligaments), and immediately felt a lot of heat and pain, and could not bear weight on it. It did not really begin to swell until about an hour later, at which point, two huge balls appeared, one on the lateral malleolus (outside of the ankle protruding round bone), and one in the depression beneath it, surrounded by general swelling in the area.
Step 1: Ice !?!
This first method, I cannot recommend 100%, however, I did do it. About 2 hours after the sprain, I decided to try the ice bath alternating with room temp bath method that I had recently heard about in the Tim Ferris Podcast with Gymnastics Bodies Coach Sommer. I wasn’t entirely sure if this was meant to be used directly following an acute injury of soft tissue, but decided to give it a try since immediately icing the acute injury is definitely the automatic protocol of our prevalent paradigm. Traditional Chinese Medicine, however, does not encourage the use of ice, but rather values the natural inflammation process. I was able to handle about 30 minutes of alternating bath waters every minute. It was quite painful to have my ankle in the ice bath but I learned to deal with it. However, I do feel that right after ending the ice bath treatment, I went into shock- I felt quite uneasy, nervous, nauseous, cold, and as if reeling out of control and had a lot of tension in my legs and back. Through massaging my upper calves and thighs and breathing I was able to calm down. So, in retrospect, I do not recommend the ice bath method, however it seems that an ice pack could be good in moderation to ease the pain and inflammation. Also, the ice bath could prove better at a less acute phase, past week 2 for example.
Step 2: Salonpas
Western Medicine protocol would say to accompany the local icing with a painkiller such as ibuprofen to reduce the swelling and help with pain. I did not find ibuprofen to help at all with the specific type of pain I was feeling -which was like a dull but completely consuming discomfort, not really a stabbing pain but a feeling of instability and vulnerability. Since the ligaments were torn, there was no support or tension through the ankle joint and the weight of the loose foot hanging put a painful pressure on the injured area. The application of Salonpas, a menthol aspirin topical pad, to the area really helped with the pervasive dull pain that made me feel quite sick. Salonpas can be found online or at an asian food mart. If I had been more on top of it, I would have liked to have put a wrap for support and compression on it that first night. I slept with it unwrapped that first night and it felt very loose and vulnerable. I also had muscle spasms throughout the night that would create too much movement through the joint and wake me up with pain.
Step 3: Compress & Support
I would recommend wrapping the ankle as soon as you can stand it. For me, I didn’t get it together until the following day. When I finally put a wrap on it, it felt so good! Any Ace bandage type wrap will be good to offer some slight compression (not too tight, since blood circulation is crucial), support the ankle and weight of the foot, help offer tension to the bone structure where the ligaments are temporarily unable to. Wrapping well with proper patterns, heel locks, and figure eights, will immobilize the joint in the right position and make it easier for the ligaments to repair and knit back together.
Step 4: Elevate
Keep ankle elevated above the heart, as much as possible- like…. all the time! Rest is needed, so a lot of sitting or lying around with foot elevated is great. Occasionally it is also good to put the foot fully skyward while lying on your back, so that blood can drain out of it back towards the heart.
All of the first 4 steps should happen immediately following the injury, and definitely continue to wrap and elevate the ankle for the first 72 hours. This is considered the acute phase of the injury. For me the acute phase lasted for about 7 days.
I got some acupuncture and also had some blood letting on the pinky toe from an acupuncturist friend on the 2nd day. I also iced again for a bit of relief from inflammation. By 24 hours, still could not bear any weight on the ankle, had to keep it wrapped to deal with the discomfort and give it compression/stability. Also acquired some crutches to help get around!
Step 5: Comfrey Poultice
The magical herb Comfrey really wins as the most obviously effective method, that I attribute my fast recovery to most. Another friend had brought me fresh Comfrey plants from her yard. I mixed a bit of boiling water with about 7 leaves, pounded them in a mortar and pestle, and wrapped it around my ankle with cheese cloth and tape, then wrapped my entire ankle with boxing hand wraps to brace it.. I left that on for a few hours. This first application of comfrey didn’t seem to do much. However…
On the 4th day, I tried another comfrey poultice for 4 hours, and this poultice really helped my ankle turn the corner. There was significant decrease in swelling around the ankle, and increased range of motion. In fact this method has impressed me the most so far of all the things I have been using, the Comfrey compress at that moment in the recovery process had the most obvious results. I began to be able to bear a bit of weight on it while standing. As the swelling of the soft tissue went down, I could feel more aches and sensations.
On the 5th day, I continued to rest, elevate, and wrap it and did another comfrey poutice, which worked wonders again! As I wore the poultice I started to be able to walk and bear more and more weight on the ankle!
To make a Comfrey Poultice, just find the live plant, take the leaves, mash them in a mortar and pestle, add a small amount of hot water, keep pounding the leaves until they are a juicy mash or cake. I started keeping the used cakes and letting them dry back out and “age”. I felt they were becoming stronger and releasing more medicine as they aged.
By the 7th day I could ditch the crutches and walk on my ankle with a brace on for small periods of time, mixed with lots of elevating and rest, otherwise my ankle would ache and throb. As the swelling receded, I found the essential oils, liniments, and salves to become the desired method.
Step 6: Massage, liniment, salves, essential oils
It was at this transition out of acute phase where massage of the areas surrounding the ankle, anywhere I could handle pressure and touching, like the calves and onward up the entire leg and into the quads and gluts felt helpful. Adding the strength of herbs to help with the healing process always felt good. Herbal foot baths are great for the after-acute phase when the ankle gets very achy and tired. Liniments are more effective if applied overnight using cheese cloth or gauze soaked in liniment wrapped around ankle and sealed with plastic wrap and sports tape. Liniments, salves, and essential oils that I used:
Heavenly Horse Liniment
Step 7: Fire Healing
As I progressed into weeks 3-5, I was able to train some martial arts again with limited range of motion and moderation. I used a rare Daoist healing method, known as Huo Liao, or “Fire Healing” to aid in this phase of the recovery. I felt there may be some residual blood stagnation from the bruising and swelling, as well as “cold qi” that had entered the joints from the icing. My ankle would typically be quite achy and stiff in the mornings or at night if I had used it too much throughout the day. Fire Healing helped warm the area deeply, increase circulation, drive the herbs from liniment in, and reduce pain. This method of Huo Liao consists of using fire, applied directly to the affected area with wet towels and alcohol. Don’t try this at home!
One final recommendation is this awesome book on sports injuries from a Traditional Chinese Medicine perspective, written by a martial artist. My Master always said that 9 out of 10 martial artists were healers…because, well, you learn to deal with all the injuries that arise from punching, kicking, jumping, and falling! In Conclusion, every injury is an opportunity to learn about the body and experiment with different healing methods!