Wednesday, May 9, 2012

The Role of Acupuncture in the Treatment of Ankle Sprains

Thousands of people from all walks of life twist and sprain their ankles every day. Whether you tripped on a sidewalk or landed on someone else's foot in a basketball game, a sprained ankle is one of the most common injuries around. Of course, everyone knows they typical advice: R.I.C.E. (Rest, Ice, Compression and Elevation). In other words, most people will advise you to just lay in bed as much as possible and ice your ankle until the swelling goes down and you can walk again. Fortunately, a new understanding of the body reveals this is not the best way to heal such an injury. In order to understand why, you need to know a little bit more about how the body works.When you have an injury, the body immediately tries to protect that area to prevent further injury. Inflammation is one of the body's best ways to protect the injured area from further movement and harm. So, in the case of ankle sprain, you will find a lot of inflammation, which means you will barely be able to move your ankle at all as the joint swells up to a softball. And it will take many weeks if not months for the inflammation to slowly decrease enough for you to walk normally again. But, as the inflammation decreases, another phenomenon will occur. Your body will produce scar tissue around the injury. Your body does this to help strengthen and protect the weakened joint from future injury. This is the body's natural response to injury if you just rest.

But, there are a number of problems with the natural healing process left to itself. One, it takes a very long time. Inflammation goes down very, very slowly and does not readily allow for the flow of fresh blood and nutrients into the injured area. It is also very hard to remove the waste from the cells in the injured area. So, although the inflammation protects the area from movement, it takes a great deal more time to heal the injury, because the ligaments and cells cannot get fresh blood and nutrients and also cannot remove waste efficiently. In other words, the inflammation blocks the free flow of healthy blood into the area as well as blocking the free flow of waste products produced from the injury out of the body. In addition, the development of scar tissue inhibits the movement of a joint, which means that in the future, your joint will be much less flexible and capable of strengthening itself.
In a nut shell, the body, if left to just rest, will heal itself as best it can, but will actually keep your ankle weak and inflexible which puts it at greater risk of injury in the future. So, here is how the body generally heals itself if left on its own:
1) Inflammation response - to protect the area from further injury which is very slow to fully heal and reduces the flow of blood and fresh nutrients into the area.
2) Produces scar tissue around the injury to help protect the injured area in the future, but also dramatically reduces flexibility and strength in the joint.
Rehabilitation, on the other hand, still allows the body to rest most of the day, but also actively moves the joint to help dramatically reduce the inflammation and avoid the build up of scar tissue. That means that the ligaments will heal much faster and better, because they get fresh blood in and can move the waste out. Also, the movement will help reduce the adhesions developed by scar tissue which will significantly strengthen your ankle joint and keep it flexible.
In fact, most people find that with proper rehabilitation, their ankles are far more flexible and strong then before they injured their ankles in the first place. Of course, this puts you at a much lower risk for injuring it again in the future. Remember, it is not working against the body, just helping the body to heal more efficiently. Joints that only rest and do not move get rusty and an injured joint, such as a sprained ankle, needs to continue to be moved, stretched and strengthened to retain it's flexibility. For example, if you were to dislocate a finger, your doctor will tell you to keep moving it (one common exercise is to make a fist and then open it and spread your fingers out as wide as possible in a sink filled with warm water). They will explain to you that rehabilitating your finger is the key to insuring you maintain its flexibility and strength in the future. But, for some reason, when you twist or sprain an ankle, everyone just says to rest. It is bizarre that people recognize that rehab is important for one joint but not another.

And now come to the point, 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.

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