Ankle Sprain — When It Does Not Heal Properly After a Twist
Table of Contents
Anatomy of an ankle sprain
An ankle sprain is an injury to the lateral ligament complex, and about 85% of all sprains are inversion injuries in which the foot rolls inward. The first ligament to be injured is the anterior talofibular ligament (ATFL), and as more force is applied, the calcaneofibular ligament (CFL) and posterior talofibular ligament (PTFL) tear in turn.
Grade I–III classification
- Grade I (mild): Microscopic injury of the ligament fibers, mild swelling, walking is possible. Recovery within 1–2 weeks.
- Grade II (moderate): Partial tear of the ligament, moderate swelling and bruising, pain on weight bearing. Takes 4–6 weeks.
- Grade III (severe): Complete rupture of the ligament, severe swelling and instability, difficulty walking. Treatment of 8–12 weeks or longer is required.
Acute care — from RICE to Korean medicine treatment
For the first 48–72 hours after injury, follow the principles of RICE (Rest, Ice, Compression, Elevation). Once swelling subsides, switch to acupuncture (Qiuxu, Jiexi, Kunlun) and pharmacopuncture to improve local blood flow and promote absorption of inflammation. Administering Danggui-susan in the acute phase accelerates removal of blood stasis and pain relief.
Incomplete recovery leads to chronic instability
The problem is that many patients judge themselves "fully healed" once the pain is gone. In reality, the ligament may heal in a lax state, or proprioception may not recover, leading to chronic ankle instability (CAI) in which the same ankle is sprained repeatedly. About 40% of initial sprain patients are reported to progress to CAI.
Korean medicine rehabilitation for full recovery
Chuna manipulation corrects the anterior displacement of the talus, and electroacupuncture trains the reaction speed of the peroneal muscles. Proprioception is systematically restored through single-leg stance and balance board exercises, and activity intensity is gradually increased while wearing an ankle brace. Strengthening herbal medicine (Achyranthis Radix, Dipsaci Radix, Eucommiae Cortex) increases the strength of ligament tissue, significantly reducing the recurrence rate.