Treatment of Ankle Sprains
Robert Filice, M.D. Former staff physician
 

Ankle sprains are a common and often aggravating injury. Although most sprains are generally minor and heal quickly, a recent study conducted at the orthopedic department of the University of Basel Switzerland showed that in 20% to 40% of patients, sprains lead to chronic ankle instability, and that 70% to 80% of this patient subset eventually develops osteoarthritis in the affected ankle. The basic mechanism in a sprain is a stretch or tear of a ligament which helps hold bones together and which prevent excessive movement of the joint. The most common method of injury is when the foot comes down on an uneven surface or on its edge rather than flat down. The most common ligaments that are injured are those on the outside of the ankle. Failure to obtain complete healing in torn ligaments is not uncommon because of their poor blood supply. When this happens, ankle instability that permits an abnormal side to side motion, and ultimately arthritis in the joint are the result.
 

Although orthopedists and family doctors know the importance that complete healing has in the ultimate result after ankle strains, they still seem to do everything in their power to prevent that from happening. Starting treatment with the RICE treatment (rest, ice, compression, and elevation) and anti-inflammatory medications, as most of them do, pretty much stops the body’s natural efforts at healing through inflammation dead in its tracks. As reflected in the above statistics, a large percentage of patients with ankle sprains go on to chronic instability and arthritis. I believe this is largely because of the application of these widely practiced improper treatments.
 

Prolotherapy doctors like myself, on the other hand, believe that the correct treatment for an acute ligament strain is MEAT rather than RICE treatment. I have written several articles recently which documented the fact that even the orthodox literature confirms that immobilizing injured joints produces inferior results. The “M” in MEAT is for mobility or motion. We avoid immobilization and encourage early movement of the injured ankle. Similarly we are inclined to avoid the use of solid braces as much as possible. In fact the “E” in MEAT is for exercise. Either passive motion or active exercise of the joint is valuable in maintaining range of motion and speeding healing. The assistance of a Physical Therapist is sometimes needed. The “A” is analgesics. If pain control is needed we recommend simple pain killing medication (analgesics) rather than anti-inflammatory drugs. ALL the anti-inflammatory drugs successfully increase your chance of making a chronic problem out of your acute ankle sprain while offering no more benefits than a simple pain killer like acetomenophen. The final element of MEAT is the “T”. This stands for treatment. Anti-inflammatory drugs do not treat anything. They suppress the body’s natural healing process. Prolotherapy on the other hand constitutes the one and only precise and direct method of treating ligament injuries that is directly in line with the body’s own efforts. In fact, Prolo kick starts the existing inflammation into a process strong enough to get the ligaments stronger, tighter, and bigger.  As this happens the pain goes away at the same time and for the same reason as the joint is strengthened and future instability and arthritis is prevented. The ligaments are being fully healed and in many cases made stronger than before.
 

For the average person who suffers a single mild to moderate ankle sprain, maintaining mobility, applying heat, using natural enzyme products to speed the healing process, and applying homeopathic Traumeel ointment in conjunction with a 50% solution of DMSO topically over the painful area every hour in the acute phase instead of anti-inflammatory drugs will probably bring sufficiently complete healing as to constitute adequate treatment. For an athlete, I would suggest doing at least two Prolotherapy treatments to insure that healing goes through to completion. I would also suggest that anyone who has sprained the same ankle more than once, or who has some chronic pain or a sensation of weakness or instability in the ankle have a series of Prolotherapy treatments. Prolotherapy can definitively undo the damage that a twisted ankle can do.