Tuina for the Treatment of Muscle Cramps in TCM

Last updated: 29 Jul 2025 | 495 Views |

Treatment of Ankle Sprains in Traditional Chinese Medicine

https://instituteforathleticmedicine.com/specialties/foot-and-ankle/ankle-sprains/

What Is an Ankle Sprain?
An ankle sprain is an acute injury involving the ligaments around the ankle joint. It typically occurs due to twisting, rolling, or missteps that stretch or partially tear the ligaments, leading to bruising, swelling, and limited movement of the joint.

Causes
- Slipping or walking on uneven surfaces, causing the ankle to roll or twist
- Improper landing during running or jumping
- Accidents such as falling, slipping on stairs, or sports injuries

Symptoms of an Ankle Sprain
- Pain in the ankle, especially during movement, walking, or weight-bearing
- Swelling, sometimes accompanied by bruising or discoloration of the skin
- Stiffness and limited ankle mobility
- Tenderness when pressing around the ankle
- A feeling of instability or looseness in the joint
- In some cases, a "pop" sound may be heard during the injury

Severity Levels
Grade 1 (Mild): Ligament stretched without tearing or with minimal tearing. Mild pain with walking possible.

Grade 2 (Moderate): Partial ligament tear with significant pain and swelling, difficulty in bearing weight.

Grade 3 (Severe): Complete ligament rupture, severe swelling and pain, inability to walk or bear weight.

https://www.joionline.net/library/the-lower-ankle-sprain/

TCM Perspective and Tuina Treatment for Ankle Sprains
According to Traditional Chinese Medicine (TCM), an ankle sprain is categorized as a tendon injury (伤筋, shāng jīn). It is primarily caused by Qi and blood stagnation, leading to blocked meridians around the ankle. This obstruction results in pain, swelling, and restricted movement.

TCM Treatment Approaches
- Tuina therapeutic massage
- Acupuncture
- Application or soaking with Chinese herbal medicine
- Moxibustion

Tuina Massage Therapy
Tuina (推拿) is a manual therapy in TCM that involves specific techniques such as pressing, kneading, pinching, and joint mobilization. It helps:
- Alleviate pain
- Promote the flow of Qi and blood
- Relax muscles and tendons
- Accelerate tissue recovery and restore joint balance

Principles of Tuina in Treating Ankle Sprains
An ankle sprain leads to Qi and blood stagnation (气滞血瘀) in the affected area. Tuina aims to:
- Stimulate circulation of Qi and blood
- Reduce local blood stasis
- Relax affected muscles and ligaments
- Restore joint mobility and functional balance

Optimal Timing for Tuina
- Avoid within the first 24–48 hours post-injury as it may worsen swelling
- Best applied during the recovery phase, once swelling begins to subside, to support healing of ligaments, muscles, and joints

Tuina Techniques Used
1. Mo Fa (摩法 – Stroking):
Gentle circular rubbing with the palm around the ankle to disperse Qi and improve blood flow
2. Rou Fa (揉法 – Kneading):
Finger kneading around the Achilles tendon to reduce inflammation and enhance circulation
3. An Fa (按法 – Pressing):
Applying finger or palm pressure on the calf muscles and acupuncture points around the tendon to relieve tension
4. Na Fa (拿法 – Grasping):
Gentle grasping or pinching of the muscles or ligaments around the ankle to stimulate circulation
5. Yao Fa (摇法 – Rocking):
Gentle rocking of the ankle joint to restore movement and flexibility

Acupoints for Treating Ankle Sprains
Stimulation of acupoints enhances the flow of Qi and blood, reduces pain and swelling, and accelerates tissue recovery. Commonly used acupoints include:

- Taixi (KI3, 太溪)
Meridian: Kidney
Function: Nourishes kidney and strengthens tendons
Location: Between the Achilles tendon and the inner ankle bone (medial malleolus)

Kunlun (BL60, 昆仑)
Meridian: Bladder
Function: Alleviates pain and tension in ankle tendons
Location: Between the outer ankle bone (lateral malleolus) and the Achilles tendon

- Sanyinjiao (SP6, 三阴交)
Meridian: Spleen
Function: Balances Qi and blood, strengthens kidney and spleen, relieves ankle pain
Location: On the inner side of the leg, about four finger-widths above the medial ankle

- Ashi Points (Tender Points):
These are sensitive or painful areas around the injury site, used for focused treatment via acupressure or acupuncture

Frequency of Treatment
Tuina sessions are recommended 1–2 times per week during the initial recovery period, and adjusted according to patient progress.

Recommendations for Care
- Cold compresses within the first 1–2 days (no more than 5 minutes per session) to reduce swelling and inflammation
- Switch to warm compresses after 1–2 days if no redness or heat remains
- Avoid high-impact activities such as running or jumping during the healing period
- Use gentle massage pressure in the early stage, combining with acupuncture to manage inflammation
- Discontinue any herbal poultices immediately if skin irritation or rash occurs; wash thoroughly with clean water

References
Wang He Wu. Zhongyi Gushang Kexue [Traditional Chinese Orthopedics]. Beijing: China Traditional Chinese Medicine Publishing House; 2007.