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Marching ankle

Updated: Apr 24, 2021

17 yrs old female

A basketball player, starting to notice pain in ankle upon dorsiflexion of the left foot. She does not remember injuring the foot or ankle. Pain is provoked when she pivots with the left foot or squats. Upon x-ray imaging no issues with bones. Orthopedic physician gave her "slight tear of anterior tibiofibular ligament." She rested for 2 weeks and felt better, but upon resuming basketball practice, she started to feel the pain again. She would like to play in upcoming games, wanting relief from the pain and getting back into the game.

Hx: Frequent straining of ankles on the left side. Fast eating with big volume, her belly is not in a good shape

Tongue: Heat in SP/ST

Pulse: Slightly rapid and wiry

Ab: Heat, tightness, and pain at CV12

Anterior Drawer Test (-)

Varus Stress Test (-)

No issues with calf muscles

Point Prescription: CV12 (contact needling), ST41 (contact needling with 11 direct moxa). Tongue, pulse and ab are all showing improvement. Upon moving ankles, 90% of the pain is gone. Patient went home after I explained the function of ST41 and importance of eating slowly.

2nd visit: She came back in 2 days stating that she was able to go back to playing basketball again. She could not play 100% with aggressiveness, but she can feel the improvement. She had a slight discomfort on the right knee on the first visit, but now it is on the left knee. Contact needle on ST42 and finish

3 days later, she was able to play well in the tournament. Her digestive issues have also resolved since the treatment. She has not yet sprained her ankles for the past year.

Tsuyoshi's Eye: Take these 3 steps to move on with diagnosis

  1. What movement creates the pain: She felt the pain upon dorsiflexion and with heavy load of her weight

  2. Where the pain is located: Anterior Ankle

  3. Why it hurts: Forced movement of ankle is causing Anterior Ankle Impingement upon dorsiflexion of the foot

Oriental Medicine Diagnosis: ST Heat

Overeating and fast eating without chewing caused the heat to accumulate in ST channel and damaged the connective tissue of ankles and knees. I wanted to showcase the importance of ST Qi in the sports performance. Many thanks to my patients and Master Nagano.

*ST41 is used to treat the heat in SP/ST, meanwhile ST42 is weaker in its strength and addresses knee

Use of ST41: Dorsiflex the ankle until the pain comes on. Then, contanct needle the tight spot at ST41. Use rice grain moxa on ST41 around 7 to 11 times.

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