Functional Medicine & Natural Healing Podcast
Functional Medicine & Natural Healing Podcast
Ankle Sprains - Holistic Treatment Matters
Ankle sprains aren’t just “part of the game.”
They’re the most common injury in volleyball and basketball, and what most people do in the first 24–48 hours is exactly what turns a simple sprain into a lingering, season-long problem.
In this episode, we break down what actually matters after an ankle sprain—and why the advice most athletes still hear is outdated, incomplete, or flat-out wrong. You’ll learn how to tell when an ankle really needs imaging, why resting too much can slow healing, and how to get back on the court faster without setting yourself up for reinjury.
If you’re an athlete trying to return safely, a coach making return-to-play decisions, or a parent navigating mixed advice, this episode gives you clear, practical direction instead of guesswork.
🩹 What You’ll Walk Away With
- The ankle sprain myths that quietly delay recovery
- Why the classic “RICE” approach is outdated—and what works better
- The Ottawa Ankle Rules: a simple, evidence-based way to know if an X-ray is actually necessary
- Why walking early (when done correctly) speeds healing instead of harming it
- How to use motion, heat compresses, and ice baths strategically—not randomly
- The surprising role of comfrey root in accelerating tissue repair
- Why many ankle sprains start with a muscle dysfunction, not just a torn ligament
- The critical difference between rehabbing a new sprain versus a chronic, unstable ankle
This isn’t about pushing through pain—or babying the injury.
It’s about rehabbing smarter, healing faster, and building an ankle that doesn’t keep betraying you every season.
If you’ve ever thought, “Why does this ankle keep getting sprained?”—this episode answers that question.
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Alright, guys, today's one of the episodes I really need to get out to you guys because this is a common thing that happens in volleyball. Ankle sprains are the most common acute injury in volleyball and basketball for that matter. And they always seem to happen at the worst possible time. What you do in the first 24 hours of the next few days after an injury is going to greatly affect essentially your outcome and how quickly you can return to play. And just, you know, on that note, like some people obviously need to get back to play, you know, tomorrow, and others have a lot of time. So the honest truth is like you can approach this however you want, but personally, I prefer to go and uh you know get back as soon as I can. So uh quick medical disclaimer on this one. I am not your doctor. While all the information I'm going to share with you today is correct, um, research-based, and it's backed by real personal clinical experience. Much of it goes against the grain. Uh, your doctors aren't going to like what I say here. Uh, but my podcast is definitely not personal medical advice. Rather, it's an educational platform uh to inform you about alternative thoughts and then maybe better or simply different ways that you can address your body than traditional standard care. Thought it would be fun today to start the podcast by going over like some common myths you might hear about uh sprained ankles, um, what what's most common and what people are doing. And so I just kind of picture someone spraining their ankle in the middle of practice. And these are kind of the things that that we do immediately. Um, so the first one actually isn't that bad. If someone goes and grabs you ice um for the first 30 minutes after an injury, I'm okay with that. Uh, the the research used to be somewhat equivocal and it does help get rid of some pain. Other than that, you want to remember from our past podcasts that we don't ice to reduce swelling. It's mainly a pain management tool. Some of the most updated research uh that's been done um says things like, it appears that both ice and complete rest may actually delay healing instead of actually helping. So it's something to know. Um, stretch your ankles before you play to prevent injury. Okay, so we might hear this before or after an ankle sprain, um, but this is definitely not something that we want to do. Remember that stretch is gonna slow down the reflexes of your muscle and make you more prone to injury. So, you know, if you're that person that's doing that wall stretch over and over because your calves are tight, we got to figure out that solution, figure out that problem. And that way you aren't stretching before every time you play volleyball, making you more prone to having a sprained ankle. Just remember that if your ankle needs to be stretched, the problem is likely that there's a muscle that can't relax adequately. And we got to figure out which one that is. All right. Uh, don't walk on a sprained ankle. We hear this a lot. Um, so you know, we've talked about boots before and just different modalities that they use to just pretty much uh lay you on bed and do nothing. Um, and that's something that we definitely don't want to do because for sure it's going to make you recover slower. Always we should essentially be walking on grade one or grain to grade two ankle sprains. I'm not saying we need to go play volleyball while it still hurts, but you want to aim to get back to walking as soon as possible, then jogging as soon as possible, then you know, hops and pogos and essentially getting back to some form of active volleyball-like movement as soon as the pain allows it. So the more we can move that ankle, the better those ligaments are going to heal. Remember that your ligaments are supposed to be like essentially keep you within normal limits. And the only reason you have a sprain on that ligament is because you went without like outside that range of motion that you were supposed to, right? Your ankle kind of turned in a weird way. Um, ligaments are not your primary weight-bearing tissue. So you should not, you don't use a lot of ligament strength or tension when you're doing average walking. Um, you're using a lot of your muscles. If it hurts, obviously it's because you putting tension on those ligaments, but we're not even coming close to like maxing them out or taxing them. So, in general, as we start to fix the muscles, as we start to go deeper into this, um, the ligaments are not a concern with just regular walking. We we could argue maybe, you know, whether you should be, you know, jumping the same moment it happens, but we'll talk about that in a little bit. Another one I read online a ton is like, you know, if you don't, if you walk on it, you're gonna get chronic ankle instability. So about 40% of people develop some form of ankle instability. They call it chronic ankle instability after a sprain, regardless of rest or movement. So it's not, it's not like did you lay down enough? Did you put take enough time off? Literally, it's going to happen to 40% of people that do nothing. So, once again, my take is simply most everyone does nothing for a sprained ankle, absolutely nothing. My opinion is that every sprained ankle needs to be treated, um, whether by yourself or by, you know, someone that knows something more than you. Um, you know, whether it's PT Cairo, whatever, athletic trainer that you have at the college or something like that. The goal is to get that ankle rehabbed rather than just kind of letting it heal on its own, because it will heal on its own, but it may not heal in the optimal form. And all the tissues that you may have damaged may keep going. In fact, I'll even talk about that a little bit because ligaments take about six weeks to heal, maybe like five weeks to eight weeks, maybe sometimes longer in the foot because there's low blood flow. But a lot of times, you know, it sounds weird. You'll say, Oh, people want you to wait until the ligaments heal a little bit before you walk on it. But that's actually not what anyone actually recommends. So, what happens is this they always say, well, just wait a week or two because you don't want to hurt your ligaments, then you can walk on it. But that doesn't make any sense to me because your ligaments haven't healed for six weeks. So you're still walking on your injured ligament when you start walking again. That's really important to know. If you're gonna take eight weeks to heal a ligament, like if you're like a severe grade two, but not quite a grade three, or even if you're a grade three, meaning you've actually torn completely through, when you start walking in, your ligaments are still not perfectly intact. They're reforming. Um, so it's just interesting to know that, you know, even though we act like we think we're avoiding creating chronic ankle stability by resting, the ligament hasn't healed anyway. So no matter what anyone tells you, I've never seen anyone say, don't walk on your ankle for six to eight weeks, um, which would be essentially the time it would take for that ligament to heal. Of course, it would then heal in a non-functional pattern, and you would have to then do ligament rehab to get that ligament working better if you waited that long. Okay. So let's just pretend you're at practice. I can picture a couple of these events myself, and I can actually picture a ton of these, but only uh I'm not involved in all the ones that I see. Um, and then in certain situations, right? Obviously, I'm not my player's doctors over the years. So some of them we just, you know, I just send them on their own way and I don't tell them any of these secrets. Other people might be also an athlete of mine, so I might coach them and they might be uh a client or a patient of mine. Um, so they might have gotten care. So what happens is someone goes and sprains their ankle. And so immediately when that happens, what you need to do is apply what I call the poor man's Ottawa ankle rules. So the Ottawa ankle rules is kind of this standard of care across all of medicine that you're supposed to follow these rules to see if you need to get an x-ray. Um, and so there's certain points that you're gonna touch. So, like let's say you have like a lot of pain after an ankle sprain in your midfoot on the outside or on the inside. Okay, well, that could be some cause for concern. But what we pay attention to on this one, the auto ankle rules really simplified it for us. And you don't always have a doctor to actually go and examine and touch and feel and figure it all out. So the first thing you're gonna do is see if you can walk on it. You don't need to mess with the shoe, you don't need to apply eyes. You want to see if you can walk on it. So the rule is if you can walk four steps, then it's likely that you don't have a fracture and you don't need to go get an X-ray. So it's an 88% chance that you don't have a fracture with just the walking test alone. So it's not flawless. And when you apply all of the Ottawa rules, which I'm not gonna go over, but if you look up the look them up, you can if you want to be like that director or that coach that knows everything. But the basic, I call it the poor man's because all we're doing is one test. Can you walk on it? And if you can walk on it for four steps, you're gonna be okay. Yes, you're gonna be hobbling. Yes, it's gonna hurt like crazy. But if it just feels like it's all in that ankle, you're gonna be okay. Um, and they actually designed it so that you wouldn't actually go in and overburden the urgent care system or the emergency room to get an x-ray when yes, we know ankle sprains hurt like crazy, but if you can walk, then you're most likely gonna be okay. So there's no time limit on this rule. So the reason I mentioned that is because from my experience, if you're if you're coaching high school boys or in general, honestly, men's sports, um, the men like to try to try to put weight on it like immediately. It's just their, I don't know if it's bravado. I don't know if it's just they're trying to figure out how broken they are, but they always want to like put weight on it within the first couple of minutes. And that's okay. So if they want to go and and walk on it in the first five minutes, that's fine. Um, and then we find that oftentimes the girls like to kind of sit there for a minute. They they prefer not to walk on it first. But what you find is after two or three minutes, maybe five minutes on the bench, all of a sudden they're like, well, let me test it out. And so just people just choose to do it at different times. And obviously that's not gender specific. It's just what I've noticed. Professional athletes, girls or boys, tend to test it immediately. They're really trying to, you know, in their brain reconcile how bad it's gonna be and how um emotionally distraught they're gonna be after this. You know, if they can put some weight on it, they get some confidence. Oh, I'll get back soon. If they can't put weight on it, or if it hurts really, really bad, then they're not gonna have that confidence. And they want to know right away in most professional athletes. The reality is most athletes, most athletes don't come into my office until it's chronic, right? They've been in a boot, they've been sitting out for weeks, no one can fix it, their foot hurts still. Um, and you can see this all across the board, everywhere from volleyball athletes to ballerinas, right? And the the problem is that a lot of our standard care just isn't doing much for them because it's always that rest model, which just will never work. Obviously, the body does heal over time if we rest it, but it's not the fastest way to get back. I guess that's a better way to put it. And then when something becomes chronic, sitting there longer isn't gonna be the solution. You have to actually do something to make that get better. So whether you are gonna test weight on it for the first four steps in the first, say, five minutes, or whether you wait an hour or two, the Ottawa ankle rule, the you know, rule out an x-ray test applies for hours, days, you know. So as soon as you can put weight on it and not have any severe pain and you feel it just in the ankle joint, you're gonna find, okay, well, I guess I don't need an x-ray. But as a clinician, if you can get an x-ray quickly, I know they don't like you to do that because they don't want to spend all their time x-raying ankle sprains. I don't have any problem with that. So you want to go do that. That's great. They they were meant to kind of, like I said, keep you out of that urgent care center and wasting resources when people might have something more severe to deal with. And they were designed in Canada, honestly, because Canada, in my opinion, I don't know all of Canada, but like they have uh more of a socialized medicine, right? So it's uh more of a government medicine, everyone has access to it. So they've designed a few more protocols to like keep people out. Where in where I'm at in Arizona, obviously people might have to pay, you know,$100 out of pocket and they don't want to spend$100 for a sprained ankle. So they won't go get an x-ray. That being said, as soon as you get the x-ray, the reason why I'm okay with that, if you could do that within the first 12 hours, what it does is it gives my patients confidence that they can start rehabbing it. Meaning they go image it and they're like, oh yeah, nothing's broken. I'll be fine. And they'll start working at it. But if they don't get an image, then they wait and they wait, and three, four days go by, like, oh man, it still really hurts really bad. My whole foot's black and blue. And they kind of avoid that concept of getting back to work because the black and blue looks scary, right? Like you really damage something. But um, especially for my young athletes, my young athletes, like if you're in high school or even college, like um a lot of times the parents don't want the kids to do any kind of rehab until they quote unquote feel better. But that's that's not how I approach this thing. So once you pass your Ottawa ankle rule, once you've taken your four steps, once you've gotten your X-ray, I ruled it out. Uh, one last thing on the X-rays. So note that X-rays cannot see ligaments. So you can grade your ankle as a one, two, or three sprain, uh, but you can't actually have a confirmed three sprain unless you have like complete dislocation. So you can prove that the foot moves in the way that it shouldn't, or if you have an MRI. Um, and so the MRI would show those. So, you know, we can call everything a one if it's not too bad, a two if it's pretty bad. And then, you know, the three is saved for imaging, you know, obviously we can get to that later. Um, but if the x-ray comes back and there's no fractures, oftentimes we're just dealing with severe grade twos and and sometimes grade threes. But it's it's more common to be like a one or two for most athletes. The big thing you're looking for, in my opinion, based upon everything I've read and what I've seen personally, is that you're looking for obviously if you step on someone's foot, um, that ankle sprain can be more severe than if you kind of just misstepped on your own. Um, that's not always the case, but anytime someone runs into you, or you step on someone's foot, or if they catch you off guard, um, those tend to be your body's not ready for that impact. Um, so you often find that those ankle sprains are some of the worst. Okay, so you've walked four steps, you passed your Ottawa poor man's test, which is, like I said, not a real thing, but I'm calling it the poor man's Ottawa test. You're walking four steps, you don't need your x-ray, or you got your x-ray. The first thing that I like to do for my family and my athletes is I use an herb called comfrey root. Comfre root used to be called the bone mender. Um, and what it does is it takes a lot of the nasty inflammatory chemicals out of there. And so what we do at home is we make a homemade uh fat-based salve, which is like essentially an herb and a fat. Um, and you can buy these on Amazon. And the word is comfrey salve. And I'll throw a few links in there. There's some, uh there's uh like Trauma Plant is a brand that they've made it into an ice cream. I actually prefer a fat-based salve. So that's how I like to look at it. But what you do is you warm this up on the stove or in the microwave, and then you apply it as like a hot oil compress, and then you leave it all overnight on this ankle. And what happens is you can often get like noticeable and dramatic relief by the next day. So essentially, my goal is to get you able to put weight on it as soon as possible. So if if we can do that in minutes, hours, weeks, whatever it takes, right? So I'm I'm always aiming for shorter, but if we can get you weight bearing or walking the next day, then your recovery time is going to be a lot less. And that's without me doing anything to like help you recover. Um, so if you have a hard time with ankle pain, whether your sprain is, you know, a day old or six weeks old, um you can apply this comfrey salve and kind of like I said, wrap it around with a bandage overnight. Um, and and you often see dramatic change. Now, I do have a lot of people that like to use it for their knees and shoulders. Um, but when I'm using knees and shoulders, I'm mostly using it post-surgical. Um, so let's say you had a knee surgery or, you know, one of those arthroscopic knee cleanouts that people talk about and then it's not recovering. We'll often use comfrey to get some of that inflammation out of there. And then the ligaments and bones healing like they should. And then other than that, I'm using it for ankles mostly overnight when we have sprained ankles. The second thing that you can do is what I call an ice bath protocol. So I know I said not to ice, but remember we don't ice for inflammation, we ice for pain management. So, what you do for an ice bath protocol for your sprained ankle is usually the next day. So your foot starts overnight. You know, you're gonna move it as much as you can while you can still move it. If it swells too much, if you essentially get this like liquid cast inside where the fluid's restricting your motion, what you can do is ice your foot for 15 to 20 minutes until it pretty much feels numb and you want to ice it. I wouldn't do it more than 20 minutes, but uh, you can ice it about up to where the pain ends. And then the goal is to make that entire foot to where it has decreased sensation. So since the ice doesn't actually remove inflammation, don't think of it that way. But think my whole goal is that I cannot really feel my ankle and the pain is reduced. And then once your foot doesn't have a lot of feeling, you take your foot out of that ice bath, the colder the better. But you take your foot out of that ice bath and you carefully remove it and then you start putting weight on that. And so as you put weight, remember that we're not putting a lot of weight, we're not running, we're not jumping, we're trying to put a little bit of weight and then maybe walk a few more steps. And so what we do is we walk on that numb foot, which you can't feel at all, feels like, you know, like a dead limb or like a foot that's asleep. And so you go and walk on it until it starts to hurt again, and then you go put your feet back in that ice bath for another 15 to 20 minutes until you lose feeling again, and then you repeat that process. I would repeat that process three or four times, and you usually notice a significant improvement in range of motion. Now, I don't want to have to always force, but you should be noticing your muscles can actually move that too. And so while that sounds kind of crazy, and usually people are like, why are you numbing my foot? That doesn't make any sense. Realize that that protocol is something that I learned uh when I was working with different athletes at Mizzou. So it was not something that I made up myself. And I'm not gonna say that all the football players that we worked with at Mizzou did it, but it was definitely one of those things that we had in our back pocket. And likewise, I've actually um applied that same protocol to Olympic speedwalkers. So it's something that we do because they have to get back walking as soon as possible. Um, pretty important to have your ankles when you're an Olympic speedwalker. Anyway, point is you can do this as a volleyball athlete, none of that foot, start walking. It's gonna get you back sooner. Because remember, the real limitation is range of motion in your ankle, and we need to get that back as soon as possible. The last thing that I would suggest is pretty important for a sprained ankle is that the ligaments is the muscles. So the ligaments are not gonna sprain or tear unless a nearby muscle is also injured. So the muscle should be absorbing that force when it can no longer absorb that force, it uses the ligaments to kind of stabilize. And so what it means is you have a muscle in your lower leg between your knee and your ankle that isn't working. So you need to find the trigger points in your calves that hurt and start working them out while you move your foot. So you can just kind of cross your leg over and start digging into those calf muscles and finding which spots hurt while trying to lift your toes up and down. And I know that like weight bearing is really hard for a lot of people, especially if you're at home and you haven't had help and you don't have an expert with you, like, but you're trying to just get range of motion as soon as possible. So, and the clinic will use a direct current therapy um a device, and then we'll identify like exact trigger points that have been essentially where the where the brain doesn't want to activate the muscle, and then we'll reactivate them. And it's more expensive to see a doctor, but it's also faster. So, once again, on a grade severe grade two, I'm trying to get someone back in seven days or less. Um, and then if it's something where you don't have a black and blue foot, honestly, uh, we had an event the other day where one of our athletes was hurt. Uh, it was like Tuesday before the Saturday, and then she didn't participate in Saturday, which is a shame. Um, but the reality was, as I told my daughter, I was like, oh yeah, if that was you, you'd be competing today. And and she hasn't seen that protocol like in person. But the reality is like, we always want to get our athletes back as soon as possible in a safe way, but there's no reason not to do um if you have no pain, if your foot works well, there's no reason not to compete as soon as possible. All right. So, how do you do this trigger point thing at home? Essentially, you're gonna press on a sore spot in your leg. And then while you hold that spot down, you're going to try to move your ankle, see if it improves your range of motion. You don't want to focus on too much on the pain of where your thumb is pushing or where your fingers are pushing into the calf, but you want to pay attention if it increases range of motion or if it reduces pain in the ankle. Um, so pain in the ankle is more important than pain where your fingers push, because obviously we can create pain with our fingers just by pushing really hard. If you can't do it yourself, you can always have someone else. A trainer or you know, a friend or family member do that too. Um, you want to go through different spots on your calf. So you might have to look at an anatomy chart for this, but the soleus muscle is the most common. And then you have usually a secondary one. So soleus is going to be your most important for getting rid of that pain and get increasing range of motion. Then you're going to look at the posterior tibialis, which hides behind the calf muscles, and then anterior tibialis, which is kind of like on the front of the shin, on the outside of the front of the shin. And then the a lot really common is that one of the peronial muscles. So the outside of your leg, about halfway between the knee and ankle, has been uh kind of sprained. And so you'll need to work all of those out. Um, and just because your ankle hurts, remember that's not where the pain started. That's not where the dysfunction started. It is where it ended up. So don't waste your time, you know, massaging your ankle or scraping your ankle or even sticking needles in your ankle. Um, if you're gonna stick needles or massage or scrape or anything like that, do it higher up, do it away from where you're seeing your black and blue, because that's where the dysfunction is that's limiting your recovery. And that information alone can change a lot of ankle rehab stories. So if you had sprained your ankles, say months ago and you haven't seen much improvement, or you're, you know, you're six months out and your ankle still hurts, I would just suggest that you either haven't done enough rehab, which is probably the most common, especially for volleyball players. You know, I'm gonna say shame on the parents for not teaching them better. But, you know, honestly, it's no one's fault. No one wants to go to the doctor, no one wants to go to rehab, no one wants to listen to this podcast. I hear you. No, but in general, we we don't really want to go do rehab for X amount of time. But if it's been hurting and you haven't seen a result, then you do need to have it evaluated, have someone look at it, at least have someone give you ideas on how to treat it differently than what you've been doing on your own. So for grade one and grade two sprains, active recovery is the key to strengthening the ligaments, tendons, and muscles. You have to be safe, but you have to get to work as soon as possible. So the sooner you get motion into that joint, the faster you're gonna recover. The ankle motion moving up and down is what pumps all that nasty blood out of there and brings new nutrition in. So, whether you want to work with me or do it on your own at home, hopefully I've convinced you that after every sprain ankle, you should take care of yourself. You should take care of that ankle so that it doesn't become a chronic problem. And that's it for now. So play hard and train harder. We'll see you on the next episode.