Ginger slices soaked in vinegar: for sprains

Nerdnote #135: a budget herbalist's solution for sprains!

I rolled my right ankle Monday morning while hiking the Lower Jordan Fire Trail in the Berkeley hills in the misty not quite rain. I was able to limp back to the car, leaning on my partner while she commented on what a miracle it is that I managed 7 months' worth of relaxin (a hormone released in pregnancy to relax the tendons and ligaments in preparation for childbirth) without spraining anything. I have very lax ankles that have both been sprained repeatedly before I ever got pregnant.

We went home and I did a self assessment to rule out ankle fracture (the Ottawa test) and spent the rest of the day on the couch with my ankle elevated, alternating ice and heat. I put some kinesiotape on in the fan cut to prevent swelling, too, instead of the usual recommended compression bandage.

Interestingly, even though I rolled my ankle clockwise, the lateral ankle felt fine, and pain was concentrated under the inner ankle bone ("inferior and anterior to the medial malleolus" in MDSpeak, "at Kidney 6 照海 zhàohǎi and Spleen 5 商丘 shāngqiū" in terms of acupoints). I think this is because I have sprained both my ankles laterally SO MANY TIMES that the ligaments are too stretched out to properly sprain anymore. If I'm ever not able to put weight on the foot for 4 steps after I roll my ankle I'll know I actually tore something completely, but usually I stop and do some range of motion exercises and then it's (mostly) fine.

It was still tender by bedtime, but not too swollen, so I put some more tape on to stabilize the joint and added a loose ankle brace on and propped the foot up on a pillow for sleeping. So far so R.I.C.E. (rest, ice, compression, elevation), the recommended course of treatment for all my previous ankle sprains.

The next morning, Tuesday, my ankle was too painful to bear weight. It was actually more comfortable to crawl to the bathroom on my hands and knees to pee at 3 in the morning. I spent that day alternating between resting and trying to get a pair of crutches from Kaiser. I learned that I cannot request crutches or other durable medical equipment from the advice nurse hotline, or at my prenatal appointment, but my PCP can do it through a telehealth appointment, after which you have to go to the hospital cast room in Orthopedics to get fitted. (There is a home delivery service for things like breast pumps and crutches, but they didn't get around to calling me until Thursday morning, which really makes me wonder how people who live alone deal with acute injuries during COVID-19 isolation.)

I realized after talking to the advice nurse that my ankle felt better without the soft brace on, so I removed all the tape and AROM immediately improved from zero to maybe 20% of my usual dorsi/plantar flexion. I decided that I don't have to compress the ankle if it's not so visibly swollen.

Then I recalled something I had read in a Chinese book as a child, years before I began to study medicine. In the story, the narrator's sister sprained her ankle very badly; it was very swollen and bruised and her doctor recommended that she stay off the foot for at least 2 weeks. Problem was, Busted Ankle Sister had an important basketball game with her high school team in less than 2 weeks. Grandma recalled a folk remedy from her childhood: rub vinegar-soaked ginger slices over the injured area to speed healing. Busted Ankle Sis spent the next week assiduously rubbing her sprained ankle around the clock with ginger and vinegar, and was able to play the game.

I sliced up some ginger and soaked them in a little dish of distilled white vinegar (the Chinese book I'd read wasn't specific about what kind of vinegar) and commenced my experiment. I found that my ankle liked the ginger more if I heated the vinegar up for 10-15 seconds in the microwave. Of course, this week the weather has been very cold and rainy.

By Wednesday I was able to stand on both legs with the weight distributed evenly. I enlisted a friend to drive me to see my housecall patient. On Thursday I could walk slowly and without pain, using a single crutch for balance. I was driven to two more housecalls. Whenever the ankle started aching from too much walking, I would rub it some more with the pickled ginger. Today (Friday, 4 days after the injury) I've been walking around crutch-free, and am considering venturing out to answer an urgent housecall request on my ownsome.

It's hard to remember that Tuesday morning I couldn't put any weight on that ankle at all. Right now my right foot is tucked under my sleeping cat, and I'm putting weight on it to prop up my laptop so that the screen is almost high enough to be ergonomic. Last night my hands hurt more from using crutches than my ankle. My sacrum was also complaining of all the sitting I've done this week.

Ginger slices soaked in vinegar, who knew? I'm considering using this on my past injuries, to restore function. We'll see how it goes!