1. Wrenching Ankle
The patient is in the supine position. Standing by the patient’s foot, the practitioner supports the heel with one hand, holds the forefoot and toes with the other hand. With the two hands manipulating ln coordination,the practitioner extends the ankle joint gradually to its painful barrier position; and then, makes a sudden and controlled wrenching to expand the extension range 3 to 5 degrees. Later on, the ankle joint is flexed, supinated, and pronated in the same manipulating manner as the above(Fig 283)．This manipulation is applicable to the treatment of the sprain of the ankle joint and the osteoarthritis of the ankle. Click to read Myasthenia Gravis (MG) in TCM.
2. Reduction of Subtalar Joint Subluxation
Sitting on the clinical bed, the patient keeps his ankle and feel stretching out of the bed and the medial malleolus (supination sub1uxation) or the lextra malleolus (pronation subluxation) touching against the bed surfaceaccording to the subluxation type of the subtalar joint. An assistant fixes the lower leg. The practitioner holds the heel from the heel side to the toe side with one hand and from the sole side to the heel side with the other hand with his two thumbs overlapping on the lateral side of talocalcanean joint (in supination sub-luxation) or the medial side of the talocalcaneal joint (in Pronation subluxation) and the rest fingers overlapping on the opposite side to support and lift the medial side(supination subluxation) or the lateral side(pronation sublauxation)of the subtalar ioint．Click to read Chinese medicine Treatment for Myasthenia Gravis.
After pulling the heel along the longitudinal axis of the tibia tor a minute, the practitioner makes the ankle flexed and then pulls the heel along the longitudinal axis of the calcaneam with the foot being kept in Supination position(supination subluxation)or in pronation position (pronation subluxation) to the greatest range. At this moment, a sudden and controlled motion is made to pronate (supination subluxation) or supinate (pronation subluxation) the suffered foot. In the meanwhile the practitioner thrusts the calcaneam proximally and inferiorly with the thumbs and wrenchs the calcaneam distally and superiorly with the rest fingers. The whole movements are like a screw．Thus the subtalar joint can be restored (Fig 284, Fig 285). This manipulation is applicable to the reduction of the subtalar joint sub-luxation. Click to read Sports Hemoglobinuria in TCM.
3. Reduction of TalOnavicuIar Joint Subluxation
Lying on the clinical bed,according to the navicular subluxation type, the patient puts the shifting side of the foot upward (the medial side of the foot is put upward for the medial subluxation type, the instep upward for dorsal subluxation type, and the sole upward for plantar subluxation type). One assistant fixes the ankle, another assistant holds the plantar and toe to pull along the longitudinal axis of the foot with his hands. The practitioner presses the point where the navicular is projected with his overlapping thumbs, while the rest fingers support and lift the opposite side. Then the assistants pull the foot oppositely for a while, and then change the foot gradually to the posture in which the talonavicular subluxation occurred, (For example, make the foot of medial subluxation in abduction position, make the foot of the dorsal subluxation in plantar flexion position and make the foot of plantar subluxatfon in dorsal flexion position)．Click to read Chinese medicine Treatment for Sports Hemoglobinuria.
As the elastic barrier position is got, the three persons coordinate their movements to suddenly wrench the foot to the opposite direction(abduction into adduction, plantar flexion into dorsal flexion and dorsal flexion into plantar flexion). And the practitioner’s thumb struts the navicular at this moment. Thus the joint can be restored (Fig 286, Fig 287). This manipulation is plicable to the reduction of the talonavicular joint subluxation. The sub-luxation of the rest minor joints of the foot can be restored by applying a similar manipulation．