SPRAINS AND INJURIES – HOMOEOPATHY AN SPORTS MEDICINE

ABSTRACT

Sports injuries as indicated by the name are the injuries that are related to sports or are associated with training, practicing, or playing. Sports injuries occur very often with the players and athletes. Sports injuries occur very often with the players and athletes. Homoeopathy is considered as one of the very best Sports medicine for treating Sports injuries like Sprains, strains, Muscle weakness etc. This article provides an overview of the aetiology, diagnosis, and appropriate general & homoeopathic management of Sports injuries.

INTRODUCTION

Sports injuries are injuries that occur when engaging in sports or exercise. Sports injuries can occur due to overtraining, lack of conditioning, and improper form or technique. Failing to warm-up increases the risk of sports injuries. Bruises, strains, sprains, tears, and broken bones can result from sports injuries. Soft tissues like muscles, ligaments, tendons, fascia, and bursae may be affected. Traumatic brain injury is another potential type of sports injury. Injuries may range from mild to severe.

Sports medicine has been defined as the scope of medical practice that focuses on

· Prevention, diagnosis treatment and rehabilitation of injuries that occur during physical activity.

· Prevention, diagnosis, and management of medical conditions that occur during or after physical activity

· Promotion and implementation of regular physical activity in the prevention, treatment and rehabilitation of chronic diseases of lifestyle.

Types of Sports injuries

Injuries can be classified into 3 broad groups:

· Acute Extrinsic Injuries - which arise from a direct external blow. These are commonly wounds, bruises and fractures.

·  Acute Intrinsic Injuries - result from failure of a patient’s structures as a result of excessive loading. Examples are tendon ruptures, avulsion fractures and ligament injuries.

· Chronic Injuries - They are those with an insidious or unknown onset, commonly inflammation or failure secondary to repetitive loading. Examples are inflammation of the Achilles tendon and stress fractures.

AETIOLOGY

Some of the most common causes of sports injuries are

· Lack of proper methods of training or extremely poor training methods are the most common causes of sports injuries. Increasing the intensity of exercising very quickly and not stopping at the time of pain causes the injury.

· Injury at the time of the game especially in sports that involve body contact such as rugby, football, boxing, wrestling, etc. Also, injuries might occur while playing tennis, cricket and badminton are to name a few of them.

· Structural abnormalities in the players or athletes are also an important cause of sports injuries. There are many who have such arrangement of bones and muscles which makes them vulnerable to be injured. Some of those conditions are the uneven length of legs, flat feet or excess pronation, extra high arches or cavus foot, knock knee arrangement, lumbar lordosis, patella alta, and a high Q angle.

· Sports injuries are also caused by weakness in the muscles, ligaments, and tendons.

· Ultimately, if the exercising environment is not safe, sports injuries might occur.

RISK FACTORS

It has been observed that the prevalence of sports injuries is more common in adolescent players and athletes as compared to adult ones. As per studies conducted over the last 16 years in the United States of collegiate athletes in 15 different sports, it is revealed that lower limb injury percentage was more than 50, with ankle and knee very commonly involved. Most of the injuries were contact injuries where more occurred during competition as compared to training. Out of the 15 sports, most injuries occurred in football with wrestling ranking second. The increasing popularity of games like football, hockey and kabaddi in India is contributing to the enhancement of the percentage of sports injuries in the country. Studies have revealed that there is no significant decrease in sports injuries over the past two decades of time.

Knee injuries have been observed in a study of 5 years in India in 24 different sports where the rate of injuries is higher during competition as compared to training. Here it was also revealed that non-contact injury was more common where the soccer and kabaddi injuries are two of the most prevalent ones.

CLINICAL MANIFESTATIONS

Some of the more common sports injuries include:

· Ankle sprain – symptoms include pain, swelling and stiffness.

· Bruises – a blow can cause small bleeds into the skin.

· Concussion – mild reversible brain injury from a blow to the head, which may be associated with loss of consciousness. Symptoms include headache, dizziness and short term memory loss.

· Cuts and abrasions – are usually caused by falls. The knees and hands are particularly prone.

· Dehydration – losing too much fluid can lead to heat exhaustion and heat stroke.

· Dental damage – a blow to the jaw can crack, break or dislodge teeth.

· Groin strain – symptoms include pain and swelling.

· Hamstring strain – symptoms include pain, swelling and bruising.

· Knee joint injuries – symptoms include pain, swelling and stiffness. The ligaments, tendons or cartilage can be affected.

· Nose injuries – either blood nose or broken nose, are caused by a direct blow.

· Stress fractures – particularly in the lower limbs. The impact of repeated jumping or running on hard surfaces can eventually stress and crack bone.

GENERAL MANAGEMENT

First aid for sprains, strains and joint injuries - Immediate measures for sprains, strains and joint injuries, to prevent further damage include:

· Rest – keep the injured area supported and avoid using for 48-72 hours.

· Ice – apply ice to the injured area for 20 minutes every two hours for the first 48-72 hours.

· Compression – apply a firm elastic bandage over the area, extending above and below the painful site.

· Elevation – raise the injured area above the level of the heart at all times.

· Referral – as soon as possible, see a doctor.

· No Heat – heat will increase bleeding.

· No Alcohol – alcohol increases bleeding and swelling.

· No Running – running or exercise increases blood flow, delaying healing.

· No Massage – massage increases swelling and bleeding, also delaying healing.

First aid for nose bleeds - Stop the activity.

· Sit with head leaning forward.

· Pinch nostrils together and breathe through your mouth.

· Hold nose for at least 10 minutes.

· If bleeding continues past 30 minutes, seek medical advice.

First aid for dislodged teeth - It may be possible to save a tooth that has been knocked out with prompt dental treatment. Rinse the tooth in water or milk, and see dentist immediately.

Emergency situations - Call an ambulance for prolonged loss of consciousness, neck or spine injuries, broken bones, injuries to the head or face, eye injuries and abdominal injuries.

Home remedies

· Castor oil can help alleviate pain and help heal injuries. It even helps to reduce pain. Warm a teaspoon of castor oil and massage swollen area. Leave it for 20-30 minutes so that the oil is completely absorbed into your skin.

· Petroleum jelly is an excellent ingredient to curb the growth of the blister (or rupture it). Apply a little bit of petroleum jelly on the blister to limit the friction on the surrounding tissues. The transparent jelly reduces the pain and swelling in the injured area and speeds up the healing process.

· Turmeric has anti-inflammatory properties and has been in use for a very long time to heal all kinds of injuries. It decreases the swelling and gives relief from muscle pain. Put 1/2 teaspoon of turmeric powder in a glass of hot milk and drink it twice a day. Make a paste with turmeric powder and ghee. Apply the mixture on injury and put a bandage on it. Make sure to change bandage twice a day.

· White vinegar helps to fix swimmers' ear. The infection occurs when the pH level of the ear is disturbed due to too much moisture and little ear wax in the ear canal. This condition makes the ears a breeding ground for bacteria. To fix this, put 0.25 milliliters of white vinegar in ear canal. Repeat this twice a day for 48 hours.

· Even ginger has strong anti-inflammatory properties. It can speed up the healing process. Include ginger in diet or can have ginger tea.

·  Mustard oil is great to treat muscle pain. Put some warm mustard oil on the painful area and massage it properly for fifteen minutes. The oil will alleviate pain and swelling.

· Pomegranate juice is packed with enzymes that contain anti-inflammatory and anti-irritant properties. The compound speeds up the healing process. Take any juice and add a teaspoon of ginger and 1/2 teaspoon of turmeric in it. Consume this drink twice a day.

PREVENTION OF SPORTS INJURIES

Can reduce risk of sports injuries if

· Warm up thoroughly by gently going through the motions of your sport and performing slow, sustained stretches.

· Wear appropriate footwear, Tape or strap vulnerable joints, if necessary.

· Use the appropriate safety equipment, such as mouth guards, helmets and pads.

· Drink plenty of fluids before, during and after the game, Try to avoid exercising in the hottest part of the day, between 11 am and 3 pm.

· Maintain a good level of overall fitness, particularly in the off season (in the months between playing seasons for a sport).

· Cross-train with other sports to ensure overall fitness and muscle strength.

· Ensure training includes appropriate speed and impact work so muscles are capable of the demands of a game situation.

· Don’t exert yourself beyond your level of fitness. Gradually increase intensity and duration of training. Use good form and technique.

· Cool down after sport with gentle, sustained stretches. Allow adequate recovery time between sessions. Have regular medical check-ups.

HOMOEOPATHIC MANAGEMENT

Homoeopathy is considered as one of the very best Sports medicine for treating Sports injuries. Homoeopathy offers a completely natural treatment without any side effects on the body that may affect performance. Homoeopathy provides effective and rapid healing and promotes the natural healing of injuries. Using homoeopathic medicines for treating sports injuries at the right time allows staying away from undergoing surgeries, which are inevitable in the case of serious injuries that progress over time. The use of the appropriate dosage and its frequency makes the overall treatment procedure even better. Apart from the oral doses, the use of external homeopathic ointments allows the skin to breathe easily speeding up the process of curing. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition.

Indicated remedies	Indications
Arnica	It’s the most common medicine used for sprains, knocks, bruises, falls etc. which basically plays the role of a painkiller. The remedy of first importance in all kinds of injuries, traumatic or bruised. It is mostly suited to cases, when any injury, however remote seems to have caused the present trouble.
Calendula	It is a great homoeopathic antiseptic. Injury caused by Clean cut injury, Surgical cuts, Lacerated wounds, Suppurating wounds. It prevents suppuration, promotes healthy granulation of tissues & rapid healing. It is excellent Haemostatic.
Rhus tox	Ailments from strains, over lifting. Hot, painful swelling of joints. Pains tearing in tendons, ligaments, and fascia. Better motion. Soreness of condyles of bones. The cold fresh air is not tolerated; it makes the skin painful. Numbness and formication, after overwork and exposure. Tenderness about knee-joint.
Ledum palustre	Easy spraining of ankle. . For punctured wounds, produced by sharp-pointed instruments or bites particularly if the wounded parts are cold.
Natrum sulphuricum	It is specific medicine for injuries to head. Ill-effects of falls and injuries to the head, and mental troubles arising therefrom. < changing posture
Symphytum	It is considered to be orthopaedic specific medicine. It is of great use in wounds penetrating to perineum and bones, and in non-union of fractures; It facilitates union of fractured bone by favouring production of Callus. Pain in eye after a blow of an obtuse body. For traumatic injuries of the eyes no remedy equals this.
Ranunculus bulbosus	Various kinds of pains and soreness, as if bruised in sternum, ribs, intercostal spaces. Muscular pain along lower margin of the shoulder-blade; burning in small spots from sedentary employment. Worse, open air, motion, contact, atmospheric changes, wet, stormy weather, evening.
Ruta	Complaints from straining flexor tendons especially. Tendency to the formation of deposits in the periosteum, tendons, and about joints, especially wrist. Overstrain of ocular muscles. Sprains. Lameness after sprains. Injured “bruised” bones. Fractures & Dislocations. Hamstrings feel shortened. Tendons sore. Aching pain in tendo-achilles. Tennis Elboe.
Bellis perennis	First remedy in injuries to the deeper tissues, after major surgical work. It acts upon the muscular fibers of the blood-vessels. Much muscular soreness. Lameness, as if sprained. Venous congestion, due to mechanical causes. Results of injuries to nerves with intense soreness and intolerance of cold bathing. It is indicated when sprain has been removed but the pain remains.
Hypericum	A great remedy for injuries to nerves, especially of fingers, toes and nails. Crushed fingers, especially tips. Excessive painfulness is a guiding symptom to its use. Prevents lockjaw. Punctured wounds. Relieves pain after operations. Quite supersedes the use of morphia after operations (helmuth). Spasms after every injury.
Calcarea phosphoricum	It is especially indicated in bone disease non-union of fractured bones. It has a special affinity where bones form sutures or symphyses, and all its symptoms are worse from any change of weather. It help to unite bones quickly.

 

CONCLUSION

Homoeopathy treats the person as a whole. It means that homoeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homoeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions.

SCIATICA - EVER SUFFERED AN AGONY - INTERVENTION WITH HOMOEOPATHY

 ABSTRACT

 Ever suffered a gnawing pain called sciatica? Sciatica pain is pretty clear cut, piercing or shooting pain in the lower back, which radiates down buttocks and legs. It is more common in men than women. Homoeopathy is considered as one of the very best alternative system for treating Sciatica pain. This article provides an overview of the aetiology, diagnosis, and appropriate general & homoeopathic management of this gnawing pain.

INTRODUCTION

Sciatica is not a disorder itself but is a general term used to describe the pain that occurs when nerve roots in the lumbosacral spine (low back) become compressed (pinched), irritated, or inflamed, often from a herniated disc or other narrowing of the spinal canal. Sciatica may be accompanied by numbness/tingling and muscle weakness. The sciatic nerve is the longest and thickest (almost finger-width) nerve in the body. True injury to the sciatic nerve “sciatica” is actually rare, but the term “sciatica” is commonly used to describe any pain that originates in the lower back and radiates down the leg. 

AETIOLOGY

Sciatica occurs when the sciatic nerve becomes pinched, usually by herniated lumbar disc, Lumbar spinal stenosis, Lumbar degenerative disc disease, general degenerative changes in vertebrae or discs, Spondylolisthesis, Muscle spasm and/or inflammation of the lumbar and/or pelvic muscles, Sacroiliac joint dysfunction

Rarely, tumors, blood clots, or other conditions in the lower spine may cause sciatica.

RISK FACTORS

Risk factors for sciatica include:

· Age. Age-related changes in the spine, such as herniated disks and bone spurs, are the most common causes of sciatica.

· Obesity. By increasing the stress on spine, excess body weight can contribute to the spinal changes that trigger sciatica.

· Occupation. A job that requires to twist back, carry heavy loads or drive a motor vehicle for long periods might play a role in sciatica, but there's no conclusive evidence of this link.

· Prolonged sitting. People who sit for prolonged periods or have a sedentary lifestyle are more likely to develop sciatica than active people are.

· Diabetes. This condition, which affects the way body uses blood sugar, increases risk of nerve damage.

· Smoking, Mental health issues, such as depression, Tall height in older age groups (50 to 60 years), Vitamin B 12 deficiency

CLINICAL MANIFESTATIONS

The symptoms of sciatica are commonly felt along the path of the large sciatic nerve. Sciatica is often characterized by one or more of the following features:

· Pain. Sciatica pain is typically felt like a constant burning sensation or a shooting pain starting in the lower back or buttock and radiating down the front or back of the thigh and leg and/or feet.

· Numbness. Sciatica pain may be accompanied by numbness in the back of the leg. Sometimes, tingling and/or weakness may also be present.

· One-sided symptoms. Sciatica typically affects one leg. The condition often results in a feeling of heaviness in the affected leg. Rarely, both legs may be affected together.

· Posture induced symptoms. Sciatica symptoms may feel worse while sitting, trying to stand up, bending the spine forward, twisting the spine, lying down, and/or while coughing. The symptoms may be relieved by walking or applying a heat pack over the rear pelvic region.

Certain symptoms of sciatica may indicate a serious medical condition, such as cauda equina syndrome, infection, or spinal tumors. These symptoms may include, but are not limited to: Progressive neurological symptoms, such as leg weakness, Symptoms in both legs, Bowel and/or bladder dysfunction, Sexual dysfunction

Types of Sciatica

Depending on the duration of symptoms and if one or both legs are affected, sciatica can be of different types:

Acute sciatica. Acute sciatica is a recent onset, 4 to 8-week duration of sciatic nerve pain. The pain may be self-managed and may not typically require medical treatment

Chronic sciatica. Chronic sciatica is persistent sciatic nerve pain that lasts for more than 8 weeks and usually does not subside with self-management. Depending on the cause, chronic sciatica may require nonsurgical or surgical treatment.

Alternating sciatica. Alternating sciatica is sciatic nerve pain that affects both legs alternately. This type of sciatica is rare and may result from degenerative problems in the sacroiliac joint

Bilateral sciatica. Bilateral sciatica occurs in both legs together. This type of sciatica is rare and may occur due to degenerative changes in the vertebrae and/or the disc at several spinal levels, or from serious conditions such as cauda equina syndrome.

DIAGNOSIS

A diagnosis of the underlying cause of sciatica is essential in formulating an effective treatment plan and managing sciatica pain.

Physical Examination and Medical History - The goal of conducting a physical exam and review of medical history is to identify the pain pattern in the patient’s leg.

Straight leg raise (SLR) test. This test includes the patient lying on his/her back and lifting one leg at a time with the other leg flat or bent at the knee. A pain encountered while lifting the affected leg usually indicates sciatica.

Slump test. This test includes the patient seated upright with hands behind the back. The patient bends (slumps) forward at the hip. The neck is bent down with the chin touching the chest and one knee is extended to a degree possible. If pain occurs in this position, sciatica may be present.

Medical imaging tests like Magnetic resonance imaging (MRI) & Discogram helps in diagnosing underlying cause

GENERAL MANAGEMENT

Sciatica treatment may include both nonsurgical and surgical methods. Typically, nonsurgical methods are tried first. Surgery may be indicated when the underlying cause is severe and/or progressive neurological deficits such as leg weakness occurs.

Massage Therapy

Certain forms of massage therapy, such as deep tissue massage, may have benefits for pain relief. The benefits of massage therapy include:

· Improving blood circulation, which in turn creates a better healing response in the body

· Relaxing tight muscles, which may be contributing to the pain

· Releasing endorphins, which are hormones in the body that function as natural pain relievers

Physical Therapy

The goals of physical therapy and exercises for sciatica include:

· Strengthen the spine and muscles of the lower back, abdomen, buttocks, and hip.

· Increase core strength

· Stretch tight and inflexible muscles, such as hamstrings

· Encourage the exchange of fluids and nutrients in the body by light aerobic exercises such as walking, swimming, or pool therapy

Hot and cold compresses

· A hot pack on your lower back and spine area can help to relax the tense muscles and improves the circulation. Either use a steamed towel or simply sit in a tub of warm water for 15-20 minutes. Do this twice a day and will be able to feel the pain ease away sooner than normal.

· Ice packs on the affected area for 10-15 minutes helps in decreasing the swelling around the nerve and also numbs the pain.

Chiropractic care

The core of chiropractic care are spinal adjustments. Manipulation of the spine frees restricted movement and helps to restore misaligned vertebral bodies to their proper position in the spinal column. Spinal manipulations help to calm the agitated and inflamed nerves, and in turn relax the muscle spasm. Ideally, spinal manipulations are not painful and are definitely effective.

YOGA

Yoga can help strengthen and stabilize core muscles, increase flexibility in hip and spine, and reduce lower back pain and sciatica

While yoga can be complex and difficult to perform, here are some easy and effective yoga stretches that can do at home using a yoga mat or a thick towel.

· Child’s Pose (Balasana)

· Half Moon Pose (Ardha Chandrasana)

· Downward-Facing Dog

· Locust Pose (Salabhasana)

· Cobra Pose (Bhujangasana)

· Knees-to-Chest Pose/Wind-Relieving Pose (Pawanmuktasana)

· Reclined Pigeon Pose (Supta Kapotasana)

· Bridge Pose (Setu Bandha Sarvangasana) 

· Legs-Up-the-Wall pose (Viparita Karani)

 

 

 

HOMOEOPATHIC MANAGEMENT

Homeopathy is an effective option to treat sciatica. The medicines given below indicate the therapeutic affinity but this is not a complete and definite guide to the treatment of this condition. Homoeopathy medicines are effective in treating. It is true that this method takes a longer time, but it is also the best one because not only the haemorroids are cured but also the patient.

Indicated Remedies	Indications
Aesculus	Pain in the very low back (the sacral or sacroiliac areas) that feels worse when standing up from a sitting position, and worse from stooping, may be eased with this remedy. Aesculus is especially indicated for people with low back pain who also have a tendency toward venous congestion and hemorrhoids.
Arnica montana	This remedy relieves lower back aches and stiffness from overexertion or minor trauma.
Bryonia	This remedy is indicated when back pain is worse from even the slightest motion. Changing position, coughing, turning, or walking may bring on sharp, excruciating pain. This remedy can be helpful for back pain after injury and backaches during illness.
Calcarea carbonica	This is often useful for low back pain and muscle weakness, especially in a person who is chilly, flabby or overweight, and easily tired by exertion. Chronic low back pain and muscle weakness may lead to inflammation and soreness that are aggravated by dampness and cold.
Calcarea phosphorica	Stiffness and soreness of the spinal muscles and joints, especially in the neck and upper back, may be relieved by this remedy. The person feels worse from drafts and cold, as well as from exertion. Aching in the bones and feelings of weariness and dissatisfaction are often seen in people who need this remedy.
Natrum muriaticum	Back pain that improves from lying on something hard or pressing a hard object (such as a block or book) against the painful area suggests a need for this remedy. The person often seems reserved or formal, but has strong emotions that are kept from others. Back pain from suppressed emotions, especially hurt or anger, may respond to Natrum muriaticum.
Nux vomica	This remedy is indicated for muscle cramps or constricting pains in the back. Discomfort is made worse by cold and relieved by warmth. Pain usually is worse night, and the person may have to sit up in bed to turn over. Backache is also worse during constipation, and the pain is aggravated when the person feels the urge to move the bowels.
Rhus toxicodendron	This remedy can be useful for pain in the neck and shoulders as well as the lower back, when the pain is worse on initial movement and improves with continued motion. Even though in pain, the person finds it hard to lie down or stay still for very long, and often restlessly paces about. Aching and stiffness are aggravated in cold damp weather and relieved by warm applications, baths or showers, and massage.
Sulphur	This remedy is often indicated when a person with back pain has a slouching posture. The back is weak and the person feels much worse from standing up for any length of time. Pain is also worse from stooping. Warmth may aggravate the pain and inflammation
Hypericum perforatum	This homeopathic remedy relieves lower back pain with sharp throbbing pain.
Ruta graveolens	This is used to relieve lower back pain caused or worsened by staying immobile.
Cimicifuga	Severe aching and stiffness in the upper back and neck, as well as the lower back—with pains that extend down the thighs or across the hips — may be eased with this remedy. It is often helpful for back pain during menstrual periods, with cramping, heaviness, and soreness. A person who needs this remedy typically is talkative and energetic, becoming agitated or depressed when ill.

CONCLUSION

Homoeopathy treats the person as a whole. It means that homoeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homoeopathic medicines are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. It is true that this method takes a longer time, but it is also the best one because not only the haemorroids are cured but also the patient.

Deep-acting medicines are required to treat the constitution and bring about lasting relief.