Sports injuries are injuries that occur to athletes participating in sporting events. When injuries occur due to sudden impact, the body reacts to that condition, which leads to immobility, pain and inflammation (Acute). During the course of sports, the activity of sportsperson experiences pain on different joints like shoulder, knee, ankle, low back region according to the nature of his/her sports activity (Chronic). The common types of injuries seen in the playground are sprains, strains, fractures, overuse injuries, wounds, epiphyseal injuries, stress fractures and dislocations. Poor training method, anatomical abnormalities, poor physical and mental strength and environmental factors are the common risk factors of sports injury. Soft tissue (muscle, tendon, and ligament) injuries are more commonly seen than that of hard tissue (bone & teeth) injury in the playground. Ayurveda is based on the ancient Samhitas and no were in those Samhitas sports medicine is mentioned. But in the classical Samhitas, medicines has been described to treat persons who get wounded while performing martial arts and also has described the formulations used for treating the wounded soldiers during the war. This can be applied for treating sports injuries according to its nature. Sports Ayurveda Research Cell (SARC) is an initiative taken by the Kerala Government for the good and welfare of sports personals all over the world.
Relevance of the Topic –
About 30% population of India are engaged in various sports. 60% of sportsmen sustain various injuries in the field. 30% of the above are permanently unfit for further sports life. A higher rate of side effects of allopathic medications and post-surgical complications also creates lots of problems for the sports-personals. Ayurveda deals with preventive, curative and rehabilitative aspects of sports injury. Ayurvedic system is safe and devoid of post-traumatic complications which is the challenge facing the current sports medicine fraternity
Objective-
The main objective is to improve physical fitness, proper and timely injury management and prevention of injuries related to sports by proper rehabilitation.
Basic Sports Injuries
Injuries are more common in contact sports like Football, Kabaddi, Basketball, Volleyball, Hockey, etc. and in outdoor games like Athletics, Long Jump, High Jump, Hurdles, Swimming, etc.
Common injuries that we come across where Sports Ayurveda have shown good result are
1. Ankle Sprain
2. Knee Injuries (Ligament (ACL, MCL, LCL, PCL) Sprain and tear, Meniscus Injury, Chondromalacia patella, Osgood Schlatter disease)
3. Shoulder Injuries (Rotator Cuff Injuries, Supraspinatus tendonitis, HillSachs lesion, Bankart lesion, AC Tear)
4. Fractures and Dislocation
5. Muscle Strain (Hamstring, Quadriceps muscles)
6. Groin Injury (Groin Pull)
7. Tendonitis (Tennis Elbow, Golfer’s Elbow, Achilles tendinitis)
8. Low back pain
9. Spine Correction
10. Repeated Strain Injuries (RSI)
Injuries may be Acute (sudden onset) or Chronic (happened in due course)
Management-
In case of Acute conditions of sports-related Injuries
- Lepa – Application of medicated paste over the affected site
- Bandhana- Bandaging the injured site
- Parishek- pouring of medicated decoction over the site
- Avagah Swedan- Sitting in a tub filled with medicated water
- Nadiswedan- Application of medicated steam
- Valukaswedan- Applying Kizhi (Potalis) with hot sand
- Upanah- Poultices with medicated paste
- Raktamokshana- bloodletting
Acute management of injuries occurs mostly on-field which can be well managed through Ayurveda. Firstly we have to stop activity to prevent further injury. Application of Murivenna over the injured site found to be very effective to reduce pain and inflammation. For almost all on-field games, due to exertion, chances of increased blood pressure and breathing problems may occur. In such conditions, medicines like kanakasam, punarnasavam, dhanwantharam gulika etc play a vital role in reducing the symptoms. Ayurvedic medicines which can affect muscle relaxant sprays and lepas are helpful in subsiding the pain as well as also help in healing the affected site in case of sprains and contusion.
• Chronic Injury
Chronic Injuries are managed with panchakarma Procedures and marma therapy. For this different kinds of medicated potalis were made and applied over the affected region to subside the disease. The next step is to strengthen the affected site. For this medicated potalis with nourishing nature and different types of massages with oils in order to regain the neuromuscular activities and improve the bone strength were administered. Yoga along with physiotherapy was also used to bring the normal status.
Treatment Protocol
Prakritisthaapana: To regain the physical fitness of a sportsperson and send him back to the field as early as possible by Rest, Medication and Rehabilitation.
Samana Oushadha: Internal medicines can also be administered to boost up tissue healing, alleviate pain and strengthen the injured part. Let us check how the medicines are acting on the body.
Mode of Action:
Abhyana (Massage) with medicated oil brings softness to the tissues. Abhyanga can increase arterial blood flow to the muscle and skin, soothes and stimulates the nerves hence increases the power and tone of muscles, tendons and ligaments. Regular abhyanga prevents early ageing and repetitive strain injuries.
Local hyperthermia produced during Swedana (steam therapy), improves local blood and lymphatic circulation and thereby helps in decreasing chronic inflammation in the injury site. Heat is also a counter-irritant i.e. the thermal stimulus may affect the pain sensation. Swedana by its Snigdha(moist) and Uśna(warm) property relieves stiffness of muscles and joints. Hyperthermia increases the rate of Transdermal drug delivery thereby helps in the absorption of drugs used for swedana and helps to expel waste and toxins from the body. In chronic muscle wasting, neurological cases, Shastikshali pinda sweda is helpful for stimulating neuro-muscular functions.
Basti (enema) with medicated decoction or medicated oil is the best treatment, whereas it can be used for all vitiated doshas. It nourishes all the body, relieves stiffness, contraction and adhesion. It is effective in the healing process of torn ligaments, tendons and fractured bone Basti can stimulate ENS(Enteric Nervous System) which secretes neurotransmitters like Acetylcholine, Norepinephrine, Serotonin, Dopamine etc. which control various types of gastric activity of GI tract.
Nasya (Administration of medicine through nostrils) reaches to the brain and nourishes all the sense organs. Proper functioning of the sense organs is of prime importance for an athlete. The nasal mucosa is the only location in our body that provides a direct connection between the central nervous system (CNS) and the atmosphere. Drugs administered through the nasal cavity rapidly traverse through the cribriform plate into the CNS. Thus, Nasya is an easy and effective modality in the management of sports injuries.
Raktamokshana (Bloodletting) helps in reducing local inflammation, pain and swelling. Jalaukavacharana( Leech therapy) is very helpful in bruises, hemarthrosis and in acute injuries. The saliva of leech contains an enzyme called hirudin which works as an anticoagulant, diuretics, and antimicrobial. It enhances wound healing and has an immune modulator effect.
Agnikarma (Thermal cautery) gives sudden relief from pain, swelling and tenderness in tendinitis. As a result of the passage of heat, relief in tension and relaxation of muscle fibres occurs, which produces space between them and helps to reduce tenderness and inflammatory edema much faster. It is found to be very effective in tennis elbow; plantar fasciitis etc. Agnikarma is beneficial to relieve the stiffness of muscles and joints and for a speedy recovery by enhancing tissue repairing in post-traumatic and in repetitive strain injuries.
Internal medication has a vital role along with external treatments. Medicines like Dhanwantaram kashayam, marma kashayam, Laksha Guggulu etc helps in tissue repair. Balarishtam, Aswagantharishtam, lohasam helps to improve strength and vitality. Medicines like Ajamamsa Rasayana, Aswagandha Rasayana, Amritaprasam etc strengthens the immune system to fight against diseases as well as improve the quality of sense organs and strength to motor neurons. Internal administration of Gandhataila, Balataila etc helps to improve bone and neuromuscular strength.
Conclusion
Ayurvedic Management is safe and non-surgical with fewer adverse effects. Acute Injuries can be well managed with lepas(Application of Medicated Paste) and Bandhanas ( Immobilizing the affected part with different types of bandages). Repeated strain injuries and chronic ailments can be well treated by Panchakarma and Marma therapy. The patient regains functional ability within a short period as regular follow-ups and changing of bandages once a week along with internal medications provides fast healing and early recovery. Prevention of injuries and Strengthening of Joints and Muscle tissues can be done by Panchakarma and Yoga as a regular practice. Sports Ayurveda not only give a strong and healthy body but a sound mind too.