Sports Injuries And Homoeopathy

Regular Physical Exercise is integral to the body staying healthy. However, stressing the human body beyond its limits may lead to injury.
Sports medicine is the science of understanding how these injuries can be avoided, recognised when they do occur, and then treated appropriately. Sports injuries are, in principle, the same as other injuries. The major difference can be in the expectation of the patients.
Sports medicine has been defined as the scope of medical practice that focuses on:
1. Prevention, diagnosis treatment and rehabilitation of injuries that occur during physical activity
2. Prevention, diagnosis, and management of medical conditions that occur during or after physical activity
3. Promotion and implementation of regular physical activity in the prevention, treatment and rehabilitation of chronic diseases of lifestyle.
Injuries can be classified into 3 broad groups:
1. Acute Extrinsic Injuries
They are those which arise from a direct external blow. These are commonly wounds, bruises and fractures.
2. Acute Intrinsic Injuries
They are result from failure of a patient’s structures as a result of excessive loading. Examples are tendon ruptures, avulsion fractures and ligament injuries.
3. 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.
Diagnosis of Sports injuries
There are some additional questions which need to be asked in the history when treating a patient with a sports injury:
1. How was the injury sustained?
2. What type of sport or training were they undertaking; mixed training or only one type of sport?
3. Have they had a previous injury? When was this and what rehabilitation have they had?
4. What were they aiming for in the way of competitions or level of sport that they performed before the injury?
5. Do they now want to compete again or are they considering retiring?
Tendon Disease
Tendons can become weak and/or painful as a result of physical damage or as a result of inflammation of the tendon sheath around them (peritendonitis). Tendon injury is either due to overload (the strength of the tendon being exceeded by the force applied) or to overuse (where there is repetitive low-level load to the tendon) leading to fatigue and failure. In this case, the patient may present with inflammation rather than rupture.
Overuse Injuries
Overuse injury can be precipitated in a tendon by:
Internal factors:
 Decreased oxygen supply
 Decreased nutrition
 Hormonal changes
 Chronic inflammation
 Ageing
External factors:
A change in the environment (new running surface), or worn out equipment (old running shoes), may both bring about an overuse injury as can excessive training when the patient is not fit enough to tolerate it.
In younger patients, the weakest area of a tendon is the apophyseal attachment.
In adults, the musculotendinous junction is more liable to injury.
In adolescents, the common sites of injury are tendon insertions. Examples are the anterior superior iliac spine (origin of sartorius), the anterior inferior iliac spine (rectus femoris), the lesser trochanter of the femur (iliopsoas) and the ischial tuberosity (hamstrings)
Muscle Injuries
Muscle injuries can be classified into:
• Sprain
• Partial tear
• Complete tear or re-tear (if there has been previous injury)
Most will heal spontaneously but may leave a painless defect in the muscle belly.
Ligaments
Ligament injuries are acute intrinsic injuries and can be graded according to their severity.
Ligament injuries graded according to severity.
Grade Description
0 – Normal ligament.
1 – No increase in joint laxity but there is tenderness around the injured ligament.
2 – Partial disruption of the ligament fibres with increased joint laxity, and a soft end point.
3 – Complete disruption of the ligament. There is a marked increase in joint laxity with no end point clinically.
Note:
• Difficult to assess in the acute phase
• Use the opposite side for comparison
• Surgical repair may be needed for complete disruption
Bursae
Bursae are found between the joints and overlying tissues or muscles and tendons and are small fluid-filled endothelium-lined Sacks. They decrease frictional forces between structures but can become inflamed. The most commonly affected sites are over the first metatarsal phalangeal joint (bunion), in front of the patella (housemaid’s knee) and behind the elbow (olecranon bursa). They can become inflamed or even infected. If they fail to settle with appropriate treatment then they can be surgically excised.
Bone Fractures and Stress Fractures
True fractures can be encountered in any sport, but the fracture type found more commonly in sportsmen and women is a stress fracture. This is caused by multiple repetitions of moderate loads. Clinically, these lesions give poorly localised pain, which is worse on exercise. They are more common in runners, especially women who may have reduced bone density. The most common sites for stress fractures are the metatarsals and the tibia.
Treatment of Injuries
In the acute phases of a sports injury price describes the treatment plan:
• protect
• rest
• ice
• compression
• elevation
Role of Homeopathy
According to Master Hahnemann, in Aphorism 186, “Those so-called local maladies which have been produced a short time previously, solely by an external lesion, still appear at first sight to deserve the name of local disease. But then the lesion must be very trivial, and in that case, it would be of no great moment. For in the case of injuries accruing to the body from without, if they be at all severe, the whole living organism sympathizes; there occur fever, etc. The treatment of such diseases is relegated to surgery; but this is right only in so far as the affected parts require mechanical aid , whereby the external obstacles to the cure, which can only be expected to take place by the agency of the vital force, may be removed by mechanical means, e.g. by the reduction of dislocations, by bandages to bring together the lips of wounds, by the extraction of foreign bodies that have penetrated into the living parts, by making an opening into a cavity of the body in order to remove an irritating substance or to procure the evacuation of effusions or collections of fluids, by bringing into apposition the broken extremities of a fractured bone and retaining them in exact contact by an appropriate bandage, etc. But when in such injuries the whole living organism requires, as it always does, active dynamic aid to put it in a position to accomplish the work of healing, e.g. when the violent fever resulting from extensive contusions, lacerated muscles, tendons and blood-vessels requires to be removed by medicine given internally, or when the external pain of scalded or burnt parts needs to be homoeopathically subdued, then the services of the dynamic physician and his helpful homoeopathy come into requisition.”
Thus, n a Sports injury, Select the true case for homoeopathic treatment. (Along with surgical aids if required, as stated in Aphorism 186). In Certain cases, External Applications also helpful along with Internal Homoeopathic medicines.
Some of the Homoeopathic Sports medicines are as follows:
ARNICA MONTANA: this is 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. It is suited to persons who are extremely sensitive to mechanical injuries, and who feel the effects of them long after; persons easily made train-sick or sea-sick. Patients complain that the bed is hard no matter how soft it may be. Allied to wounds are haemorrhages, and arnica causes and cures hæmorrhages of many kinds: dilatation and rupture of small blood-vessels. It is especially suited to cases when any injury, however remote, seems to have caused the present trouble. After traumatic injuries, overuse of any organ, strains. A muscular tonic. Traumatism of grief, remorse or sudden realization of financial loss. Limbs and body ache as if beaten; joints as if sprained. Bed feels too hard. Marked effect on the blood. Affects the venous system inducing stasis. Ecchymosis and haemorrhages. Relaxed blood vessels, black and blue spots. Tendency to haemorrhage. Worse, least touch; motion; rest; wine; damp cold. Better, lying down, or with head low.
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 TOXICODENDRON: ailments from strains, over lifting. Hot, painful swelling of joints. Pains tearing in tendons, ligaments, and fascić. 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.
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.
SYMPHYTUM: It is considerd 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.
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.
LEDUM PALUSTRE: Easy spraining of ankle. . For punctured wounds, produced by sharp-pointed instruments or bites particularly if the wounded parts are cold.
BOVISTA: Swelling of the foot after sprains.
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.
DULCAMARA: Sprain of neck, lying on affected side.
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.
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
Rubrics
INJURIES (traumatisms) – Acet. ac., Acon., Angust., Arn., Bellis, Bufo, Calend., Cic., Crot. t., Euphras., Glon., Ham., Hyper., Led., Mag. c., Millef., Nat. s., Physost., Rhus t., Ruta, Stront. c., Sul. ac., Verb.
Bruises
Contusions – Acet. ac., Arn., Bellis, Con., Echin., Euphras., Ham., Hyper., Led., Rhus t., Ruta, Sul. ac., Symphyt., Verb.
Bone [of] – Arn., Calc. p., Ruta., Symphyt.
Breast [of] – Bellis, Con.
Eye [of] – Acon., Arn., Ham., Led., Symphyt.
Parts, rich in sentient nerves [of] – Bellis, Hyper.
Persistence of ecchymosis [with] – Arn., Led., Sul ac.
Sprains, strains – Acet. ac., Acon., Agn., Arn., Bell., Bellis, Calc. c., Calc. fl., Calend., Carbo an., Formica, Hyper., Millef., Nux v., Rhod., Rhus t., Ruta, Stront., Symphyt.
References
• SHORT PRACTICE of SURGERY: Bailey & Love’s 26th EDITION. Edited by Norman S. Williams MS FRCS FMed Sci Professor of Surgery and Director of Surgical Innovation, Barts and the London School of Medicine and Dentistry, Queen Mary, University of London and President, The Royal College of Surgeons of England, London, UK. Christopher J.K. Bulstrode MCh FRCS(T&O) Emeritus Professor, University of Oxford, Oxford, UK. P. Ronan O’Connell, MD FRCSI, FRCPS Glas., Head, Surgery and Surgical Specialties, UCD School of Medicine and Medical Sciences Consultant Surgeon, St Vincent’s University Hospital, Dublin, Ireland
• Brukner & Khan’s Clinical Sports Medicine(Vol.1 Injuries) By Brukner & Karim Khan. McGraw-Hill Medical; 5th edition (11 September 2018)
• Boericke’s New Manual of Homeopathic Materia Medica with Repertory: Third Revised & Augmented Edition Based on Ninth Edition by Garth W. Boericke , REPERTORY by Oscar E. BOERICKE, M.D. Publisher: B.Jain
• Organon of Medicine by Samual Hahnemann; R.E.Dudgeon. Publisher: B. Jain Low Priced; Fifth & Sixth edition (23 September 2013)
• Illustrated Guide to the Homeopathic Treatment: 3rd Edition by Harbans Singh Khaneja. Publisher: Health Harmony; Third edition (1 April 2012)