Modern Sports medicine evolved as a sub speciality of orthopedics later developed in to a separate entity of clinical medicine which deals with the overall care of a sports person. Sports medicine, a team work of specialities including physicians, orthopedic surgeons, cardiologist, medicine speciality, physical therapists and nutritionist and clinical psychologist.
In older days the sport-related problems are addressed as musculoskeletal disorders under orthopedic speciality, rises many questions regarding complications like post traumatic stiffness, Complex regional pain syndrome (or RSD- Reflex Sympathetic Dystrophy Syndrome), disuse atrophy which may badly affect the total performance of a sports person and also regrading back to sports. There is much more to sports medicine than just musculoskeletal diagnosis and treatment. The questions regarding psychological, physiological, pathological and aspects of physical therapy and rehabilitation of sports injuries lead to the evolution of sports medicine.
Sports medicine, as a separate recently originated medical speciality deals with diagnosis, managements of sports related injuries which helps the athlete return back to field as early as possible with his full potential. The goal / aim of sports medicine is to maintain, sustain, and at times to regain peak physical fitness i.e adaptability to stress, physical and mental. Main functions of sports medicine are promotive, educative, formative, recreative, competitive, therapeutic and rehabilitative in nature.
Sports Medicine in Ayurveda
When going through the Ayurvedic classics, we do not have ready-made references regarding the term 'sports medicine and management of injuries under the heading ' sports injury'. But we definitely find direct references regarding the daily regimen (dinacarya), seasonal regimen (ṛtucarya), diet and lifestyle optimization (pathya - apathya) and of course, dosha based diagnosis and managements of fracture, dislocations (bhagna chikitsa) and soft tissue injuries which can be clinically correlated as counter part in Ayurveda which are closely resemble to current practices of sports medicine. Ayurvedic sports medicine thus contribute an integrated approach with its traditional knowledge in selection, preparation, prevention and management of sports related interventions.
The principles of Ayurveda, though there had been many innovations and additions in practice, applied aspects of sports medicine in current Ayurvedic knowledge make this speciality superior than conventional injury management and Vital point management (marma chikitsa).
Despite this wide scope, there are several quacks practicing in the label of Ayurveda, who are found to have a false assumption that management of pain or injury is just a localized situation that may be easily manipulated. This misconception is against all the basic principles of Ayurvedic injury management. These quack and their faulty practices seem to be the major threat, not just to Ayurveda, but also to the entire society.
Ayurveda's contribution to Sports Medicine
Ayurveda covers all possible disciplines of modern sports medicine with its traditional wisdom contributing an integrated frame work as ' Sports Ayurveda'.
- Using the doṣa and prakṛti evaluations to identify born athletes and sporting events and specific training best suitable to their body types.
- Identifying their emotional and mental temperament (satva balam) to understand their ability to cope up with extreme pressure, pain and perseverance.
- Evaluating their routine and habits (sātmya) and adopting the right diet and lifestyle modifications to enhance their health and capacity.
- as performance enhancer
-Daily dietary regimen
- in off season
- during event
-as single drugs and combination
- Ayurvedic Marma chikitsa
- Bandaging techniques
- Management of fracture and dislocation (bhagna chikitsa)
- Maintenance and improvement of tissue health (dhātugata doṣa chikitsa)
- Management of inflammatory conditions and reactive conditions of blood (Vātarakta chikitsa)
- Surgical and parasurgical procedures (Anuśastra and śastra karma)
4 Stress management
- Yoga and meditations.
The impact of Body Types, Habits and Tissue essence in Sports Medicine
Considering the basic principles of Ayurveda the selection and performance of an athlete, there are certain features mentioned in Ayurvedic texts like prakṛti (constitution of the body), sāra (essence), satva (will-power), sātmya (habit) determine his career and the over all performance in the filed.
Each person is born with inbuilt and unchangeable prakṛti and is an inevitable factor for selection of particular event with which the output will be maximum in his performance. For example, depending upon the prakṛti, a vāta prakṛti person may be better in endurance athletics like marathon, vāta-pitta prakṛti in aggressive sports like martial arts, racket sports, football, and kapha-pittaprakṛti in weightlifting body building etc.
Sāra is considered as the essence of tissue (dhātu). For example, the dominance of the dhātu in sports individuals like asthi-sāra, in which strong prominent bones and joints with slim but strong high energy and can tolerate utmost strain and pain, like gymnastics, racket sports running sports and also in aggressive sports like martial arts etc.
Majja sāra usually with small body and having good endurance, strong bones and joints, oily in complexion with good physical stamina, can be most suitable for cardio respiratory endurance training, muscle endurance sports like cycling, marathon cross country athletics and in sports with utmost flexibility is mandatory.
Habit (sātmya) is a very unique concept and the implementation, especially of habituation to aspects that are counter-productive to health or well being (oka-sātmya) is related to sports which helps the athlete to withstand extreme physical stress and climate.
Sātmya, the will power of mind is also important for best in performance both in indoor and outdoor sports. So it is the basis in talent sports like chess, aggressive sports like tug of war, martial arts etc. In general asthi-sāra and majja-sāra individuals can be a better sports person who can perform well in outdoor events.
The importance of daily regimen and seasonal regimen
An athlete with vigorous exercises and training schedule has to follow daily regimen, seasonal regimen and proper dietary habits to maintain his best possible performance through out his career. A concept of Daily and Seasonal regimen mentioned very elaborately to promote a healthy living can be scientifically incorporated in athletic training depends on individual sports event. The diet in aggressive sports is entirely different from endurance sports. Similarly, the amount of water intake, duration of rest, sleep and optimum seasonal regimen also differ individually based on śarīra doṣa, sāra and the sports event itself. Daily regimen like when one should get up in the morning, duration of sleep, the necessary activities to be done, the amount of exercise he should perform, type of food and seasonal purification therapies to detoxify the body periodically etc. are explained in Ayurveda in great detail.
The role of herbs and medicines
There are certain herbal drugs like ginseng, aśvagandha and certain groups of drugs which have jīvanīya (enlivening), bṛṃhaṇa (nourishing), balya (strengthening), śophahara (anti-inflammatory) properties mentioned in Major textbooks of Ayurveda, which can be considered as the most important contribution from Ayurvedic literature to Sports Medicine. Along with food and seasonal regimen, the judicious use of these drugs can be the best alternative as sports performance enhancing agents and it even has the potential to replace the conventional practice of anabolic steroids and other performance enhancers in near future.
Ayurveda also addresses the challenges faced by a modern sports person especially psychological and social, stresses with its holistic approaches like Yoga, Pranayama and other meditations.
The benefit of Ayurvedic Surgery and Para Surgical Procedures
Ayurvedic Surgery (śalya tantra cikitsa) incorporated with modern sports medicine principles is the basic foundation for this Ayurvedic sub speciality, i.e Sports Ayurveda. The notorious manipulations by the quack practitioners in Kerala making the novel concept of Ayurvedic Sports is forcing modern practitioners and sports therapists to look at it with skepticism and disbelief. It is our duty to explore all possible areas of Ayurvedic references of sports related events incorporating modern principles to fulfill the concept of Sports Ayurveda.
Injuries in the sports, like those to ligament, tendon muscle and closed fractures, contusions etc. are to a certain extent inevitable. Ayurveda has got very effective remedies based on dosha predominance both for diagnosis, selection of medicines, and treatment methods. Along with Orthotics, (supporting equipment for postural correction or enhancement) and rehabilitation protocol, complete recovery may be possible without any chance of recurrence.
Ayurvedic treatment principles of open fracture (savrana bhagna chikitsa) in acute sports injuries, tissue diseases due to vata (dhatugata vata chikitsa) in chronic cases including para-surgical procedures like thermal cauterization (agnikarma), blood-letting (raktamoksha) and also uthana vatarakta chikitsa in repetitive overuse injuries. These principles should be kept in mind while dealing with sports injuries
Ayurveda has numerous herbal drugs and formulations that can fasten the healing process even after a surgery, also during rehabilitation of an injured muscle, bone, and enhances performance levels.
Thus, the basic principles of Ayurveda, marma chikitsa along with modern sports medicine & rehabilitation protocols give a new direction as a sub speciality 'Sports Ayurveda'.
An integrated approach using modern principles and clinical trials should be initiated and should be published as an evidence based data makes the concepts of Ayurvedic sports medicine more acceptable.
_ Ashtanga Hrudaya
_ Charaka Samhitha
_ Susruta samhita
_ Brukner and Karim khan, Clinical sports medicine 3rd edition
_ Natarajan &Mayilvahanam - Text Book of orthopaedics and traumatology 4th edition.
_ Augusto Sarmiento &Loren L Latta -Non surgical treatment of fractures, 1st edition-2010
_ Ronald Mc Rae Clinical orthopaedic examination Second Edition 1985
_ Sureshwar Pandey Clinical Orthopaedic Diagnosis McMillan India Limited 1999
_ David J Magee Clinton clinical orthopaedic assessment, musculo skelital rehabilitaion series 6th edition.
_ Essential orthopaedics principles and practice- Manish kumar varshney -2nd edition 1volume, 7th section.