Injuries are an inherent part of sports. All athletes have sustained some injury or another during the span of their careers. No matter which sport you play, be it football, hockey, tennis or cricket, whether you are representing your country or your college, you are likely to get hurt at some time. An injury has the potential to end careers and ruin dreams. That is because the injury takes a toll not just on the body but the mind as well. It instils confusion and hesitation and sometimes after an especially traumatic accident, athletes find it difficult to return to practice because they are crippled by a sense of fear.

That is why along with treatment or surgery, a sportsperson also needs to undergo rehabilitation therapy.

Why Psychological Rehabilitation is Important? 

After suffering a serious injury that almost jeopardized their career, athletes suffer a wide range of psychological and physical challenges, which makes them retreat from the outside world. These are problems they would not be able to cope with unless they opt for rehabilitation programmes.

  It helps them accept that getting back to the game will be a mammoth task 

  Inspires in them the confidence to keep trying 

  Deal with the pain 

  Go about their practice sessions with as little discomfort as possible 

  Overcome feelings of fear or despair 

  Cope with depression 

  Prevents the person from sinking into a state of self-pity which hinders recovery 

  Look at the injury not as something that might put an end to their career but as a mere impediment in the path to success 

Psychological rehabilitation adopts a wholesome and expansive approach to healing the athlete. It takes into account several factors in chalking out a course to recovery that is individualistic   

  The personality- the toughness, determination, will power of the athlete, ability to deal with anxiety

  Medical history- past injuries or illnesses 

  Resources of coping- the athletes  support system, a network of friends and family, management of stress, treatment and medicines etc 

Psychological rehabilitation also takes into account the individual s response to therapy to ensure that it is as effective as possible. These are   

  Cognitive appraisal - Monitors a person s growth or decline in self-esteem or worth as well as confidence. The aim of rehabilitation is to restore the person s faith in his/her capabilities 

  Behavioural response - This ensures that the individual s behaviour shows traces of denial or avoidance because negativity will only delay recovery 

  Emotional response - The profile of Mood States (POMS) is utilized to analyze or gauge the person s emotional reaction to therapy. It is supposed to uplift the athlete mood and deal alleviate feelings of despair or hopelessness. Medicines and physiotherapy become more successful in treating a sports injury when coupled with psychological rehabilitation. 

Athletic Injuries - How Effective Is Psychological Rehabilitation As A Line Of Treatment?

A hand fracture is a condition characterized by broken bones of the hand. The bones in the hand include the bones that are present in the fingers and the wrists. A fracture of the hand tends to occur when you bend or twist your hand in the wrong manner. It may also be caused by injuries related to sports and falls.

Symptoms
Symptoms of swelling and pain are the most common of them all. The range of motion for the affected hand will be reduced as well. The knuckle bone may appear to have been sunken in. Most obviously, it will be difficult in carrying out regular tasks which need the hands.

Therapies
The initial treatment for a hand fracture will be focused on reducing the pain. Pain relieving medications such as ibuprofen will be administered which provides relief from the pain. The next step will be to keep the affected hand immobilized so as not to hamper the recovery process. Once stability is restored, therapeutically relevant exercises are prescribed to help normalize the regular hand movements.

The following exercises are relevant in case of a hand fracture:

Wringing a towel: This is an exercise wherein you wring a towel to improve flexibility and strength in the hand. Simply grab a towel and twist it in both directions; imagine wringing water from the towel.
Rolls of the wrist: Wrist rolls aim to increase the ROM (range of motion) in your wrists and the hands. Hold the hand steady and rotate your wrists both clockwise and anticlockwise. You can also hold a light weight in your hand to make it more challenging.
Prayer stretch: A prayer stretch is another exercise that can help boost your wrist flexibility. You start by positioning the palms together like in a prayer, then hold up the elbows while pushing the hands against each other. You should feel a stretch in your wrists and hands.
Grasping: This is a technique wherein you grasp objects to improve your grip strength. Try gripping objects such as tennis ball or stress balls to get your gripping ability up to normal levels.


4 Effective Therapies Post Hand Fracture!

The core muscles, mainly concentrated around the abdomen, hips, lower back, trunk, and glutes, are indeed a powerhouse that gets you going. The stronger the core muscles, the fitter you stay. Without a proper core strength, a lot of the day to day activities including lifting or bending gets affected. Certain health conditions can weaken the core muscles. But how to know if the core muscles are weak? There are many signs and symptoms associated with weak core muscles. 

Mentioned below are some important signs that may be an indication of weak core muscles.

For your posture to be correct, the spine and pelvis need to be stable: The muscles of the lower back and the abdomen does exactly that, ensuring a steady and correct posture. However, when the core muscles weaken, they are unable to provide stability to the spine and the pelvis resulting in a poor posture. Left unattended, poor posture, in turn, can trigger a myriad of complications and discomfort.
The body loses its balance: As already mentioned, the core muscles go a long way in stabilizing the body and helping you to maintain the body balance. You can perform a small test to know if your balance is affected. Close your eyes and stand on one foot. Repeat the procedure with the other foot as well. If you have a developed core, you will be able to hold the position for at least 10 seconds, if not more (both the legs).
A pain concentrated to the lower back: Do not ignore a lower back pain. It could be an indication of your core muscles not being strong enough, especially the ones adjacent to the spine. The weak muscles fail to provide the necessary support to the discs and the vertebrae resulting in pain (mild to severe depending on the severity of the condition) and discomfort. Timely medical intervention may help improve the condition.
Weakness throughout the body: The strong core muscles are an indication of a healthy and fit body. When the muscles start to lose its strength, the entire body gets affected. A person finds it difficult to even lift things. Doing even a small and regular work leaves a person weak and tired.
You can also perform the Hollowing Test to check your core strength: Sit in a comfortable position. Starting breathing in and out. As you breathe out or exhale, try to pull your stomach inwards towards the spine for at least 10 seconds. Unable to pass this test (can't hold the position for 10 seconds) indicates weak core muscles.
You can also try the plank test: Get yourself in a push-up position with the entire body resting on your elbows, arms, and toes. The hip should be level and steady. Failing to stay in this position for 50 seconds is indicative of weak core muscles

Core Muscles - How To Know If They Are Strong Or Weak?

If you are suffering from gout, you should try undergoing a homeopathic treatment. Gout is a type of arthritis and is considered to be the most painful type. It is featured by the inflammation of joints accompanied by great pain. The pain and inflammation occur because of the deposition of urate crystals in a joint. The accumulation occurs when there is excessive uric acid present in the blood.

Here are some effective homeopathic remedies for the treatment of gout:

Colchicum: This medicine is the primary homeopathic medicine for treating gout because of its effectiveness. It is mostly used in chronic cases of gout. Usually, a patient experiences extreme pain in the big toe, which is too intense to be touched. The toe and other parts which get affected become swollen, red and hot. The pain worsens in the evening and at night. Patients who require this medicine should keep away from warm weather conditions. This medicine is also used in case of increased weakness and internal cold.
Ledum Pal: This effective medicine is used in cases where the pain travels in an upwards direction from below. The pain is likely to start at the feet and gradually move upwards, affecting the knees and legs. The pain also shoots through limbs. Small joints are commonly affected. There is a sensation of decreased warmth in the joints and in the body. The patient will find it difficult to tolerate any kind of external warmth. The pain improves by cold applications. The ankle balls or big toe may be swollen.
Benzoic acid: This homeopathic medicine is used for treating gout where offensive urine is experienced. The urine becomes very offensive with a very strong odor, which can be detected from a distance. The odor is usually repulsive and the color of the urine is brown. Extreme pain is experienced in the big toe and the knees are swollen.
Antim Crudum: This is an efficient homeopathic medicine used for treating gout. It is used when a patient experiences gastric symptoms along with joint pain and inflammation. The patient may develop an increased craving for food and hence, several problems occur due to over eating. Pain is experienced in the heels and fingers.
Sabina: This homeopathic medicine is important for treating gout in women, when the patient already suffers from another female disorder. Uterine symptoms are experienced along with the basic symptoms of gout. Shooting pain is experienced in the toes and heels. The joints get swollen and look red and shiny.
Homeopathy offers a completely natural treatment for different types of gout and goes beyond just curing the symptoms. You need to consult your doctor before starting a homeopathic treatment for gout.

5 Homeopathic Remedies for Treating Gout Pain

The bones are a porous matrix which is filled with minerals like calcium and phosphorus which make them strong. Over a period of time, the mineral content is lost and therefore the matrix gets brittle. Bones are more likely to fracture in these people.

Causes/Risk factors:

The bones get fragile and brittle with age in most people, and people over 60 years of age are likely to be affected
Asian women about the age of 45 are prone to osteoporosis
Reduced vitamin D intake (either by sun exposure or through diet) also makes bone porous and prone to fracture
Sedentary lifestyle with minimal or no exercise
Lower levels of estrogen, especially post menopause
Cigarette smoking
Reduced testosterone levels
With fracture, there is severe pain, loss of mobility, and need for prolonged nursing.
Foods which can help control/prevent osteoporosis:

Yoghurt: Derived from milk, it is rich in animal protein and also contains good amounts of vitamin D and B2, calcium, phosphorus, and magnesium. It helps in maintaining estrogen levels during menopause, thereby preventing osteoporosis. They also provide a good supply of gut bacteria, which improves immunity.
Milk: Similar to yoghurt, this is also rich in various minerals that are essential for bone health. The vitamin D in it also improves calcium absorption, thereby prolonging the occurrence of osteoporosis.
Fish and meat: Lean meat and fish are good sources of oils and protein and form an essential part of diet for preventing osteoporosis. Sardines and salmon are ideal as the tiny fish are rich sources of calcium.
Eggs: This contains good amounts of natural protein, minerals, and vitamins essential for bone health. It also helps in estrogen formation, which has a bone-protective effect.
Cabbage: Any form of cabbage is good for preventing osteoporosis. It promotes bone metabolism and has calcium which help in strong bone formation.
Bananas: Another effective food in preventing osteoporosis, it helps improve absorption of calcium and other essential nutrients to ensure bones are formed and maintain health. It also has natural oils, potassium, and vitamins A and C in good quantity.
Almonds: It forms an integral part of preventing osteoporosis by increasing bone density and promoting bone health. It also has good oil content, which is also essential for bone health.
Legumes: Beans and other legumes are rich source of proteins and minerals and therefore prevent onset of osteoporosis.
Chickpeas: Another great source of various minerals and vitamins, it is very low in calories and sugar and is great to lose weight. It also improves bone health by increasing density.

Osteoporosis - How A Healthy Diet Can Reduce Its Risk?

Knee replacement can be extremely painful. Previously, opioids or narcotics were administered for pain relief. But excessive addition of opioids is not exactly effective for controlling pain. 

Multimodal pain management has become an important part of the perioperative care of patients undergoing total joint replacement. The principle of multimodal therapy is to use interventions that target several different steps of the pain pathway, allowing more effective pain control with fewer side effects. Many different protocols have shown clinical benefit. The goal of this review is to provide a concise overview of the principles and results of multimodal pain management regimens as a practical guide for the management of joint arthroplasty patients.

Multimodal denotes administering two or more than two types of medications that work with different mechanisms. The following are the techniques used:

Pre-operative Femoral Nerve Block: Prior to the surgery, a catheter is placed beside the femoral nerve for blocking it. This nerve is located in the upper thigh. Medication is delivered through the catheter for the nerve to be numbed for 24 hours. Thus, pain signals to the brain are blocked. This method reduces the use of narcotics and the consequent side effects.

Patient Controlled Analgesia (PCA): This method is also known as  Pain Pump . An intravenous pump is used to administer pain relief medications, such as oxymorphone or morphine, after the surgery. The control button of the machine could be pressed, by the patient for 6 to 10 times per hour. The machine is used for two post-operative days.

Oral Medications: The oral medications include Non-Steroidal Anti-Inflammatory drugs or NSAID; such as Celebrex which is similar to aspirin, structurally. Alternatively, acetaminophen, such as Tylenol or its equivalent composition, can also be used.

Acetaminophen: It acts on the Central Prostaglandin Synthesis and relieves the patient of pain through multiple mechanisms.

Epidural Analgesia: It produces lower pain scores and involves less time for achieving physical therapy goals. However, this is subject to side effects such as dizziness, urinary retention and itchiness.

Gabapentinoids: These medications include membrane stabilizers such as Gabapentin and Pregabalin.

The objective of multimodal treatments is to provide quick relief to the patient and immediately so. Earlier the rehabilitation, more successful will be the knee replacement surgery.

Multimodal Pain Relief After Total Knee Replacement

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