Autonopedia

SPORTS INJURIES

IF, LIKE MANY WORKING PEOPLE, you spend the majority of your time chained to a desk, occasional athletics are likely to provide your primary avenue of exercise. The information age may have saved you from being injured falling under the tractor, but, instead, you twist your back trying to knock a few points off your golf handicap or you sprain an ankle trying to keep up with teenage dancers at a nephew's wedding.

Here are some common injuries you might experience, nearly all of which come from overdoing it.

* Muscle cramps occurring during or after exertion. These cramps are often triggered by dehydration. The best prevention is to drink ample fluids before, during and after exercise. Don't wait to become thirsty; it's too difficult to catch up on your fluid losses. If you plan to exercise for more than an hour, switch from plain water to a sports drink. These products help replace carbohydrates and salts. If you develop a cramp, stop and gently stretch the affected muscle. Sometimes gentle massage helps. So does heat. Once you're home, you can soak in a hot bath or apply a hot, damp towel or hot-water bottle.

* Sore muscles while exercising. Dehydration may be the culprit here, too, along with depletion of muscle fuels and accumulation of the waste product lactic acid. Part of the solution lies in consuming sufficient amounts of the many nutrients exercising muscles require. Try eating a banana or other fruit 30 minutes before exercising.

* Stiff and sore muscles after exercising. This type of pain signals that you've overdone it. Dr Edmund R. Burke, director of the Exercise Science Program at the University of Colorado at Colorado Springs, calls it an athletic hangover.

Such muscle strains arise from tiny tears in the muscle. Intense exercise can generate unstable molecules called free radicals, which contribute to this muscle damage. Increased blood flow makes the muscle actually swell. For these aches try soaking in a hot bath, a sauna session, gentle stretching or massage. As long as the muscles are only stiff, not injured, heat acts to loosen and relax them. It also promotes better circulation to carry away the muscles' waste products. Dr Burke says the most important remedy is rest. If you use prevention and increase your training level gradually, you may not need a remedy! Forget the 'no pain, no gain' adage. Getting right back on the exercise bike after muscle tears can do more harm than good.

EASING THE PAIN OF A STRAIN
If you experience significant pain or limited range of motion because of a sports injury, see a doctor. You can treat mild sprains and strains at home, starting with RICE, an acronym for rest, ice, compression and elevation. Rest means just that. Sounds easy but, if you must keep active, gently exercise the parts of your body that don't hurt. Swimming and yoga can often be tolerated.

Ice is also simple. Apply a plastic bag of ice cubes or crushed ice, a bag of
frozen peas or sweetcorn, or a commercial cold pack. Protect your skin by
covering it with a damp cloth. The day of the injury, ice the area for 20 to 30 minutes, three or four times per day. Continue ice compresses until a couple of days after the injury begins to feel better. Because heat increases swelling, some experts don't recommend using it within the first two weeks - unless the primary problem is tight muscles, in which case heat helps muscles relax. Others say you can alternate hot and cold applications as long as you end with cold.

Compression entails wrapping the injured limb with an elastic bandage,
but only as snugly as, say, a trouser sock. You don't want to cut off the
circulation and increase swelling below the injury. Remove and rewrap the bandage at least twice a day.

Elevation means raising the injured area above the heart, not just propping your ankle, if that's what you've hurt, on a footstool. Instead, lie flat and prop your leg or other injured area on pillows. This improves the return of blood and other fluids to the heart to reduce swelling.

VITAMINS FOR WEEKEND WARRIORS
Vitamins C and E are both antioxidants, a class of chemicals that help mop up the free radicals that contribute to tissue damage after an athletic injury. Vitamin C is also critical for production of collagen, a major component of the musculoskeletal system. For sports injuries, try a daily dose of 800 to 3,000 milligrams of vitamin C and 200 to 1,000 IU of vitamin E. Because vitamin C is rapidly excreted, it's best to divide the total into 500-milligram doses and take it frequently.

DRUG TREATMENT

Analgesics
Aspirin, ibuprofen, ketoprofen (Orudis), paracetamol. Function: reduce pain and (except paracetamol) inflammation. Aspirin side effects: heartburn, indigestion, stomach irritation, mild nausea or vomiting. Ibuprofen and naproxen side effects: dizziness, nausea, stomach ache, headache; with continuous use, stomach lining irritation. Paracetamol side effects: with high dosage, liver damage, as evidenced by jaundice, nausea, vomiting and an all-over ill feeling.

HERBAL REMEDIES

Turmeric (Curcuma longa)
Long prized as an anti-inflammatory and antioxidant agent, turmeric is now turning up in research studies that examine the effect of its active ingredient curcumin. Experiments confirm that curcumin is a potent anti-inflammatory agent. In Ayurvedic medicine, turmeric is used both topically and internally for sprains and other musculoskeletal inflammations. Typical dosage: 400 to 600 milligrams three times per day. You'll see some products that include bromelain with turmeric for better absorption. You can boost absorption yourself by taking curcumin with a little fat, such as flaxseed oil, another good anti­
inflammatory. Caution: high doses of curcumin may irritate the lining of
the stomach and intestines. Do not take if you are pregnant or have ulcers, gastritis, gallstones or bile duct obstruction.

Ginger (Zingiber officinale)
This spice has anti-inflammatory, antioxidant and analgesic properties. Ginger inhibits the production of inflammatory chemicals called prostaglandins and leukotrienes. Meanwhile, the component 6-shogaol mildly reduces pain, probably by blocking the nerves' transmission of
pain signals. Typical dosage: up to eight 500-milligram capsules per day;
or 10 to 20 drops of tincture three times per day; or % to 1 teaspoon of dried ground root per day, or 10 grams fresh root (about a 6-millimetre slice) per day.

Kava-Kava (Piper methysticum)
This herb from the South Pacific has a long tradition of use in relieving pain and relaxing tight muscles. Typical dosage: up to six 500-milligram capsules per day, or 15 to 30 drops of tincture three times per day. Caution: avoid if you're pregnant or breastfeeding. Do not combine with alcohol or sedatives. Do not exceed the recommended dose.

Cayenne (Capsicum annuum)
Topical use of capsaicin, the active compound in cayenne, has been the focus of much pain research. When first applied to the skin, capsaicin activates pain nerves, then renders them unresponsive. Although this can relieve pain on the skin, it may not do much for deeper musculoskeletal pain. It does, however, increase local blood flow and produces a sensation of warmth. Taken internally, cayenne acts as an antioxidant and anti-inflammatory agent. Typical dosage: three 500-milligram capsules
a day; or 5 to 10 drops of tincture in water three times per day. Caution:
excessive doses may irritate a sensitive gastrointestinal tract.

Peppermint (Mentha x piperita)
The aromatic oil menthol in peppermint is a 'counterirritant', a substance that causes an irritation that blocks another irritation. Simply put, the cooling sensation of mint oil interferes with the sensation of pain. Many commercial and herbal liniments contain menthol. Look for them at your health food store or chemist, and apply them topically as the manufacturer directs. Caution: some people develop an allergic skin rash when they contact peppermint oil or pure menthol. Heat seems to aggravate possible skin reactions. Try a test patch before you apply a menthol-containing ointment generously. If you use peppermint essential oil for massage or in a warm bath, dilute it first - about 10 to 15 drops in 2 tablespoons of vegetable oil.

Boswellia (Boswellia serrata)
The gum resin extract of this tree has anti-inflammatory and analgesic properties. Commercial products are used in India for the treatment of arthritis and have become available in Europe. Because they are so new, little research has explored dosage. Follow the manufacturer's instructions.

Arnica (Arnica montana)
This lovely wildflower helps heal bruises and the swelling associated
with sprains. To use it externally as a compress, add I tablespoon of
tincture of arnica to 450 millilitres of water; soak a clean cloth and apply it to the strain or bruise. Several commercial creams, gels and ointments contain arnica either alone or in combination with other remedies. Apply these topically as the manufacturer recommends. Caution: arnica is also used internally in homoeopathic preparations for trauma, but the doses used are minuscule. Don't confuse homoeopathic use with taking the whole herb internally; the latter is not recommended. Also, do not apply arnica products to open wounds.

Comfrey (Symphytum officinale)
Applied externally, comfrey can relieve pain, swelling and inflammation. You can buy commercially made comfrey salve and ointments and apply them as needed. To make a poultice of the dried leaves, coarsely chop them, then dampen them with a little hot water. Allow to cool before applying to the painful area. Cover with gauze or clean cloth. Leave on for at least 15 minutes. Re-apply four times per day or as needed.

Horse Chestnut (Aesculus hippocastanum)
The bark, seeds and leaves of this tree have a long history of use as a remedy against bruises, sprains and swelling. Horse chestnut contains astringent tannins and the anti-inflammatory, compound aescin, which has been shown to slow the leakage of fluid from stressed or irritated blood vessels. (it's this 'leakage' that causes tissue swelling after an injury.) You can apply a gel containing horse chestnut extract; just follow the manufacturer's instructions.