In the previous article Ayurveda sports medicine was discussed, and, as promised in the previous article, today we will mainly focus on diagnosis and treatment modalities that are associated with a sportsperson. 
Sports injury is defined as damage to the tissues of the body that occurs due to a sports activity or an exercise. In order to diagnose the type and severity of the damage, modern technology and authentic Ayurveda diagnostic methods are used. In modern technology X-ray, CT scan, ultrasound, and MRI scans can be used. In Ayurveda, there are several diagnostic methods as well and they are the “Thrividha Pareeksha” (three-fold test), “Ashtavidha Pareeksha” (eight-fold test), and “Dashavidha Pareeksha” (10-fold test). By combining both techniques, sports injuries or tissue damage can be diagnosed accurately and this can lead to creating a personalised and successful treatment plan which will give maximum results. The common objective during management of sport injuries is to manage the pain, fix the dislocated part, rehabilitate the injury, ensure active mobilisation, passive mobilisation, strengthening, and also boosting the healing process. Ayurveda medications given internally and externally will help to achieve these objectives. The main aim of the internal medication is to alleviate pain and reduce the inflammation, to boost the tissue healing process and also to strengthen the injured area. Similarly, the aims of external treatment are to alleviate pain and inflammations and to improve functions while strengthening the damaged tissues.
The main focus in this article will be on external treatment modalities. Among various treatment modalities, “Snigdha” oiling, “Sweda” heat application along with “Alepa/Lepana/Upanaha” (application of medicated pastes with different thickness), and “Bandhana” (bandaging) are done. Out of these common treatment modalities, the appropriate ones are used according to the final diagnosis of the injury. “Bandana” is similar to general bandaging but oil application and medicated pastes can also be applied before bandaging – that is the uniqueness of Ayurveda bandage techniques. Authentic texts of Ayurveda have mentioned more than 15 types of “Vrana Bandana”.
Among the specific external treatments “Pichu” application is very basic and commonly seen. “Pichu” is a treatment that is practiced to relieve the stress and stiffness of the joint and the affected area. Cotton pads or linen pads are soaked in warm medicated oil that is prescribed and it is then gently placed on the damaged area in the body for a specific time period. This treatment will offer immediate relief from pain and discomfort. The warmth of the soaked pads seeps into the body and induces a deep sense of relief. Another commonly practiced treatment is oil pooling. It is known as “Vast/Basti”; the specific name changes according to the location of the body where it gets applied. For example, oil pooling on the back of the neck is called “Griva Vasti”, oil pooling in the lumbosacral region “Kati Vasti”, and oil pooling in the knee joint “Janu Vasti”. This time-honoured, intensive treatment is highly recommended for relieving fatigue in the injured joints. This treatment modality not only minimises the intensity of the pain and stiffness by pacifying “Vata Dosha” (body humour related to pain) but also improves the quality of life of the sportsperson.
The most commonly observed casualties that can be observed in all sports personnel are pain, stiffness, and tension that occur around the neck, shoulder, and back region. “Prishta Mardana” is a treatment that has been practiced to eliminate the stress and bring relief through neck, shoulder, and back massages with medicated oils. After this treatment, heat treatment or fomentation treatments are done and that is known as “Sewda Karma”. The fomentation is done using a variety of herbs that have high medicinal value. These herbs are packed in leaf bundles which are then steamed and used to apply warmth to the affected area. Other than these treatments, “Rasayana Karma” will help in rejuvenating the whole body as well as the damaged tissues by improving longevity, complexion, memory power, intelligence, voice, and physical functions.
The Ayurvedic approach towards sports medicine will not be limited to these external treatments. Since Ayurveda has a holistic approach, these treatments will help to enhance the quality of a sportsperson.
Compiled by Dr. Hiruni Poornima, BAMS (Hons) – University of Colombo; Msc in Food and Nutrition – University of Peradeniya (Reading), Diploma in Panchakarma
