British Homoeopathic Journal July 1992, Vol. 81, pp. 142-147

Homoeopathy in sports medicine STEVEN KAYNE, PHD, MBA, BSc, MRPHARMS, MCPP, DAG VET PHARM, MIPHARMM

"Abstract Having considered the advantages to the athlete of using hom0eopathy in sports medi- cine, some of the many opportunities to treat acute conditions are discussed. Examples of appropriate generic and OTC medicines are given.

It is concluded that hommopathy can be used successfully to complement, or in some cases to replace, existing techniques of treating sports-related conditions.

Hom~eopathy for athletes The use of hommopathic medicines in the treat- ment of sports-related injuries and illnesses has a number of important advantages over conven- tional preparations. They are effective, quick acting, and cheap, and they do not interfere with any subsequent therapy. Because there is no unfair competitive advantage to be gained from taking homceopathic medicines and they are totally safe, the medicines are not subject to any controls by the International Olympic Commit- tee. It has been suggested that sports medicine may be the source for a large increase in demand for homoeopathy in the future. 1

Sports medicine is 'the medical and para- medical supervision of athletes, and the treat- ment of their injuries and illnesses whether sustained in training or competition, to facilitate a return to the competitive environment. 2 The pressure to overcome injuries as quickly as poss- ible is intense in professional sport, where com- mercial considerations are extremely important. The temptation to return before complete recov- ery is difficult to resist.

At first sight, the special nature of hom0eo- pathic prescribing would seem to preclude the use of hom0eopathic preparations in acute first aid situations. In fact, it is possible to transfer the discipline into the sports arena with great suc- cess, using polychrests, or a ' three legged stool' approach to repertorization. There are also a large number of over-the-counter (OTC) prod- ucts available. In more chronic situations, how-

ever, classical techniques can still be applied.

The source of injury and illness in sport Sports persons are like any other patient, suf- fering from the usual range of common condi- tions, but because of participation in sport, they are subject to a greater risk of injury and illness in some circumstances. Many causes of sporting accidents are quite specific and can be avoided) --Insuff ic ient preparation, including faulty

techniques, insufficient warming up and poor coordination

- - B r e a c h of rules: unfair or deliberately over exuberant activities

- - Overtiredness and fatigue due to incomplete training

- - R i s k s from especially dangerous sports, e.g. ocular trauma in boxing

- - Exaggerated or inappropriate ambition. Sports injuries fall into three categories.

Acute traumatic injuries due to collisions with people or equipment, overuse injuries and environmental injuries. Overuse injuries are caused not only by training errors or inadequate equipment, but also by actions stemming from mental attitudes, including pushing oneself to the limit by excessive competition. F m example, professional and amateur golfers who practise several hours a day exert tremendous twisting action on the tibia, the risk of stress fracture being even higher if the player is overweight. Environmental injuries include heat exhaustion

142

Volume 81, Number 3, July 1992 143

field, through personal contact, droplet spread or fungal and viral infection in the warm, damp changing room. Although homceopathic prep- arations are effective in treating all these condi- tions, they may not provide the complete answer alone, and should be used to complement other methods of rehabilitation whenever appropriate.

Common sports injuries and treatment Abrasions and wounds Cuts and abrasions should be cleaned using run- ning water and a solution of Calendula tincture applied. The latter must be diluted with water to prevent stinging, and used to soak a sterile dress- ing. This can then be used to cover the wound to check bleeding and inhibit sepsis. Calendula cream, ointment, or lotion can be applied if the skin is not broken and promotes rapid healing. The preparation may also be given orally three times daily for 3-4 days as necessary. Calendula dressings are said to have been used in the American Civil War by a number of surgeons who warmly recommended their use. 4 The 'blood and crush' medicine, Hypericum, soothes painful lacerations, especially in areas rich in nerve endings. It may be used orally or as a top- ical preparation, and the injured part should be rested and elevated. Hypericum and Calendula may be mixed to produce a particularly useful treatment for superficial cuts and abrasions. Hepar sulph, or Sulphur are appropriate if the wound becomes infected, and Staphysagria should be considered for deep lacerations.

The most serious risk for infection of a wound is from contracting tetanus, which is readily pre- ventable by immunization. Leclum is also said to prevent the disease if given early enough. 4 This medicine is indicated for painful puncture wounds, caused for example by spiked running shoes or insect bites, and it may be administered half hourly for the first six doses. It is especially effective if pain in the injured part is alleviated by cold.

When a player has received a severe blow resulting in great contusion, laceration and dis- placement or fragmentation of teeth, Arnica should be administered without delay. 5

Blisters Blisters caused by footwear (walking boots or training shoes) or by equipment friction (tennis racquets or golf clubs) are a nuisance, especially at the start of the season when the equipment is new, and skin is soft. Calendula or Hypericum

may be applied locally, and Causticum given orally twice daily if they are burning. The blisters should be covered with a non-adhesive sterile dressing with padding, if appropriate. Blisters caused by burns respond to Cantharis and Urtica.

Eye injuries Providing the pain is relieved by cold appli- cations, Ledum, given two to four hourly, is almost specific for a black eye. If there is no relief from cold applications, then Staphysagria should be given. Arnica and Symphytum are also appropriate remedies.

Fractures Arnica may be given immediately to allay shock and reduce traumaJ '6 The principal feature rela- ting to Arnica is the sensation of soreness; this often makes the patient irritable, restless and even morose, because the pressure of sitting or lying causes pain and necessitates a change of position. 7 Symphytum is given once the fracture has been reset, and it may act deeply on the peri- osteum, perhaps even assisting in the formation of new bone and cartilage; it has never been proved, s Calc. phos. is also commonly used for fractures.

Muscle, tendon and ligament injuries A 'pulled muscle' involves tearing of muscle fibres and commonly affects hamstrings at the rear of the thigh. A 'dead leg' results from tear- ing of many muscle fibres in the area to the front of the thigh following a direct blow. There are also 'strains' with pain, but without impaired movement, and 'sprains', a more serious con- dition involving pain and damaged ligaments. A frequent injury concerns rupture or inflam- mation of the achilles tendon, and this can require surgery or immobilization and 6-12 months lay-off. Arnica should always be used first in any soft tissue injury, and this may be sup- plemented by Rhus tox. where there is tendinitis or stiffness that feels better for warmth and movement. Ruta is often given after Rhus tox. or Arnica, but may also be used on its own for strained muscles.

Topical homoeopathic preparations (Arnica or Rhus tox.) can be used either by simple direct application, by direct application with occlusive dressings, or in combination with physical ther- apy including massage and ultrasound. 9 There is also an OTC massage balm available {Weleda (UK) Limited, Ilkeston).

144 British Hom~eopathic Journal

apy including massage and ultrasound. 9 There is also an OTC massage balm available (Weleda (UK) Limited, Ilkeston).

The use of injected homceopathic prep- arations such as Rhus tox. has been reported in the USA for foot problems involving consider- able stiffness in the morning. TM

'Tennis elbow' refers to a painful condition involving the detachment of muscular and tend- inous fibres; 'golf elbow' is a similar type of injury. Both respond to Argent met. twice daily for ten days. Ruta may also help. 'Runners ' knee' is a frequent complaint of joggers, and may be treated with a variety of preparations including Arnica, Rhus tox., Rhododendron and Ruta in turn, according to the severity of the con- dition. Apis has also been suggested as a possible treatment where oedema and infammation are involved, 11 and Bryonia if the knee is red and inflamed, worse with motion, but better with rest, cool, and pressure. 12

Low back pain or lumbago is a problem with windsurfers and weightlifters. Rhus tox. and Ruta taken together are often successful.

In the period following strenuous exercise there is gradual development of soreness, accompanied by a perception of stiffness in the sore muscles which reaches a peak 24-48 hours later and is often referred to as 'delayed onset muscle soreness' or 'DOMS' . Arnica, taken by mouth, is extremely effective in dealing with this condition; the practice of putting Arnica mother tincture in the bathwater is probably effective by placebo response. Old strains, associated with intermittent pains and swellings, can be helped by Strontium carb., night and morning for a week or two. ~3

A new OTC product 'Sport Relief' has recently been released in New Zealand (Naturo Pharm Limited, Rotorua) and claims to give relief from pain and aching joints following sports activity. The product 'Sportenine' (Boi- ron-LHF, Sainte-Foy-les-Lyon) has been used as tablets or in effervescent powder form by French national sports teams to aid recovery after sports exertion and comprises arnica, a zinc salt, dex- trose, lactose and a lemon flavouring agent. It is not licensed for sale in the UK.

Pain, bruising and swelling Pain due to physical shock is relieved rapidly by Arnica. It has been stated that the 10M potency should be preferred to the more usual 30c potency. 14 Even in concussion, or if the patient is unconscious, the medicament may be placed on

the tongue in granule or liquid form, and will serve to give rapid relief while not interfering with any subsequent treatment in hospital. Arnica can be used topically as an ointment or lotion, and also internally, being administered every 15 minutes for 6 doses, and then 3--4 times daily as required.

In the event of a patient not responding to Arnica there are a number of other possibilities. Acid sulph., where the skin is 'angry' and the bruise black and blue, and Bell&, where a deep intense pain is present and the injury is sensitive to touch, and worse with cold. This medicine is said to be almost specific for cases where women have been bruised on the breast. 15 Hypericum is also available.

Hamamelis is often prescribed in cases of injury to soft tissues especially if the injury is in the thigh or larger muscles, when inflammation of the veins or low grade phlebitis may be present. 16

There is a German product Traumeel (Heel Gmbh, Baden-Baden) that can be applied with gentle massage. It is also available as drops for internal use, and comprises fourteen different homeeopathic medicines mostly in lx and 3x potencies. It is reported to be efficient in the temporary relief of pain, discomfort and inflam- mation. 17 The product has been the subject of an impressive number of clinical trials, 3 and is one of a number of complex OTC products marketed by the company to treat sports injuries in Europe (excluding the UK), and the US.

Common sports illnesses and treatment

Conditions contracted during sports activity Scrumpox in rugby is commonly caused by the virus Herpes simplex. It is highly infectious, spreading by direct con- tact, via clothing and towels or by droplet spread. Impetigo and erysipelas are also blamed for this condition. Rhus tox. or Apis might be appropriate in the latter cases, while for the former, there is a nosode available.

Water related conditions Swimmers are susceptible to a number of ill- nesses including eye conditions that may respond to Calendula or Euphrasia eyedrops (Weleda (UK) Limited, Ilkeston). Gastro- intestinal diseases may be treated with Nux yore., Arsen. alb. or the OTC Melissa comp. (Weleda (UK) Limited, Ilkeston). Jelly fish stings respond to Ledum.

Volume 81, Number 3, July 1992 145

Effects of climate. In hot weather, the possibility of heat exhaustion must be considered. Together with the normal first aid activities (lying the patient down in the cool, giving plenty of fluids etc), either Natrum carb. (patient quiet, thirsty and sensitive to noise), Glonoin (better from uncovering the head, throbbing headache and no thirst) or Bell- adonna (red hot swollen face, sudden onset of headache) should be administered. Sunburn can be treated topically in golfers or cricketers with Cantharis. The remedy Sol is effective in preven- ting fierce reactions to the sun's rays.

Chilblains are best treated topically with Tamus ointment; if they should become broken and septic, Petroleum by mouth is an appro- priate treatment. Frostbite medicines include Agaricus, Apis and Laches&.ls

Insect bites respond quickly to Apis (bee stings) or Ledum (if the skin is punctured). Pyrethrum spray (A. Nelson & Co., London), a mixture of seven hom~eopathic tinctures, can be applied topically.

Conditions contracted in the changing room Coughs, colds, sore throats and influenza Person-to-person spread of these conditions through infected droplets is common. They may be treated by OTC preparations such as Bryonia linctus (A Nelson & Co, London), Infludo (Weleda (UK) Limited, Ilkeston) or a Combi- nation Remedy (New Era Laboratories, Hull). Generic medicines like Gelsemium, Aconite or the combination AGE (Arsen iod., Gelsemium and Eupatorium) are available to treat colds, while depending on the type of cough, Bryonia, Phosphorus. Antim. tart. and others are appro- priate. Belladonna is a high potency clears a sore throat quickly.

Fungal infections The most commonly occurring fungal infection is athletes' foot (tinea pedis). Presentation is usually as flaking skin between the toes. A red, itchy or sore area is left as the scales peel off, and the lesion can then become soggy, spreading to the whole foot. Generally this and other similar ringworm infections, including tinea cruris ( 'Jock itch'), are self limiting, but athletes are unwilling to allow these conditions to linger on untreated for weeks or months. Old fashioned remedies like Whitfield's ointment and potas- sium permanganate are still available, and these

may be augmented with hom0eopathic medi- cines such as Sepia, Tellurium, Sulphur or Rhus tox. as appropriate. 19

Verrucae Plantar warts are caused by a virus that pen- etrates moist skin. They are most commonly found on the soles of the feet, having been caught from others by walking barefoot across the floor of a changing room or showers. Acid nitric, is used orally; Thuja is also a possibility for both warts and verrucae, topically as mother tincture or orally in potency.

Other conditions Allergies Exercise-induced asthma can be provoked by inhaling irritant substances, sometimes in very small quantities. Irritation of the nose provokes rhinitis, while irritation of the bronchi leads to difficulties in breathing, especially on exhala- tion. Running in cold atmospheres is most likely to cause an attack. Pure allergic asthma due to a hypersensitivity reaction is seen most often in children and may be due to pollen or grass sensi- tivity. Homceopathic medicines are particularly appropriate to treat allergies because of the absence of any drowsiness. The condition may be treated classically with Euphrasia. Allium cepa or Sanguinaria, or it may be treated iso- pathically with a homoeopathic dilution of the offending allergen. There are also OTC hay- fever remedies (A Nelson & Co, London; New Era Laboratories, Hull).

A new homceopathic ointment has been pro- duced in the Netherlands, containing 10% Card- iospermum mother tincture (VSM, Alkmaar) , and this might offer a new approach for a variety of allergic skin reactions in the future. 2~

Anxiety and stress This is another area in which hom0eopathy is useful. Anxiety and excitement can affect per- formance in competitive sport; in-such circum- stances Argent. nit. or Aconite is effective. Two doses of Gelsemium have also been suggested to relieve anxiety before a boxing ma tch / ' Rescue remedy (Bach Centre, Wallingford) is a mixture of five Bach flower remedies, and can be used to alleviate anxiety, especially following injury. Naturo Pharm have a 'stress relief' product in New Zealand (Naturo Pharm Limited, Rotorua).

Insomnia Due to excitement will respond to Passiflora or Coffea. If the celebration after a big win has

146 British Homceopathic Journal

involved too much beer and curry Nux vomica might help to induce sleep!

There is also the OTC product 'Noctura' (A Nelson & Co, London).

Diarrhwa Diarrhoea may be brought on by sudden changes in eating habits, by anxiety or stress or through irritable bowel syndrome. Oral rehydration therapy, and dosing with Arsen. alb. should cure the problem. There are a number of other anti- diarrhoeals including Podophyllum, Verat. alb. and Croton tig., but these drug pictures are less frequently indicated in sports persons.

Headaches In some sports where intense concentration is necessary, headaches may be triggered by visual problems, but occasional tension headaches respond well to homoeopathic medicines. Igna- tia, Glonoin and Belladonna are the most useful for this condition.

Motion sickness Sports persons who suffer from motion sickness need to be careful that they do not use conven- tional OTC medicines containing IOC banned substances. Cocculus is an effective treatment for nausea and vertigo; Tabacum is indicated if the patient breaks out into a 'cold sweat'.

Post infection debility This condition can follow certain virus infec- tions, and the Coxsackie group of enteroviruses can have long-term effects on muscle and nerve tissue. Many prescribers have their own methods of dealing with ME ~2 but there are Cox- sackie B homoeopathic nosodes available.

Performance enhancing homoeopathic preparations There is a remarkable report of the remedy Arsenic being administered to the members of a boxing team in the Indian Military Academy with apparent success, two remarkable wins having been recorded subsequently. 23 Tissue salts and trace elements have also been given to players routinely. In order to accelerate the oxi- dation rate within cells, important to facilitate the release of energy, it has been suggested that the remedies Vanadium and Ferrum met. should also be used, together with Cobalt to improve n e r v o u s r e f l e x e s .

It would be interesting to pursue this work further.

The future for hom~eopathy in sports medicine This review is meant to demonstrate the appli- cation of hom0eopathy in the treatment of a large number of sports-related conditions. The list is not exhaustive by any means, being merely an indication of the many opportunities available. Sports persons are, for the most part, specialists. Their treatment cannot be a standardized pro- gramme; it depends on the unique character- istics of each athlete and his or her chosen sport, and is not complete until a return to the competi- tive environment has been achieved. Homoeo- pathy is all about treating individuals', and together with the advantages already identified, its holistic nature means that it is ideally placed to complement, and perhaps even replace, exist- ing patterns of treating athletes. Note: The choice of potency has been left to the discretion of the reader, as views on low and high potency prescribing vary.

References 1 KayneSB. Homoeopathy--DemandandScepticism. Phar-

maceutical Journal 1991; 247: 602-4. 2 Kayne SB. An introduction to sports medicine--part 1.

Pharmaceutical Journal (in print). 3 Stock W. Latest Clinical Results with Traumeel ointment

in sports injuries. Biological Therapy 1988; 6: 73~8 . 4 Shepherd D. Homceopathy for the First Aider p. 13. Safron

Walden, Essex: The CW Daniel Company Limited, 1986. 5 de Beaux J. Experience with arnica in a fracture clinic.

Midlands Homoeopathic Research Group Communications 1984; 11: 5%66.

6 A double blind trial of Arnica. British Homoeopathic Research Group Communication 1991; 21: 34-38.

7 MclvorEG. Arnicamontana . A clinical trial following sur- gery or trauma. Journal of the American Institute of Homceopathy 1973; 66: 81-84.

8 Leafy B. Letters to the Editor. British Hom~eopathic Journal 1986; 1 :54

9 Subotnick S, Sisney R Treatment of achilles tendinopathy in the athlete. Journal American Podiatric Association 1986; 67: 552-557.

10 Subotnick S. lnjectible biologics for treatment of podiatric problems. Biological Therapy 1990; 8: 39-40.

11 Ullman D. Homceopathy: Medicine for the 2lst century p.178. Berkeley, Ca: North Atlantic Books, 1988.

12 Subotnick S. Sports and exercise injuries p.245. Berkeley, Ca; North Atlantic Books, 1991.

13 Speight LJ. Sports injuries: their treatment by homoeopathy and acupressure, p.21. Safron Walden, Essex: The CW Daniel Company Limited, 1989.

14 Campbell A. Two pilot controlled trials of arnica montana. British Homoeopathic Journal 1976; 65: 154-8.

15 Homoeopathic injury remedies. (Discussion report). British Homceopathic Journal 1959; 48: 283.

Volume 81, Number 3, July 1992 147

16 Trexler HL. Five important drugs in industrial medicine. Journal o f the American Institute of Homceopathy 1966; 59: 244- 5.

17 Casper J, Foerstel G. Traumeel in traumatic soft tissue swelling. Biological Therapy 1986; 4: 17-20.

18 Lockie A. The Family guide to homeeopathy pp. 99-100. London: Penguin Books, 1989.

19 Morgan LM. Treating sports injuries the natural way, pp. 92-94. Wellingborough, Northants: Thorsons Publishers

Limited,. 1990. 20 The Homceopathy International Research and Develop-

ment Newsletter 1990; 1(3): 2. 21 Schmidt R Athletic injuries. Hahnemanian Homceopathic

Sandesh 1988; 12: 115-23. 22 Allen J. Myalgic Encephalomyelitis. Homoeopathy 1992;

42: 152-154. 23 Negi RS. Homceopathy in sports medicine. The Hahne-

mann Gleanings 1985; 52: 244-8.

Address for correspondence Dr Steven Kayne 79 Milverton Road White Craigs Giffnock Glasgow G46 7LQ