First Aid and Rehabilitation

First Aid and Rehabilitation play a crucial role in the field of Sports and Yoga, helping individuals recover safely from injuries and return to their routine activities. In both sports and yoga practices, understanding basic first aid and proper rehabilitation techniques ensures long-term physical well-being and enhanced performance.

Previous Years Questions

Year	Question	Marks
2023	Define and write the difference between sprain and strain.	2M
2021	What is rehabilitation in sports? Define TENS therapy.	5M
2018	Write a note about “Green Stick Fracture”.	2M

First Aid

“First aid is the medical assistance provided to an injured person at the accident site before the arrival of a doctor.”

First aid is the provision of initial care for an illness or injury, usually performed by a non-expert person to a sick or injured person until appropriate medical treatment can be accessed.It generally consists of a series of simple and in some cases, potentially life-saving techniques that an individual can be trained to perform with minimal equipment.

The basic objectives of First Aid are:

1. To provide immediate assistance to the injured person:- 
   • While the actual medical treatment of the injured person is done by a doctor, the first objective of first aid is to ensure the safety of the injured person using the available means, to minimize the severity of the situation until the doctor arrives.
2. To save life:-
   • The second major objective of first aid is to save the life of the injured person. For this, the first aider needs to use their judgment and wisdom. They should take all possible actions and measures to preserve life until medical help arrives.
3. To prevent the severity of the accident from increasing and to instill self-confidence in the injured person:-
   • The person administering first aid is not a doctor. This medical assistance is provided only for the period until professional medical help is available. The purpose of first aid is to provide immediate treatment using available resources during emergencies, in order to stabilize the injured person.
4. To give immediate care.
5. To protect the casualty from further harm.
6. To relieve pain.
7. To promote recovery.
8. To ensure that he/she reaches the hospital safely, if the injury is serious.

First Aid Box

First Aid Items and Their Uses

Item	Use
Pain Relief Tablets	For headaches, stomach pain, fever, cold, cough, vomiting, diarrhea, and dizziness caused by cold.
Amrit Dhara	–
Pachanoul	For indigestion and stomach pain.
Glucose	For dizziness, weakness, and to provide energy.
Boro Line & Acid Ointment	For applying on wounds.
Burnol, Coconut Olive Oil	For applying on burned skin.
Glycerin	For mouth ulcers.
Alum	For stopping bleeding from wounds.
Spirit, Boric Powder, Tincture	To disinfect tools and wounds.
Iodex	For gentle massage on non-wounded areas.
Laquila & Itan	For eye infections.
Cotton Bundle	For various types of sterilized cotton use.
Nail Cutter, Razor with Blade	For cutting nails and hair.
Pieces of Wood	For bandaging in case of bone fractures.
Cotton Thread	For bandaging and cleaning wounds.
Matchsticks	For lighting a candle or gas.
Spoon or Glass	For giving water or medicine.
Other Medicines	Paracetamol, Quinine, Saridon, Boric Acid, Eye Drops, Pudina Hara, Soda Mint, Codeine, Betadine, Rose Water, Aspro, Navalgine, Sofromycin, Nivasal Powder, etc., should be kept in the box.

First Aider

In reality, humans are social beings, and as an act of humanity, the person present at the accident site is the one who can provide timely assistance to the injured person as soon as an accident occurs. In this way, every individual can play the role of a first aider.

Qualities of a First Aider

To successfully perform first aid, the following essential qualities are required, allowing the first aider to effectively fulfill their responsibilities:

1. Good Health and Strong Heart – A first aider must be in good health and possess physical strength to provide assistance effectively during emergencies and manage the injured person with care.
2. Complete Knowledge of First Aid – A first aider should have a thorough understanding of first aid techniques, so they can provide appropriate treatment based on the condition of the injured person in emergency situations.
3. Availability of Resources – A first aider should have access to the necessary resources and equipment, ensuring they can deliver proper care using the available tools and supplies in emergencies.
4. Awareness and Foresight –  A first aider must have good judgment and foresight to anticipate potential complications and take timely decisions to prevent worsening conditions for the injured person.
5. Ability to Make Quick Decisions – A first aider should be capable of making quick decisions in critical situations, which helps to manage the injury effectively before medical help arrives.
6. Discretion – A first aider should be discreet and use their judgment to take appropriate action at the right time, avoiding further complications or harm to the injured person.
7. Clever and Skilled – A first aider must be careful and skilled in performing tasks, ensuring that treatment is administered swiftly and effectively without wasting time.
8. Patience and Optimism – A first aider should be patient and optimistic, staying calm under pressure, reassuring the injured person, and maintaining composure during emergencies.
9. Self-confidence – A first aider should be self-confident, making them capable of taking immediate action without hesitation in high-pressure situations.
10. Knowledge of Local Language – A first aider should have knowledge of the local language so that they can communicate effectively with the injured person, understand their condition, and provide timely assistance.

Principles of First Aid

Immediate Action

• The first aider should create an action plan quickly.
• Stay calm, act quietly, and avoid panic to handle the situation efficiently.

Calling for Medical Assistance

• Inform the nearest medical unit using the fastest communication method available.
• Ensure the patient is transferred to an ambulance or moved away from the site of injury or illness safely.

Medical Alert Devices

• Individuals with chronic conditions may have medical alert devices that contain their medical history and emergency contact information.
• First aiders should check for these devices to provide better assistance.

Reassurance and Mental Health

• Reassuring the patient is just as important as physical treatment.
• Some individuals may go into shock, worsening the situation.
• First aiders should calm them down to reduce stress and tension.

Response to an Emergency

• People react to emergencies in different ways, such as crying, fear, or anxiety.
• These reactions may last for weeks, but a positive approach from the first aider can help the patient cope with the situation.

First Aid and Precautions

In our daily lives, unexpected incidents frequently occur. In such situations, a doctor needs to be called. However, until the doctor arrives, the injured person is given immediate treatment, and even after the doctor’s consultation, special care must be taken for the patient.

1. Pulse Rate Testing:

The pulse rate helps in determining the state of the heart’s function. The pulse can be measured at several points, but the most appropriate place is the front part of the wrist, where two fingers should be placed in the direction of the thumb. A normal pulse rate is 72 to 80 beats per minute. To check the pulse rate accurately, it should be counted every 15 minutes. If the same number appears each time, the pulse is steady and consistent; otherwise, it is unstable and uncertain.

2.Taking the Patient’s Temperature:

The temperature of the patient should be checked regularly, and the date and time of the readings should be recorded. The temperature should be taken using a thermometer. The thermometer should be placed under the patient’s tongue for 2-3 minutes, then removed to read the temperature. A normal healthy person’s temperature is generally 98.4°F (37°C). For small children, the thermometer should not be placed in the mouth but rather in the armpit or thigh.

3.Observing the Breathing Process:

The breathing rate of the patient should be observed. To determine the breathing rate, place a hand on the chest or abdomen and count the breaths per minute. Generally, the breathing rate is between 15 and 20 breaths per minute. Any irregularities in the breathing rate should be addressed promptly with medical intervention.

4. Urination and Defecation:

Patients who cannot go to the toilet should be assisted with urination and defecation in a bedpan. Before doing this, a rubber sheet should be placed on the bed to prevent any splashes. After defecation, the anal area should be cleaned with plain water, toilet paper, or wet cotton. If the patient is able to go to the toilet, they should be assisted carefully. In the toilet water, adding disinfectant like Dettol is helpful. The patient’s hands should be washed with antiseptic soap.

5. Bathing the Patient:

The patient should be bathed with warm water. If the patient is unable to bathe fully, a damp towel should be used to wipe down their body. Windows in the room should be closed during the bath to avoid the patient getting cold.

6. Cleaning the Teeth, Tongue, and Mouth:

The patient’s teeth and tongue should be cleaned regularly. If the patient is able to sit, a pillow should be placed behind them, and their teeth and tongue should be cleaned, followed by a mouth rinse. The rinse should always be with an antiseptic solution. A good mouth rinse should be given before the patient sleeps at night

7. Giving Medicine to the Patient:

The patient should be given medicine on time and with caution. A slight carelessness can lead to severe consequences. The medication should always be given according to the doctor’s instructions, including the correct time, dose, and method of administration.

Sports Injuries

SKIN INJURIES 

Laceration :

• Deep tears or cuts in the skin caused by sharp objects like cleats, equipment, or glass.
• May result in bleeding and require stitches if severe.

Punctures: 

• Small but deep wounds caused by pointed objects like nails or spikes.
• Risk of infection is high, often requiring tetanus shots.

Avulsions

• A portion of the skin or soft tissue is torn away, often exposing underlying layers.
• May require surgical intervention to repair.

Strain :

• Overstretching and tearing of muscle units is known as strain, when a muscle or tendon is stretched beyond its normal range, resulting in a tear or damage to the tissue. 
• Symptoms include localized inflammation, severe pain etc. 
  1. Grade I: Mild – slightly pulled 
  2. Grade II: Moderate- Tear of fibre 
  3. Grade III: Sever – Rupture of muscle. 

Sprain:

Overstretching and tearing of ligaments is known as sprain. Symptoms include Pain, Tenderness, Loss of Function.

Falling, twisting or getting hit > can cause ligaments around the joint to tear.

1. Grade I: Stretching or minor tear of one or more ligaments 
2. Grade II: Partial tearing resulting in weakness or some loss of function 
3. Grade III: Extensive tearing or complete rupture of ligaments generally require surgery.

BLEEDING 

1. General Bleeding:

Bleeding can occur due to accidents such as sudden collisions or falls. Upon bleeding, the blood clots once it is exposed to air. After the clotting, it should not be disturbed, and cold water or ice should be applied to the injured area. The opposite blood vessel should be pressed to stop the bleeding, and a bandage should be applied securely to the affected area.

2. Arterial Bleeding:

Arterial bleeding occurs when an artery is cut, and blood exits in bright red spurts. If the artery is close to the heart, the blood flows out with each heartbeat. The key features of arterial bleeding are:

• Bright red, pure blood.
• The flow is pulsating in rhythm with the heartbeats.
• Treatment:
  • Lie down the patient: This reduces the blood flow as compared to sitting.
  • Elevate the affected limb to reduce blood flow.
  • Apply pressure on the wound: A cloth should be tightly applied over the wound. If this doesn’t stop the bleeding, pressure should be applied to the nearest point of the artery (near the heart).
  • Use a tourniquet on the pressure point,towards the direction of heart ( blood flow).
  • Apply tincture of iodine or ferric chloride solution to the wound to prevent infection.
  • Antiseptic solution should be sprayed on the wound and surrounding skin, and a tetanus shot should be administered.
  • If any foreign object is stuck in the wound, it should be removed carefully.
    

3. Venous Bleeding (Vein Bleeding):

In venous bleeding, the blood is darker and flows slowly in a continuous stream from the veins. It is relatively less dangerous than arterial bleeding but still requires immediate attention.

• Treatment:
  • Dress the wound with a cloth soaked in antiseptic solution or a disinfectant.
  • Apply a tourniquet above the injury, opposite to the direction of the heart (reduce blood flow).
  • Press the wound with your thumb and cover it with a thick cotton pad to stop bleeding.
  • Apply a tincture of iodine, sulfadiazine, or mercury cream and secure with a bandage.

4. Capillary Bleeding:

This is the most common and mild type of bleeding, where blood flows slowly and is a mix of both clean and impure blood. The color of the blood is typically bright red.

• Treatment:
  • Remove any foreign objects from the wound and clean it thoroughly.
  • Press the bleeding site firmly with a clean cloth. A wet cloth can be used to bind the wound tightly to stop the blood flow.

5. Nosebleeds (Epistaxis):

Nosebleeds often occur due to excessive heat or collisions, especially in sports. The delicate lining inside the nose can rupture, causing bleeding.

• Treatment:
  • Seat the patient with their head slightly tilted backward. Keep the patient in front of an open window or fresh air and lift their head.
  • Soak a cloth in cold water and place it on the back of the neck, face, or forehead.
  • Loosen the clothing around the neck and chest to promote proper airflow.
  • Soak the feet in warm water to help stop the bleeding.
  • Avoid vigorous nose blowing and encourage the patient to breathe through their mouth.
  • Clean the nose with a solution of alum in ice-cold water.
  • Seek immediate medical assistance.
  • Pack the nose with cotton or gauze to stop the bleeding.
  • Do not give the patient any hot drinks.
  • A hydrogen peroxide solution or yellow clay soaked in water can be given for inhalation.

Bone Injury

Fracture:

It is a complete or incomplete break in a bone or discontinuation of bone resulting from the application of excessive force 

• Close Fracture: A closed fracture is when the bone breaks but there is no puncture or open wound in the skin 
  • Transverse Fracture: Broken at right angle to long axis of bone. Transverse fractures of long bones are usually the result of direct impacts, and thus are more common in older children after sports injuries.
  • Oblique Fracture: A fracture in which the line of break runs in oblique direction to long axis confined to one plane. It is a slanted fracture of the shaft along the bone’s long axis.
  • Spiral Fracture: Occur when one end of an extremity is fixed (e.g., a foot is planted on the floor) but the rest of the extremity remains in motion.
  • Comminuted Fracture: A fracture in which the bone has broken or fragmented into several pieces. It happens mostly due to a crush.
  • Impact Fracture: An impacted fracture is one whose ends are driven into each other. This is commonly seen in arm fractures in children and is sometimes known as a buckle fracture
  • GreenStick Fracture: An incomplete fracture, that occurs most often in children, in which the bone bends and partially breaks.
• Open Fracture: An open fracture is one in which the bone breaks through the skin. 
  • Compound Fracture: is an injury that occurs when there is a break in the skin around a broken bone. In order for an injury to be classified as a compound fracture, the outside air (and dirt and bacteria) must be able to get to the fracture site without a barrier of skin or soft-tissue. Therefore, a bone does not need to be through the skin in order for the injury to be called a compound fracture.

JOINT INJURY 

Dislocation: “Dislocation is the displacement of contiguous surfaces of two or more bones which are in a joint.”

When bones shift their place from normal position, they do not meet properly at the joint is known as dislocation. It can be divided into two types : 

• Subluxation: There is partial dislocation in joints where slight displacement of bones takes place. 
• Luxation: There is complete dislocation where bones completely separate from each other

Dislocation of joints can occur in contact sports such as football and hockey and in sports that may involve falls such as downhill skiing, wrestling, gymnastics and volleyball.  

• The players of basketball and football usually face dislocations of joints in their fingers and hands by striking the ball, ground or another player.  
• A hard blow to a joint, a fall, a forceful throwing, lifting or hitting may cause dislocation.  
• In fact, it is a dislocation of the surfaces of bones. There are the following types of dislocations. 
  • Dislocation of Lower Jaw 
  • Dislocation of Shoulder Joint 
  • Dislocation of Hip Joint  
  • Dislocation of Wrist 

Common causes of injuries

There are a number of common risk factors that can lead to Athletic injuries.

1. Improper Conditioning  
2. Improper Warming-up  
3. Unscientific Way of Training   
4. Lack of Fitness  
5. Nutritional Inadequacy  
6. Lack of Sports Facilities  
7. Injudicious Officiating  
8. No Use of Protective Equipment  
9. Practice during the Stage of Fatigue  
10. Pressure of Competition  
11. Carelessness during the Games  
12. Recurrence of Injury  
13. Improper Sports Equipment  
14. Overuse of Muscles

Prevention Of Sports Injuries

Basic Physical Fitness

• General fitness is crucial before engaging in physical activity.
• Strong bones and muscles help in performing activities effectively.
• Proper fitness prevents fatigue and injuries.

Equipment

• Choose equipment that meets the demands of the sport.
• Double-check safety and technical equipment for quality.
• Comfortable and appropriate equipment is essential for both leisure and performance.

Health

• Avoid physical activity after suffering from illness (e.g., infection or cold).
• Post-illness, the body is weaker and responds slower, increasing the risk of injury.

Warming Up and Cooling Down

• Warming Up:
  • Prepares the body by increasing temperature and muscle mobility.
  • mproves mental preparedness for the activity.
• Cooling Down:
  • Lowers body temperature after activity.
  • Stretches muscles to prevent injuries.

Systematic and Scientific Training

• Follow a structured and scientific training schedule.
• The training plan should be designed by a qualified expert.
• Unscientific training increases the risk of injury.

Safety Measures

• Carefully check all protective gear before use.
• Ensure the playing surface and equipment are safe.
• Follow rules and regulations to minimize risks.
• Keep first aid available for emergencies.

Psychological Considerations

• Before the activity:
  • Mental readiness and alertness are necessary.
  • Confidence and focus help in preventing injuries.
• After the activity:
  • Address psychological factors like memory and recovery.
  • Helps in maintaining mental well-being and injury prevention.

Tips for Preventing Sports Injuries

1. Avoid training when you are tired. 
2. Increase your consumption of carbohydrates during periods of heavy training. 
3. Increase in training should be matched with increase in resting. 
4. Any increase in training load should be preceded by enough strengthening  
5. Treat minor injuries very carefully.
6. STOP your training session immediately, if in pain. 
7. Pay attention to hydration and nutrition. 
8. Use appropriate training surfaces. 
9. Equipment should be appropriate and safe to use.
10. Introduce new activities gradually. 
11. Allow a lot of time for warming-up and cooling-off. 
12. Check over training and competition courses beforehand. 
13. Be extremely fussy about hygiene in hot weather. 
14. Monitor daily for signs of fatigue, if in doubt, ease off.

Techniques For Preventing Sports Injuries

PRICE Treatment 

stands for:

• P-Protect the wound 
• R-Rest-No more movement 
• I-Ice-To stop the bleeding 
• C-Compression – To stop bleeding 
• E-Elevation – Heart level 

MICE Treatment 

stands for :

• M – Mobilization 
• I – ICE 
• C – Compression 
• E – Elevation 

REST Therapy 

stands for :

• R – Rest 
• E – Elevate 
• S – Support 
• T – Tight 

RICER 

RICER is used to manage soft tissue injury to reduce scarring and pain for faster recovery. This is a technique to be used as a first aid technique immediately after an injury occurs. It stands for:

• R – Rest
• I – Ice
• C – Compression
• E – Elevation
• R– Referral

TOTAPS 

It is helpful in assessing all non-serious injuries. It stands for:

• T – Talk
• O – Observe
• T – Touch
• A – Active movement
• P – Passive movement
• S – Skill test

No-HARM 

or Avoid harm technique stands for No-Heat, No-Alcohol, No-Running and No-Massage. These are important precautions that any injured athlete must take for the first 72 hours after an injury occurs. 

SALTAPS- for injury assessment 

• See-  Stop and observe the injury 
• Ask – Ask questions about the injury 
• Look Look for specific signs e.g. swelling
• Touch – Touch to identify painful areas 
• Active – Active movement- move the injured part without assistance
• Passive – Passive movement- move the part through full range of movement
• Strength- Strength testing- put pressure/ weight on the injury.

Energy-based Physiotherapy-

• TENS – a transcutaneous electrical nerve stimulation (TENS) machine delivers an electric current to stop a patient‟s nerves sending pain signals to patient‟s brain and encourages endorphins (natural pain killing hormones) to be released. 
• Ultrasound – high-frequency sound waves treat deep tissue injuries by stimulating blood circulation and cell activity. It is thought to help reduce pain and muscle spasm and speed up the healing process. 
• Laser therapy – lasers (narrow beams of light) help reduce pain and muscle spasms. Laser therapy is thought to be most effective at treating tendon conditions, although studies have shown that it may not be as effective as other types of energy based therapies. 
• Shortwave diathermy – an electromagnetic field generates heat within patient‟s body‟s tissues This is thought to help reduce inflammation (swelling), strengthen tissues and reduce pain

Sports Rehabilitation

Sports rehabilitation is a therapeutic process that helps athletes regain their strength, flexibility, mobility, and physical endurance after an injury or medical condition.

• Uses exercise, movement, and therapeutic interventions to help people recover and reduce pain. 
• Principles of ACT IS IT:Avoid aggravation; Timing;Compliance;Individualization;Specific sequencing; Intensity; Total patient are followed for Sports injury rehabilitation..

It helps in 

• Restoration of athlete’s functional and performance level;
• Regaining physical fitness in its original position before injury
• Returning to sport participation in a safe, efficient, and timely manner;
• Reducing the risk of re-injury.

Stages

5 Stages of Injury Rehabilitation 

• Phase 1. Protection and Offloading. … 
• Phase 2. Protected Reloading and Reconditioning. … 
• Phase 3. Sport Specific Strength, Conditioning and Skills. … 
• Phase 4. Return to Sport. … 
• Phase 5. Injury Prevention

Sports medicine

Sports medicine, also known as Sport and Exercise Medicine (SEM), is a branch of medical science that specialises in the prevention, diagnosis, and treatment of injuries related to exercise and sports. It lays stress on improving sports performance of athletes.  

Aims of Sports Medicine  

•  Providing information to athletes about injuries
• Providing knowledge about the causes of injuries
• Providing treatment and rehabilitation for sports injuries
• Providing knowledge about preventive measures for sports injuries
• Scientific promotion of sports
• Developing preventive healthcare
• Providing sports medical extension services