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\begin{document}


\def\RunningAuthor{Prasanth R Krishnan and Najeeb T K}
\firstPage{3114}
\articleType{Original article}
\receivedDate{01 Apr 2020}
\acceptedDate{02 Jun 2020}
\revisedDate{01 May 2020}
\journalVolume{2020, 11}
\journalIssue{3}
\journalDoi{ijrps.v11i3.2420}
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\title{\textbf{The Role of Sringavacharana and Bandages In Sports Injuries \textbf{WSR to Acromio-ClavicularJoint Dislocation and Low Back Pain}}}
\author{Najeeb~T~K\textsuperscript{1}, 
            Prasanth~R~Krishnan\textsuperscript{*}\textsuperscript{2}~\\[5pt]{\textsuperscript{1}Department of Shalyatantra, Vishnu Ayurveda College, Kerala, India}~\\{\textsuperscript{2}Department of Dravyaguna, Parul Institute Of Ayurved \& Research Parul University, Gujarat, India}}

\begin{abstract}
Ayurveda is attaining the attraction globally not only as an ancient life science but also as a successful aid to treat and manage the ailments in style, Apart from the common sayings that Ayurveda does not have quick-acting treatment modality, Nowadays Ayurveda is successfully managing sports medicine effectively and smoothly, as far as sports medicine and athletes are concerned Injuries are part \& parcel of a sportsperson's life. They are a class of people who torture their body to the maximum to get the maximum result. Injuries are sustained due to faulty techniques, accidents as in the case of contact sports. In the process, they sustain a lot of injuries. Despite advanced treatment techniques injuries tend to recur. It severely hampers the progress of their career \& shortens their active sports life. It forces them for early retirement. Ayurvedic treatment like sringavacharana \& bandaging technique help to heal the injuries more effectively. Sringavacharana is an essential tool in the armarium of Ayurvedic physician to deal as emergency care in low back pain.here the technique and step involved in executing the Sringavacharana in the modern era and swastika bandhana is explained with essential photographs and also with the help of a clinical study.
\end{abstract}\def\keywordstitle{Keywords}

\begin{keywords}Sringavacharana,\newline Swastika bandhana,\newline Sports injuries,\newline Bandaging techniques
\end{keywords}
\twocolumn[ \maketitle {\printKwdAbsBox}]
\makeatletter{\raggedright\textsuperscript{*}Corresponding Author\par Name:\ Prasanth~R~Krishnan~\\ Phone:\ 9947873825~\\  Email:\ prasanth.r.krishnan@gmail.com
        \par}\vspace*{-11pt}\hrulefill\par{\fontsize{12}{14}\selectfont ISSN: 0975-7538}\par% 
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\section{Introduction}
Low back pain is a common problem among sportsperson due to repeated strain \& trauma. Although there is no clear cut evidence that incidence of low back pain has increased, resultant absence from matches, low performances \& loss of wages has increased over the years.

Sringavacharana\unskip~\citep{801462:19129882} is a well-accepted treatment modality in dealing the emergency care in low back pain. Acromioclavicular joint injuries \unskip~\citep{801462:19129885}  are common when somebody falls on the shoulder and roll over as in the case of a goalkeeper. Swasthikabandhan, along with oral medication, is an essential tool in the management of acromioclavicular joint injuries.
    
\section{Materials and Methods}
Sringa, vacuum extractor, surgical blade no-11, spirit.

The most tender areas in the lumbosacral region are cleaned with surgical spirit. Sringa attached with vacuum extractor is kept in position, a vacuum is created for 3 minutes and is released after it. Multiple cutaneous incisions are made with surgical blade no-11. Sringa is kept in position \unskip~\citep{801462:19129880}  \& vacuum is created \& maintained for five minutes \unskip~\citep{801462:19129881}. 


\begin{table}[!htbp]
\caption{\boldmath {Immediate effect of sringavacharana on second day} }
\label{tw-d9d49b42676f}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.50\linewidth-2\tabcolsep}p{\dimexpr.50\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Assesment Criteria & Relief in Percentage\\
\tblmidrule 
Pain &
  98\%OF RELIEF\\
Tenderness &
  10\%OF RELIEF\\
Movements &
  97\%OF RELIEF\\
\tblbottomrule 
\end{tabulary}\par 
\end{table}

\begin{table}[!htbp]
\caption{\boldmath {Showing Effect after 7 Days} }
\label{tw-06c3638ffc51}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.4393\linewidth-2\tabcolsep}p{\dimexpr.5607\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Assesment Criteria & Relief in Percentage\\
\tblmidrule 
Pain &
  97\%\\
Tenderness &
  80\%\\
Movements &
  95\%\\
\tblbottomrule 
\end{tabulary}\par 
\end{table}

\begin{table}[!htbp]
\caption{\boldmath {Showing Effect after 28 Days of treatment} }
\label{tw-756f12abcce3}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.4445\linewidth-2\tabcolsep}p{\dimexpr.5555\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Assesment Criteria & Relief in percentage\\
\tblmidrule 
Pain &
  90\%Relief\\
Tenderness &
  75\%Relief\\
Movements &
  80\%Relief\\
\tblbottomrule 
\end{tabulary}\par 
\end{table}

\begin{table}[!htbp]
\caption{\boldmath { Showing the effect of bandage after 36\ensuremath{^{th}} Day of treatment} }
\label{tw-2d5d820361bd}
\def\arraystretch{1.1}
\ignorespaces 
\centering 
\begin{tabulary}{\linewidth}{p{\dimexpr.4515\linewidth-2\tabcolsep}p{\dimexpr.5485\linewidth-2\tabcolsep}}
\tbltoprule \rowcolor{kwdboxcolor}Assesment Criteria & Percentage of relief\\
\tblmidrule 
Pain &
  100\%\\
Tenderness &
  100\%\\
Movements &
  80\%\\
\tblbottomrule 
\end{tabulary}\par 
\end{table}

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\centering \makeatletter\IfFileExists{images/5a7c4086-1581-49b2-be5c-fde6d1f5b17d-ugraph-1.png}{\includegraphics{images/5a7c4086-1581-49b2-be5c-fde6d1f5b17d-ugraph-1.png}}{}
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\caption{\boldmath {Immediate effect of sringavacharana on second day}}
\label{f-f70e21cce5c0}
\end{graph}
\egroup

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\makeatother 
\caption{\boldmath {Effect after 7 Days of Treatment}}
\label{f-e4d15d6aaaef}
\end{graph}
\egroup

\bgroup
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\makeatother 
\caption{\boldmath {Effect after 28 Days of treatment}}
\label{f-3d0a3bf51099}
\end{graph}
\egroup

\bgroup
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\centering \makeatletter\IfFileExists{images/4c13b108-fa26-4046-9d65-caf70a202a82-ugraph-4.png}{\includegraphics{images/4c13b108-fa26-4046-9d65-caf70a202a82-ugraph-4.png}}{}
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\caption{\boldmath {Effect of bandage after 36\ensuremath{^{th}} Day}}
\label{f-62d681f191b4}
\end{graph}
\egroup

\bgroup
\fixFloatSize{images/69ad9e97-75a2-4d85-9a51-1c2bc6f65ca7-upicture2.png}
\begin{figure*}[!htbp]
\centering \makeatletter\IfFileExists{images/69ad9e97-75a2-4d85-9a51-1c2bc6f65ca7-upicture2.png}{\includegraphics{images/69ad9e97-75a2-4d85-9a51-1c2bc6f65ca7-upicture2.png}}{}
\makeatother 
\caption{\boldmath {Steps of Sringavacharana}}
\label{f-6093ddd6cf03}
\end{figure*}
\egroup

\bgroup
\fixFloatSize{images/d446e9ef-9fd4-4389-8cf6-1f6b3f16fdb7-upicture1.png}
\begin{figure*}[!htbp]
\centering \makeatletter\IfFileExists{images/d446e9ef-9fd4-4389-8cf6-1f6b3f16fdb7-upicture1.png}{\includegraphics{images/d446e9ef-9fd4-4389-8cf6-1f6b3f16fdb7-upicture1.png}}{}
\makeatother 
\caption{\boldmath {Steps involved in Swastika bandhana}}
\label{f-8227e71f120d}
\end{figure*}
\egroup
The vacuum is released after 5 minutes. Blood is collected in a kidney tray. The area is watched for hemostasis \unskip~\citep{801462:19129886} cleaned \& dressed. Figure~\ref{f-6093ddd6cf03}.

\textbf{Inclusion criteria}

1. Patient between the age of 10 and 30 years

2. A person with sports-related trauma.

\textbf{Exclusion criteria}

1. Patients with associated emergencies like head injury,

2. Patients with abdominal injuries

3. Patients with a rib fracture.

\textbf{Investigations}

1. X-RAY Lumbosacral spine AP-LATERAL View

2. CT and MRI if required

\textbf{ASSESSMENT CRITERIA}

1. Pain.

2. Tenderness.

3. Range of movement.

The assessment was made on 1\ensuremath{^{st}}-day 2\ensuremath{^{nd}} day 7\ensuremath{^{th}} 14nth 21\ensuremath{^{st}} and 28\ensuremath{^{th}} day,

\textbf{Swastika bandhana}

The patient is made to sit with arms resting on the hip. 

Murivenna soaked cotton is placed over the injured acromioclavicular joint. Swastika Bandhan is applied with a crepe bandage \unskip~\citep{801462:19129884}; clavicle brace is used to make the bandage more stable. 

The dressing is maintained for 36-45 days \unskip~\citep{801462:19129883}  with rebandage every 6\ensuremath{^{th}} day \unskip~\citep{801462:19129887}, Figure~\ref{f-8227e71f120d}.

\textbf{Inclusion Criteria}

1. Patient between the age of 10 and 30 years.

2. Patients with sports-related trauma.

\textbf{Exclusion Criteria}

3. Patients with associated emergencies like head injuries,

4. Patients with associated sternoclavicular injuries with clavicle falling behind the sternum.

5. Patients with rib fractures causing visceral injuries, 

\textbf{Investigations}

1. X-Ray Shoulder AP-View.

2. CT, MRI and USG If necessary.

Assesment was made on first, 6\ensuremath{^{th,}}16\ensuremath{^{th}} ,26\ensuremath{^{th}} and 36\ensuremath{^{th}} days. Pain and tenderness was assessed on all thes e days and range of movement on 36\ensuremath{^{th}} day. Table~\ref{tw-d9d49b42676f}, Table~\ref{tw-06c3638ffc51}, Table~\ref{tw-756f12abcce3}  and Table~\ref{tw-2d5d820361bd}\unskip~\citep{801462:19129879}.
    
\section{Result }
Sringavacharana gives immediate relief of pain, and restricted movement improved rapidly,.Singavacharana relieves aavarana and obstruction and thus relieves the symptoms immediately. Swastika Bandhan relieves pain immediately. Bandaging reduces dislocation. Ayurvedic bandaging technic gradually stabilizes the joint. Associated ligament injuries heal which support and restore movements completely in acromioclavicular joint injuries. Graph~\ref{f-f70e21cce5c0}, Graph~\ref{f-e4d15d6aaaef}, Graph~\ref{f-3d0a3bf51099} and Graph~\ref{f-62d681f191b4}.
    
\section{Conclusion}
Immediate relief of symptoms with sringavacharana is a marked feature in sports-related low back pain,Tenderness does not show immediate relief may be due to cutaneous incision made for sringavacharana. Tenderness improved during the follow-up. During follow up there was slight , pain with some restricted movement. For a stable result, sringavacharana can be repeated after performing snehaswed procedures like pathrapodalasweda. This will make the result more stable.

Swastika bandana helps in immediate relief of pain \& gradual reduction of the dislocation in the case of acromioclavicular joint disorder. The prominence remains a bit after the treatment period. Range of movement or the strength of the joint is not compromised with this traditional Ayurvedic treatment. Ayurvedic treatment helps in perfect healing of the ligaments. It, in turn, helps in maximizing their performance and preventing recurrence of the injury.
    
\section{Acknowledgements}
I have a great pleasure to acknowledge all the supports and cooperation that I~have received from my teacher's parents and friends during the conduction of this research.

\textbf{Funding support}

No Funding Supports were availed from any agencies for the conduction of this research.

\textbf{Conflict of interest}

No conflict of interest was reported during this research work
    

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