Module 4

Nutrition, First aid and posture

NUTRITION
Nutrition is the process by which the body takes in and uses food.
DEFINITIONS
“Nutrition is the science of the food and its relationship to health. Its concerned primarily with the
part played by the nutrients”
WHO,1971
“Nutrition is science that deals with the study of nutrients and foods, their effect on nature and
function of organism under varied conditions of age, health and disease”
Dr Nizel,1989
“Nutrition may be defined as the sum total of the process by which the living organism receives
and utilizes the food materials necessary for growth, maintaince of life, enhancing metabolic
process, repair and replacement of worn out tissues and energy supply”
Z S C Okoye.
DIET
“Diet is the total intake of food material that provide energy. Diet is the customary allowance of
food and drink taken by person from day to day”
New burn
A normal diet contains, protein, fat and carbohydrates.
FOOD
“Food is any substance which when taken in to the body of an organism may be used either to
supply energy or to build tissue”
Finn.
SPORTS NUTRITION
Sports nutrition is the study of nutrition and diet as its related to athletic performance. Sports
nutrition is unique to each sports person and it is planned according to goals of an athlete. Well
planned and designed sports nutrition plans are important for athletic performance. “Athletes
consume between 1.2 to 2 grams of protein per kilogram of body weight per day to build muscle,
depending on how hard the athlete is training” (The Academy of nutrition and dietetics and
American college of sports medicine).”
BALANCED DIET
Balanced diet basically a good nutrition and important for your life every day. A balanced
diet supplies all nutrients. Without balanced nutrition your body is more prone to diseases,
infection, fatigue and low performance. Children who don’t get enough healthy foods may face
growth and developmental problems, poor academic performance and frequent infection.
A balanced diet is one that fulfil all of a person’s nutritional needs. Humans need a certain
amount of calories and nutrients to stay healthy. A balanced diet provides all the nutrients a person
requires, without going over a recommended daily calorie intake and avoid eating junk food, or
food without nutritional value. Balanced diet usually provides 50-60% energy from
carbohydrates,10-15% from proteins and 20-30% energy from fat.
DEFINITIONS
“A diet that contains the proper proportions of classes of food necessary to maintain good health”
“A diet that contains adequate amount of all the necessary nutrients required for healthy growth
and activity”
A balanced diet takes care of the following aspects:
• Includes a variety of food items
• Meet the RDA for all nutrients
• Includes nutrition in correct proportions
Benefits of balanced diet
• Improved body composition
• Improved immunity and prevention of disease
• Increased energy
• Makes you look younger and fresher
• Best solution to fight obesity
• Increases productivity at work and school
• Living a longer, more fulfilled life
• Reduces health care costs
• Enables you to better handle stress
The objectives of a balanced and healthy diet
• To achieve a healthy weight and energy balance.
• Elimination of saturated fats. Consumption of unsaturated fatty acids.
• Intake of simple sugar will be limited.
• Include a high amount of vegetables, fruits, nuts, legumes and whole grains.
• Intake iodized salt and limit consumption of sodium.
• Essential amino acids should form a major part of diet.
• Avoid consumption of food substances containing artificial preservatives.
• Foods contaminated with human pathogen should be strictly avoided.
• Limit intake of caffeine and alcohol.
• Inclusion of vitamins, minerals and fiber in diet.
 • Consume plenty of water.
A healthy, balanced diet will usually include the following nutrients:
• Vitamins, minerals, and antioxidants
• Carbohydrates, including starches and fiber.
• Proteins
• Healthy fats.
Calories
Calories are an indicator of the energy content of food generally, a person’s calories may
depend on their gender, age, and physical activity. Moreover, men need more calories than women.
People who are more into exercising require more calories in comparison to people who don’t do
physical exercise.
Person Calorie
requirement
Sedentary children:2-8 years 1000-1400
Active children:2-8 years 1000-2000
Females:9-13 years 1400-2200
Males:9-13 years 1600-2600
Active females:14-30 years 2400
Sedentary females:14-30 years 1800-2000
Active males:14-30 2800-3200
Sedentary males:14-30 2000-2600
Active people:30 years and over 2000-3000
Sedentary people:30 years and over 1600-2400

MALNUTRITION
Malnutrition is a worldwide problem. Malnutrition affects billions of people worldwide.
Some population have a high risk of developing certain type of malnutrition depending on their
environment, life style and resources.
Malnutrition is the condition that results from taking an unbalanced diet in which certain
nutrients are lacking, in excess (too high an intake), or in the wrong proportions. The deficiency
of any constituents of food lead to malnutrition. It can lead to serious health issues, including
stunted growth, eye problems, diabetes and heart disease.
DEFINITIONS
“Malnutrition is the dangers single threat to global public health”
WHO
“The cellular imbalance between the supply of nutrients and energy and energy and the body’s
demand for them to ensure growth, maintenance, and specific functions”
WHO
The term malnutrition covers two broad groups of condition:
1.Under nutrition
This type of malnutrition results from not getting enough protein, calorie or micronutrients.
Malnutrition is most often used to refer to undernutrition.
2.Over nutrition:
Overconsumption of certain nutrients, such as carbohydrates and fat, can also lead to
malnutrition. This usually results in overweight or obesity.
Symptoms
• Fatigue
• Dizziness
• Water-electrolyte imbalance
• Loss of muscles and muscle weakness
• Weight loss
• Low growth
Causes of malnutrition
• Lack of nutrient in diet.
• Reduced dietary intake
• Increased energy expenditure (in specific disease process)
• Political, legal and cultural factors
• Anorexia [loss of appetite due to disease)
• Inability to process food (swallowing difficulties following stroke or poor dentation)
• Digestive problems and issue with nutrient absorption.
• Altered metabolic requirements (e.g. elevated protein and amino acids needed for wound
healing and wasting diseases like cancer, COPD and cardiac cachexia)
• Lack of awareness and illiteracy.
• Excessive alcohol consumption.
• Mental health disorders
NUTRIENTS AND DEFICIENCY DISEASES
Nutrients are molecules in food that all organisms need to make energy, grow, develop and
reproduce. Nutrients are classified in to two types, macronutrients and micronutrients.
Macronutrients are nutrients which people need to eat regularly and in fairly large amount.
Nutrients can be classified as macronutrients and micronutrients on the basis of the required
quantity to be consumed by us every day. Carbohydrates, fats and proteins are macronutrients.
These substances are need for supply of energy, growth, metabolism and other body functions.
The term micronutrients are used to describe vitamins and minerals in general. Body needs smaller
amounts of micronutrients relative to macronutrients, their deficiency leads to critical health
problems and these nutrients are needed for proper utilization of macronutrients
Deficiency diseases
Diseases that are caused by the lack of some particular nutrient in a person’s diet are called
deficiency disease.
MACRONUTRIENS AND DEFICIENCY DISEASES
1.CARBOHYDRATES
Carbohydrates are the most important source of energy. The word carbohydrates can be traced
back to Germans, who called them “Kohlen hydrates”. It was then termed carbohydrates in
English. ‘Carbo’ means that they contain carbon, ‘hydr’ means that they contain hydrogen and the
third part of the name ‘ate’ mean that they contain oxygen. The ratio of hydrogen atom to oxygen
atoms is 2:1. Carbohydrates are actually the organic compounds that are important for body
functions. Carbohydrates are much abundant in plants, rather than in animals. Animals utilizes
carbohydrates in the form of food. There are lots of differences between carbohydrates and the
other elements important for nutrition such as proteins and fats. Generally, it is seen that a diet rich
in carbohydrates needs less amount of water in comparison to diet rich in proteins and fat. There
are two main type of carbohydrates, i.e., simple carbohydrates and complex carbohydrates.
Glucose, fructose, maltose and lactose are called simple carbohydrates. These carbohydrates are
soluble in water. Starch, dextrines, glycogen and cellulose are called complex carbohydrates or
polysaccharides. They are insoluble in water. These are not sweet in taste. Deficiency of sufficient
carbohydrates leads to body weakness, hypoglycaemia and loss of stamina.
Sources of carbohydrates: generally, carbohydrate is found in rice, jowar, bajra, dry pea, sweet
potato, banana, dates etc.
2.FATS
Fats represent the most concentrated form of energy available. In the early 1900s, dietary fat
was viewed simply as a source of calories, interchangeable with carbohydrates. George and
Mildred Burr discovered that fatty acids were critical to health. Fats contain carbon, oxygen and
hydrogen in the percentage of 76,12, and 12, respectively. Fats also known as triglycerides, are
esters of three fatty acid chains and alcohol glycerol. fats are necessary for many body functions.
Fats keep us warm and protect our organs, Fats also help in the production of hormones. Fats can
be classified according to their structures. Different types of fats have different characteristics and
they react in different ways inside the body. There are three different groups of fat in diet, that is
saturated fats, polyunsaturated fats and mono-unsaturated fats. Saturated fats are the biggest
dietary cause of high LDL levels (bad cholesterol). The intake of saturated fats increases the chance
of heart diseases. Such fats found in Fatty meats, whipped cream and desserts. Monounsaturated
fat is a type of dietary fat.it is one of the healthy fats, along with polyunsaturated fat. The poly
unsaturated fats are slightly better than monounsaturated fats. Omega-3 fatty acids are a specific
type of polyunsaturated fat. Fats are essential in diet but the quantity of intake should be limited.
avocado, outstand vegetable oils such as olive oil and peanut oils contains monounsaturated fats.
Corn, soybean, walnuts, pine nuts, fatty fish, pumpkin seeds contains polyunsaturated fats.
Diseases caused by deficiency of fat
 • Poor vitamin absorption (vitamin A, D, E, K are not absorbed)
• Immunity decreases
• Depression
• Phrynoderma or toad skin
• Excess of fat in diet interferes in absorption of calcium
There are three different types of fat cells in the body, white, brown and beige, fat cells can
be stored in three ways, essential, subcutaneous and visceral fat. Essential fat is necessary for a
healthy functional body. subcutaneous fat makes up most of our bodily fat and is found under the
skin. This is the body’s method of storing energy for later use. Visceral fat is found in the abdomen
among the major organs. It can be very dangerous in high levels. A high body fat percentage, and
in particular the presence of visceral fat, can increase your risk for a number of diseases.
3.PROTEINS
“Chemically protein is composed of amino acids, which are organic compounds made of carbon,
hydrogen, nitrogen and sulphur, amino acids are the building block of proteins and proteins are
the building blocks of muscle mass” (National institute of health).
Proteins are large, complex molecules and important for necessary function in the body.
Amino acids are building blocks of proteins. Proteins cannot be directly absorbed in to our blood.so
they are turned into amino acids by our digestive system. There are 23 amino acids. Out of these,9
amino acids must be available in the diet. These amino acids are used to create blood, muscles,
nails, skin hair and tissues in internal organs. Proteins form new tissues, repair the broken tissues,
regulate balance of water and acids, transport oxygen and nutrients, lack of neurotransmitters in
the nervous system, weakened immune system and make antibodies. excessive use of protein in
diet, especially animal proteins can result in heart diseases, osteoporosis, stroke, kidney stone,
marasmus and kwashiorkor.
Kwashiorkor
Kwashiorkor is a common and severe form of protein deficiency in children, this condition is
also known as protein energy malnutrition(PEM)
WHO,2010
Symptoms
• Producing belly
• Brownish hair
• Dark and scaly skin,
• Stunted growth,
• Under weight
• Swollen legs
• Anaemia
• Mental retardation
• Reduced resistance
Marasmus
The term marasmus is derived from the Greek word ‘marsmos’, which means wasting.
Marasmus is an extremely severe type of nutrition disorder in which there is significant wasting
of fats, muscles and tissues of the body.
Symptoms
• Chronic diarrhoea
• Respiratory infections
• Intellectual disability
• Stunted growth
• Weight loss and loss of muscle’s mass
AMINOACIDS
Essential amino acids: These are amino acids which have to be taken in with diet and can’t be
made in the body.
Non-essential amino acids: These are amino acids which do not have to be taken in with the diet
and can be made in the body.
Essential amino acids Non-essential amino acids
Histidine Alanine
Isoleucine Arginine
leucine Aspartate
lysine Cystine
Methionine Glutamic
Phenylalanine Glycine
Threoinine Ornithine
Tryptophan Proline
Valine Serine
Asparagine
Tyrosine

Sources of protein
From the point of view of sources, protein can be divided in to two categories.
a) Animal protein: Protein which get from animal products, is called animal protein. This protein
found in eggs, milk, milk products, meat and fish. Egg is the best example of rich protein because
sufficient amounts of amino acids are found in eggs.
b) Vegetable protein: Protein, which we get from vegetables, is called vegetable protein.
Vegetable protein is found in soya bean, green peas, nuts, groundnuts, mustard and food grains.
MICRONUTRIENTS AND DEFICIENCY DISEASES
1.VITAMINS
Vitamins are naturally occurring organic compounds, which are required very small amount
to maintain the normal health and development of the organism. Vitamins are consumed
exogenously and cannot be synthesized by the organism. The daily requirement of any vitamins
for any individual is related to size, age and rate of metabolism of the individual. The requirement
of vitamins increases when a person perform exercise. Vitamins are classified in to two groups,
fat soluble and water soluble vitamins.
A). Fat soluble vitamins: These vitamins are easily dissolved in fat. Fat soluble vitamins have
specific functions in the development and maintenance of tissue structure. Vitamin A, vitamin D,
Vitamin E and vitamin K are fat soluble vitamins.
B) Water soluble vitamins: These vitamins are soluble in water. Water soluble vitamins
participate in catalytic function or act as control mechanisms in the metabolism.eg. as co-enzymes.
Vitamin B group (there are 8 vitamins under vitamin B complex) and vitamin C are water soluble
vitamins.

A) FAT SOLUBLE VITAMINS AND DEFICIENCY DISEASES

a) Vitamin A(Retinol)
Functions: Helps maintain good vision (necessary for night vision), resistance to infections and
supports growth and repair of body tissues. Also maintains integrity of white and red blood cells,
assists in immune reactions, helps maintain the stability of cell membranes.
Main sources: cod liver oil, fish liver oil, tomatoes, carrots, green and yellow pigments.
Deficiency diseases: night blindness, dryness of skin, retarded growth, resistance of infection is
lowered.
RDA:800mcg

b) Vitamin D (Calciferol)
Functions: Regulates absorption of calcium and phosphorus for bone health.
Main sources: egg yolk, milk, meat, liver, fish liver oil. formed in skin when exposed to sunlight.
Deficiency diseases: rickets, poor formation of teeth, osteomalcia.
RDA:5-10 mcg

c) Vitamin E (Tocopherol)
Functions: Helps maintain cell membranes, red blood cell integrity, protect vitamin A and fatty
acids from oxidation, cell-membrane stability.
Main sources: vegetable oils such as germ oil, soya bean, leafy vegetables, milk, eggs.
Deficiency diseases: sterility, muscular degeneration, muscle pain, visual problems.
RDA:15mg

d) Vitamin K (Menadion)
Functions: clotting of blood
Main sources: leafy vegetables such as spinach, tomatoes, cabbage, carrot.
Deficiency diseases: prevents blood clotting and hemorrhages.
RDA:90-120 mcg
B) WATER SOLUBLE VITAMINS AND DEFICIENCY DISEASES

a) Vitamin B1 (Thiamin)
Functions: Carbohydrate metabolism, nervous system function.
Main sources: eggs, peas, yeast, milk, nuts, whole grains
Deficiency diseases: Beri beri, loss of appetite, fatigue, weight loss, nerve degeneration, heart
failure.
RDA:1.2 mg

b) Vitamin B2 (Riboflavin)
Functions: Conversion of food in to energy, growth and development, red blood formation
Main sources: Egg, milk, meat, milk, mushrooms, poultry, seafood, spinach
Deficiency diseases: anemia, angular cheilosis, stomatitis.
RDA:1.2 -1.8 mg

c)Vitamin B3(Niacin)
Functions: growth and development, helps maintain muscle tone in the GI tract, involved in the
production of sex and stress hormone, helps improve circulation, required for DNA production,
involved blood sugar regulation.
Main sources: milk. egg yolk and dry fruits.
Deficiency diseases: pellagra (dermatitis, dementia, diarrhea), muscle fatigue, mental disorder.
Mouth sores.
RDA:14-18 mg

d)Vitamin B5(Panthothenic acid)

Functions: conversion of food in to energy, fat metabolism, hormone production, nervous system
function, red blood cell formation.
Main sources: egg, milk, liver, broccoli, beef, beans etc.,
Deficiency diseases: fatigue, retarded growth, muscle cramps, anemia
RDA:5mg.

e) Vitamin B6(Pyridoxine)
Functions: immune function, nervous system function, metabolism of macronutrients, red blood
cell formation.
Main sources: meat, liver, fish, nuts, whole grains, fresh vegetables.
Deficiency diseases: nervous disturbances, anemia, retarded growth, fatigue.
RDA:1.3 -2.0 mg

f) Vitamin b7(Biotin)
Functions: Energy storage, protein, carbohydrate and fat metabolism.
Main sources: avocados. eggs. raspberries, liver, pork, salmon. whole grains
Deficiency diseases: dermatitis, loss of hair and progressive paralysis.
RDA:30mcg

g) VITAMIN B12 (CYANO COBALAMINE)

Functions: conversion of food into energy, nervous system function, red blood cell formation.
Main sources: dairy products, eggs, meat, poultry, sea food.
Deficiency diseases: Pernicious anemia, degradation of spinal cord, malformed red blood cells.
RDA:2.4 mcg

h) Folic acid
Functions: prevention of birth defects, protein metabolism, red blood cell formation.
Main sources: beans and peas, green leafy vegetables, meat, seafood, asparagus, oranges
Deficiency diseases: abnormal RBC, intestinal tract disturbances, depression, spina bifida, growth
impairment.
RDA:400 mcg

i)Vitamin C (ASCORBIC ACID)

Functions: immune function, wound healing, collagen synthesis.
Main sources: Orange lemon, green vegetables, berries, cabbage etc.
Deficiency diseases: scurvy, weakened connective tissues, slow healing wounds.
RDA:60-95mg
2.MINERALS
Minerals are very important nutritive components of food. A balanced diet usually provides
all of the essential minerals. About 4 percent of our body weight is made up of minerals. Minerals
can be classified into macro, i.e., major minerals and micro minerals or trace minerals. Macro
minerals are needed in larger amount than trace minerals in order to perform their specific roles in
the body calcium. phosphorus, sodium, chlorine, magnesium, potassium, and sulphur are macro
minerals.
a) Phosphorous
Functions: acid –base balance, Important for strong bones, hormone activation.
Main sources: brown rice, almonds, lima beans, spinach, fish, green vegetables.
Deficiency diseases: impotence, teeth/gum disorders.
Adult dosage range:300-600 mg

b) Potassium
Functions: Important for water balance, muscle contraction, and nerve impulses. Works with
sodium helps to control blood pressure.
Main sources: tomatoes, bananas, beans, mango, orange, apple.
Deficiency diseases: stress, atherosclerosis, high blood pressure.
Adult dosage range: 4700 mg

c) Calcium
Functions: vital for strong bones and teeth, muscle function, nerve transmission
Main sources: leafy: milk, cheese, yolk, green vegetables and orange.
Deficiency diseases: rickets, asthma, skin diseases like scabies, chilibians.
Adult dosage range:200-1500
d)Sodium
Functions: Important for water balance and muscle contraction and relaxation. Works with
potassium helps to control blood pressure.
Main sources: Table salt, meat, egg, milk.
Deficiency diseases: High blood pressure,
Adult dosage range:1500mg

e) Copper
Functions; Helps turn food into energy. Important mineral for certain brain and nerve functions.
Helps body pull iron out of food to use.
Main sources: Liver, seafood, nuts, lentils, semisweet chocolate.
Deficiency diseases: fatigue, problems with memory and learning, pale skin, vision loss, arthritis,
anemia, osteoporosis.
Adult dosage range:900 mcg

f) Iodine
Functions: Important mineral for make certain hormones, especially for the thyroid gland. Growth
and development, metabolism, and reproduction.
Main sources: Iodized salt, seafood, milk, navy beans, potatoes, turkey, breads and cereals.
Deficiency diseases: thyroid enlargement and goiter
Adult range dosage:150 mcg

g) Iron
Functions: Carries oxygen through the body and helps build red blood cells. Also helps turn
food into energy, red blood cell production.
Main sources: Meat, seafood, dark leafy greens, lentils, raisins, black berries.
Deficiency disease: anemia, dizziness, depression.
Adult dosage range:10-30mg

h) Manganese
Functions: carbohydrate and protein metabolism, cholesterol metabolism, cartilage and bone
formation, wound healing.
Main sources: beans, nuts, pineapple, sweet potato, whole grains.
Deficiency diseases: diabetes, asthma, digestive disturbances.
Adult dosage range:2-10 mg

i)Zinc
Functions: immune function, good sense of taste and smell, protein formation, reproduction,
wound healing, nervous system function.
Main sources: Nuts, beans, peas, beef, dairy products, poultry.
Deficiency diseases: dermatitis, emotional disturbances. Night blindness, delayed wound healing,
hypogonadism
Adult dosage range:11 mg

j) Sulphur
Functions: formation and functioning of cells of body, formation of hair and nails.
Main sources: carrot, radish, peas, tomato, cabbage, cereals.
Deficiency diseases: arthritis, depression, memory loss, slow wound healing.
Adult dosage range:300 mg

FIRST AID
First aid is vital for saving life. When you provide basics medical care to someone
experiencing a sudden injury or illness, its known as first aid. First aid involving timely response
to emergencies and immediate care of sick and injured people.it is care given as soon as possible
after an accident or illness prior to the arrival of expert medical help. In some cases, first aid
consists of the vital support provided to someone in the middle of a medical emergency. This
support might help them survive until professional help arrives.in other cases, first consists of the
care provided to someone with a minor injury. For example, first aid is often all that’s needed to
minor burns, cuts and insect stings.
Trained first aiders apply a range of procedures and technique that after care when accidents
and injuries occur, often making the difference between life and death during high- risk, low-
frequency emergencies. More than ever, first aid intervention is a valuable link in the life saving
chain, where causalities are addressed and monitored prior to the arrival of emergency service
personnel. First based is based on scientific method. After the doctor takes charges the first aiders
responsibility ends. He can then stand by to help the doctor.
DEFINITIONS
“The assessment and interventions that can be performed by a first aider during an emergency
with minimal equipment until appropriate medical personnel arrive”
DOSH (Department of Occupational safety and Health) Guidelines

“emergency care provided for injury or sudden illness before emergency medical treatment is
available”
US OSHA (Occupational Safety and Health act)

AIM
The main aim of first aid is to try to save the precious life of the wounded person or victim.
OBJECTIVES OF FIRST AID
1.To preserve life: to preserve or to save the life of the victim or wounded person is the significant
objectives of first aid. However, there are limitations of first aid but even then every possible effort
is done to save the life of a wounded person or victim with the help of first aid.
2.To alleviate pain and suffering: the second important objective of first aid is to alleviate pain
and suffering of the victim or wounded person. Pain is natural in any type of accident. pain
becomes unbearable in case of fracture or dislocation of joint during accident.so.it is a major
objective to reduce such unbearable pain.
3.To prevent the condition from worsening: Till the wounded person or victim does not get the
help of a doctor, to prevent the condition from worsening becomes the major objective of first aid.
According to this objective, the victim’s condition should not be worsened. generally, when first
aid is provided, the wound or victim’s condition does not worsen while being taken to the doctor
for treatment.
4.To promote recovery: The main objective of first aid is to start process of recovery as early as
possible. Sometimes, the treatment of injury is also included in this objective.
5.To procure early medical aid: To procure early medical aid is one of the most important
objectives of first aid. In fact, there may be certain situations where there is a dire need for medical
assistance. However, the first aider should pay attention to provide first aid victim or wounded
person but efforts should also be made to seek medical aid as early as possible.
PRINCIPLES OF FIRST AID
The following are the principles of first aid:
• Calling for medical assistance.
• First aider should be able to remain calm under pressure and help to reduce the overall
stress levels of the injured person as well as other people who may be considered.
• Check for consciousness, open the air way, check circulation
• Do not allow people to crowd around as fresh air is essential.
• Administration of CPR if breathing has stopped.
• Remove the cause of injury or the patient from the cause as early as possible. he should
then render such help that may prevent further injury.
• The bleeding should be stopped immediately irrespective of other injuries
• Keep the patient warm by wrapping him in clothes rugs or blankets and sheet as the cause
may be.
• Remove the clothes of the patient only when essential such removal of clothes must not
cause pain or discomfort to the patient. He should very softly study the ankle and then undo
the laces of shoes and cut off the socks if needed.
• The wound should be covered at once with a clean dressing in case of a fracture the injured
limb should be supported and placed in natural position as far as possible with splints and
bandages.
• Make immediate proper arrangements to transport to a hospital or to a qualified doctor are
the vicinity.it should however be remembered that the first aider need not to be a doctor.so
he should never take upon himself the duties and responsibilities of a doctor. His
responsibilities are over as soon as proper medical aid is available.
• The injured should be given as much rest as possible and his body should be kept in a
restful position.
• In case of fracture the broken part should be saved from movement till proper medical aid
is available.
• Offer warm milk or tea if the patient is in sense he may be given a cup of a warm milk or
tea.
 • Full knowledge of anatomy is essential for giving first aid. The first aider must have
complete knowledge of anatomy and physiology.it will enable him to render proper first
aid to the injured.
• The first aider should remember that he is not a doctor so he should never take upon himself
the duties and responsibilities of a doctor.
FIRST AIDER
“A person who has successfully completed a first-aid course and has been awarded with a
certificate of proficiency in first-aid by a recognized institution”
(DOSH guidelines)
QUALITIES OF FIRST AIDER
The following are the qualities that a trained first aider should possess;
1.Prompt and quick
As soon as an accident or injury takes place the first aider should be prompt and quick to render
help to victim without delay.
2.Calm and controlled
He should be a calm and controlled sort of man because he has to take immediate action without
any fuss or panic.
3.Wise and intelligent
He should be intelligent and wise enough to decide what immediate treatment is essential even
before a complete diagnosis in case of serious injuries and severe bleeding
4.Resourceful
He should be resourceful enough to make available his first aid material at once or get the required
things on the spot for giving immediate relief to the victim
RESPONSIBILITIES OF A FIRST AIDER
• Protect from danger
• Identify the illness or injury
• Decide on priorities of care
• Ensure dignity of the patient
• Good communication to the patient
• Good documentation
FIRST AID EQUIPMENT OR APPARATUS
Sterile gauge pieces Bandages of different size
Adhesive plasters of different sizes Scissors, safety pins. needles, tweezers
Pads of various sizes Splints
 Antiseptics e.g. Dettol, spirit, Silver sulphadiazine cream
tincture
Measuring tape Thermometer

FIRST AID MEASURES

1.Bleeding through nose
Bleeding from the nose is caused by heat or injury on the nose. The following point should
be kept in mind while giving first aid for bleeding nose.
• Seat the person in front of an open window and bend his heads backwards with hand raised
up.
• Loosen the tight clothing around the neck and chest.
• Ask the patient not to breathe through nose but through the mouth.
• Place the feet in warm water
• Apply cold compress over the neck
• Do not allowed the patient to sneeze.
2.Electric shock
Electric shock occurs when a person comes into contact with an electrical energy source. An
electrical shock is a physical reaction to electrical currents passing through body.
• It is important to remember that a higher current causes more damage than a higher voltage.
• While every effort must be switch off the source of electricity, time should not be wasted
while removing the patient from the electrical source.
• Push the patient with any wooden, plastic materials or a dry drop or even a hastily removed
shirt or any other clothing material.
• Do not use metal knives or scissors to cut the wires.
• Do not allow person to crowd around the victim
• Lay him down a blanket in a cool place.
• If he becomes unconscious place his head between his knees.
• Put cold water drop by drop in his mouth.
• Call for the doctor at once.
• Try to keep the patient vigilant
• Protect him from anxiety and provide encouragement and comfort
• Give artificial respiration if needed.
• Treat the burns.
3.Dog bite
Animals may bite in self defense, in an attempt to prey in food and as part of normal
interactions. A dog bite can lead to rabies or tetanus infection.
 • The aim of first aid in a case of dog bite is to prevent rabies, to reduce the risk of infection
and to get medical aid as soon as possible.
• Wipe the saliva away from the wound using a clean cloth .do not come into contact with
the saliva that gets wiped away.
• Wash the wound with water and soap
• Apply carbolic acid with a match stick at ever place of bite inside and outside the wound,
• Cover the wound with a dry, sterile dressing.
• Get medical aid or send the patient to the hospital as soon as possible.
4.Snake bite
Snake bites occur when a snake bites the skin, and are medical emergencies if the snake is
poisonous.
• Although not all the bites from snake result in the release of poison, once the skin is
punctured by snake fangs you should assume that poison is present and act accordingly. It
is urgent that a snake bite victim be taken to a hospital for anti-venom serum as quickly as
possible.
• Recognize the kind of the snake that has bitten
• If the snake is poisonous make every effort to avoid circulation of poison throughout the
body.
• Keep the stricken limb below the heart
• Allow bite to bleed 30 seconds
• Wash the wound with soap and water and rapidly disinfect the area with betadine, savlon
etc.
• Apply potassium permanganate on the wound.
• Give him courage so that he may not fear snake bite.
• Take the victim to the nearest hospital
5.Burns
A burn occurs when there is injury to the tissues of the body caused by heat, chemicals,
electric current, or radiation.
• Call the doctor for help
• While approaching the patient it is advisable to hold a thick rug or blanket, in front of you
and immediately wrap the burning patient in it.
• The patients must be made to lie down quickly and the flames are brought under control
by gentle rolling or gentle pats on the flames with rug, etc.
• Do not use thick fabrics and plastics putting of the flames,
• Always wear a wet handkerchief round your face when going to rescue from fire. Do not
use ice cold water as the ice may intensify the shock reaction of the patient.
• Removes the burned clothes carefully .do not remove clothes from above the vesicles
formed due to burns.
• Don’t disturb vesicles.
 • Do not remove sticking particles of charred clothing from the patient’s body.
• Cover the burnt area with clean and dry cloth.
• Do not allow the patient to run
• Do not apply any oil, ointments or lotions at home since this carry infection.
• Transport the affected person immediately to the hospital
6.Drowning
In India a large number of children die through drowning. It can happen in the swimming
pool, in the ponds, in the large water tanks, canals, or rivers while swimming, bathing or crossing
deep contaminated or flowing water. The victim of drowning dies as result of getting choked. This
is due to water entering into air passage and into stomach. Saving a drowning person carries risk.
Before swimming out to someone in trouble be sure you can handle this situation.
• In case the patient has been drowned, his body is placed in prone position (face downward)
with the head lower than the chest and turned to one side to allow the water to flow out of
the lungs and stomach.
• Clean the patient’s mouth or throat to remove the mud or any other things that might have
gone in it along with water swallowed.
• Put the victim in prone lying position and press the back to bring out the water from the
lungs and the stomach.
• if the person is unconscious and is not breathing and has no pulse .do CPR
• when the victim starts breathing or even when artificial respiration is being given, take
cold, wet clothes off the victim and cover him or her with something warm to prevent
hypothermia.
• To keep the body warm he should be covered with blanket or other heavy cloth, depending
upon the situation or availability of material for the same purpose. A hot water bottle may
be used to warm his body.
• If the first aider realizes that he is not able to revive the breathing/respiration, he should
immediate make arrangements to take casualty to the doctor.

COMMON INJURIES AND THEIR MANAGEMENT

Injury, also known as physical trauma, is damage to the body caused by external force.
This may be caused by accidents, falls, hits, weapons, and other causes.
There are basically two types of injuries, acute injuries and overuse injuries:
A. OVERUSE INJURY
Overuse injuries are a lot more common than acute injuries. Usually, overuse injuries occur
over time. This makes them difficult to diagnose and treat. They are the result of repetitive micro-
trauma to the tendons, bones and joints. Common examples include tennis elbow (lateral
epicondylitis), swimmer’s shoulder (rotator cuff tendinitis and impingement), Little League elbow,
runner’s knee, jumper’s knee (infrapatellar tendinitis), Achilles tendinitis and shin splints. In most
sports and activities, overuse injuries are the most common and the most challenging to diagnose
and treat.
Training errors are the most common cause of overuse injuries in sports. These errors involve a
too rapid acceleration of the intensity, duration or frequency of your activity.
B. ACUTE INJURY
An acute injury is a sudden and overwhelming injury that results from some kind of physical
activity. Typically, acute injuries are caused by a sudden movement or impact during either
exercise and sports. Acute injuries are usually the result of a single, traumatic event, common
examples include wrist fractures, ankle sprains, shoulder dislocation and hamstring muscle strain.
The human body has a tremendous capacity to adapt to physical stress. In fact, many positive
changes occur as a result of this. With exercise and activity, bones, muscles, tendons, and ligaments
get stronger and more functional. This happens because of an internal process called remodeling.
The remodeling process involves both the break down and buildup of tissue. There is a fine balance
between the two and if break down occurs more rapidly than build up, injury occurs. This can
happen when you first begin a sport or activity and try to do too much too soon. If playing tennis
and play for several hours in an attempt to improve rapidly, you are setting yourself up for an
overuse injury. This is because you are trying to do too much and do not allow your body adequate
time to recover. As a beginner, you may also have poor technique which may predispose you to
tennis elbow. With overuse injuries, it often takes detective- like work to understand why the injury
occurred.

SOFT TISSUE INJURIES

1. SPRAINS
A sprain is commonly known as torn ligament, is damage to one or more ligaments in a joint,
often caused by trauma. Sprain is an overstretched, torn, or twisted ligaments. A ligament is a
tough band of fibrous tissue that connects bones to other bones or cartilage. Ligaments are usually
located around the joints. Commonly sprained areas include the wrists, ankles, thumbs, and knees.
Signs and symptoms
A sprain usually happens suddenly around a joint. Symptoms may be mild or severe, according
to how many tissue fibers are affected. Symptoms include:
• Pain
• Swelling
• local tenderness
• Bruising
• Limited movement around the joint
• Inability to put weight on the joint or use it normally
Causes of sprain
 The most common causes of sprains are falling, twisting, sudden jerks or experiencing trauma
to the joint. These type of injuries may cause the joint to move out of its normal range of movement,
tearing or stretching the ligaments as this happens.
Classification
First degree sprain: A first degree sprain is when the ligaments have been stretched but not
torn.it is the mildest form of sprain, resulting minimal tissue damage and quick recovery time.
Second degree sprain: A second degree sprain is the most common type of sprain and is a partial
tearing of the ligament.it happens one or more ligaments has been damaged.it can takes 2-6
weeks to completely heal.
Third degree sprain: A third degree sprain is the most severe type of sprain. With this sprain
ligament has been torn completely.it can takes 6-12 weeks to fully recover.
Management
PROTECTION: Protect the injured area of the victim from further injury. The type of protection
used varies depending on the injured area but may include an ace bandage, aluminum splints, sling,
protective tape etc.
REST: It is very beneficial to have was much rest as possible in the early stages in order to allow
the wound to heal. So, for proper treatment, reduce the exercise and the other activities Completely
and how complete rest
ICE: apply ice to the injury for up to 20 minutes every 2 to 3 hours.
COMPRESSION: to help reduce swelling, a person can rap the affected area with a bandage or
trainer’s tape. Loosen the wrap if the area gets numb or if the pain increases.
ELEVATION; keep the injured area raised above chest level if possible. Keeping the sprained
joint elevated also helps minimize swelling.
2. STRAINS
A strain is an acute or chronic soft tissue injury that occurs to a muscle, tendon, or both.
Generally, the muscle or tendon overstretches and partially tears, under more physical stress than
it can withstand, often from a sudden increase in duration, intensity, or frequency of an activity.
Strain most commonly occur I the foot, leg or back.
Signs and symptoms
• Localized stiffness
• Discoloration and bruising around the strained muscle
• Loss of function of part
• A sharp pain felt immediately after injury
Causes
• Over training
• Poor training methods
• Poor flexibility
• Muscle imbalance
• Structural abnormalities
• Trauma
• Mineral imbalance deficiency
• Over stretching
Mangement
There is a procedure for the treatment of strain i.e., PRICE. The procedure of management or
treatment of strain is described below.
PROTECTION: The first Principle is protection. The purpose of protection is to avoid further
injury to the area by protecting injury structures.
REST: Rest is the second component of the PRICE Principle. the purpose of resting is to allow the
body's own Healing processes to naturally occur without being impeded by movement of the
injured area. Any increase in movement of an injured tissue result in increased circulation to the
area which intent may result in further damage do the injured tissue and / or increased swelling.
ICE: Ice should be applied directly of the site of the strain injury As soon as possible. it reduces
bleeding and swelling by slowing down blood circulation. It also relaxes the injured area by
reducing pain. Ice should be wrapped in a wet cloth to prevent skin burns. Ice should be applied
for five minutes for a small area like the rest and for 20 minutes for a large area at a time.
Application of ice should be done 4 to 8 times a day.
COMPRESSION: When the ice pack is removed, compression wrap should be applied to the
injured area. Compression of an injured muscle help to reduce swelling as well as bleeding. There
are a number of compression wraps available on the market, but the most commonly used in an
elastic or ace bandage. compression should not be applied round a whole limb. The compression
should not be applied very hard as it may hind the flow of blood circulation.
ELEVATION: The last component of the PRICE Principle is elevation. Elevation helps to reduce
the amount of blood flow to the injured area. The key is that the injured person needs to keep the
injured area above his/her heart level.

3.WOUNDS
Any break in the external or internal surfaces of the body involving a separation of tissue, and
caused by external injury or force.
In general wounds can be either closed or open.in closed wound skin surface is not broken,
therefore tissue damage and bleeding occur below the surface. A closed wound is usually caused
by direct blunt trauma sustained when falling don or in motor vehicle accidents. Even with the
skin intact the damage can reach down to the underlying muscles, internal organs and bones.
Closed wounds can also occur during sports, physical games and other physical activities. An open
wound is an injury involving an external or internal break of body tissues usually involving the
skin. In open wounds, the skin is broken and the underlying tissue is exposed to the outside
environment. Nearly everyone will experience an open wound at some point in their life. Most
open wounds are minor and can be treated at home. Falls, accident with sharp object are the most
common cause of open wounds. Closed wounds are more dangerous than open wounds. Closed
wounds can have complicated by severe bleeding, large bruises, nerve damage. However, the most
serious complication of closed wounds is known as the compartment syndrome. This syndrome
involves lower and/or upper limbs, where the damage causes swelling and increased pressure in
the fascia that surrounds the muscles, nerves and blood vessels in that area. The increased pressure
can block the blood supply to the affected limbs, causing severe damage to the muscles and nerves.
The damage can be permanent, leading to loss of function, and may necessitate amputation.
A) OPEN WOUNDS
a) Abrasion
Abrasions are very common injuries. An abrasion is a type of open wound that’s caused by
the skin rubbing against a rough surface. Abrasions are not usually as serious as laceration or
incision wounds.
“abrasion means when there is a loss of epidermis done and dermis is exposed on the surface in
the injured area”
Abrasions are most likely to occur on the:
• Elbows
• Knees
• Shins
• Ankles
• Upper extremities
Abrasion can be painful, since they sometimes expose many of the skin’s endings. However,
they don’t typically cause much bleeding. Most abrasions can be treated at home. Abrasion can be
range from mild to severe. Most abrasions are mild and easily be tended to at home. Some
abrasions, however, may require medical treatment.
Signs and symptoms
Bleeding, discomfort, peeling or scabbing of the top layer of your skin.
First degree abrasion: A first degree abrasion involves superficial damage to the epidermis. The
epidermis is the first, or most superficial, layer of skin. A first degree abrasion is considered mild.
It won’t bleed. First degree of abrasion is sometimes called scrapes or grazes.
Second degree abrasion: A second degree abrasion results in damage to the epidermis as well as
the dermis. The dermis is the second layer of skin, just below the epidermis. A second degree
abrasion may bleed mildly.
Third degree abrasion: A third degree abrasion is a severe abrasion. It’s also known as an avulsion
wound.it involves friction and tearing of the skin to the layer of tissue deeper than dermis. An
avulsion may bleed heavily and require more intense medical care.

Management
• A first and second degree abrasion can usually be treated at home. To care of an abrasion:
• Begin with washed hands
• Gently clean the area with cool to lukewarm water and mild soap. Remove dirt or other
particles from the wound using sterilized water.
• For the mild scrape that’s not bleeding. leave the wound uncovered.
• If the wound is bleeding. Use a clean cloth or bandage and apply gentle pressure to the area
to stop any bleeding. Elevating the area can also help stop bleeding.
• Apply antibiotic ointment and cover it with a clean bandage or gauze. Gently clean the
wound and change the ointment and bandage once per day.
• Watch the area for signs of infection, like pain or redness and swelling. see your doctor if
you suspect infection
• Most mild abrasions will heal quickly, but some deeper abrasions may lead to infection or
scarring. It’s important to treat the wound right way to reduce your risk for scarring. Make
sure to keep the wound clean.
b) Laceration
A laceration is an irregular wound through the skin and deeper tissue. A laceration is a
separation of the skin with relatively sharp edges. Laceration means, when there is a complete cut
in the skin and both dermis and epidermis are lost and subcutaneous tissue are exposed. These
injuries are caused by the impact of cricket ball or blunt edged instruments. A laceration can cause
external and internal bleedings. a significant cut can cause profuse bleeding if it isn’t treated
promptly and properly and it causes damage of the internal organs. eyelid, lower jaw, face, knee
cap are the common sites of laceration.
Signs and symptoms
The patient comes to us with variable amount of bleeding. There is moderate degree of wound.
Management
 • First of all, you should control bleeding before anything else.to stop bleeding put pressure
directly on the laceration while holding.it above the level of heart 15 minutes. If you are
unable to stop bleeding, try to use pressure points.
• Once bleeding has stopped, wash the laceration with warm water and mild soap. If bleeding
start again repeat step one.
• Assess and see if the laceration requires stiches. If the affected person requires stiches, take
him/her to the doctor.
• For example, laceration which do not requires stitches, use antiseptic ointment.
• Cover the laceration with sterile gauze and wrap with roller gauze. Clean the laceration
whenever you change the dressing.
• Watch the infection and change the dressing regularly
• Take painkiller if pain persists.

c)Puncture wound
A puncture wound is a traumatic injury caused by an object piercing the skin.
A puncture wound is a deep wound that occurs due to something sharp and pointed, such as
nail. The opening on the skin is small, and the puncture wound may not bleed too much. Puncture
wound can easily become infected. A doctor should always examine a deep puncture wound.
Signs and symptoms
Signs and symptoms of a puncture wound depend on its location and severity. Common
associated signs and symptoms are pain at the site of the wound and mild bleeding.in some cases
infection may set in and lead to additional symptoms like swelling, drainage of pus and redness of
the skin. Some puncture wound may cause significant bleeding or loss of sensation or numbness
in the affected area.
Management
• First attempt to stop the bleeding by covering the wound with a clean bandage and applying
gentle pressure. If the wound is bleeding heavily and you cannot stop it, immediately seek
medical care.
• Next, clean the area thoroughly using a small alcohol wipe. Don’t attempt to wash a
puncture wound. If you notice debris embedded in to the puncture wound, don’t try to
remove it.don’t probes the wound if you realize part of the object that caused the wound
has broken off. Instead, seek emergency medical attention immediately.
 • Once the skin is clean, apply an over the counter antibiotic cream to prevent infection.
Cover the puncture wound with a bandage. you should change the bandage daily or sooner
if it becomes we or dirty.
d)Incision
A clean, straight cut caused by a sharp edge (i.e. knife).it may be superficial or deep. The
deep wounds lead to severe blood loss. connecting structures such as ligaments and tendons may
be injured.
Signs and symptoms
• Bleeding
• Pain
• Problems with movements
Management
First aid includes cleaning the wound with antiseptic solution. The after placing a piece of
cotton on the wound, a bandage should be applied.in such cases dirt should not enter in to the
wound.in case of excessive bleeding, the bandage should be kept, tight, if the wound is too deep,
a doctor should be consulted immediately.

CLOSED WOUNDS
a) Contusion/bruise
Contusion is a muscle injury. These are a common type of sports injury. A direct hit with or
without any sports equipment can be the main cause of contusion. Contusion can also be due to
minor accidents to the skin, such as falling, bumping into something or being hit or kicked. Where
a direct blunt trauma can damage, blood vessels and capillaries, muscles and underlying tissue, as
well as the internal organs and, in some cases, bones.
Signs and symptoms
• Swelling and pain
• Stiffness
• Limit joint range of motion near the injury
• Blood vessels become bluish coloration
• Injured muscle become weak and stiff
 • In severe case swelling and bleeding beneath the skin make shock
Management of contusion
• Cold compression should be used immediately; ice or cold water should not be used for
more than 40 minutes persistently. The cold compression should be performed 5 to 6 times
daily.
• If there is more swelling at the area of contusion, anti-inflammatory medicine should be
given.
• If the swelling still persists, consult a doctor immediately.
• For the purpose of rehabilitation, flexibility exercise should be performed carefully.

b) Hematomas
A hematoma is a common problem that occurs as a result of damage to one of the larger blood
vessels in the body. Most people experience a hematoma at some point in their lives. A hematoma
can look like a bruise, but bruises occur due to damage to small blood vessels rather than large
one. While many hematomas are relatively harmless, some can indicate a more serious medical
problem. The term hematoma describes an area of blood that collects outside of the larger blood
vessels. Hematomas typically present as a painful, spongy rubbery lump like lesion. Hematomas
can be small or large, deep inside the body or just under the skin, depending on the severity and
site of the trauma.
Signs and symptoms
• Pain and swelling
• Redness
• Disfiguring
• Bruises
Management of hematoma
Simple therapies at home may be utilized I treating superficial (under the skin) hematomas.
REST
ICE: apply the ice or cold pack for 20 minutes at a time,4 to 8 times a day
COMPRESSION: compression can be achieved by using elastic bandages
ELEVATION: elevation of the injured area above the level of the heart is recommended
c)Crush injuries
These are usually caused by an external high pressure force that squeezes part of the between
two surfaces. The degree of injury and pain can range from minor bruise to a complete destruction
of the crushed area of the body, depending on the size, site, duration and power of the trauma.
4.DISLOCATIONS

A dislocation occurs when a bone slips out of a joint. A dislocation means bone is no longer
where it should be. A dislocation is often accompanied by considerable damage to the surrounding
connective tissue. An untreated dislocation could cause damage ligaments, nerves or blood vessels.
Every dislocation has its own unique healing time. Most people experience a full recovery in
several weaks.for some joints such as hips, full recovery may take several months or years and
may require additional surgeries. The healing time will also be longer if blood vessels or nerves
were damaged in the dislocation. If the dislocation is severe or is not treated in time, there may be
permanent problems such as persistent pain or the cell death of parts of bone around the joint.
Anyone can dislocate joint if they fall or experience some other of trauma. However, older persons
tend to have a higher risk, especially if they lack of mobility or are less able to prevent falls. After
a joint dislocates, it’s more likely to dislocate again in the future, Common sites of the body where
dislocations occur are the finger, hip, shoulder and patella.

Signs and symptoms of dislocation include

• Loss of movement at the joint

• Obvious deformity
• Swelling and tenderness
• Pain at the injured site
• Tingling feeling
• Numbness around the area.
• discolored
Causes

• Dislocation typically result when a joint experiences an unexpected or unbalanced impact.

This might happen if you fall or experience a harsh hit to the affected area.
• Poor flexibility
• Lack of strength
Management

• Call medical help immediately

• Don’t try to move the joint or to place it back in the socket
• Rest your dislocated joints: Don’t repeat the action that caused your injury, and try to avoid
painful movements. All movements are restricted in the neighborhood of the joint, to
prevent the complications.
• Protective swapping or splinting is provided with the help of sling and bandages.
• Putting ice on your injured joint helps reduce inflammation and pain. Use cold pack for 15
to 20 minutes at a time. For the first day or two, try do every couple of hours during the
day. after two or three days, when the pain and inflammation have improved, hot packs or
a heating pad may help relax tightened and sore muscles. Limit heat application to 20
minutes at a time.
• After one or two days, do some gentle exercise as directed by your doctor or physical
therapist to help maintain range of motion in your injured joint. Total inactivity can cause
stiff joints.

5) Fractures
Our skeleton is made up of bones. Bones are a type of connective tissue, reinforced with
calcium and bone cells. Bones have a softer center, called marrow, where blood cells are made.
The main functions of our skeleton are supporting our body, enabling movement and protecting
our internal organs.

The ‘word’ fracture. According to the oxford English Dictionary is defined as “the act of
being broken”. There are different types of fracture and broken bones, but these words meaning
same thing.

Fractures are the commonest injuries involving the bones. Fracture is a break in a bone. It can
range from a thin crack to a complete break. This can result from a direct force, an indirect force
or repetitive smaller impacts (as occurs in a stress fracture).
There are different types of bone fractures. Some are more severe than others, depending on
the strength and direction of the force, the particular bone involved, and the person’s age and
general health. Bone can fracture crosswise, lengthwise, in several places, or into many pieces.
Most fractures happen when a bone is impacted by more force or pressure than it can support.
Common bone fractures include the wrist, ankle and hip. Hip fractures occur most often in older
people.

Broken bones take around four to eight weeks to heal, depending on the age and health of
the person and the type of break
The signs and symptoms of a fracture include:

• Pain at the site of the injury

• Loss of power and movement
• Deformity
• Inability to move the injured part
• Unnatural movement of the injured part
• Discolored skin around the affected area
• the affected bone or joint may have grating sensation.
• Grating of bones
• Swelling around the seat of fracture
• bruising in the injured area
• Visible deformity in the injured area
• Inability to use the limb
• Difficulty supporting weight with the injured area
• If it is an open fracture, there may be bleeding

Causes of bone fractures

• Traumatic incidents such as sporting injuries, vehicle accidents and falls

• Conditions such as osteoporosis, oesteogenesis imperfecta and some types of cancer that
cause bones to fracture more easily, meaning even minor trauma and falls can become
serious
• Weakness of bones with ageing
• Poor health and nutrition
• Inherited gene diseases
• Incomplete calcification
• Physical inactivity
• Use of corticosteroids

Complications of bone fractures

Other problems caused by bone fracture can include:

• Blood loss: bones have a rich blood supply. A bad break can make you lose a large amount of
blood
• Injuries to organs, tissues or surrounding structures: for example, the brain can be damaged by
a skull fracture. Chest organs can be injured if a rib breaks

• Stunted growth of the bone: if a child’s long bone breaks close to the joint where the growth
plates are found.

TYPES OF FRACTURE

A) Due to acute stress

1.Simple fracture/Closed fracture

2.Open/Compound fracture.

COMPOUND FRACTURE

Also called open fractures. In this fracture broken bones that penetrates through the skin and
expose the bone and deep tissues to the exterior environment. Infection and external bleeding are
more likely. Compound fracture are considered much more serious than simple because they may
be complicated by deep infections, if pathogens enter the body through wound.

SIMPLE FRACTURE

Simple bone breaking. Also called closed fractures. In this fracture broken bones are
remaining within the body and do not penetrate the skin. In some cases, a simple fracture can be
difficult to detect.

a) Greenstick fracture

A small, slender crack in the bone. A fracture occurs when a bone bends and cracks, instead
of breaking completely in to separate pieces. The fracture looks similar to what happens when you
try to break a small. “Green” branch on a tree. This can occur in children, because their bones are
more flexible that an adult’s bones.
b) Depressed fracture

Seen in flat bones of the skull. Fracture segments will have depressed below the surface.

c) Complicated fractures

The broken ends of bone endanger some important neighboring organs. There may be damage
to the veins, arteries or nerves, and there may also be injury to the lining of the bone (the
periosteum). e.g.; fracture of the ribs may be complicated by injury to the lungs.

d) Comminuted fracture

A fracture I which a bone is broken, splintered or crushed in to a number of pieces.it usually

occurs in elderly people, people with weak bones, or from tremendous force to the bone. This type
of complicated fracture tends to heal more slowly.

e) Impacted fracture

An impacted fracture occurs when two pieces of a fractured bone are driven in to each other.
Because it involves more than a break in the bone, it is more serious than a simple fracture.
f) Oblique fracture

A fracture that is diagonal to a bone’s long axis. This type of fracture crosses a bone at
approximately 45 degrees.

g) Spiral fracture

The fractured segments to separate in spiral fashion. A spiral fracture, also known as torsion
fracture, is a type of complete fracture. It occurs due to a rotational or twisting force. However, it
always results in the bone being separated two distinct pieces. A spiral fracture can be either
displaced or stable. In a displaced fracture. the parts of the bone at the no longer line up correctly.
In a stable fracture, the parts of the bone line up and are barely out of place.

h) Liner fracture

It has a break that runs parallel to the bones main axis or in the direction of the bone shaft.
I) Longitudinal fracture

It is similar to a linear fracture extended along the shaft but is more irregular in shape and
doesn’t run parallel to the bone axis.

j) Transverse fracture

Bone is completely broken in a manner that is perpendicular to the way of bone runs. Bone is
separate in to two pieces.

k) Compression fracture

Occurs when two bones are forced against each other. The bones of the spine, called
vertebrae, can have this type of fracture. Older people, particularly those with osteoporosis, are at
higher risk.
l) Segmental fractures

In which your bone is broken in two places in a way that leaves at least one segments floating
and unattached.

m) Avulsion fracture

An avulsion fracture occurs when a small chunk of bone attached to a tendon or ligament gets
pulled away from the main part of the bone.

n) Torus fracture

There is very common fracture in children because of a child’s softer bones. One side of the
bone might buckle or bend without any break in the other side. This injury is also called an
incomplete fracture for this reason. It’s also called a torus fracture. These fracture heal faster than
complete fracture.

Management

• Good first aid care of fractures is always important. Moving the broken bones can increase
pain and bleeding and can damage tissues around the injury. This can lead to complications
in the repair and healing of the injury later on.
• First aid for fractures is all about immobilizing (limiting movement of limbs) the injured
area. Splints can be used for this. Control any external bleeding. Complicated breaks where
a limb is very deformed may need to be realigned before splinting, only paramedics or
medical staff should do this.
• Fractures of the head or body such as skull, ribs and pelvis are all serious and should be
managed by paramedics.
• Keep the person still: do not move them unless there is an immediate danger. Especially if
you suspect fracture of the skull. spine. ribs. Pelvis or upper leg. Help them into a
comfortable position.
• Attend to any bleeding wound first: stop the bleeding by pressing firmly on the site with a
clean dressing. If a bone is protruding. apply pressure around the damage of the wound.
• If bleeding is controlled, keep the wound covered with a clean dressing
• Never try to straighten broken bones.
• For a limb fracture, provide support and comfort such as a pillow under the lower leg or
forearm. However, do not cause further pain or unnecessary movement of the broken bone
• Apply a splint to supports limb. Splints do not have to be professionally manufactured.
items like wooden boards and folded magazines can work for some fractures. You should
immobilize the limb above and below the fracture.
• Use a sling to support an arm or collarbone fracture.
• Raise your fractured area if possible and apply a cold pack to reduce swelling and pain.
• Call emergency department for professional help.
• Stop the person from eating or drinking anything until they seen by a doctor, in case they
will need surgery.

B) Due to chronic stress

a) Stress fracture

A stress fracture is a crack in a bone. It can be common injury in high impact sports such as
long distance races or basketball.etc. Such type of fractures can be very painful. However, these
fractures usually heal themselves if proper rest is taken for appropriate duration which may be up
to two months.

Management of stress fracture

• First of all, elevate the extremity and rest while the bone heals itself
• Apply ice to the affected area for 24 to 48 hours.
• If pain persists, give some pain killers
• If there is any need of immobilization of the affected area, use a splint.
• When swelling is reduced, start putting partial weight on the affected area. Crutches or
walking stick may be used in the beginning. After two weeks start putting normal weight.
• For 6 to 8 weeks, avoid the activity that caused stress fracture. Then start doing the activity
slowly.

b) Hairline fracture

The most common form is a stress fracture, often occurring in the foot or lower leg as a result
of repeated stress from activities such as jogging or running.

CARDIOPULMONARY RESUSCITATION
C - Cardio (Heart)
P - Pulmonary (Lungs)
R – Resuscitation (Recover)
Cardiopulmonary Resuscitation (CPR) is a lifesaving technique. CPR can be performed by
any trained person. It involves external chest compressions and rescue breathing. It aims to keep
blood and oxygen flow through the body when a person’s heart and breathing have stopped.
Functions of CPR
• As basic life support.
• To minimize the occurrence of panic during times of emergency.
• For early diagnosis and detection of the symptoms of heart attack.
Procedure
• Check if the person is awake. Tap the shoulder and shout loudly.
• Check to see if the person is breathing normally, if they are breathing, place them in a
recovery position by turning them onto their side.
• Call for assistance.
 • Open the airway. With the person lying on his or her back, tilt the head back slightly to lift
the chin.
• Check for breathing. Listen carefully, for no more than 10 seconds, for sounds for
breathing. if there is no breathing begin CPR.
• Push hard, push fast, Place your hands, one on top of the other, in the middle of the chest.
Use your body weight to help you administer compressions that are at least 2 inches deep
and delivered at a rate of at least 100 compressions per minute.
• Deliver rescue breathe. With the person’s head tilted back slightly and chin lifted, pinch
the nose shut and place your mouth over the person’s mouth to make the chest rise. Two
rescue breathe, then continue compressions.
• Continue CPR steps. Keep performing cycles of chest compressions and breathing until
the person exhibits signs of life, such as breathing, an AED becomes available, or EMS or
a trained medical responder arrives on scene.

POSTURE
The meaning of posture varies from individual to individual .one posture which may be
considered good for one individual may not hold true for another. There are numerous concepts
and views regarding human posture and its significance. To doctors, artists, sculptors, dancers,
psychologists and physical educationists, the term posture conveys different meaning.to a physical
educator, posture is a measure of mechanical efficiency, of kinetic sense, of muscle balance and
of neuromuscular coordination.
Posture is defined as “the position or bearing of the body” and referred to overall alignment
of the body parts to each other when the person is standing in a relaxed stance. Posture is the result
of many underlying processes and tensional relationship throughout the body.
p- Pelvis in neutral
O-on the whole foot
S- Stable joints
T –tight abdominals
U –upright ribs
R-retracted shoulder and
E-ear over shoulder
“Posture is the correct alignment of all body structure” Shyam anand
The head, thorax, pelvis, lower limbs, and feet are referred as body segments and the spinal joint,
hip, knee, ankle and shoulder joints referred as body linkage.
Posture are basically divided in to two types;
1.Inactive postures
There are those positions or postures we implement for resting or sleeping.in these postures
require minimal muscle activity and used for relaxation.
2. Active posture
The integrated positions or action requires many muscles to maintain the active postures.
A. Static postures: In this type of posture the body segments and linkages are aligned and
maintained in a fixed position. Example; standing, sitting.
B. Dynamic postures: In this type of posture body segments and linkages are moving.in this
type of posture the muscles and whole body structure have to coordinate and adapt as per
changing circumstances. example; walking, running, jumping.
Good posture
A good posture can be defined as “when the Skeleton is held is held erect and if an imaginary
vertical line called as “pump line “is drawn from the apex point of the skull to downward till feet.
This line should pass through the shoulders, hip bone, knee and ankle joint. Good posture involves
training your body to stand, walk, sit and lie in positions, where the least strain is placed on
supporting muscles and ligaments during movement or weight bearing activities.
A good posture is one which requires a minimum expenditure of energy for the maintenance
of good alignment, whereas utilization of excess energy and effort indicate bad posture. Good
posture permits mechanically efficient functioning of joints wherein friction in the joints is
minimised, tensions of opposing ligaments are balanced and pressures within the joints are
equalised, requiring minimum wear and tear of joints. A posture can be said to be goof if it fulfils
the purpose with maximum efficiency and minimum efforts. To conclude, in good posture body
will be at ease involving less effort, weight equally distributed, all the axes being parallel to a
vertical line, the curves of the spine are not twisted, abdomen held inside, chest held high in such
a way that the shoulders are in an erect position.
Poor posture
 Poor posture is a position resulting from any way deviation from ideally aligned erect
posture (good posture).
Effect of bad posture on body
• Soreness and pain: soreness and pain are common effect of bad posture that are often
overlooked, but it can lead to long-term health issues. Chronic pain can be a result of bad
posture, especially in the lower back area. Poor posture puts a lot of stress on the spine and
causes lower back pain.
• Poor circulation: women are taught that crossing your legs is the “proper” way to sit.
When actually, it increases the pressure of fluids and gases moving through our bodies.
Crossing your legs can also lead to lower back pain and spider veins if you don’t change
this habit
• Negative mood: As good posture fights depression. Bad posture invites it. individuals
who sat with a slouched or slumped posture exhibited more fear, lower self-esteem, and
worse moods than those who sat upright. More negative words are used than positive in
the linguistic analyses.
• Fatigue: When you have poor posture, the body works harder to keep you upright, and you
will be left feeling tired. Upright is the normal position of the body, so your body is
constantly trying to get it back to where it’s supposed to be. So to do this, the body requires
more energy, which will lead you to feeling of fatigue.
• Poor digestion: poor digestion is one of the negative effect of bad posture that often gone
unrealized. When you slouch and hunch over, your organs bunch up together. This makes
it harder for the body to digest food and can lead to constipatiom.it can also impact your
metabolism and ultimately damage your bodily processes to consume and process food,
leading to life-altering metabolic process.
• Increased stress: increased physical and mental stress are two more negative effects of
bad posture. Physical stress on the body causes soreness and pain, and can also translate
into mental stress. Bad posture can also decrease level of testosterone.
• Poor breathing: The lungs function optimally when diaphragm and rib cage and properly
expand. poor posture restricts blood and oxygen flow, which makes it difficult to breathe
and speak.
• Less motivation: since one of the effects of bad posture is lower confidence, less
motivation can also stem from bad posture. People will also see you as less confident or
shy if you are slouching, which can affect both social and work situations. Less motivation
also goes hand in hand with depression and fear, so it makes sense that it’s affected by poor
posture.
CAUSES OF POOR POSTURE
There are many causes of bad posture. Some are environmental and other may due to heredity.
Bad posture causes many health problems.it reduces the physical output or efficiency to a great
extent.
1. Congenital /Inherited
 Present at birth or hereditary. These can be minor or major which may affect the
individual’s day to day life.
e.g.; clubfoot, spina bifida, Arthrogryposis (curved joints), dysplasia, abnormally curved or
malformed spine.
2.Environmental/Acquired
A. Accident: It may arise due to accidents .it may cause postural deformity due to injuries of
muscles, joints and bones.
B. Diseases: Many leads of health problem like diseases, illness and chronic sickness cause
bad posture.
C. Lack of nutritional diet: Sometime bad posture arises due to unbalanced diet, over diet,
under diet and lack of nutritional diet.
D. Wrong postural habits: The wrong postural habits during sitting, standing, working etc.
E. Improper treatment: Sometimes the improper treatment or wrong treatment for curing
injury causes bad posture.
F. Psychological stress: Psychological stress in life leads to mental tension, unbalances
emotions or behaviour changes. Sometime it leads to postural deformity.
G. Lack of sufficient strength: The poor muscular strength or the unbalance strength of agonist
and antagonist muscles causes postural deformity.
H. Age factor: In old age the muscular strength reduces this may cause bad posture.
I. Poor eye sight: Poor eyesight causes stress our neck and head. Thus body bends forward
and it may cause bad posture.
J. Bad shoes or clothes: In some cases, bad posture arises due to poor quality shoes or
clothing.
K. Fatigue: If we work continuously for a longer duration, we experience fatigue and become
lazy and lethargic. So we adopt a bad posture, if we continue doing that work. Even after
work, when we take rest, we tend to adopt a wrong posture which ultimately results in a
poor or bad posture.
L. Imitation: Imitation also plays a major role in forming wrong posture. Children usually
imitate others as they look for role models. Hence they also adopt poor postures. They
forget their own natural posture.
M. Lack of fresh air and light: lack of fresh air and light are also responsible for wrong
postures. Lack of fresh air may cause kyphosis.
N. Lack of rest and sleep: Lack of rest and sleep may make one slump and thus lead to poor
posture.
O. Lack of proper exercise: lack of proper exercise may also result in proper posture. So,
exercise should be done regularly in a proper way under good supervision. If exercise is
done in a wrong way, then an individual may adopt a wrong posture. Someone should also
know the proper method of exercise and preferably do exercise under guidance.
P. Lack of awareness: lack of awareness regarding good posture may also cause bad posture.
If one is consciousness or aware of postural defects, he will always keep in mind that he
has to adopt a good posture while performing any task.
 Q. Obesity: Obesity enhances the chances of extra stress on the muscular and skeletal
structures of the body. It may cause flatfoot, bow legs, knock knees etc.
R. Improper way of carrying weight: Improper way of carrying weight can cause structural
deformities of the body and especially of the feet. Muscles of the foot suffer from abnormal
stress and it is repeated for a longer time, it may cause poor or bad posture of the foot.
BENEFITS OF CORRECT POSTURE
A. Attractive physical appearance: The first image of personality comes through good
posture. A good posture makes individual appear smart, good looking, charming and
attractive.
B. Improves health status: Correct posture of body reflects positive health status of an
individual. good posture in an image of good health and sound body.
C. Psychological balance: A good posture improves the psychological balance of the body
and mind. It improves the activeness of mind and leads to in optimum development.
D. Lesser strain and pain over joint: good posture causes less strain and pain over joints as
it distributes the body weight equally over the joints.
E. Improves social status: A good physique reflects positive social qualities. Good posture
is an image of happy life style and social well-being of an individual.
F. Better functions of body systems: various systems of body set full chance to function well
if good posture is maintained .it provides optimum functioning of internal organs.
G. Improves appetite: Good increases appetite. Thus health status is improved, it causes less
pressure over abdomen. Thus digestive organs functions properly.
H. Reduces postural deformities: Correct posture helps to prevent postural deformities. Thus
health problems are reduced like kyphosis, lordosis, scoliosis etc.
I. Skill perfection: Good posture improves skills. Thus more perfection in activity. It makes
the movement graceful.
J. Better selection of players: Posture help coaches and teachers for better selection of
players for various activities.
K. Better optimum physical efficiency: Good posture provides optimum opportunity an
individual to improving physical fitness and health’
L. Good body balance: correct posture provides sound body balance thus more stability of
individual while performing workout.
M. Fatigue: A correct posture reduces the fatigue because all the systems of an individual’s
body perform their functions more efficiently.an individual feels less fatigue due to less
stress on muscles and joints.
N. Improves concentration power: As a matter of fact, a good posture helps in breathing
properly. When an individual breathes properly his concentration power as well as thinking
ability are improved.
O. Improves speech: a correct posture helps to improve speech because it gives freedom to
diaphragm. if there is too much stress on diaphragm, an individual cannot speak clearly
and efficiently.
CORRECT POSTURE OF STANDING AND SITTING
Correct standing posture
In the standing position,
• Both the heels of the feet should meet each other.
• Toes of the feet should be 3 to 4 inches apart.
• The whole body should be erect, with straight knees, chin inside, chest forward, belly
backward and press inside, with equal body weight on both feet.
• The entire body should be balanced in this position.
• From the side, the line of center of gravity must pass through the ear, shoulder, hip, knee
and ankle.
• In such position, the muscles and ligaments remain free of stress.

Correct sitting posture

• Hip should be as far back in the chair as possible.
• Head, spinal column, shoulder and hips should be in straight line and erect.
• Legs should touch the ground and should not be in hanging position.
• Thighs should be in horizontal position.

POSTURAL DEFORMITIES
Deformity is the malformation of any component or body part or joint of the body. There are
various types of deformities like spinal curvature, knock knee, bow legs, flat foot etc.
Spinal curvature
 Everyone’s spine curves a little in your neck, upper back and lower back. These which create
your spine’s S shape are called the lordotic (neck and lower back) and kypotic (upper back). They
help your body:
• Absorb shock
• Support the weight of the head
• Align your head over your pelvis
• Stabilize and maintain its structure
• Move and bend flexibly
This type of deformity is related to the spine. This deformity is caused by carrying excessive
weight beyond one’s capacity. In other words, we can say that weak muscles cause the formation
of spinal curvature. This defect is generally in number of children. Excessive strain during
childhood on the vertebral column makes it curve and causes spinal deformities. There are three
types of spinal deformities:
(a) Kyphosis (b)lordosis (c) scoliosis
1.Kyphosis
This deformity is also called round back or hunch back. Kyphosis usually refers to an
abnormally curved spine.it is a condition in which the spine in the upper back has an excessive
curvature. The upper back of the spine (thoracic region) is normal. The spine naturally curves in
the neck, upper back, and lower back to help absorb shock and support the weight of the head, but
the term ‘kyphosis’ refers to an exaggerated rounding more than 50 degrees.
If you have kyphosis, you may have visible hump on your upper back. From the side, your
upper back may be noticeably rounded or protruding.in addition, people with kyphosis appear to
be slouching and have noticeable rounding of the shoulders. Kyphosis can lead excessive pressure
on the spine, causing pain. It may also lead to breathing difficulties due to pressure put on the
lungs. Kyphosis in older women is known as dowager’s hump.
Symptoms
• Visible hump on back
• Spine stiffness
• Rounded shoulder
• Fatigue
• Tight hamstring
• Loss of sensation
• Numbness, weakness, or tingling in the legs
• Breathing difficulties

Causes
 Kyphosis can affect people of any age. It rarely occurs in new born child since poor posture
is usually the cause. Kyphosis from poor posture is called postural kyphosis. Other causes of
kyphosis include:
Aging Tumors
Muscle weakness in the upper back Polio
Scheuermann’s diseases Diseases of the connective tissue
Arthritis or other bone degeneration Birth defects, such as spina bifida
diseases
Osteoporosis, or the loss of bone strength Paget diseases
due to age
Injury to the spine Muscular dystrophy
Slipped discs Mal nutrition
Scoliosis or spinal curvature Improper use of equipment
Infection in the spine Due to heredity
Lack of physical exercise Improper sports training

Precautions
• We should take balanced diet
• We should do regular exercise
• We should learn to correct sitting and standing position to avoid this deformity.
• We should not lean forward or study for longer period
Remedial measures
• While sitting in a chair buttock should be touching the back of the chair, hips should be
placed as far back as possible hold your hand by the other hand behind the back of the chair
stretchy your shoulders backwards stay in this position for some time.
• We should do chakrasanas, dhanurasanas, bhujangasana and ushtt asanas regularly.
• All exercise of backward bending is useful.
• Lie down your chest keeping hands on hips allow raise your trunk with head a few inches
above the ground. Try to raise it slowly come back to earlier position, this exercise
should be repeated 10 times.
• Use pillow under your back at night while sleeping.
• Bend your head backward in standing position.
• Perform swimming
• Activate weak muscles + stretch tight muscles
• Reverse prank bridge, arch up (shoulder flexion, shoulder extension, horizontal
abduction)
2.Lordosis
Lordosis is also called hollow back. Lordosis is the inward curvature of the spine bends in
front beyond the normal level. Thus abdomen is ahead of body and shoulders come outward and
sideward.it create problem in standing and walking. Commonly seen in lumbar spine.
The most common symptom of lordosis is muscle pain. when your spine curves abnormally,
your muscles get pulled in different directions, causing them to tighten or spasm. If you have
cervical lordosis, this pain may extend to your neck, shoulders and upper back. You may also
experience limited movement in your neck or lower back.
Symptoms
• Numbness
• Tingling
• Electric shock pain
• Weakness
• difficulty maintaining muscle control.
Causes
Lordosis can affect people of any age. Certain condition and factors can increase your risk of
lordosis. This includes:
Imbalanced diet Spondylolisthesis
Improper development of muscle Achondroplasia
Obesity/over weight Osteoporosis
Diseases affecting vertebrae Osteosarcoma
Lack of physical activity Kyphosis

Precautions
• Balanced diet should be taken
• Stand straight while carrying weight
• Never take excessive food
• Maintain your weight
• The body should be kept straight while carrying weight
Remedies
• Perform toe-touching at least 10 times
• Perform sit-ups and hyper extension
• Perform halasana, paschimottanasana, vipreetakarni asana and uttan padasana
• From standing position bend forward from hip level. repeat this exercise 10 times.
• Lie down your back, raise your head and legs simultaneously for ten times
• You should lie down supine position, i.e., on your back, then should raise your legs at 45-
degree angle. Remain in this position for some time.
• Toe touching should be performed for at least 10 times.
• Sit down and extend your legs forward. Try to touch your forehead to your knees. Repeat
this exercise 10 times.

3.Scoliosis
Scoliosis is an abnormal curvature of the spine. It is problem of spine in which vertebral
column bend to sideward (lateral curvature of spine). The normal shape of a person’s spine
includes a curve at the top of the shoulder and a curve at the lower back. If your spine is curved
from side to side or in an “s” or “c” shape, you might have scoliosis. People with a family history
of scoliosis are more likely to develop the condition. Women have a more severe form of scoliosis
than men.
Symptoms
Symptoms vary depending on the degree of scoliosis. Common symptoms associated with
scoliosis include;
• One shoulder blade that’s higher than the other
• One shoulder blade that sticks out more than the other
• Uneven hips
• A rotating spine
• Problems breathing because of reduced area in the chest for lungs to expand.
• Back pain
Causes
Cerebral palsy Rickets
Muscular dystrophy Carrying heavy load in one shoulder
Spina bifida Wrong standing structure
Spinal injuries or infections Partial deafness
Diseases in the joints and bones Lack of physical training
Under-developed legs Genetic condition and neurological
abnormalities

Remedies
• Bending exercise should be done on the opposite side of the ‘c’ shaped curve.
• Hold the horizontal bar with hands and let your body hang for some time
• Hold the horizontal bar with your hands and swing your body to the left and right side
• Swim by using breast stroke technique
• Perform ardha chakrasana, trikonasana. And tadasana
• Perform chin ups

4.Knock knee
Knock knee, known as genu valgum, is a knee misalignment that turns your knee inward. The
gap between the ankles goes on increasing. The individual faces difficulty in walking and running.
He cannot walk or run in a proper manner. Owing to this deformity, people cannot be good player.
Knock knee is common in young children and usually corrects itself as they grow. Up to 75 percent
of children between age 3 and 5 have knock knees.
Symptoms
• Hip pain
• Knee pain
• Feet not touching while standing with knees together.
• Stiff or sore joints
• A limp while walking
Causes
infection in knee or leg Lack of balanced diet calcium,
phosphorous etc.
 Rickets Weak legs due to weak muscle
Arthritis Chronic illness
Obesity Ligament weakness at early age
Flat foot Fractures and injuries involving knee
joint

Precautions
• Balanced diet should be taken
• Babies should not be forced to walk at very early age
• Perform proper exercise
Remedies
• Keep a pillow between the knees and stand erect for same time
• Horse riding
• Use walking callipers
• Perform vrikshasana, akarana danurasana, padmasana, and gomukhasana.

5.Bow leg
Bow leg is also a postural deformity.it is opposite to knock knee position. If there is a wide
gap between the knees when standing with feet together, the individual has bow legs or genu
varum.in this deformity, knees are wide apart. There remains a wide gap between knees when a
bow legged person keeps his feet together. This deformity can be observed easily, when an
individual walks or run.
Symptoms
• Knee or hip pain
• Reduced range of motion in hips
• Difficulty in walking or running
• Knee instability
Causes
Deficiency of phosphorus and calcium Obesity
Deficiency of vitamin D Rickets, Piget’s disease
Using defaulted footwear Improper way of walking
Dwarfism Blount’s diseases

Precautions
 • Normal exposure of sunlight
• Appropriate level of vitamin D, calcium and phosphorous in the diet
• Prevent the children from getting over weight
• Children should be given balanced diet
Remedies
• Dietary supplements like vitamin D, calcium, phosphorous, should be taken
• Walk on inner toe of foot
• Perform ardhachakrasana, garudasana and ardhamalsendrasana
• Stand erect keeping the feet together, wrap a soft cloth tightly in both knees-try to squat as
far as possible it 4 to 6 times.

6.Flat foot
Flat foot (pes planus) are commonly known as fallen or collapsed arches. flat foot is a postural
deformity in which the inner curve of foot has bulge more than normal.in this default of feet person
gives complete print of his foot sole over the plane surface.
It is important to care for flat foot properly since they can lead to pain, stress and imbalance
in other parts of your body.
Symptoms
• Inflammation of soft tissue
• Heel, foot, and ankle pain
• Abnormal walking pattern
• Arthritis
• Plantar fasciitis
• Posterior tibial tendon dysfunction
• Shin splints

Causes
 Obesity Weak muscles
Injury of foot and ankle Using improper shoes
Aging Carrying heavy weight for a long
period
Rheumatoid arthritis Rapid increase in body weight
Diabetes Lack of physical activity
Precautions
• Always wear the shoes of proper shape and size
• Obesity should be avoided
• High heeled shoes should be avoided
• Don’t carry heavy weight for a long time
• Babies should not be forced to walk at very early age
Remedies
• Walking on sand
• Regular running
• Writing with foot
• Jumping on toes regularly
• Performing up and down on heels regularly
• Rope skipping regularly
• Perform tadasana
• Perform stretching exercise

Model questions

Very short answer type questions

1.What is first aid?
2.What is laceration?
3.What is incision?
4.What is sprain?
5.What is strain?
6.What do you mean by posture?
7.State or mention postural deformities?
8.What is knock knee?
9.Suggest two exercise for correcting flat foot?
10.What is balanced diet?
Short answer type questions
1.Discuss the objectives of brief first aid brief?
2.Discuss the management of sprain?
3.Briefly explain about vitamins?
4.Briefly explain about protein?
5.What are the corrective measures for bow legs?
6.How can we correct/treat the problems of scoliosis?
7.What are the causes of knock knee?
Long answer type questions
1.What are the causes of bad posture? Explain detail?
2.What do you mean by posture? What are the benefits of correct posture Explain?
3.Write in detail about dislocation and Fractures among the bones and joint injuries.
4.Discuss the management of abrasion, contusion and laceration.