Any avid sportsperson is well aware of the possibility of sustaining an injury. Sports injuries are an almost unavoidable aspect of physical activity. If you are physically active for long enough, there is a big possibility that you will encounter some type of injury during your lifetime.

Our ‘Get Fit’ column is designed to provide practical information that you can implement into your training regime to minimise and prevent as many sports injuries as possible. It’s an interactive column where all your queries about sports injuries, and how to get fit and to be at the top of your game, are answered by eminent experts.

Following are some of the queries from our readers:

Q: In my mid forties, I am an avid sportsman and play games like cricket, tennis and squash regularly. But over the years I have been experiencing a decline in the level of my performance. I almost always have problems sleeping. Do you think my lack of sleep is causing issues for me in my sports? If yes, how do I overcome it? - Tahir Ahmed

A: It seems that you have maintained quite a good level of physical fitness up till now as you have been involved in high intensity sports. However, considering your age it may be prudent to know that body muscles and joint experience fatigue with advancing age. The sleeping pattern you mentioned maybe the result of over activity. You should consider decreasing your physical activity and opt for proper coaching for the activity level of your choice. However, it seems that you might also be suffering from some sort of sleep disorder which can be affecting your performance. Depending upon your BMI sleep apnea syndrome can be one of the causes of your sleeping troubles. Sleep pattern disruption needs to be evaluated as proper rest is also one of the mainstays of physical performance for an avid sportsman.

Dr. Muhammad Sufyan

FCPS (Ortho) A.O Fellow
(Germany), Sports Medicine Fellowship (Singapore)

Assistant Professor

Department of Orthopaedic Surgery

Q: I am a social golfer and suffer from stiff back and have also developed an elbow problem which affects my game. What can I do to overcome it? --M. Asif

 A: It seems that your problems are stemming from two issues of posture and your general health conditions. Stiff back is the most common problem golfers face due to inadequate warm-up and weak back muscles. You are most likely also developing a problem in your elbow known as a Golfers Elbow due to repeated wrist and finger clenching movements. Excessive and repeated stress to your forearm muscles is mostly the cause of this problem. Depending upon your age you need a proper warm up and correction of your posture in order to be apt in your game. It is advisable to seek assistance from a coach to correct your posture and strengthening of your forearm muscles in order to help with your swing.

Dr. Muhammad Kazim Rahim

MD, FCPS (Ortho) A.O. Fellow (Germany), Sports medicine Fellow (IRI) (France),

Hip and Knee Arthroplasty Fellowship (PAS, Pak)

Assistant Professor

Department of Orthopaedic Surgery

A: Thank you for your question. Dietary proteins are chiefly responsible for increasing muscle mass and strength. Though we want your son to increase weight, it should be mostly from muscle mass than fats. He should increase his protein intake, take carbohydrates in moderation, and eat less fat. Proteins are both animal and plant based. While selecting animal based proteins, low fat animal proteins should be preferred.

Egg is a great source of protein. He should eat 3-4 egg whites daily. If he can tolerate milk, he should take 3-4 glasses of low fat milk every day. Cottage cheese and low fat Greek yogurt are good choices. Meat, be it beef, mutton, chicken or fish, are rich sources of proteins. Try not to cook in oil so as to avoid fat. Include beans, lentils, some nuts, and vegetables like broccoli and spinach in his diet.

Whey powder may be used, but at his age, I think it would be great to go with dietary sources of proteins. He is young, with a lot of growth potential coming up in the next decade, with all the right hormones working for him to grow his muscles. He should also have a good exercise routine and should have at least seven hours of sleep every night.

I would also advise him to see a nutritionist to get a proper diet schedule. Your son certainly seems to have a great future in golf in Pakistan; wishing him all the best!

Dr. Ali Asghar

MRCP (UK), FACE (USA) Fellowship in Diabetes & Endocrinology

Assistant Professor

Department of Diabetes,
Endocrinology and Metabolism

Q: My son is an excellent sportsman and performs really well in routine events. But I believe that he is mentally weak because when there is any kind of extra pressure he mostly crumbles. What can we do to make him mentally strong? -Mrs Samar Ali

A: First of all he will need an assessment by a trained mental health professional to find out what is actually causing his performance to suffer when he is under pressure. This will require an assessment of both the child and parents and possibly require input from the coach and other teachers. A hierarchy needs to be established starting with the least anxiety provoking situation culminating with actual performance in matches. This form of therapy is called systematic desensitisation and works exceptionally well with anxiety disorders. Along with this, the child should be taught relaxation techniques. It will also be important to know what this child is thinking during periods of extreme stress. Is his performance related to anxiety in crowds or due to perceived personal failure?

Secondly, parents need to be educated about not putting extra pressure. They should be taught to provide encouragement at every turn in order to build his self-esteem. Importantly they should let the child know that he is still loved no matter what.

Lastly, the term ‘mental weakness’ needs to be taken out of the vernacular. The child is suffering from a very common ailment that can easily be addressed over time. It is also important to educate all concerned that progress will happen over time. There is no quick fix. Medications should only be prescribed if therapy is not progressing as expected.

Dr. Mehmood A. Rehman

M.D, Diplomat of American Board

Consultant, Assistant Professor

Department of Mental Health

(All the specialists on our experts’ panel are associated with Liaquat
National Hospital. Please send your queries at khalidhraj@gmail.com or Anjum.Rizvi@lnh.edu.pk.)