The mighty Jansher Khan won a record eight World Open titles. He could have easily won a few more but a career-ending knee injury made sure that he won’t add any more world titles to his tally.

I still remember the 1997 British Open final in Cardiff when Jansher, already suffering from a knee problem that finally ended his career, tamed a younger and fitter Nicol in a five-game thriller.

The very next year, however, I was there to witness the beginning of the end of Jansher’s era. The venue was the National Indoor Arena in Birmingham where despite all odds, Jansher cruised into the final, looking for his seventh British Open title in a row. Before the final, he confessed to me that his knees were hurting "too bad" and it showed when he gave up after losing a gruelling first game 16-17 against Nicol.

After that defeat Jansher couldn’t win any major title though he continued trying till 2007 when he made his last comeback at the age of 38. In this week’s column, we get experts to answer a variety of questions from our readers including one about a squash players suffering from a bad knee.

Q: My father has the initial signs of dementia. He used to play golf. I’ve been told that it helps with such patients. Would you recommend that my father, who is in his sixties, resumes playing? Will it be beneficial for him?  --Sadia Ahmed

A: First of all, I am assuming that the diagnosis of dementia given to your father was after consultation with either a properly trained neurologist or a psychiatrist. For an individual to be diagnosed with dementia, this requires not only a proper history and physical exam, but also investigations such as blood tests and either a CT scan or MRI of the brain. Common conditions such as depression can easily be ruled out by a proper history. This is important as depression in older individuals can easily present with concentration and memory problems that can be erroneously diagnosed with dementia.

Most cases of dementia are progressive and so far no medical treatment can reverse the symptoms of dementia or halt its progress. Medications approved for dementia will only delay the symptoms of memory disturbance at best by 6 months to a year. One variety of dementia, called vascular dementia, caused by strokes, can be halted by controlling risk factors for cardiovascular disease.

It is important that your father stay busy. If he enjoys playing golf, then he should continue with this activity. However certain commonsense precautions are in order. He should not be left on his own, but with an attendant. It is very common for people with dementia to get lost and not know how to get back. Also given our weather, it is important that your father not get dehydrated, as this may lead to further confusion. In fact any activity, especially if it increases social contact is beneficial. It may not reverse the illness, but will ensure a better quality of life.

Dr. Mehmood A. Rehman

M.D, Diplomat of
American Board

Consultant, Assistant
Professor

Department of Mental Health

Q: I was an avid body-builder but quit the sport a few years ago. Now at 53, I have lost a lot of my muscle mass and feel week. Can I resume doing weight training at my age? --Tahir Shah

A: Firstly, I would truly value that you worry about your wellbeing and wellness at the age of 53. A major contributor to muscle mass decline is lack of exercise and sedentary life style, the muscle emaciation is reduction in bulk, which is because of rapid protein breakdown or decreased protein formation in skeletal muscle. Quitting games and physical exercises for a while degrades the protein in your muscle and decreases lean body mass.

Hence, exercises can be utilised as a strategy to treat muscle emaciation. Before Resuming strengthening exercise after a three year interval please avoid some common mistakes done by weight lifters and sports men, they do painful repetitive exercises which causes ligamentous sprains and muscular strains.

So you can begin with mild to moderate exercises, for example, rowing, cycling and walking. Furthermore 45 minutes of strengthening exercises 2-3 days per week for all the significant muscles will be very useful. At that point progress towards progressive resisted exercises that can be performed 2 to 3 days per week which should be possible with free weights, exercises machines and elastic bands.

Here I can tell you some specific exercises which can help you. Make sure you do these exercise in the supervision of a trainer or physiotherapist these exercises includes biceps curls, leg curls, bench press squats, planks ,double leg bridging side lying hip-abdominal lift.

Syed Hasan Abbas Rizvi

Principal & Associate
Professor

Doctor of Physiotherapy, MSPT, BSPT, BSc (Physiology), PGD (Speech Language Pathology)

Q: I’m a regular squash player but in recent times I’ve been suffering from a knee problem. I’ve been told to quit squash while another recommendation is to get knee surgery. What do you recommend?  --Asif Khan

A: Squash is an intense and highly dynamic sport when it comes to terms of kinesthetic responses. Proper warm up and stretching exercises before a round are imperative. It is also highly possible that you may be suffering from a torn ligament or meniscal injury which can lead to internal knee derangement for which clinical examination and radiological tests are mandatory. Kindly consult a sports specialist and get expert help for your joint before it is too late.

Dr. Muhammad Sufyan

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

Assistant Professor

Department of Orthopaedic Surgery

Q: I am a club cricketer. I have a chronic lower back problem which is giving trouble. What should I do? --Syed Asim Mahmood

A: Cricketers usually develop these problems because of their strenuous activity throughout the day for their bowling, fielding and batting activities which place great stress on different parts of the body and specially the back. Fast bowling consists of actions which transfer stress to the trunk with various actions of sudden forward and backward movement at the delivery stride. You formally need an evaluation of your spine for any pars interartuclaris defects as this becomes the cause of lumbar stress fractures. There are certain things that your physiotherapist should look into the foremost being the bowling technique. Your physio should follow a proper warm up before the match and proper rest periods before the next match. Hope this helps in eliminating your back problem.

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

(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.)