From knee pains to shoulder injuries, sportspersons of all ages and skills levels have to deal with them. In this column our panel of experts answers all your queries about fitness issues and injuries.

Q: I’m a club level footballer age 26, and having knee pain in recent times. Scans have shown no major injury. What can I do to strengthen my knees in order to continue playing? - Amir Altaf.

A: Beside the acute injury, did you experience the effect of repetitive micro trauma and joint overloading as it also causes knee joint pain.

In order to strengthen your knee you must follow the proper exercises to avoid recurrent pain.

Strengthening involving Isometrics Muscle Settings Exercises which develop muscle control then progress to isotonics to improve Ecentric Loading in lower extremities.

Plyometric Exercises are very beneficial for you because they are more functional than open-chain exercises. They help in early return to sports activity and include jump-landing, rope skipping, box skipping and figure of eight running all of which improve your agility and speed during playing.

Concentrate on strengthening the quadriceps through appropriate exercises and resistance training with theraBands, to regain neuromuscular control and to improve lower-limb mechanics.

Syed Hasan Abbas Rizvi

Principal & Associate
Professor

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

Q: I’m a swimmer. My age is 17. I want to represent Pakistan at the international level. I need your advice to get fitter for my future goal? - Mazhar Habib.

A: It’s good to hear that you wish to represent Pakistan at international level in swimming. Basically swimming relies on propulsion through the water using both the upper and lower limbs.

First of all you must understand the swimming biomechanics and stroke proficiency to minimise risk of injury.

As you go about your swimming workouts, take hydration and nutrition into account. Just like any other form of activity, you must eat well both before and after the session especially after higher-intensity swims.

If you want to become free style swimmer in which you need to generates force, you must focus on following chest, lats abdomen and back muscle exercises.

If you want to swim breaststroke, you need good strength and cardio vascular workout and need to develop shoulder, chest and lat muscles.

Back stroke is perfect for recovering after an intense workout, focus as on building back and hamstrings.

The butterfly swimming is good for fat burning and boosting metabolism. You will need to develop chest, back, core and shoulder muscles.

You should also practice breathing exercises or breathing alternately on right and left sides. To do it, turn your body to either side every time you take a breath during these swimming workouts. It enhances your aerobic capacity and endurance.

You should train individual groups, of muscles especially in upper extremities, beca use adequate strength and control of the scapular stabilising muscles and the internal external rotators of shoulder make your stroke efficient and powerful and will also prevent you from shoulder pain in the future.

Syed Hasan Abbas Rizvi

Q: I’m 42 years and an avid sportsman and cannot stay away from playing various sports like tennis and squash. But I’ve been suffering from joint pains and my activities have become painful. What sort of treatment should I seek? -Mansoor Ali

A: It seems obvious that you have enjoyed quite a good level of fitness by staying active in sports like squash and tennis. What you need to understand is that the body undergoes a change as you age which is a natural phenomenon and there are certain adaptations that you need to follow in order to enjoy the quality of life you desire.

Joint pain is a phenomenon which has various causes one of which is development of osteoarthritis in your age group. It is strongly recommended to undergo a review with your nutritionist, physiotherapist and physician. Treatment varies from change of life style which includes choosing of one sport and training your body accordingly to investigations regarding your bones and joint health. Balance of these will allow you to continue enjoying your sports in best health.

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

Q: I’m a young fast bowler and have recently developed a shoulder problem. What should I do about it? I am 18 years old? -Pervez Ilyas.

A: The shoulder pain is common in cricketers because of repeated actions of throwing and bowling. Shoulder joint has a group of very sensitive muscles and ligaments which can become damaged due to overuse during cricket. Injuries to these soft tissues are very common and they need early diagnosis so to prevent further damage. As an 18-year-old and a fast bowler you need to stay in touch with your physiotherapist looking into strength of your muscles and improving them along with flexibility of your tendons and your bowling action. At times the bowling action needs to be changed in order to resolve the pain and discomfort. If you persistently continue to have problems despite these measures it is strongly advised to undergo complete evaluation of your shoulder to improve your pace and keep you in the field.

Dr. Muhammad Sufyan

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

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.)