Over the years, the use of illegal substances and supplements has resulted in the untimely deaths of several bodybuilders and weightlifters in Pakistan. It’s a practice that needs to end. Ask experts and they will tell you that the best way to attain strength and fitness is by relying on a natural diet. In this week’s Get Fit segment we get expert advice about the use of sports supplements and a variety of other issues.

Q: I am 29 years old and a tennis player. My eye sight is perfect and I don’t wear glasses even for reading. Lately I’ve developed a vision problem while playing.  The tennis ball seems blurred when it approaches me. Some friends say it’s a "double vision".  I need your advice as I am worried about it. --Mohammad Rafiq

A: Dear Rafiq what you have described is typical of a refractive error. Most likely Hypermetropia. Sometimes double vision can be associated with it too. You need to go to an eye doctor and get a complete eye exam.

Dr. Azam Ali

FRCOPHTH (UK), FRCS (Edinburgh), FRCS (Glasgow), MRCS OPHTH (UK)

Associate Professor | Department of Ophthalmology

Liaquat National Hospital & Medical College

Q: Recently a friend of mine had a twisted ankle while playing football. Doctors plastered his ankle and advised him a complete rest. People say that after the recovery, he will never be able to play football again. Is it true?  --Saghir Khan

A: Ankle Injury is one of the common injuries that happen during football game as player tackles each other for the possession of the ball which lead to this injury. Ankle joint consist of ligaments, tendons, bone and articular surface for its stability. Any injury outcome depends upon its severity and the tissues involved. Prompt expert management of these injuries by Orthopedic Sport surgeons will help in early and good recovery from the associated injury and prevent from neglected or maltreatment which may lead to delay or chronic problems which might be incurable ever. So please consult your Orthopedic Sports surgeon to avoid handicap later in life.

Dr. Muhammad Kazim Rahim

MD, FCPS (Ortho) AO Fellow (Germany), Sports medicine Fellow (IRI) (France), Hip and Knee Arthroplasty Fellowship (PAS, Pak)

Assistant Professor | Department of Orthopaedic Surgery

Liaquat National Hospital & Medical College

Q: I am 27 and play cricket regularly. I am a fast bowler. I have been told by a senior that efforts to increase the speed while bowling could damage my rib cage. Can you please explain me what a rib cage fracture is and how it occurs. --Mazhat Butt

A: The rib cage consists of the 12 thoracic (chest) vertebrae, 12 ribs on each side, and a breastbone (sternum). The ribs are curved, compressed bars of cancellous bone. The uppermost is the first rib. The subsequent ribs become larger in size and have a greater arc of curvature till the 8th rib after which they again reduce in size and curvature. 11th and 12th ribs are straight, small and do not attach to breastbone and hence are called floating ribs. The first seven ribs are attached to the breastbone by cartilages called costal cartilages. The ribs are anchored posteriorly to the 12 thoracic vertebrae (T1-T12).

A broken rib is a common injury. The ribs break when direct force is applied to chest wall, such as a fall from height, motor vehicle accident or an impact during contact sports or assault. Many broken ribs are merely cracked, while the fragments are not displaced. Cracked ribs while painful aren’t as potentially dangerous as the ribs that have been broken into separate pieces and the pieces are displaced.

A jagged edge of a broken rib can damage major blood vessels or internal organs, such as the lung. Broken ribs usually heal on their own in 6-12 weeks. Adequate pain control is important in early stages so that one can continue to breathe deeply and avoid lung complications, such as pneumonia. If lung or blood vessels are damaged they need treatment on its own merits.

There are few factors which can increase ones risk of breaking a rib; such as Osteoporosis: a disease in which ones bones lose their density and strengths, participation in sports such as contact sports, rugby, hockey or football, where ribs can suffer in direct blows to chest, and cancerous lesion which can weaken the bone.

Dr. Syed Mahmood Ul Haq

FRCS

Head of Department, Assistant Professor | Department of Thoracic Surgery

Liaquat National Hospital & Medical College

Q: I am a weightlifter and bodybuilder. I am not very muscular, but my friends ask me to take extra food supplements to develop my muscles. Is it alright for me to take these supplements, and are there any side effects? --Mohammad Naeem

A: Worldwide, many bodybuilders and weightlifters use food supplements to build up their muscles. But some of these sports supplements can be harmful to the human body.

Muscles are basically composed of proteins. These proteins can either be taken in diet or as food supplements. Increasing dietary proteins is the best method to increase muscle mass. Dietary protein sources also contain vitamins and minerals, which are essential for smooth functioning of many body functions. Egg white, low fat milk, cottage cheese, low fat Greek yogurt, red meat, beans, lentils, some nuts, vegetables like broccoli and spinach are good sources of dietary proteins.

Supplements available in the market may contain proteins, steroids, hormones and other stimulants. You may only use protein supplements, stay away from the rest. Many illegal products may be available in the market. Always select reputable and genuine products, and always study the product label. Take recommended doses only, not more. Protein intake should not exceed double the daily recommended intake. Be careful not to consume excess proteins, as excess proteins can unnecessarily burden your kidneys. Please stay away from steroid and hormone supplements, as well as illegal and unauthentic supplements. These can lead to kidney, liver and heart problems, as well as other side effects like nausea, diarrhea, insomnia, headaches, restlessness, increased blood pressure and heart rate.

In short, prefer dietary proteins over supplements. If supplements have to be taken, only use protein supplements from reputable brands in recommended doses.

Dr. Ali Asghar

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

Assistant Professor | Department of Diabetes, Endocrinology and Metabolism

Liaquat National Hospital & Medical College

(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.)

Khalid Hussain