From cramps to tennis elbow, there are a variety of problems that can affect any sportsperson at any stage of his life. Most of us who engage in some sport just as a pastime tend to forget the importance of proper warm-up. We just get there and throw ourselves in the deep end. In this week’s column, we get expert advice about a variety of sports-related injuries and fitness issues.

Q: I am a swimmer. I’m 25 years old. Recently, while swimming, I develop cramp on my left thigh muscle. It’s so painful that I have to get out of the pool. After half an hour or so, the cramp settles down. Is this some kind of disability? What measures should I take to avoid these cramps? –Yousuf Pervez

A: Well it appears to be a muscle pull. The possible causes for your injury are that the muscles in the front of your thigh (the quadriceps) are tight as they pull your pelvis forward and fix the hamstrings. Cramps may also be a result of dehydration. So first of all tell me about nature or type of pain which you experienced. Then I am able to answer your question properly.

Generally, it happens when the gluteus are weak, hamstrings can be over-burdened and become strained.

This isn’t a disability, it’s just a muscle pull which can be happen at any time so don’t stress over that. Leg cramps can strike at any time and to anyone and the pain is typically temporary – lasting from many seconds to up to fifteen minutes.

I suggest that whenever you go for a swimming session you have to do some simple stretches like hamstrings and calf raises. This will minimise the risk of injury for you in future.

Take warm or hot water bath it’s better for cramps, as hot liquids increase blood flow to your skin and may relax cramped muscles. You can also eat water-based foods to increase your hydration, including: lettuce, celery etc.

Your kick should be flexible so as not to create tension in your lower extremities. The arc of your kick should be small and keep the legs close together, encouraging a small and quick kick with straighter legs.

Ignore fast and sprint kicking for now. Go easy on all the kicking sets for the next 2-3 weeks and then try some faster kicking later in the program to see if the muscles have strengthened.

Syed Hasan Abbas Rizvi

Principal & Associate Professor

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

Liaquat National Hospital & Medical College

Q: I’m a wicket-keeper. I am 21 years old, and play for my university. For the last six months I am experiencing a severe pain in my back, after spending an hour or two behind the wickets. Is this called a back injury, and what measures should I take to keep myself fit? –Hassan Khan

A: Wicket-keeping is the least injury prone discipline in cricket. However, the repetitive nature of wicket-keeping, involving bending forwards, squatting, jumping and diving, puts a number of body parts at risk of injury.

Lower back pain from repetitive bending forwards is the result of a lumbar disc bulge. Pain may increase on firmly touching the affected level of the spine and there is often associated muscle spasm and restricted spinal movement. Symptoms often increase with wicket-keeping, batting, repetitive or prolonged sitting, bending, lifting, coughing or sneezing and are often worse first thing in the morning.

Keeping the rest of your body moving appropriately is beneficial in lowering the chances of an injury to your lower back. When preparing the body for wicket-keeping, you may do these exercises.

Lie on your tummy, bend the knee of the hip you want to stretch and place it underneath your other thigh. Squeeze your buttocks and try to push your hip to the floor.

Kneel on the ground with a rolled towel under your toes. Sit back on your heels

Lean forwards and place both hands on a chair, extend your back. Keep your elbows straight and push your shoulders to the floor. Whilst pushing your chest towards the floor and keeping your arm straight take one hand and reach through to other side, rotating your trunk.

Performing simple back strengthening exercises, swimming, running and taking care of posture may, Alleviate pain. If the pain persists, please see a neurosurgeon.

Prof. Dr. Salman Yousuf Sharif

FRCS (SN), FRCS (Eng)

Head of the Department | Department of Spinal and Neurosurgery

Liaquat National Hospital & Medical College

Q: While playing basketball, intercepting a powerful and speedy pass, the ball hit my nose. Bleeding started from my nose but stopped after sometime. Now I feel difficulty in breathing, with a blocked nose. I am 26, and need your advise. –Marghoob Ahmed.

A: Injuries to the nose are among the most common sports injuries and nasal bones are the most commonly fractured facial bones. Pain and bleeding are the most common symptoms soon after injury while swelling and difficulty in breathing through the nose may develop after a while. The bleeding usually stops after variable period of time. Nasal obstruction can be due to generalised swelling inside the nose but sometimes it is due to ‘septal hematoma’ which is collection of blood within the nasal septum. This is a serious condition which needs to be treated as an emergency by surgery.

What you should do now depends upon the time duration since the injury. If it is only few days you should consult an ENT surgeon straight away but if your injury is old then it is not an emergency but a consultation is required.

Dr. Saeed Akhtar

FRCS (Edinburgh)

Assistant Professor | Department of E.N.T-Head And Neck Surgery

Liaquat National Hospital & Medical College

Q: I am 36 years old and a regular tennis player. I had only heard of a “tennis elbow” but never experienced it. But for the last two months, after the game I feel pain in my elbow. If its “tennis elbow” what’s the cure? –Ahmed Y. Khan

A: Tennis elbow is a painful condition of the elbow which develops due to overuse. It is most commonly seen in people in whom hand and elbow are repetitively and vigorously used. There is pain on the outer part of the elbow. This condition is treatable with rest, pain management drugs, physiotherapy, bracing, use of injections like Platelet Rich Plasma and steroids. In resistant cases rarely there is a chance of surgery to treat this condition. Overall the response is very good with non-operative methods. There is also another condition in which pain is on the medial side of the elbow which is called golfers elbow. What you are experiencing can be any of these problems. It is highly recommended that you see a specialist who can diagnose your problem correctly after which it can be correctly managed to keep you in sports.

Dr. Muhammad Sufyan

FCPS (Ortho) AO Fellow (Germany), Sports Medicine Fellowship (Singapore)

Assistant Professor, Department of Orthopaedic Surgery

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.)