As they say, it’s better to be safe than sorry. That holds true for all athletes regardless of the nature of their respective sport. In this week’s column, our panel of experts answers your queries on a variety of issues that include shin injuries to problems an athlete might face in his old age.

Q: I am 17 years old and I play cricket regularly. I am a medium pacer and work hard to get some extra pace to become a fast bowler. I have been advised to wear spike shoes, or else I may suffer a shin injury. I tried wearing such shoes, but feel very uncomfortable. Can you please guide me what is a shin Injury, and how dangerous it is for a bowler, and is wearing spike shoes the only solution?  -Naseem Khan

A: Cricket requires passion to have best performance as sportsman and I love to see someone like you who is committed and dedicated to achieve the highest level in his cricket career. I can understand you being a fast bowler trying your level best to achieve your goal to attain the highest position in your field. Shin pain is related to the stress and strain in leg muscle due to exhaustion, exertion and over-use of muscle, tendon and ligaments. These lead to strain and muscle spasm. The main advantage of wearing spikes by the bowler is to have better ground grip to increase their pace and to prove themselves as a fast bowler. Spikes also help to off load stress during stance and swing phase of running which help bowlers to further increase their bowling speed. I advise you to have good physical fitness of your body and specially work hard on your leg muscle strengthening exercise to avoid getting shin injury. Always start with warm-up exercises, don’t over exert your body and keep your-self rehydrated. Have good food to provide the necessary energy to your body. This will protect you from shin injury and help you to overcome your problem.

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 33 years old sports enthusiast and play cricket. Five years ago, while facing a fast bowler without wearing a helmet, the ball hit my forehead in the nets. It was painful, but applying usual remedies like Iodex, the pain vanished and I came back into the game after an interval of two weeks. Lately, I’ve developed a headache, especially when travelling in an aircraft, and in winter. Is it due to the old head injury, or something else, and which specialist should I see?  -Khurram Ali.

A: Headaches can be due to multiple reasons. Most common causes of headache are migraine, cluster headache tension headaches and headache due to other reasons which include structural lesions/sinusitis.

This incident happened five years ago and the likelihood of it causing the headache is possible but a little unlikely.

I suggest that you should visit a neuro-physician/neurosurgeon. He will further elaborate on history and perform physical examination and will order some blood and radiological investigations if required. He will also prescribe medication for this headache until the work is completed.

Dr. Saad Akhter Khan

FCPS

Assistant Professor | Department of Spinal and Neurosurgery

Liaquat National Hospital & Medical College

Q: My father is 74 years old. In his youth he used to play hockey for his departmental team. For the last two years or so, he complains of severe pain in his right knee and his left ankle. This aggravates in winter. Is it because of the injuries he might have suffered during his youth while playing hockey, or is it a common thing in old age. Please advice which doctor should I take my father to?
-Safdar Raza.

A: Dear Safdar, at 74 years of age your father is in geriatric age group. His problems in knee and ankle started two years back which suggest that he is having issues due to his old age. Advancing age causes destruction in joints which leads to osteoarthritis of knee and ankle. Injuries in the youth do play a role but in this age it is mostly secondary changes which aggravate the condition. Joint and bone pains are very common in elderly and it depends upon the extent of arthritis. Your father needs a composite care involving a geriatric medicine specialist, a physiotherapist and an orthopedic surgeon specialized in joint preservation and replacement. Depending upon the severity and extent of his problems his treatment can be decided by mutual involvement of these specialties.

Dr. Muhammad Sufyan

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

Assistant Professor | Department of Orthopaedic Surgery

Liaquat National Hospital & Medical College

Q: I am an athlete, and regular participant of 1000 meters race. I run 10 kilometers every day on a practice track to improve my stamina. A fellow Athlete suggested me to eat lot of protein diet and carbohydrates. He advices me to take extra food supplements containing these elements to keep myself fit and avoid exhaustion. Please guide me. -Qamar Butt.

A: Like every athlete you also need a comprehensive eating plan, especially designed to meet your physical needs. Your focus on good nutrition will enhance your performance. Carbohydrates are an athlete’s main source of fuel. During running, carbohydrates provide you with immediate source of energy. An athlete should try to get 60-65% of calories from carbohydrates. Likewise, protein in case of runner is muscle rebuilder. For men 25-30 grams of protein per meal should be enough. Including very high protein diets may result in increased body weight and may have a negative impact on kidney function. Dietary supplements are only beneficial if you have any diagnosed deficiency.

Nutritional misinformation can harm you. Avoid performance enhancing drugs as they can be dangerous and can have severe long term impact on your health. You can seek help of a qualified dietician. They will not only help you to plan a healthy diet taking your nutritional needs, food preferences and performance targets into consideration, but also help you in adjusting your;

· Pre-event meal

· Eating during exercise and

· After exercise

An individualised diet plan designed by a dietitian is important for you if you want to get the most of your athletic performance.

Ms. Munazza Haq

Chief Dietitian,

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.)