This week, our panel of experts answers your queries on a variety of fitness issues ranging from shoulder pains to the special dietary requirements of athletes especially cyclists.

Q: I am a swimmer. I’m 22 and lately I develop a cramp near my right shoulder blade area, which makes swimming quite an impossible task. Is there any remedy for this, or which specialist doctor should I visit? –Samina Khan.

A: Mostly poor stroke technique causes painful shoulder and cramps around the shoulder joint musculature.

Shoulder is a very hyper mobile joint and it needs to be well controlled by muscles and ligaments. Over-training, fatigue, hyper mobility, poor technique, weakness, tightness, previous shoulder injuries are the causes of recurrent shoulder injuries.

Now we talk about the remedy. Firstly you should do some preventive measures. You must avoid training with tired muscles and sudden increases in training volume or intensity and straining the shoulder muscles, get icing done twice a day for 15 to 20 minutes.

When pain has been minimized and swelling is not showing significantly you should focus on strength training of Rotator cuff and scapular muscles to improve stability of the shoulders. It is to heal scar tissue via joint mobilisations, massage, shoulder muscle stretches and light active-assisted and active resisted exercises.

Major cause of rotator cuff impingement is poor scapulo thoracic rhythm it requires pain-free and powerful shoulder function to improve scapula thoracic rhythm do exercises like elevation, protraction, retraction with hold relax technique and get back your speed, agility and develop neuromuscular control.

During free style swimming, when breathing, keep the head in line with the body to avoid neck pain or numbness and tingling in the arms. Rotate your body towards the breathing side to avoid excessive neck movement and over-reaching with the arms it will help prevent injuries in upper limb.

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 am a cyclist and 26 years old. A friend of mine advised to take extra food supplements to strengthen my leg muscles which would help boost my performance. Should I go for it? –Mohammad Inam

A: Cycling is a sport of endurance which places a high demand on your muscles. For this, good nutrition is very important. Like many others, you are concerned about taking food supplements. If you are taking a balanced diet then there is no need of muscle building supplements including protein powders and amino acids unless you have a proven deficiency of it in your body or if you are not taking a balanced diet. Same is with vitamin and mineral supplements, if taken in excess will not help to improve your performance.

Try to consume right amount of calories through natural food sources. Plan your diet to maintain carbohydrate stores. Carbohydrates are body fuel that give you energy and will boost your endurance. Include high quality proteins in the form of meat, egg, dairy and fish, which will provide you muscle building amino acids. Whey protein is one of the proteins found in dairy products. It not only digests quickly but is also rich in branched chain amino acids which build and maintain muscle mass and increase muscle strength. Ricotta cheese is one of its best dietary source. Foods rich in Omega 3 fatty acids found in fish, nuts, and seeds relieve pain and inflammation associated with overworked muscles.

Eating a balanced diet with right proportion of carbohydrates, fats and protein is a key to maintain muscle strength.

Ms. Munazza Haq

Chief Dietitian,

Liaquat National Hospital & Medical College

Q: I am a 28 years old cricketer and a fast bowler. I need your help for suggesting me the right doctor who can advise me to use right type of spikes in my shoes in order to avoid shin injury. --Altaf Rana

A: Dear reader, shoe spike is important for a fast bowler in order to enhance the skill and accuracy of performance. A good grip on the ground improves energy transfer and enhances acceleration, agility, speed and performance. Spike placement on shoe needs careful evaluation of foot shape and size. The arch of foot should be carefully evaluated and pressure points of should be accurately marked for spike placement in order to distribute pressure evenly. All these measures are taken by an Orthotist who is specialized in foot wear and foot dynamics in stress conditions. You should get an evaluation of your foot by an orthotist after which accurate spike placement in your shoes will help you to enhance your performance without complications.

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 33 and a car rally driver. Whenever we participate for a longer rally, we consume lots of water and salt tablets to avoid dehydration. Recently my cousin read in a magazine that salt tablets can cause kidney failure. Please advise me whether it’s true? --Tariq Iqbal.

A: If you do not have renal disease or risk factor like hypertension diabetes or heart disease, you probably can take low amount of salt tabs with water during your driving race. For detail information and advice you should see a nephrologist.

Prof. Kunwar Naveed Mukhtar

MD Diplomate American Board of Internal Medicine

Diplomate American Board of Nephrology

Head of the Department | Department of Nephrology

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