Your body will only perform well when given the proper type of food in correct amounts and proper timings In this week’s column, our panel of experts about eye injuries suffered during a sporting activity and how to deal with issues like being overweight and feeling unfit.

Q: I am 29 and play football regularly. Three months ago I fell down while playing and had a knee injury. The doctor cleared me of any serious injury, but since then either during a game, or simply walking, my knee gets stiff, and I cannot even bend it. A friend of mine suggested that it could be tendonitis. Can you please explain me what is tendonitis and which specialist I should see? –Maqbool Ahmed.

A: Playing football can cause a number of sport injuries that happen while tackling or some sudden jerk which leads to twisting injuries as a result of it. It leads to some bone-related and in most instances soft tissue injuries. In the knee, internal knee derangement consist of meniscus, ligament or articular surface defect which causes locking of knee, giving away or other specific symptom due to injury. In your case I think you might be suffering from meniscus injury which is the shock absorber of your knee joint and it leads to locking or stiff knee for a few moments and pain. You require to consult an Orthopedic Surgeon in the sub-speciality of Sports Injury so you can be thoroughly examined and investigated for diagnosis and prompt treatment to prevent you from further aggravation of this injury.

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 43 and used to play basketball regularly. By the passage of time due to my professional engagements, I could not play as frequently as I used to but at least three times in a month I still play. My problem is that I have increased my weight, which resulted in getting tired too soon and have to leave the court. How can you help me to control my obesity problem? --Zaheer Hassan Khan

A: Basketball is an intermittent, high intensity sport requiring both physical agility and mental sharpness. Being overweight is never healthy. As you age, it can be little harder to lose weight. Running with excess weight can increase your heart rate and hence oxygen consumption and increase in pressure exerted on the bones and joints. Individual with sedentary lifestyle need between 2200-2400 kcal/day, but if you are moderately active you may need 2400-2600 kcal/day. Eating 500 kcal less what you need to maintain your weight help you lose 2 kg in a month. If you are less active then you may also need to reduce the proportion of carbohydrate intake. Eating variety of whole grains, fruits and vegetables, lean sources of protein (meat) and healthy fats will provide high quality nutrition for best performance while playing basketball and maintain weight as well. Seeking help of a dietitian will help you in setting realistic attainable targets.

In your 40’s try to include foods rich in antioxidants like foods high in Vitamin C ( citrus fruits, strawberries, tomatoes) and Vitamin E (sunflower seeds, almonds, peanut butter). Carrots, sweet potatoes, green vegetables are also rich in antioxidants.

Pay attention to portion sizes. Remember your body will only perform well when given the proper type of food in correct amounts and proper timings.

If you want to lose weight you can get best result by combining your healthy diet with exercise. Walking is a moderate intensity exercise that can easily fit into your busy lifestyle.

Munazza Haq

Chief Dietitian,

Liaquat National Hospital & Medical College

Q: While playing tennis, the ball hit my left eye. Since then my left eye vision is affected badly and objects seem blur. Please help me by suggesting a good doctor. I am 38 years old. -–Shahid Mirza.

A: Injury by a tennis ball can lead to many problems in the eye and depends on the speed of ball as well. There can be Corneal Abrasions and Epithelial ulcers as well as hyphema or Blood in Anterior or Posterior Segment which can cause blurred vision. One such hyphema is called 8 ball hyphema named after the snooker ball. This can cause rise in Intra ocular pressure and it's an Emergency. One of the serious complications can be damage to your retina like Retina Detachment or Macular hole after Retinal oedema gets resolved.

You need a thorough and detailed examination by any good eye specialist and better be seen in a Tertiary Care Hospital, which deals with all eye problems and are better equipped.

Dr. Munira Shakir

MCPS, FCPS, FRCS (UK) Fellowship in Paediatric Ophthalmology

Associate Professor | Department of Ophthalmology

Liaquat National Hospital & Medical College

Q: I am a swimmer since my childhood. I am 35 years old. Lately I noticed that while swimming, I get tired very soon with abrupt breathing. This hampers my swim and I leave the pool. Please advise what to do, and is it some kind of an ailment? –Muzaffar Khan

A: How many times did you experience that? If it happens always then you should have a complete cardiopulmonary fitness assessment done and it will evaluate your problem more efficiently.

Actually Breathing is an activity that will function without interruption. When necessary, we can assume conscious control in order to increase oxygen supply while under stress or in a fight/flight state of mind. For swimmers it’s a tough task to control their breathing especially under water.

Reduction in lung compliance and vital capacity also make you fatigued and tired repeatedly and swimmers have been advised to do inspiratory muscle workout. Respiratory muscles are not only essential for breathing but they are also involved in the body movement. Regular aquatic exercise may mimic resistive inspiratory muscle training and expansion of chest.

Inspiratory muscle training, also known as breathing training, involves breathing against a resistance to improve Inspiratory muscle strength. Respiratory muscle training can improve performance in a vast range of exercise modalities including running, cycling, swimming, and rowing activities.

You can do breathing drills like going into the water with breath hold and exhale when come out Repeat this activity at the corner of the pool, also keep your head down and take a breath every ten kicks then exhale out. Use of respiratory muscles training device is very helpful. The use of these devices is very simple: it’s weight training for your breathing muscles.

During free style swimming when breathing, rotate your body towards the breathing side to avoid excessive neck movements.

Syed Hasan Abbas Rizvi

Principal & Associate Professor

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

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