This week our panel of experts answers your questions on issues ranging from whether you can continue your sporting activities during pregnancy and also on how sportspersons can deal with backaches.

Q: I play tennis regularly and love the game. Lately I underwent an appendix operation and now feel completely fit. My question is can I resume playing tennis or I have to leave the game? I am 31 years old. —Mohammad Ashfaq

A: Dear Ashfaq, Appendectomy is one of the most commonly done procedures in the general surgery repertoire. The recovery is excellent with no residual disability in the vast majority of patients. Normal every day routine is resumed as soon as the patient in comfortable. There is no reason to abandon tennis after an appendectomy. If you have had a Laparoscopic appendectomy then you may resume the game after a month. In case of an open appendectomy, waiting for 6 weeks would be appropriate. In either case start slowly. If after starting you feel any discomfort then consult your surgeon immediately.

Dr. Faisal Siddiqui

FCPS, FRCS

Associate Professor | Department of General Surgery

Liaquat National Hospital & Medical College

Q: I am 27 years old. I am a swimmer and practice regularly. Can I continue swimming during my pregnancy? —Mrs. Rubina M

A: If you are healthy and your pregnancy is normal, it is safe to continue or start regular physical activity. Physical activity does not increase your risk of miscarriage, low birth weight, or early delivery. However, it is important to discuss exercise with your obstetrician or other member of your health care team during your early prenatal visits. If you are physically fit and active you can easily adapt to the physiological changes of pregnancy occurring in your body .It will also help you to cope with labour and to achieve pre pregnancy weight after delivery. If you start a new exercise during pregnancy, discuss with your instructor and begin with 15 minutes continuous exercise 3 times a week and gradually increase to 30-minute session.

You can continue swimming or other water activities in pregnancy. Some swimming pools provide Aqua natal classes with qualified instructors. It will help you in maintaining weight and keep you active. No adverse effects of swimming or other water activities are reported up till now. However reassuring results were found for those who continued swimming throughout their pregnancy. But make sure that proper cleaning and chlorination of swimming pool water is done and no toxic chemicals are used in it to avoid infectious diseases and fetotoxic effects of the chemicals.

Dr. Tahira Yasmeen

FCPS, Fellowship in Gynaecological Oncology (AKUH)

Assistant Professor | Department of Obstetrics
and Gynaecology

Liaquat National Hospital & Medical College

Q: I am 35 years, and played cricket regularly. Lately I have been diagnosed type-2 diabetes. With the help of medicines and improved eating habits, I am managing it well. My question is can I resume playing cricket? If yes, what precautions I should take? —Jamal Hassan

A: Thank you for your question. Around the globe, many cricketers have type-2 diabetes. If your diabetes is well controlled, it should not have any adverse impact on your game. Rather, diabetes brings in a lot of discipline which may eventually help you.

The most important aspect in diabetes management is discipline. You have to be disciplined in your diet, your exercise routines, your fluid management before and during a game, your weight management, your medicines and your overall physical and psychological health.

Be careful about your weight. You should aim normal body mass index. This will help you remain fit on and off the field. Diet is extremely important. A low to moderate carbohydrate, low fat, and high protein diet should be helpful in the long run. You may need to increase both short and long acting carbohydrates before a game, and may need frequent snacks during a long game. Keep vigilant about symptoms of hypoglycemia (low blood sugar level) during games. Your fluid intake should be adequate.

Medication adjustment is very important especially before a game. Insulin and some oral diabetes medicines can cause hypoglycemia. As such, it is very important to reduce the dose of such medicines before a game, although with advice of your physician.

Psychologically, diabetes may impact you more than you would think. You should see a sports psychologist to keep you mentally strong. You should meet your diabetes specialist regularly to maintain good health. All the best for your diabetes and your cricket!

Dr. Ali Asghar

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

Assistant Professor | Department of Diabetes,
Endocrinology and Metabolism

Liaquat National Hospital & Medical College

Q: I play snooker on a regular basis. Last year I developed a backache, which I did not take seriously and now the pain is aggravated, especially when I bend myself to play a shot. Please advise me an appropriate doctor who can cure my backache. —Hameed Javed

A: Dear reader, backache while playing snooker is a very common problem. This pain is due to repetitive strain from the poor postural position that the body is put into whilst playing a shot. The most common reason is due to strain and sprain of back muscles. Repeated episodes of backache while playing for a long time starts giving rise to long term problems of spine. Special attention should be given during bending which should be from the hip joint rather than the waist. It is strongly advisable that you undergo complete evaluation of your back from a spine surgeon so that appropriate measures are taken to help you continue your game.

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.)