From flat feet to pain management, our panel of experts answers all your queries in this week’s column.

Q: I am 36 years old, and a squash player. Lately I observed that my 8 years old son has a flat foot and knocking knees. I have been told by few friends that my son cannot become a good sportsman with flat foot and knee knock. Is it true? –Aqil Ali.

A: Your son has the problem of Valgus knees (knock knees) and flat feet as you mentioned. This condition needs medical treatment after some blood tests of bone weakness at the age you mentioned. If the knee problem does not resolve till puberty (around 16-18 years age), then surgical treatment is required.

Flatfeet do not need any treatment if there is no complaint.

After correction of the problem, your child can do all activities including sports.

Prof. Dr. Zaki Idrees

FRCS, A.O. Fellow

Professor | Department of Orthopaedic Surgery

Liaquat National Hospital & Medical College

Q: I play cricket regularly and I am a wicket-keeper. After the game by evening my fingers of both hands are swollen and it’s extremely painful to move them. I usually dip my both hands in warm water added with salt to release the pain and reduce the swelling. I am 24 years old. Please advise what to do? –Shehbaz Gondal.

A: I have read your concern in detail and it is not uncommon to have swelling after prolonged use of your hands and one way to avoid is to have periods of rest in between times and sometimes people use tight inners as thick cotton gloves inside keeping gloves but having said this it may still be worthwhile to take rest in between and also to have good keeping gloves I mean good quality ones to that can absorb shock better.

Prof. Dr. Shehab Afzal Beg

FRCS (UK), FRCS PLAST (UK), DIP PLAST (UK), CERT PLAST (UK), Fellow in Hand Surgery (UK)

Professor | Department of Plastic and Reconstructive Surgery

Liaquat National Hospital & Medical College

Q: while playing volley ball my index finger was badly hurt. The X ray shown no fracture, but the pain is still there and I stopped playing. Please guide me to a good doctor. –Ashraf Khan.

A: Dear Reader, Hand has a very delicate group of soft tissues which includes many ligaments and small joints. Forceful impact on hand may lead to fracture or damage to soft tissue ligaments present around the joints. It is a possibility in your case that the ligaments of your index fingers are damaged which is causing pain and inability to play. It is advisable to visit an orthopedic surgeon with special interest in hand surgery in order to get a complete evaluation of your injury so that you can resume 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

Q: My son is 19 years old. He plays hockey and wants to excel in this game. He is underweight and gets tired very soon. Please advise me good nutritionist who can help him making his diet chart. –Mazhar Khanzada

A: Teenagers go through big physical changes in puberty. They need extra nutrition to fuel these physical changes —- which means they need to eat healthy food. How much to eat depends on daily activity and needs but in general boys require an average of 2800 Kcal a day if moderately active.

A healthy eating plan includes fruits, vegetables, whole grains, low fat dairy products and protein foods. It’s important for your son to eat a range of foods from all these five food groups. This will give him all extra nutrition and energy he needs with focus on calcium rich foods like milk, cheese, yogurt to help him reach peak bone mass and strong bones for life and protein rich foods like fish, lean meat, eggs, chicken, beans and nuts as these are important for his growth and muscle development.

The days when he plays hockey will not differ too much from everyday eating, but look for;

- Hydration

- Pre game meal

- Post game meal

Encourage him to take water at least 8 oz. 1-hour before exercise, next serving of 8 oz. 15 minutes before exercise, 8oz during activity and 20 -24 oz. within 2 hours after activity.

Prior a game his primary nutrient needs should come from a solid food source — to balance his blood sugar and to provide energy required for hockey throughout entire game. Not taking care may lead to lower blood sugar level decreased focus, decreased energy and weakness.

Post game meal is similar to pre game meal except a little more carbohydrate and protein to bring protein back to muscles.

Body image may be a concern for teens, as they start to form thoughts and feelings about the way they look. You as parents are the most influential role model in his life - so teach him about healthy body image and encourage him to eat an overall balanced diet. If you have any further query about his weight or relationship with food seek guidance from our dietitian.

Ms. Munazza Haq

Chief Dietitian

Liaquat National Hospital & Medical College