In this week’s column, our panel of experts answers your queries ranging from suspected arthritis to headaches caused by injuries sustained on the field.

Q: I am a 26-years-old cricketer. I am a leg break bowler and believe that I’m going good at it. While bowling, mainly I use the third finger to get the maximum spin. Lately, I noticed that my third finger aches a lot while delivering the ball. My coach says it’s some kind of arthritis and if it continues, I will not be able to bowl. Please advise which doctor I should see, and is there any cure? —Nadeem Shaikh.

A: Bowling style is a very important part for a successful bowler in cricket. Leg break bowling requires a considerable amount of ball movement with spinning. Due to repeated use of the ring finger for spin there is swelling of ligaments and tendons around the joint which causes pain. It is advised that you visit a hand surgeon who has special interest in sports for complete evaluation of your fingers. It is required a bit of warm up and rest of your fingers. Complete evaluation will help you solve this 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 a hockey player. I am 29 years old. Two years ago while playing in a tournament in Malaysia, a rising ball hit my forehead. The pain was bearable and I continued with the game. After returning I consulted a few doctors to ascertain my injury, and I have been told not to worry and that everything is alright. My concern is that lately I have developed a permanent headache, and at times it becomes severe to bear. Please advise me what to do? —Riaz Qadir Khan.

A: Headaches are classified as primary, secondary or as referred pain from other areas. A headache can occur due to multiple reasons. It has different types including migraine, cluster headache etc. Furthermore, stress and anxiety can also trigger headache (primary headache).

Secondary headaches that are due to underlying condition such as sinusitis, brain infection etc. Treatment is treating the cause.

The incident in Malaysia occurred two years back and may not be related since it was assessed by doctors with reassurance.

I suggest that you see a neuro-Physician, who will further assess with detailed history and examination. He may also order blood test and MRI brain to further evaluate. Medications will also be prescribed accordingly.

If the MRI does not show any significant finding than these headache will only require medications for prophylaxis. There is nothing to worry about. Hope this answers your query.

Dr. Saad Akhter Khan

FCPS

Assistant Professor | Department of Spinal and Neurosurgery

Liaquat National Hospital & Medical College

Q: I am an athlete and participate in high jump events. Four years ago, while taking part in an event, my ankle suffered a fracture. After a few weeks the plaster cast was taken off and I have been told that my injury is healed. Though my ankle had a bearable pain but the doctor advised me to avoid the sports for eight months and the pain will vanish. Since then it’s been four years, my pain is not subsiding. Please suggest me what to do? —Habib-ur-Rehman.

A: Dear reader, the ankle is a very sensitive joint and gets commonly injured during high jump activities. Fracture around the ankle needs a very careful examination after which management is decided. You had a conservative treatment of your ankle fracture after which there is a persistent pain for four years. It is advised that you visit an orthopedic surgeon with special interest in foot and ankle. There is an element of post-injury-arthritis around the ankle which happens after management of fracture. You need careful evaluation of the ankle joint which might include some further radiological evaluation after which management can be decided.

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 a boxer. I am 32 years old. Lately, while participating in a bout, the opponent hit me hard on my ribs. After the game was over I went through a regular medical check-up, where nothing serious was found. My question is that if all is well with me, then why my ribs area aches. The pain aggravates while walking. Please help. —Salahuddin Choudhry.

A: Boxing is a high-contact sport that leaves your ribs vulnerable to continuous trauma and pressure. The most common and mild rib injury you will deal with in boxing is a simple bruise to the soft tissue of the ribcage. After trauma is sustained through a punch to the ribs, the blood vessels in the surrounding cartilage will rupture, causing them to release blood into the tissues that surround your floating ribs.

The term “bruised rib” is sometimes used to describe an injury where the ribs are hurt, but they are not broken. In this case, it is not the bones that are involved.

The pain of a bruised rib is actually from the strain or injury of the tissue, cartilage, and muscles of the chest wall.

Treatment should be rest for 6-8 weeks and analgesics.

Rib protector is used for sparing session and in some bouts so once your pain settled you can try this.

You should not participate in any boxing or contact sports for eight weeks.

Dr. Syed Mahmood Ul Haq

FRCS

Head of Department,

Assistant Professor | Department of Thoracic 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.)