In this week’s column, our panel of experts answers your queries ranging from wrist injuries to overcoming slow reflexes.

Q: I am 29 years old, and regularly attend gym to maintain my fitness. Now in this lockdown situation, I do a little exercise at home, but clueless about my diet. Please suggest a diet plan, and the calories I should take in a day to maintain my fitness. –Sarwar Ali Khan

A: You should consume about 2500 to 3000 calories per day. When it comes to eating, you need to eat the right type of food at the right times of the day. Start your day with healthy breakfast. Don’t skip breakfast as skipping can make you feel lethargic. Choose all meals comprising of complex carbohydrates, lean protein sources, healthy fats and a variety of fruits and vegetables and stay well hydrated.

The diet plan for people who go to the gym regularly differs from others and is based on your eating habits, exercise, nutritional needs and health parameters. A nutritional expert will help you in planning your diet.

Do not skip exercising. Try to get sleep with sleeping and waking up at the same time everyday which will enable you to take your meals at proper timings and will keep you fit.

Ms. Munazza Haq

Chief Dietitian,

Liaquat National Hospital and Medical

College

Q: My son is 16 years old and plays football. Lately while playing, his left thigh muscle pulled, leaving him in severe pain. After two days of rest he once again experienced the same while playing. What could be the reason as he is too young for these types of injuries. Is it a permanent injury or is there any cure for it? –Altaf Mujahid Khan

A: Dear reader, your son is having hamstrings strain in his thigh which is a condition in which one or more muscles of the thigh gets overloaded and can even develop a tear. This happens during activities like lot of running and jumping with sudden movements. The main reason of developing a hamstrings strain is lack of warm up before exercising, weak muscles of thigh and inadequate hydration. This is not a permanent injury and heals with rest and supportive treatment. Proper healing time is required and early return to sports is not advisable until the pain subsides and strength of the affected leg is returned. It is advised that your son needs a proper warm up before the game, a good hydration status and proper strength of muscles in order to prevent repeated episodes.

Dr. Muhammad Sufyan

FCPS (Ortho) AO Fellow (Germany), Sports Medicine Fellowship (Singapore)

Assistant Professor | Department of Orthopaedic Surgery

Liaquat National Hospital and Medical

College

Q: I am 26 years old, and play squash regularly. Two months ago, while playing, I started feeling pain in my racket held wrist. Next time I wore a wrist band and played, but to no effect. Please advise what to do, as in squash wrist movement is vital? –Javed Ghani

A: It seems to be a common wrist injury, usually caused by a significant impact like a fall or may be stroke with poor technique. Wrist sprain is common in athletes especially in squash due to rapid movement of the hand.

Squash is a high-speed racquet and ball game that requires the repetitive use of your spine, legs and especially your dominant arm.

It is very important that you have a warm up and cool down routine before match. Having your muscles warmed up before putting them under high load decreases your risk of muscle strains including sustained stretches of wrist against the wall and gravity

Usually 1st degree sprains can follow ( PRICE) Protection, Rest, Icing, Compression, Elevation for the first 48 hours. This can minimise the swelling and promote healing through vasoconstriction.

Strengthening exercises through resistance bands or rubber tubes effectively strengthen the wrist muscles.

In sitting position, one end of resistance band can be wrapped under the foot and the other is wrapped around the dominant hand tightly. Then flex your wrist and slowly extend to increase eccentric loading at wrist flexors. You can also do isometric hold relax for wrist muscles which will be increase your local endurance and resistance to fatigue.

Another exercise to strengthen your wrist is by Griping Exercise and by playing with play dough.

A weight-based exercise called ‘Ulnar and Radial deviation’ helps in making your Wrist strong. This involves holding a weighted bar in your hand with the arm by their side. In Ulnar and Radial deviation, arm stays in the same position.

We recommend not to over train yourself as it may lead to a stressed body. As a physical therapist I recommend you to focus on Wrist Strengthening Exercises based on flexion and extension. These exercises will lower your chance of injury over a long play session of squash.

Syed Hasan Abbas Rizvi

Principal School of Physical therapy and

Rehabilitation

Liaquat National Hospital and Medical

College

Q: I am a table tennis player and am 32 years old. This game needs quick reflexes but lately I observed that my reflexes are slowing down. What could be the reason? –Khalid Mehtab

A: I am sorry you are having problem in your favourite game, but don’t worry you will be fine Inha-Allah. I just need a few clarifications.

How long it has been with you – is it a story of few days, few months or about a year or so? Is the problem progressing, or it is felt almost the same when it started?

Do you feel the problem right at the beginning or after a few minutes of starting the game, especially in the end of long volleys?

Do you feel the symptoms while doing tasks other than playing table tennis?

Are you a diabetic?

Have you also observed some problem with your mental reflexes too?

These questions in mind you should see a neurologist who will run a few investigations on you to look for a disorder in your nerves (neuropathy), muscles (myopathy), myoneural junction (Myasthenia gravis) or basal ganglia (early Parkinson disease or related disorders).

Dr. Syed Ahmed Asif

Assistant Professor and Consultant

Neurologist

Head of the Department of Neurology

Liaquat National Hospital and 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