Q: My younger brother aged 17 years is fond of playing tennis, and before the Covid-19 lockdown he used to play regularly. Now staying at home, he is complaining a pain in his elbow. I have heard of a term ‘tennis elbow’ but don’t know much about it. Can you please give some information on this, and what is the cure? –Tauseef Nazeer

A: Tennis elbow is a painful condition of the elbow caused by overuse. Playing tennis or other racquet sports can cause this condition.

Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse and repeating the same motions again and again. This leads to pain on the outside of the elbow.

Several other sports and activities also are a risk for this condition. Treatment is mainly non operative which includes rest, non-steroidal anti-inflammatory medicines, stretching exercises, physical therapy with ultrasound guided massage, Steroid and PRP(Platelets Rich Plasma) injections to the elbow. It is advisable to visit an orthopedic surgeon once this lockdown is over so that your brother is examined properly in order to relieve his problem.

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 34 years old, middle management executive, and visit gym three times a week to keep myself fit. My problem is that I have a fear for heights. I have tried only once to visit Murree, but I couldn’t make it and came back. My work requires me to meet senior executives of different organisations, and if the office I want to visit is on 9th or 10th floor looking beyond the window glass makes me nervous making it very difficult to concentrate on the business. Please suggest me how to overcome this fear. –Waleed Choudhry.

A: The symptoms that you are describing point towards a diagnosis of specific phobia. Clearly your fear of heights is interfering with functioning and causing distress. Phobic disorders are one of the most common conditions. Many people have fears but they don’t interfere with personal or occupational life. Some fears are evolutionary such as a fear of snakes, though majority have never been bitten by a snake. Some fears are learnt by observing family members such as fear of cats etc. Some fears are acquired when someone has an anxiety attack and then associates that situation as responsible for the anxiety. This frequently leads to avoidance and anticipatory anxiety.

The first step would be a consultation with a psychiatrist to clarify the diagnosis and to make sure that there are no other medical or psychiatric disorders contributing to your anxiety. If the diagnosis is confirmed, then you should be referred to a psychologist for behaviour therapy. This form of therapy is guided by a trained psychologist in behavioural techniques. Unfortunately there are no medications to treat specific phobia. Certain medications can control symptoms on an as needed basis, but again the treatment of choice is behaviour therapy.

Dr. Mehmood A. Rehman

M.D

Consultant, Assistant Professor | Department of Mental Health

Liaquat National Hospital and Medical College

Q: I am a sportsman and play cricket regularly, participating in departmental tournaments. Covid-19 lockdown has ceased all types of sports, therefore staying home. The problem I am facing is that different joints of my body started aching. I know while in the game various injuries are common and they heal quickly but staying home, it seems all the old injuries coming back. Please suggest what to do? –Liaqat Nazir Shah

A: A regular sports man is in habit of warm up and keeping muscles tone up. Because of the lockdown and staying home, you are not being able to work out and exercise.

Exercise effects positively not only on muscles but on brain and over all metabolism of one’s body. Exercise releases stress by release of endorphins. It mobilises glycogen stores and has an effect on the circulatory system.

Not being able to do exercise which your body was used to, is causing these effects on your bodily systems.

The myth of belief that the old injuries give trouble in later life is not correct. If an injury has healed well, so that you are able to do sports afterwards, should no longer cause problem.

So my recommendation for you is to do home exercises e.g. push-ups, back strengthening, Quads and hamstring exercises regularly at home. These aerobics will keep you active and your muscles warmed up. If you have treadmill at home do regular running on that.

Take lot of water and prevent dehydration. If you are fasting during Ramadan then make sure to fulfill the quota after Iftar. Avoid fizzy drinks and lot of fried items as well. Take some vitamin D and calcium supplements.

Dr. Nasir Ahmed

Assistant Professor and Consultant

Orthopedic Surgeon

Department of Orthopedic Surgery

Liaquat National Hospital and Medical College

Q: I’m diabetic, 48 years old. My diabetic management includes, apart from medication, a long walk daily. This kept me fit and helped me to control my sugar levels. These days due to coronavirus and lockdown, I am not able to go for a long walking, resulting in increase of blood sugar levels. Please suggest any alternate exercise at home to maintain my sugar levels. —Javed Bokhari

A: Daily exercise is one of the three pillars of diabetes management; along with medications and diet. Since it is usually not possible to go out for a walk these days due to the lockdown amidst Corona virus pandemic, alternate exercises at home are essential to control diabetes.

At home, you don’t need strenuous exercises. Don’t exercise immediately after meals, do so few hours after meals. You may take a snack before exercise though.

If you already have an exercise bike or treadmill at home, use them to keep yourself fit. If you don’t have them, try walking briskly in the house, may be in the most spacious place in your house. Walk at least 30 minutes every day. Stand or walk around while you are on the phone. Try to keep moving in the house frequently rather than sitting or lying down for long periods. Doing yoga or skipping rope can also be helpful.

Resistance exercises may be done two to three days per week. Squats, sit to stand exercises, and wall push-ups can easily be done at home. You can even do some stretching exercises. Even if you are lying down, you can keep moving your arms and legs in order to exercise.

Use smart phone apps or internet resources to learn more about home exercises. Physical activity not only helps in controlling diabetes, but also boosts your immunity. That’s why it becomes even more important to continue your exercises during this lockdown.

Dr. Ali Asghar

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

Assistant Professor | Department of Diabetes, Endocrinology and Metabolism

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.)