In this week’s column, our panel of experts answers your questions on a variety of issues ranging from back injury to whether it’s safe to engage in outdoor sports like horse-riding these days.

Q: I am 43 years old. My passion is horse-riding and before the Covid-19 lockdown I and my friends used to go on a riding track at least thrice a week. For the past two months we stopped our activity, and missing our rides miserably. Can we resume our riding? If yes, what precautions should we take for our safety? –Yousuf A. Qader

A: Yes, you may certainly resume horse riding while maintaining social distancing protocols.

However you need to take the following precautions:

• Avoid direct contact, especially without a mask with your peer group.

• While traveling to the site, do not use public transport and drive alone.

• If you have symptoms like fever, cough, loss of smell or shortness of breath then isolate yourself at home, report to your physician and discontinue the activity for at least 10 days.

Dr. Faridah Amin

MCR, MRCGP (INT), FCPS, PhD

Head of Department, Associate Professor | Department of Family Medicine

Liaquat National Hospital & Medical College

Q: I am 23 years old and a fast bowler. Is there any way that enables me to increase my bowling speed through some special diet or through any kind of Physiotherapy exercise? My height is 5’ 11” and my body weight is 75 Kgs. –Tehseen Butt

A: Bowling fast is all about rhythm and placing your body in correct biomechanics.

Bowling perfection and accuracy comes with consistency. Once you get it right subconsciously, then you can concentrate on different techniques and angles. Improve your fitness, endurance and neuro-muscular activity. As a physical therapist I am giving you some tips which will not only protect you from injury but will also maximise your bowling speed.

Towel Stretch:

Hold a towel right behind your back. Your top arm should reach over your shoulder while your bottom arm is straight and by your lower back. Pull the towel with your top arm until you feel stretch in your lower arm. It can improves your shoulder mobility.

Side-lying External Rotation:

Lying in a side lying position with your head supported by your bottom hand. Hold a dumbbell in your top hand with your elbow against your side. Now lift the weight up without moving your upper arm away from your side. Pause for a second then repeat it again.

Plank:

Push yourself onto your forearms so that you’re supporting your weight between your forearms and toes like four point hold test. Hold this position for at least 30 seconds.

Over head Gym Ball exercise:

Hold a medicine ball over your head with your arms straight. Twist your body to the left and slam the ball into the ground on your left side. It will tone up your shoulder musculature and also improves thoracic and lumbar mobility.

Forward Lunging and slamming with Gym ball:

Take a big step forward with your left leg Slam the ball into the ground as hard as you can to the right of your front leg. Most important component for it maximizes the power and strength of your lower limbs.

Syed Hasan Abbas Rizvi

Senior Manager & Principal

School of Physical Therapy & Rehabilitation

Liaquat National Hospital & Medical College

Q: I play football and during the game minor injuries are a common practice. Three months ago, before the official lockdown, during a match, a player of opponent team, while trying to take the ball away from me, hit on my shin. It was a full blown kick, and I had to leave the field. I did not visit a doctor, and instead, applied different kind of oils as remedy for this injury. Till to date, neither the swelling on my shin reduced nor the pain. Please advise which specialist doctor can help me to cure my injury? –Qamar Baloch

A: Dear reader, you have sustained a high velocity direct impact on your shin bone during sports. There are two bones in the shin area along with various soft tissues including muscles in different compartments of the leg.

There is a chance of having a fracture in any one of the bones along with muscles injuries leading to rupture of compartments. You mentioned that you never visited any doctor during all this time.

Usually minor soft tissue injuries settle in a few weeks but persistence of symptoms suggest that you need a proper examination of your leg along with some investigations. It is advised to visit an orthopedic surgeon with special interest in sports injuries management. Please follow proper SOPs during the visit in order to stay protected in this ongoing pandemic.

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 play squash regularly. Last year while in the heat of the game, bending down to return the opponents shot, I experienced a sharp pain in my back. By the time game was finished, the pain subsided, but following day again I experienced the same. I was advised by my coach to leave the game for the time being and take a long rest, which I did. I want to visit a specialist doctor for a permanent cure of this injury. Please suggest which specialist doctor should I visit? –Zia Orakzai

A: Sports related back problems are very common. It can be due to multiple reasons ranging from awkward posture, muscle spasm and degenerative changes due to age etc.

I suggest that you should consult a neurosurgeon, who will take detail history and examine you as well.

Radiological and blood workup will be ordered if required. This will help in sorting any correctable cause for this pain. If the workup shows nothing significant, than I believe only analgesics and physiotherapy will suffice.

Dr. Saad Akhtar Khan

MBBS, FCPS, FEBNS

Assistant Professor & Consultant | Department of Spinal and Neurosurgery

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.)

– Khalid Hussain