Q: I am a cricketer and fast bowling is my department. Like many sports persons, I also have a hamstring problem. Due to the severe pain, at times it is difficult to walk. Can you please advise me which doctor to consult and I’ll be grateful if you may explain the reason for hamstring pain. I am 32 years. –Riaz Khairuddin.

A: Bowling requires a lot of energy with maximum stamina and fitness to obtain optimum results. Your problem is one of the most common complaints pertaining to your level of sports and is multi-factoral.

My advice to you is to always start your sports activity with warm-up exercises by stretching your body parts before the start of a game.

Drink plenty of fluids that contain minerals and essential vitamins for body hydration and energy.

Always acclimatise your body to the surrounding temperature a couple of days before the start of an official match to avoid hamstring pain and never unduly fatigue yourself as this can cause damage to your body parts, leading to soft tissue injuries that can be chronic and irreversible.

I advise you to consult an orthopedic surgeon with expertise in sports injuries for thorough evaluation and best management of your problems. This will enable you to start your sports activity at the highest fitness level and achieve your peak performance in field of bowling allowing you to represent Pakistan at an international level.

Dr. Muhammad Kazim Rahim

MD, FCPS (Ortho) AO Fellow (Germany), Sports medicine Fellow (IRI) (France), Hip and Knee Arthroplasty Fellowship (PAS, Pak)

Assistant Professor & Consultant | Department of Orthopaedic Surgery

Liaquat National Hospital & Medical College

Q: I am a cyclist and participate in various competitions held across the country. Lately, while practicing I felt a sharp backache which could not enable me to continue cycling. Please suggest me what to do? I am 26 years old. – Zohair Abdullah

A: Since you are a professional cyclist. I hope that you are well aware of the importance of positions and adjustment of your cycle’s saddle, handle and cleat.

If all of these are in right position according to your professional needs, your body habitus during cycling is another important factor.

Maintain a steady position on the saddle and do not move your back too much to right and left to push hard on the pedal for gaining speed. Also the back must be kept straight as much possible. As hunching you back and pushing on the paddles can lead to muscle spasm and disc problems. By the history you gave it seem very probable that you either had a severe muscle pull or a tear in intervertebral disc.

You must do rest for 2 weeks. Take some pain killers and do hot fomentation. Spasm will settle with this but if the pain doesn’t settle then you must consult us and after examination we may suggest MRI if required.

Dr. Nasir Ahmed

MCPS (Surg), FCPS (Tr & Orth)

Assistant Professor & Consultant | Department of Orthopaedic Surgery

Liaquat National Hospital & Medical College

Q: while participating in a hurdle’s race, I didn’t time my jump properly while crossing a hurdle and fell down resulting in few bruises and a sharp pain in my right side ribs. It’s been over a week but I still suffer from ribs pain. Please advise. – Shahnawaz Ahmed.

A: You need to consult thoracic surgeon. Get chest X-ray, you might have right sided rib/ribs fractures.

A broken rib is a common injury that occurs when one of the bones in your rib cage breaks or cracks. The most common cause is chest trauma, such as from a fall, motor vehicle accident or impact during contact sports.

Many broken ribs are merely cracked. While still painful, cracked ribs aren’t as potentially dangerous as ribs that have been broken into separate pieces. A jagged edge of broken bone can damage major blood vessels or internal organs, such as the lung.

Broken ribs usually heal on their own in one or two months. Adequate pain control is important so that you can continue to breathe deeply and avoid lung complications, such as pneumonia.

Bruised or broken ribs can be very painful, but usually heal by themselves.

It takes three months for complete healing of fracture. Pain gets relieved on its own in atleast six weeks.

Do not wrap a bandage tightly around your chest to stop your lungs expanding properly. Do not lie down or stay still for a long time. Do not strain yourself or lift heavy objects. Do not play any sports or do any exercise that makes your pain worse. Do not smoke - stopping smoking may also help your recovery.

Take painkillers, such as paracetamol or ibuprofen - avoid taking ibuprofen for 48 hours after your injury as it may slow down healing. Hold an ice pack (or a bag of frozen peas in a tea towel) to the affected ribs regularly in the first few days to bring down swelling. Rest and take time off work if you need to breathe normally and cough when you need to - this helps clear mucus from your lungs to prevent chest infections. If you need to cough, hold a pillow against your chest. Walk around and sometimes move your shoulders to help you breathe and clear mucus from your lungs. Take 10 slow, deep breaths every hour to help clear your lungs. Try to sleep more upright for the first few nights.

Dr. Syed Mahmood-ul-Haq

FRCS

Head of Department, Assistant Professor & Consultant | Department of Thoracic Surgery

Liaquat National Hospital & Medical College

Q: I play football regularly. Few days ago while playing I fell down and my left elbow suffered an injury. Beside severe pain there is a swelling in the elbow area which has increased my concern. Please suggest which specialist doctor to consult. My age is 29 years. –Khalid Dahri.

A: Dear reader, elbow injuries among athletes is a common problem especially with direct impact. Pain and swelling suggests that there is a possibility of injury which can range from soft tissue injury to a fracture in elbow joint. Elbow is a very sensitive joint and requires accurate diagnosis with management in order to achieve full function and return to sports. It is advised that you visit an orthopedic surgeon with special interest in Upper limb so that complete examination of your elbow is done and management is decided accordingly. These injuries also require long term physiotherapy in order to regain the normal range of motion of elbow.

Dr. Muhammad Sufyan

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

Assistant Professor & Consultant | Department of Orthopaedic 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.)