Q: I am 30 and play cricket on regular basis. I am a wicket-keeper and I practice regularly. Lately, I have observed that after a match by the evening I develop a swelling in both my hands. This swelling continues for a couple of days. I do not feel any pain in my hands but I am afraid it’s not a normal situation. Please advice. —Hassam S. Khan

A: You are a professional cricketer and you have a very important position in the field which no other player has. You have said that you feel swelling in your hand by the end of practice.

What I have come to know about wicket-keepers is that they wet the inner part of their gloves to make the leather soft, so that it can easily mold it to their hand position. By doing this the fingers become a bit numb especially in cold weather. When you catch a ball at high speed it transmits tremendous force to your bones and soft tissues. This can cause damage to your bones and joints, but being numb you don’t feel much pain.

The swelling which you get by the end of the day signifies injuries. You must take it seriously. You should consult an orthopedic surgeon, and get clinical examination and X-rays of your hands. I hope that will answer your concern.

Dr. Nasir Ahmed

MCPS (Surg), FCPS (Tr & Orth)

Assistant Professor & Consultant | Department of Orthopaedic Surgery

Liaquat National Hospital & Medical College

Q: I’m 26. Riding bicycle is my favourite sport and hobby which keeps me physically fit. Now that I am three months pregnant, can I still continue bicycle rides? —Mrs. R. Khan

A: I am glad to know that you are actively involved in self-care and are cognizant of the effects of exercise on one’s mental and physical health. Having an exercise routine during pregnancy is highly recommended as it not only keeps you healthy, but also prepares for the process of the childbirth.

However, only 15% of pregnant women exercise at a recommended level. Guidelines recommend minimum 30 min moderate exercise weekly. Although riding bicycle is an absolutely healthy activity, caution needs to be exercised during pregnancy. Riding a bicycle during pregnancy may not have a direct effect on your pregnancy, but it might exhaust the body, which is already working extremely hard to nourish a baby in the womb. Also, we cannot ignore the risk of falling from the bicycle, regardless of how trivial it is. Finally, as your pregnancy advances maintaining balance while riding becomes difficult so it’s definitely better to stay off the bike later on in pregnancy. If you experience backache or aching joints, it can aggravate with riding. Sports that may cause abdominal trauma, falls or excessive joint stress should be avoided according to NICE guidelines. I would emphasise that if you want to continue riding your bicycle during pregnancy, consult with your obstetrician first so that any medical contraindication should be ruled out. I would suggest avoiding long rides or training sessions. I would highly recommend engaging yourself in aerobics or yoga, and going for a walk to keep yourself healthy and active during pregnancy.

Dr. Tahira Yasmeen

FCPS, Fellowship in Gynaecological
Oncology (AKUH)

Assistant Professor & Consultant | Department of Obstetrics And Gynaecology

Liaquat National Hospital & Medical College

Q: I am 57 years old and go for walking in the evening for one hour every day. Lately, my left knee has developed a pain which makes it very difficult for me to continue the walk. Please suggest a cure. —Tariq Abbas Leghari

A: Pain in knee is a quite common complaint among people who are above the age of 50 years. There are many reasons for pain in the knee. If the pain is short lived, rest and short course of painkillers will resolve the symptom.

If the pain is persistent and disabling, then it is important to establish cause of the pain. The specialist doctor would examine your joint and do a list of investigation, including x-ray in standing position as well as blood test. Occasionally MRI of the knee is required to exclude tear in cartilage.

Having established the diagnosis, the knee specialist doctor will prescribe a short course of painkiller and physiotherapy. If the diagnosis is wear and tear in the joint, he will prescribe supplements to increase lubrication of knee joint. In most cases this conservative treatment will resolve symptoms. To avoid recurrence, you should reduce weight and do muscle strengthening exercise.

If the symptoms persist and the diagnosis is a tear in cartilage, you will benefit from a key whole surgery as a day care procedure. When pain is disabling, your symptoms might be due to advance arthritis of knee with complete loss of cartilage and bone rubbing against bone. No medication will resolve symptom at this stage, rather painkillers will cause ulcer in the stomach as well as kidney failure leading to dialysis. Total Knee replacement surgery will transform quality of life of patients. It is highly successful procedure in the hand of specialist knee surgeon. Modern knee implant would last more than twenty years. With a pain free knee joint you can reduce weight, avoid painkillers and their complications. You can also control sugar, blood pressure, and reduce chances of heart attack and stroke.

Prof. Dr. Syed Shahid Noor

FRCS (Tr&Orth), FRCS (Eng), FRCS (Edin), MS Trauma (University of
Birmingham), A.O. Fellow

Head of Department | Department of  Orthopaedic Surgery

Liaquat National Hospital & Medical College

Q: I am 24 and love to play cricket. I am a medium-fast bowler and happy with my performance. Lately my colleagues started telling me that I “chuck” the ball. That means instead of “bowling” I developed a “jerk” in my right arm. My coach says only a doctor of sports injury can determine whether its shape of your arm or you developed a “jerk” in your arm. Can you please advise me what to do? —Ameen Janjua.

A: As you are aware of the fact that shoulder joint is unique as it has the maximum range of motion in all direction.

Being a fast bowler requires maximum fitness and strength of the joint to have best performance in your game.

Your problem might be related to some soft tissue injury which may be rotator cuff, tendonitis or impingement of your joint.

You need proper assessment of your joint by orthopedic surgeon specialist in sports medicine for complete evaluation and management of your problem so you are able to get back to your bowling rhythm at your previous best 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

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