The importance of warming up

Whether it is football or athletics, volleyball or cricket, a good warm-up is crucial before any match or even a training session. Most physical injuries are sustained by athletes because of a lack of proper warm-ups sessions. This week our panel of experts answers a variety of questions on several fitness issues ranging from shoulder to wrist injuries.

Q: I’m 24 and play regularly. I participate in different football tournaments held in different cities of Pakistan. For the last six months, while playing my right thigh muscle pulls, leaving me in pain. This is happening frequently now. I am very worried. Is it the end of my football career? –Muhammad Bashir

A: Dear Bashir, I always love to see such enthusiastic and zealous footballers and I am sure one day you will be representing Pakistan at the international level. Basically this injury is related to soft tissue that might be of tendon or muscle. As this has been now six months it is labeled as chronic injury which needs to be addressed at its earliest to avoid any irreversible damage. Muscle pull or spasm might be related to exhaustion of soft tissues due to lack of warm-up, which decreases nutrients to the body or over exhaustion of the body. Focusing on this issue may address your problem; if not then you need to see an Orthopedic Sports Surgeon.

Dr. Muhammad Kazim Rahim

MD, FCPS (Ortho) AO Fellow

(Germany), Sports medicine Fellow (IRI) (France), Hip and Knee Arthroplasty

Fellowship (PAS, Pak)

Assistant Professor | Department of

Orthopaedic Surgery

Liaquat National Hospital & Medical College

Q: I’m an active cricketer. Last year, while fielding I fell on my right shoulder and since then I have developed a shoulder pain, which is becoming an obstruction in continuing my game. What should I do? –Ahsan A.

A: Dear Ahsan, I see that you have in most likelihood sustained an injury to the rotator cuff with the mechanism of your fall. If this is causing you persistent pain then this also means that the injury has not healed. An injury to the cuff is just one possibility. There are numerous structures around the shoulder joint that can become injured after a fall. If you are an active sportsman like what is evident from your brief history, and aspire to continue to play then I suggest that you need an expert consultation. These injuries are mostly completely treatable and you should be able to take up sports regularly. My advice to you is to consult our sports injuries team which is a dedicated specialty within the department of orthopaedic surgery at Liaquat National Hospital. I am sure we can help you recover.

Dr. Ather Siddiqui

MRCS (Glasgow), FCPS (Ortho), Diploma in Tissue banking (NUS)

Assistant Professor | Department of Orthopaedic Surgery

Liaquat National Hospital & Medical College

Q: I am 33 years old and play volleyball regularly. Lately I’ve developed a severe pain in the joint of my palm and wrist. Once I leave the game for few days,

the pain subsidises, but once I start playing, it aggregates. Is it a serious injury?

– Qamaruddin Khan

A: It seems that you have either sprained or ruptured a ligament at the wrist joint but it does not seem like a fracture. Actually the wrist joint is among the most complex joints in the body and just to give you an idea this joint has fifteen bones forming the joint. Wrist itself has eight small bones about the size of an olive each and five bones of the palm and two long bones of the forearm. All these are connected together with an intricate mechanism of ligaments and sheaths and a capsule covering it. Within the capsule there is a lubricant to avoid friction between joints. Each joint at the adjacent surface has a joint congruent to the adjacent bone.

Each ligament and joint surface is so delicately balanced that even minor disruption can cause dysfunction.

If the injury is trivial it will not disrupt the mechanism but will cause inflammation and hence pain. Which will settle with rest but will not heal completely and even slight movement will provoke it again.

So this injury requires proper understanding and examination to diagnose and hence proper treatment.

Definite diagnosis can only be made after proper examination of the wrist and it may require some tests also. Once diagnosed, we can start treatment, which may also be surgical in some instances.

Prof. Dr. Mirza Shehab Afzal Beg

FRCS (UK), FRCS PLAST (UK), DIP PLAST (UK), CERT PLAST (UK), Fellow in Hand Surgery (UK)

Assistant Professor | Department of Plastic and Reconstructive Surgery

Liaquat National Hospital and Medical College

Q: I am a university student, and an athlete. My specialty is javelin throw. I practice a lot to improve my throw and increase the distance. Lately my right arm aches a lot after the throw. Is it some kind of an injury, or is it over practicing? Please advice. --Raghib Hussain

A: Dear reader javelin throw is a sport in which there is violent movement around the shoulder and upper arm. As a specialty you require a very high level of assisted training under supervision of a coach and a physiotherapist. As a young sportsman you are naturally trying to achieve perfection in performance. Pain is generally a sign of fatigue which has many causes including over use, muscular imbalance, tear of muscles and ligaments inside the shoulder. In majority of cases limitation of activities along with rest and physiotherapy of shoulder muscles resolves the problem. Muscle coordination is achieved with multiple sessions of physiotherapy after which throwing activity can be resumed. If you persistently continue to have problems despite these measures it is strongly advised to undergo complete evaluation of your shoulder to improve your throwing activity and keep u in the field.

Dr. Muhammad Sufyan

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

Assistant Professor | 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.)

By Khalid Hussain