MORE Singaporeans are taking part in sport activities during the weekend, with favourite sports such as running, cycling, basketball, tennis and badminton. Most people do not prepare their body for sport; hence come the risk of sport injuries. Sport injuries happen usually because of inadequate strength and poor flexibility.

Dr Roger Tian, Consultant from Changi Sports Medicine Centre at Changi General Hospital, gives detailed answers to your questions.

Question by kp

Hi Dr Tian,

I like to have your advise on sport injuries like 'ankle sprain' while on threadmill

Recently, I had a bad sprain on my left ankle after a 30min on threadmill machine. I always do stretching & warm-up before exercising.

Now I can only 'brisk-walk' on the machine instead of jogging.

Does it makes a different between brisk-walking & jogging?

nyway to cure the pain & to prevent it from happening again in future?

Thanks,
Kris

Answered by Dr. Roger Tian Consultant Sport Medicine Changi General Hospital

A sprain is a tear of the ligaments holding bones together at joints. In the ankle, the anteriotalofibular ligaments (on the outer edge of the joint) is most commonly affected. Once partially torn, the joint is unstable, and there is a high risk of recurrence, usually within the initial 1-2 years. During brisk walking, the forces through the ankle joint, as well as the range of motion required at the joint, are lower when compared to running. Hence, if your ankle is still painful, walking is definitely preferable to running.

Anti-inflammatory medication, ice massage, and physiotherapy can help with pain and swelling. To reduce recurrence, always wear shoes with an adequate heel counter and ankle support, use a ankle brace when participating in sports requiring twisting/turning/jumping, and strengthen the muscles that are involved in ankle stability.

Question by tanksjohn

Hi Dr Tian

What are the symtoms of Groin Pull & Hamstring Strain? Are they similar to "bone spurs"?

Answered by Dr. Roger Tian Consultant Sport Medicine Changi General Hospital

A groin pull is a strain of the adductor muscle, which runs along the innermost part of the thigh. A hamstring strain involves the hamstring muscles at the back of the thigh.

There may be acute pain during activies such as running, jumping or walking, associated with reduced strength. In acute cases, brusing or swelling may be visible.

These symptoms differ from those experienced in bone spurs.

Question by carolwong

Dear Dr Tian,

My son has hamstring strain for about 1 and a half year. He is in the army and because of his hamstring strain, he cannot do active duty which is making him frustrated.

For the past 6 months, he has seen a private Sports Dr and was recomended for physio treatment once a week. It has no improvement . Whenever he is home, he has to put a ice-pack on his thigh where the pain is but it doesn't seem to go away.

After I saw yesterday's TODAY advertisement on healthxchange, I know there is help for my son. Please advise if my son should go and see you instead as his present treatment has shown no improvement at all.

Looking forward to your advise.

Thks & rgds,
lsp

Answered by Dr. Roger Tian Consultant Sport Medicine Changi General Hospital

Muscle strains are usually due to a combination of overuse, excessive muscle tightness, inadequate strength and endurance, as well as fatigue. Management hinges on the identification and correction of these factors. Rehabilitation involves 4 – 6 weeks of exercises aimed at improving muscle flexibility, strength and endurance. As these exercises are usually performed several times weekly at home, patient participation is of utmost important for successful management.

Question by Angeline

My husband has flat feet. is he at a higher risk of knee problem ? He has been suffering from intermittence knee pain problem and has been taking glucosamine. He enjoys jogging very much. What should he do to reduce any potential risk to his knee? Should he switch to other sport?

Angeline

Re-post by administrator

Answered by Dr. Roger Tian Consultant Sport Medicine Changi General Hospital

The incidence of flat feet, or pes planus, can be as high as 50% in certain demographic groups. The majority of people with flat feet are asymptomatic, do not have any problems and hence do not require treatment. Symptoms usually arise from fatigue of the foot and calf muscles, and included soreness in the feet and calf after prolonged walking or at the end of the day. Runners with flat feet may have excessive pronation, which can in turn increase the internal rotation of the tibia and increase the torque at the knee, which may cause knee pain. Asymptomatic patients with flat feet do not require treatment. For those with symptoms, exercises to improve muscle balance and control, proper footwear (those with a medial arch support), and the use of customized orthotics, is sometimes necessary.

Question by Andre19203

I suffered from sprained ankle few years ago; I think the ligament was torn. Till today, when i play basketball, I feel that my ankle is dislocated and once I twist or turn the ankle a few times, it feels alright.

Is this a condition that I should be worried about?

Answered by Dr. Roger Tian Consultant Sport Medicine Changi General Hospital

Ligaments are the “ropes” that hold joints together. A sprain is a tear (either partial or complete) of a ligament. Hence, if the ligament is torn, there will be excessive movement and stress at the ankle joint during activities such as basketball. Overtime, this subjects the joint to excessively high loads, which can accelerate the wear and tear or degeneration of its cartilage covering, causing early osteoarthritis. Movement at osteoarthritis joints will be reduced, painful and stiff.

Instability of the ankle joint can also cause excessive friction between the bone and soft tissue during physical activity, giving rise to ankle impingement. It also increases the risk of the joint giving way during activities, which may convert a partial ligament tear into a complete one, or damage other ligaments as well as the cartilage covering of the joint.

Ref: U11