bone corrector One wrong move can put your body out of whack. Culprits include repetitive injuries, accidents and sports.

lower back pain My husband has been complaining about low back pain. Is it a slipped disc? Will it go away on its own or should he see a specialist? Low back pain is a very common complaint for a simple reason. Since the lowest part of the spine, the lumbar spine, is connected to your pelvis, it is where most of your weight bearing and body movement take place. Typically, people tend to place too much pressure on this area by twisting, lifting or carrying a heavy object. At the workplace, too, your husband may strain his back – for instance, he’s a dentist and needs to constantly bend to tend to patients, or he’s an office worker and is not very comfortable sitting at his desk. Such repetitive injuries can lead to damage to parts of the lumbar spine. A simple slipped disc is a sprain, most likely caused when one of the spinal discs has moved beyond its normal range. Tissues get torn, leading to pain, swelling and stiffness. Sometimes, all a slipped disc needs is proper rest, such as sleeping on a firm mattress. But there are also cases where a slipped disc is serious enough to warrant surgery, of which one of the most effective – and most popular because the patient requires a shorter hospital stay and recovers faster – is keyhole surgery. As the name suggests, keyhole surgery requires only a small "keyhole" incision. Instruments reach the disc through this tiny incision and remove the ruptured disc fragment with precision or, in severe cases, replace it with a cage device or an artificial disc. My advice is, pay attention to your body. Any time there’s pain or discomfort in the back, it needs to be looked at by a doctor. If the condition is left untreated, it can get worse and the pain can run elsewhere, for instance along a nerve, causing extreme discomfort, tingling, numbness or tightness where the nerve travels. It is important to remember that massage soothes but does not cure the condition. Consult an orthopaedic doctor for steps to take to correct and limit the injury.

tips for a healthy back • Pay attention to your body: If something you are doing causes your back to hurt, stop and rest or stop altogether. • Be sure your back and neck are properly supported when you sit or sleep. Get expert help in choosing your mattress and pillows – you can upset the alignment of your spine if a mattress is too soft, or a pillow too high. • Lose weight: If your weight is causing excessive pressure to your spine, weight loss can reduce your discomfort. • Lift objects properly: Always bend your knees so your arms are at the same level as the heavy object you plan to lift. • Exercise is vital for a healthy spine. If you have never been in the habit of doing exercise or if you already have an injury to your spine, talk to your doctor or physical therapist before you start on an exercise routine.

loose joints out of joint My boyfriend used to run a lot. Now he complains of his knees occasionally getting "out of joint" when he walks, causing him a lot of pain. What can be done? There are many conditions that can give the sensation of the knee feeling "loose" or "getting out of joint". For example, "runner’s knees" is an injury from overuse that results from excessive pressure between the surfaces of the kneecap and the knee joint. Usually causing pain, it can also cause a sensation of weakness or looseness when bearing weight, eg when climbing stairs. "Runner’s knees" can result from any number of reasons: an abrupt increase in running, over-pronation of the feet and muscle tightness of the quadriceps. (Pronation is the movement of the foot that occurs on walking and running; it helps the foot adapt. In pronation, the arch of the inner border of the foot lowers.) Help to prevent developing runner’s knees by gradually increasing your training load, selecting proper shoes for your type of feet and also by doing regular stretches. Besides running, "runner’s knees" can also occur in ball games like soccer and basketball and also sports that require lunging, eg squash. While painful, the condition can be reversed with a period of rest, followed by a programme of stretching and strengthening exercises. Do see a sports medicine specialist for more personal advice and the different options and courses of treatment.

"Better posture leads to better spine health. Simple things count. For example, at work make sure your chair has proper lower back support – chairs with an ‘S’ curve are more ergonomic and therefore better for your back. Sit into your chair and push it all the way in to your desk. When working at your desk, make sure your shoulders and elbows are resting comfortably."

Cutting-edge medical technology – including minimally-invasive surgery – and the expertise of the Specialists make the Department of Orthopaedic Surgery at Singapore General Hospital the premier referral centre for joint replacement, spinal care and ankle and foot treatment, musculoskeletal tumours, trauma and sports-related injuries.
Call 6222-3322 (main line) or visit www.sgh.com.sg.

3 common sports injuries • Ankle sprain occurs when the foot rolls inwards, leading to a tear of the ligament(s). Treatment depends on the extent of injury and also on the stage of the injury. • Shin splint is a lay term that refers to pain on the inner side of the shin which occurs from excessive running and jumping. The pain results from inflammation of the point of attachment of the deep calf muscles to the shinbone. It accounts for 16-20 per cent of running injuries. A brief period of rest from running may be necessary to allow the pain to subside. Treatment then focuses on correcting the factors contributing to the condition. Stretching and strengthening exercises for the calf muscles as well as gait retraining, selection of footwear and corrective insoles will help recovery. • Achilles tendinitis, or more accurately Achilles tendinopathy, occurs from excessive use of the Achilles tendon, for instance in long-distance running. It can also occur as a result of excessive strength training of the calf muscles. Left untreated, the condition can lead to degeneration of the tendon. Treatment varies from making changes to your running or training programme, to using orthotics to raise the heels, to stretches. Surgery may be required in extreme cases.

recognising the injury
Stitch: Pain in the upper abdomen that occurs with strenous activity (often, running) and attributed to ‘cramp’ of the diaphragm muscle. It can occur when you are running at an unaccustomed pace or if you run too soon after eating.
Sprain: Denotes a tear of a ligament. It can range from a tear of the small fibres of the ligament to partial or full tears. The severity of the injury depends on the degree of the tear and also on which ligament is involved.
Spasm: Sustained contraction of the muscle in response to pain/injury; it is a protective mechanism (initially) to limit movement.
Cramp: Painful sustained contraction of the muscle. Dehydration, fatigue and salt imbalance are some of the causes. Sustained stretching of the muscle can help.
Muscle fatigue: This can be due to various reasons. Adequate nutrition is important to restore depleted glycogen after training. Training and strengthening the muscle makes it more resistant to fatigue.

Is your man a sportsman? Keep these in your medicine chest • Anti-inflammatories to control swelling • Acetaminophen to control pain • Topical analgesia for muscle soreness • An assortment of plasters for minor cuts and abrasions • Cold packs for icing injured areas • Vaseline for those that find chaffing a problem, as seen in long runs

"To prevent sports injuries, perform warm-up and cool-down exercises, including stretching exercises to maintain flexibility, and resistance training to increase the strength of the muscles predominantly used in your sport. Plan your training regime to include sufficient rest periods and gradually increase your training volume so as as to avoid overuse injuries. The correct technique is also important in injury prevention. For example, poor backhand technique can lead to excessive use of the forearm muscles, thus putting one at risk of getting tennis elbow." – Dr Jason Chia, Associate Consultant Sports Physician, Changi General Hospital

The Changi Sports Medicine Centre at Changi General Hospital provides a comprehensive range of services including treatment of sports-related injuries, weight management, exercise testing, exercise prescription, gait analysis, and performance enhancement. Call 6850-3333 or visit www.cgh.com.sg/medical/sports.asp.