Wednesday, 31 December 2008

Left Teres Minor strain (Grade II)

A wushu ex-elite athlete came with complaints of pain and weakness in his left shoulder after landing awkwardly with his arm hyperextended during training yesterday. He could only lift (abduction) his left arm with much difficulty above the level of his shoulder. He would feel more pain as he lifts his arm further.

Upon examination, I found that he had difficulty rotating his arm outwards (External Rotation) and lifting sideways (abduction).There was tenderness of the insertion of the teres minor muscle. He also has a lesser shoulder muscle bulk on his left and some multidirectional instability.

He was advised to continue RICE treatment for another 2 days and prescribed isometric exercises. He was also given simple exercises for the painfree range of motion while starting early proprioceptive exercises using the wall and ball. However, he was advised not to abduct his arm above the level of his shoulder initially.

He would be reviewed in 1 week to reassess his progress. An elite athlete would undergo an ultrasound scan to determine the extent of muscle strain. Clinically, he was having a Grade II strain.

Sunday, 28 December 2008

Bad Ankle Contusion after hit by hockey stick

In the midst of an important hockey match, one of my players had a hard hit by the follow-through of the hockey stick by an opposing player. The burly defender hit the ground at an instant holding onto his ankle and the umpire immediately signalled me to run in to evacuate the player.

There was a large soft swelling (2cm X 3cm X 8cm) on the outer (lateral) aspect of his left ankle which looked really angry looking. He was carried out with 2-man carry and immediately examined on the bench. He was extremely lucky that it was just a soft tissue injury and the tendons and bone was spared.

We treated him with RICE treatment, NSAIDS medication and Arnica gel. He played in the finals yesterday despite having mild pain.

Friday, 26 December 2008

Urticarial rash due to Allergy?

A gentleman came to see me this evening with itchy multiple red patches on his trunk, upper and lower limbs. He remembered going to a Christmas event and putting on an old jacket (belonging to his dad). He thinks he is allergic to the dust mites or fungal spores on the jacket, or is it the food served at the dinner?

He was given an injection of Anti-Histaminics to relieve his symptoms and given some new generation oral histaminics to take in the day time and a drowsy 1st generation Anti-histaminic for the severe itch at night. If his symptoms are severe, he may benefit from some corticosteroids orally or by injection (However, care needs to be taken as these should be given to athletes in emergencies only as they are on the Prohibited list and require TUE).

MHL Finals on 27th December 2008

Here's an invitation to all the lovers of field hockey to join in the hockey match of the year between Sapura and Ernst & Young. Be there early before 5pm to catch the match as the Pantai Hockey Stadium will be full to the brim.

All the best to the nationals, ex-internationals, and ex-nationals, coaches and officials involved in both teams. A job well done!

Tuesday, 16 December 2008

1st Asian Indoor Hockey Championships 2008

The 1st Sultan Azlan Shah Asian Indoor Hockey Championships was held in Stadium Indera Mulia, Ipoh from the 11th - 14th December 2008. The experience of covering an indoor hockey tournament is that you have lot's of opportunities to see defensive and offensive tactical measures executed by players to meet the challenges of their opponents. There were lots of bruising, contusions, several ankle sprains and muscle cramps and strains but there were no serious injury.

Congratulations to the Malaysian Team A for putting up a splendid display of courage and determination during the finals. Malaysia Team A lost 2-3 to Iran. A big pat on the back to the coaching team for the tactical strategy which worked well to counter the opponent's game.

Here are some of the injury photos taken from the championships: