Saturday, 10 April 2010

Rt 5th finger sprain


A junior rubgy player came after competition with a painful Rt 5th finger. He had pain at the side of the Metacarpo-phalangeal joint after feeling a sharp pain and loss of power after 'losing grip' of an opponent's shirt.

He suffered from torn collateral ligament and would benefit from buddy taping or splinting over the next 4 to 6 weeks.

Tuesday, 6 April 2010

Extensor Digitorum tenosynovitis


A guitarist came with complaints of left wrist pain and swelling a few days ago. She had been training vigourously and held the 'chords' with the fingers (left hand) and subsequently did her biceps and triceps curls using dumbbells. Soon after the episode she started having pain and noticed 'fullness' in the back (dorsum) of her wrist.

She was advised to do RICE treatment and apply the anti-inflammatory gel. She was also treated with Ultrasound therapy and isometric wrist exercises. After a few days, the symptoms subsided and she was given a step-by-step exercise program to prevent recurrence.

Read up more here.

Sunday, 13 December 2009

Hydrotherapy after competition




A few photos from the team workout in a swimming pool after competition. It included slow jogging (forwards and sideways), hig knee jogging, striding, jump and rotate drills. This is often a useful training session for recovery and relaxation. Variations of this exercise may be useful for rehabilitation of lower limb injuries.

Salomon X-Trail Run 2009

Here are some photos from the Salomon X-trail Run 2009 event which drew a crowd of 900 entries from all walks of life. Congratulations to the event organisers. There was supply of water for rehydration and orange cuts too. The Gardenia van was also there to provide tasty buns for immediate carbohydrate intake for recovery. The photos show the RICE treatment that comes in really useful for first-aid and some wound care for abrasions suffered by some of the participants. Remember, do not ice for more than 20 minutes and use gloves if there are open wounds.







Saturday, 21 November 2009

ACL Rupture - Joint Aspiration




Photos taken from a karatedo athlete who twisted his knee during competition. Note that the aspirate always consist of blood. He also complains of his knee 'giving-way' and locking.

Finger Dislocation


This is the photo of a basketball player who dislocated left 5th finger. The finger was immediately rediced easily by the coach. He subsequently used RICE treatment which reduced the symptoms. He taped the finger to prevent a recurrence but refused further examination.

Tuesday, 6 October 2009

2nd Malaysian International Basketball Championships 7-10 October 2009


The 2nd Malaysian International Basketball Championships would be held at MABA from the 7-11 October 2009. This competition involves men (Korea, Hongkong, Philipines, Chinese Taipei, Malaysia, China) and women (Chinese Taipei, Singapore, Malaysia, China) teams from 7 Asian nations.



More details may be obtained from the MABA website or the official MIBC website.

Friday, 28 August 2009

1ST MALAYSIA INTERNATIONAL ICE HOCKEY TOURNAMENT 2009

There's an exciting adrenaline pumping Ice-Hockey International event coming up this weekend. Paramedics and doctors volunteers are wanted during the whole tournament.

Date: Sept 2-5 (Wednesday to Saturday)
Time: Sept 2 :8pm to midnight
Sept 3 & 4 :8am to midnight
Sept 5 :8am to 7pm
Venue: Sunway Pyramid Ice Rink
Estimated number of players: 180-200
Players' ages: 5-50
Organizer: Malaysia Ice Hockey Federation (MIHF)
Contact person: EeLaine (012-2261048) or Dr Aston (019-2103787)

See the video of launch and join us if you love the excitement!

Saturday, 30 May 2009

Subcutaneous hematoma in distal part of left leg


A 10 months old toddler was brought by his mother yesterday with a painful lump in the distal part of her left leg. She apparently fell 4 days earlier but his mother noticed the swelling only after 2 days when she was attending to her.

She was still able to hobble from one end of the table to the other end while hanging on to the sides. She only grimaced slightly when we examined the swelling. We did an Ultrasound scan for her showing a cystic swelling adjacent (but separate) to the Achilles tendon. He plain X-ray of the andkle and leg was normal.

The swelling subsided significantly with RICE treatment and topical Reparil gel. Her mother was advised to continue the same treatment for another few days. She was not given any NSAIDS.

Monday, 18 May 2009

Right 1st metatarsalgia in Ballet dancer


A young lady in her (28 yrs old) came to see me with chronic pain (3 yrs) in the Right big toe. The pain would worsen with repetitive jumping and landing during ballet and modern contemporary dance. Despite getting better shoes, she still seemed to suffer from the pain. Her toes was also 'crowding' in her shoes with the big toe moving towards the 2nd toe (Hallux valgus).

She had tenderness at the base of the right 1st metatarsal bone and moreso adjacent to the 2nd toe. Upon treatment with ultrasound she felt better and we taught her some strengthening exercises and taping. She should be feeling much better if she takes adequate precaution and implements RICE treatment when she feels sore after training.

Saturday, 7 March 2009

Ankle lateral ligament sprain




Friday, 30 January 2009

Supracondylar fracture of Humerus?

Here's 2 photos of a male patient in his 30's who had a fracture to his left elbow (believed to be supracondylar) when he was 4 yrs old. He was treated by a traditional healer but was not given the option of modern medicine. He has some physical deformity but is able to carry out manual work without any difficulty. He is happily engaged to his female companion who doesn't seem to mind the difference.


Tuesday, 20 January 2009

When you know you have a Torn ACL? (Part II)


Here's what happens when he tells me that the previous video wasn't clear enough for some to visualise the laxity.

When you know you have a Torn ACL?


Here's how a soccer player demonstrates his loose ACL ligament 'without moving a limb'.

Wednesday, 7 January 2009

Tibialis Anterior Ganglion Cyst


Here's a photo of one of the recreational badminton athlete who found that he had a small swelling at the ankle. Upon examination, I found a 2cm X 2cm cystic swelling just before the insertion of the Tibialis Anterior tendon. An ultrasound scan should be done to confirm the findings.

Usually, the cyst is treated conservatively with a corticosteroid injection. Care should be taken to ensure that the tendon is not damaged in the process. Surgical excision may also be carried out. However, such lesions are known to recur.

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: