Tuesday, 5 July 2011

Biceps partial tear

A bodybuilder felt a snap in his biceps muscle while doing his upper body workout in the gym. He immediately felt a sharp pain and weakness in the arm adjacent to the elbow. He discontinued his training session for the day.

A day after the incident, he could not extend his elbow fully and had pain at the myotendinous junction of the biceps muscle. The was a noticeable defect in the muscle compared to the other side. He was advised rest from upper limb exercises and RICE treatment was given. Kinesiotape was applied to prevent elbow extension.

A week after the incident, there was significant bruising seen and the pain had mostly subsided. He was still advised against full extension of his elbow.

At day 10 post-injury, there was some bruising as the athlete started some minimal biceps curled in flexion. He was advised to do just isometric exercises and ice after exercises.

At 14 days post-injury, the site of injury was pain-free and he had full range of motion. He required careful monitored strengthening of the upper limb for at least 4 t0 6 weeks while protecting the biceps muscle.

Monday, 27 December 2010

2011 Prohibited List (mobile) - World Anti-Doping Agency

2011 Prohibited List (mobile) - World Anti-Doping Agency has been available since 1st September 2010. Both athletes and coaches should be aware of the various subtances prohibited by sports which could still be inadvertently used by some ignorant medical personnel, personal trainers and nutritionists. One should also be aware of Therapeutic Use Exemption and Monitoring Programme. ADAMS continue to play a major role in the coordinating the athletes data via Athlete Whereabouts notification which has been made available on SMS in US, France and UK.

If you are savvy in social media, you may find some useful interaction on facebook, twitter or youtube.

Downloads of the Prohibited list, Monitoring Program, Summary of Modifications and Explanatory Notes.

Sunday, 26 December 2010

Slipping Rib Syndrome (12th Rib Syndrome)

This basketballer suffered from loin pain at the tip of the Right 12th rib and along the 11th intercostal space after feeling at 'pull' during competition. The pain persisted despite taking oral NSAIDS but reduced slightly with ice application. Similar injuries have been seen previously in martial arts, dancers, boxers and swimmers.

We ruled out fracture by clinical examination and X-rays and progressed to do some PNF stretching and strengthening exercises. An ultrasound scan was not done as we did not suspect a torn muscle. His symptoms subsided significantly after the first visit and was resolved within the next 2 weeks. He was told to strengthen his intercostal muscles and oblique abdominal muscles with rotary torso and stomach crunch exercises. Kinesiotaping was applied to provide a controlled lateral rotation and back extension while reducing pain.

Read articles in swimmers and non-athletes.

Monday, 20 December 2010

Plantar Fascia Rupture

This gentleman suddenly felt a snap followed by sharp pain in the hindfoot (medial tubercle of calcaneus) while playing badminton. He could only place his weight on his forefoot and had to use a pair of crutches to walk.

He was diagnosed with a partially ruptured plantar aponeurosis and told to use a pair of running shoes with a silicone gel pad. However, he was not allowed to bear weight due to the severe pain. His X-rays did not indicate any signs of fracture of the calcaneus.

After vigourous RICE treatment over the next few days and the use of oral Cox-2 inhibitor, the pain reduced significantly and he was able to walk with less pain. He was treated with ultrasound for several sessions and started with toe and foot exercises. We encouraged him to go into the swimming pool for hydrotherapy to maintain his aerobic fitness. He would require at least another 2 to 4 weeks before he can return to training.

Monday, 16 August 2010

Singapore 2010 Youth Olympic Games

The Singapore 2010 Youth Olympic Games will be held on the 14 August 2010 - 26 August 2010 in 17 competition venues in Singapore.

Participants: 3,600 young athletes between 14 - 18 years of age, 5,000 young athletes and officials.

The organisational aspect: 205 National Olympic Committees, 1,200 media representatives, 20,000 local and international volunteers and 370,000 spectators.

Highlights: 26 sports and culture & education programmes. You can find out who the athletes are here and keep updated with the results. Also join in the Celebration at Marina Bay.

If you are interested to get some exciting and fun-filled moments, get your tickets and be there early!

Friday, 13 August 2010

National Basketball League 2010

Here are some photos of basketball injuries taken by the press (Lim Chee Sen) during the National Basketball league 2010. Most of the tournament was covered by St John's Ambulance or Red Crescent volunteers with ambulances on standby for emergencies.

Another player twisted his ankle after accidentally tripping over another player's foot. He was back to play the semifinals after vigorous physiotherapy and rehabilitation exercises.

This player suffered from a scalp laceration after jumping over another player and suffered from a scalp laceration from the elbow of the player. He had a 2.5 cm scalp laceration which had to be sutured at a local hospital. The coach ensured that untrained personnel were not allowed to intervene until the doctor arrived to ensure that there were no cervical spine (neck) injuries.

Laceration wounds seen just adjacent to the eyebrows due to accidental elbow defensive manouvre. Apply pressure to the wound immediately with sterile gauze to control bleeding of the wound. Once the wound stops bleeding apply an adhesive plaster to hold the edges of the laceration and send the player to the doctor.

Player caught in an awkward position during a challenge by opposing player. He suffered from a lateral ligament complex ankle sprain and was duly iced to prevent swelling and reduce pain. Keep ankle elevated while icing it and ensure that he is examined by his team doctor as soon as possible.

You can read more about the event here.

Sunday, 20 June 2010

Muay Thai thumb sprain

An elite Muay Thai fighter came with a swollen and painful thumb after hurting his thumb when he accidentally hit the side the head of his opponent during a professional bout. Treated it aggressively with RICE therapy, electrotherapy and rehabilitation exercises and he returned to fight again in 2 weeks duration. He had a protective taping for the fight and managed well.

Monday, 24 May 2010

Jelajah Malaysia 2010

Some photos from the national road race competition from the 27th April 2010 to the 1st May 2010 from Kuala Selangor to Kuala Perlis. Thanks to a relatively good weather, skillful riding, good recovery preparations and well coordinated road safety by marshalls, commissaires and police, we had a safe journey during the competition. There were no serious injuries.

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


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!