Disabled Sailing

I had my first experience with disabled sailing when I was asked to be trained as a classifier for the Malaysian Paralympiad 2008 for the sport. 5 participants from Asia (3 doctors, an occupational therapist and a physiotherapist)attended at 3 day seminar on Classification during the IFDS Skud18 World Championship Singapore (20th - 28th March 2008). The seminar was organised by Singapore Disability Sports Council and endorsed by the Asian Paralympic Committee with the objective of training more regional classifiers for the paralympic sports.









Classification of Disabled sailing is essentially divided into 3 parts:-

1) Functional Anatomical Test (clinic physical examination)
2) Functional Dock Test (assessment in the boat by the jetty)
3) Functional Sailing Test (observation during practice or competition)






The practical sessions were definitely helpful at introducing sailing, sailing equipment, the physical requirements during sailing and safety precautions of disabled sailing. We also learnt about the different types of boats involved in disabled sailing competition e.g. Sonar (3-person boat) and Skud (2-person boat). The excitement of watching the sport while braving the winds (and waves) definitely helps keep the adrenaline pumping. If you are careful to take lots of water, use sunscreen lotion and a hat, you could yourself from heat injuries and sunburn.

I was told to get a sailing license soon to ensure that I could take my classification training a step further. I would recommend this sport to Doctors, physiotherapists or occupational therapists who wouldn't mind getting wet and some tan! You may contact me or your local disabled sailing association if you would like to train to be a classifier.

For further information, here's a few useful sites:
IFDS Skud18 World Championship Singapore
Location: SAF Yacth Club
Live results
ISAF:Disabled Sailing
Singapore Disability Sports Council
Getting Started

Hyperlaxity Syndrome

Here's a badminton athlete who was found to be able to hyperextend his fingers without any discomfort. He does not seem to have hyperlaxity in other joints although he is flat footed.

Flexor Carpi Ulnaris tendinopathy in Goalkeeper

Lance (not his real name) is a badminton and futsal athlete who deflected a fast soccer ball during play 10 months ago. He was given a physiotherapy and wrist brace for several months but he could not resume competitive play due to Ulnar-sided wrist pain. He could not palm-off the ball (hyperextended wrist) and do forceful wrist skills (e.g. lob, flick, repetitive jabbing and smashing) with the badminton racquet.

He had tenderness over the Triangular Fibrocartilage Complex (TFCC) and along the Flexor Carpi Ulnaris tendon, pain with wrist hyperextension and resisted flexion of the hyperextended wrist joint. He also had laxity of the Distal Radio-ulna Joint.



He did not want to do further investigations (plain X-rays, Ultrasound scan and possibly an MRI) despite being advised so. We proceeded to teach him how to tape his wrist and forearm to give him a pain-free range of motion while allowing explosive powerful smashes (badminton) and some goalkeeping. He was given some Theraband exercises and proprioceptive exercises using a soccer ball for balance.

I expect him to take at least 6 - 8 weeks to return to normal play. However, if he is keen on competitive soccer, he would require further investigations and possibly, surgery to rectify the TFCC and DRUJ injury.

Interesting links:
TFCC Injuries
Ulnar-sided wrist pain

Yonex 2008 All England Badminton Championships

The 98th All England Open Badminton Championships(also known as the 2008 Yonex All England Badminton Championships) will be held between the 4th and 9th March 2008. The prestigious tournament will be held in the the National Indoor Arena, Birmingham. It will be sponsored by Yonex for the 25th consecutive year.

I had the opportunity of joining the Malaysian team in 2000 as their Team Physician for the exciting tournament. Don't forget to catch Live action on Sky Sports or just go there to watch the tournament!

Useful links:
About All England Badminton Championships
Official All England Badminton Competition Website
Time-table
Visitor Information and Weather; Getting there and Maps
Booking online & Discounts
Badminton England website

Finger Injuries in Martial Arts athlete

This sub-elite athlete suffered from an old punching injury to his 3rd metacarpal phalangeal joint a year ago during competition. The initial swelling and pain had subsided with treatment but he still has movement restriction. He should be able to continue training with taping but he will need an X-ray to find out the extent of damage. If the X-ray is normal, physiotherapy with finger exercises would help him regain full range of motion.






This sub-elite athlete suffered from an Index finger injury 6 months ago. His proximal interphalangeal (PIP) joint is still swollen although the pain has mostly subsided. He wanted to fight in another competition and was advised to tape his PIP joint. He should also obtain an X-ray of the PIP joint to rule out more serious injury.

Le Tour de Langkawi 2008

25 teams (5 Pro Tour outfits and 10 from Asia) will race in the 13th edition of the UCI sanctioned prestigious Le Tour de Langkawi from 9th to 17th February 2008. The 1377.4km race has been re-routed and shortened to only nine stages and the Genting route would be replaced by a more challenging Fraser's Hill climb.

RACE ROUTE

STAGE ONE (9th February 2008) – Alor Star to Kepala Batas (182.9km)

STAGE TWO (10th February 2008) – Butterworth to Sitiawan (159.7km)

STAGE THREE (11th February 2008) – Sitiawan to Banting (209.4km)

STAGE FOUR (12th February 2008) – Port Dickson to Batu Pahat (175.5km)

STAGE FIVE (13th February 2008) – Johor Bharu to Bandar Penawar (143.1km)

STAGE SIX (14th February 2008) – Bandar Penawar to Kuala Rompin (182.0km)

STAGE SEVEN (15th February 2008) – Kuala Rompin to Kuantan (127.6km)

STAGE EIGHT (16th February 2008) – Temerloh to Fraser's Hill (127.0km)

STAGE NINE (17th February 2008) – KL Criterium (80.4km)

Let's join in with the excitement and find out who will wear the varying colour of jerseys:
1) Yellow Jersey: the overall leader and final winner

2) White with Red Polka Dot Jersey: the King of the Mountains

3) Blue Jersey: the leader in the sprints

4) Blue and White: the Best Asian Rider

Important links:
Official Website
Race Schedule
Participating Teams and Team Profiles
Photo Gallery and News
Results
CyclingNews.com

Distal Radioulnar Joint Subluxation

A video of the wrist of a martial arts exponent who had a fall on his right hand 2 years ago during competition. He sustained an injury to his wrist causing him to have pain during punching. He also had painful full flexion of his wrist and resisted extension.

I have demonstrated the dorsal movement of the ulna with a fixed radius in the video. Although he would maintain some form of wrist stability with taping, he should be seen by a Hand surgeon to correct the instability.

Interesting links:
Radioulnar Joint Instability

Finger (Thumb) Dislocation

Here's a video of a female martial arts exponent who dislocated her left thumb 2 years ago after receiving a kick during competition. I did a test to evaluate the hypermobility of her joint. She is also having some hypermobility of her right thumb but it was less mobile.

Interesting Links:
Dislocation of the Thumb MP Joint

Corneal Laceration

James (not his real name) is a 22 yrs old martial arts sub-elite athlete who sustained a kick to his right eye 6 months ago. He sustained injury to his right cornea laceration due to the contact lens. Although he was seen by an Ophthalmologist and treated for several weeks, he still has blurred vision in his right eye. The corneal injury is visualised as a white patch on the cornea (corneal opacification). It is best seen under slit lamp after fluorescein eye stain. In full thickness corneal laceration, aqueous humour may leak out or there may be bleeding (hyphema) there may be distortion of the shape of the eyeball.


Since he wanted to continue to fight, he has been asked to obtain further treatment with Phototherapeutic keratectomy (PTK) or Corneal Transplant. Failure to do so, he may not be able to clear his Preparticipation examination with 'one good eye'.

Interesting links:
Corneal Laceration
Corneal Abrasion
Corneoscleral Laceration
Sports Pre-participation Examination

PROTON MALAYSIA OPEN SUPER SERIES 2008

The Proton Malaysia Open Super Series 2008 will be held from the 15th January to 20th January 2008 featuring the top world ranked players (e.g. Lee Chong Wei, Bao Chunlai, Peter Gade and Taufik Hidayat). Once again the prestigious event will be held in the Putra Stadium, Bukit Jalil, Kuala Lumpur. The Malaysian Open offers a total purse of US$250,000. For the first tine, winners of the men's and women's singles will get an equal prize money of USD15,000 while the men's and women's doubles champions will get US$13,800 each.

The qualifying rounds started on the 15th January 2008 and Championship events started a day later. It would be interesting to see who will feature in the Semifinals (19th January 2008) and Finals(20th January 2008).

It was upsetting for the Chinese that women's singles top seed Xie Xingfang pulled out of the competition due to an elbow injury. Anita Kaur shocked 2005 Sea Games champion Adriyanti Firdasari of Indonesia by defeating her 16-21, 25-23, 21-19. There will be more surprises as the championship progresses.

All the best to the players for this tournament!

Important links:
Seeded Entries
Badminton Association of Malaysia Website: News Updates
Match Schedule and Results
Tickets
Players
BWF Rankings

Knee Hyperextension in Ex-Rhythimic Gymnast

Ms Lim is a 35 yrs old ex-rhythmic gymnast who came to see me after a fall on her right knee. It was interesting that she had an extremely flexible left knee with an additional range of 35 degrees in extension. She had been perfectly normal in the left knee and did not suffer from any nagging pain.

She was advised to maintain an active lifestyle to ensure that she looses some weight and also strengthen her back, abdomen, hip and lower limb muscles to prevent injuries.

Blister after unmonitored heat therapy

An adult male patient came yesterday with back pain 2 days after injuring his back carrying a light object at work. He did not complain of any 'shooting pain' (radiating pain) to mentioned that the pain did not subside despite placing a hot water bottle (heat therapy) overnight. He had no pain bending forwards (flexion) but pain getting up from bent position (deflexion).

I examined him and found that he had 4 blisters (fluid filled sac in the skin) on his back (see photo) and spasm of his right erector spinae muscle. He didn't know that some of the pain was due to the blisters!

His muscle strain would recover with a week of physiotherapy and some medication for pain and muscle relaxation. He was not advised any treatment for the blister as it would heal on its own. I advised him to avoid using the hot water bottle directly onto skin or longer than 30 minutes to avoid blisters.

Right forefoot contusion

Dave played soccer 2 days ago and had slight right forefoot pain during the match but completed the game despite the pain. The pain worsened in the evening and he was given a hot ointment (Methyl Salicylate) by his mother. He faithfully massaged his right foot with the ointment and found that the foot was swollen (the light shade in the picture). He limped into my clinic yesterday and I thought that he had had a fall and or suffered from a stress fracture of one of his metatarsal bones.


He had oedema and tenderness of the softhis 5th metatarsophalangeal joint and both 4th and 5th metatarsal bones.

He was given some RICE treatment, Arnica Comp gel and 5 days of NSAIDS to reduce the swelling and pain. He is expected to get much better and I will review his injury once the swelling subsides over the next 48 hours.



Interesting links:-
Jones Fracture

Right knee lateral meniscus tear

Ms JW, a 21 yrs old lady was walking on her high-heels when she suddenly twisted her ankle and knee yesterday. The knee swelled up slightly and she could hardly walk. She was brought in by her father yesterday evening and could not bear her weight on the right knee.

Clinically, she had moderate effusion and slight slight restriction of knee flexion. She had tenderness of the joint line (lateral aspect) and a positive McMurray's test. She also had mild tenderness of the proximal attachment of the Lateral Collateral Ligament (LCL). She was treated with RICE treatment and sent for further evaluation with plain X-rays and MRI of the Right knee (to evaluate extent of meniscus injury and injury to other structures e.g. ACL). She has been started on isometric exercises. However, she may require early surgical intervention if the meniscus tear restricts movement or can be repaired. Post-surgical rehabilitation would often require up to 12 weeks commitment before return to play.

FOr further reading:-
Meniscus injury
Lateral discoid meniscus

Right Axillary Follicular Abscess

Ramli is a 30 yrs old club soccer player who came with painful right armpit (axillary region) painful swelling of 3 days duration. He usually shaves his armpit hair for hygiene purpose but this is the first time he suffered this fate.

I examined him and found several peasized tender, firm swelling in his right axilla but there were no other enlarged lymph nodes. The skin in the groin and axilla is commonly colonised by Staphyloccus Aureus. Minute skin cuts or abrasion could have introduced the infection to the hair follicles. We treated him with a course of antibiotics and some topical antibiotic ointment for 5 days duration. His symptoms resolved quickly as the infection was still at early stage. If the swelling failed to subside, he would have required incision and drainage surgery.

For further reading:-
Folliculitis
Lympadenitis

Tinea Pedis (Athlete's Foot) and Onychomycosis

Tinea pedis (athlete's foot) is a common fungal condition occuring in the feet of athletes or workers who routinely wear their shoes without drying and cleaning them properly. Although it is more common to find the itchy, scaly (not always) and smelly skin lesion in between the toes, they can also infect the sole of the foot. Athletes who have the habit of wearing shoes belonging to their team mates may transmit the disease to others. This condition is easy to treat with foot hygiene, topical anti-fungal creams and occasionally require oral anti-fungal medication.

The nails may also be infected (see 2nd photo) causing Onychomycosis. This condition is more difficult to treat often requiring oral anti-fungal medication, topical anti-fungal lotion after filing the infected nail.

Links of interest:-
Athlete's Foot: MayoClinic.com
Nail Fungus

Wrist (Radiocarpal ) Impingement and mild arthritis

Mr White (not his real name) is a 120kg weightlifter in his 20s who suffered from right wrist pain since 2 weeks duration. Prior to his competition he came to see me as the pain was preventing him from lifting beyond maximal capacity during 'clean and jerk'. His earlier X-ray did not show any fracture or osteophytes.

I examined his wrist yesterday morning only to find tenderness and slight fullness (synovitis) over the lunate bone in his right wrist. Forceful wrist hyperextension ellicits the same pain he experiences doing 'cleans'. Resisted extension was unaffected (ruling out extensor digitorum communis tendon involvement) He would need to rule out a lunate stress fracture (Radioisotope Bone Scans would be useful). He did not have any scaphoid bone tenderness although it is more common amongst weightlifters.

While awaiting his Radioisotope Bone Scan to rule out a stress fracture or Kienbock's Disease he would need to avoid doing 'cleans' and reduce the load of lifts. An ultrasound scan would be able to determine the extent of joint and tendon involvement with a musculoskeletal radiologist. Meanwhile, he should not participate in competition as it could worsen his condition. He would benefit from daily low frequency ultrasound (Exogen) for another 2 - 4 weeks. If symptoms persists he would need to be reviewed. MRI Scan could be an option then.

Interesting links:-
Wrist arthritis
A possible complication: Kienbock Disease

Posterior Cruciate Ligament Rupture

Posterior Drawer Test

Samsung Champions Trophy 2007

Kuala Lumpur is hosting the 29th Champion's Trophy featuring 8 world class national teams from 29th November 2007 to 9th December 2007 at the National Hockey Stadium, Bukit Jalil. Entrance will be free to promote the exciting and highly tactical sport in the country.


The teams participating in the championships are:-
1. Australia
2. Germany
3. Great Britain
4. Korea
5. Malaysia
6. Netherlands
7. Pakistan
8. Spain

Although the host Malaysia is fielding young players, the team promised to surprise their stronger opponents with fine skills and courage. I will be watching the team from the stands (instead of the bench) and cheering them on. You may also find a live commentary (with live feeds every 30 seconds) on the official website. All the best to the participating teams!

Find out more here:-
Official Website
The fixtures (schedule) and results
Points Table
Players and Officials
Photo gallery
News Updates
Samsung Official website

SEA Games Korat 2007

The 24th Southeast Asian Games (SEA Games) will be held in 3 different venues i.e. Korat, Bangkok and Chonburi (Pattaya), Thailand from 6th December to 16th December 2007 in conjunction with the commemoration of 80th birthday of His Majesty King Bhumibol Adulyadej.

The sports featured at the games are:-

* Category I - Athletics and Aquatics including Diving and Water Polo.
* Category II - Archery, Badminton, Basketball, Baseball, Billiards & Snooker, Tenpin Bowling, Boxing, Canoeing, Rowing, Cycling, Equestrian & Polo, Fencing, Football & Futsal, Golf, Gymnastics, Handball, Hockey, Judo, Karate, Rugby 7’s, Sailing & Windsurfing, Sepaktakraw, Shooting & Skeet & Trap, Softball, Table Tennis, Taekwondo, Tennis, Triathlon & Duathlon, Volleyball & Beach Volleyball, Weightlifting and Wushu.
* Category III - Dance Sport, Lawn Bowls, Mauy, Pentanque, Pencak Silat and Traditional Boat Race.

Find out the location of sports here:-
1. Korat: Venues and maps
2. Bangkok: Venues and maps
3. Chonburi (Pattaya): Venues and maps

Find out more about SEA Games 2007 here:-
Official Website for Sea Games Korat 2007
Competition Schedule
Events
Results
News Updates and more news
Sports and logos