Don`t Let Sickness Get You Down Don`t Let Sickness Get You Down
Transcription
Don`t Let Sickness Get You Down Don`t Let Sickness Get You Down
A PUBLICATION BY REGISTRATION No. 198901967K MICA (P) 034/11/2010 COMPLIMENTARY COPY ISSUE 04 / 2011 Sports Medicine Don’t Let Sickness Get You Down Exercise to improve your health Getting Back into Shape Steps to help you relive your glory days Dealing with Sports Injuries Putting you on the road to recovery Get Sporty in Unique Get Sporty Ways in Unique sports and why they’re great Unique Ways Unique sports and why they’re great OrthopaedicCentre Stop Living With Pain Physiotherapy is a holistic approach to healthcare and plays a vital part in pain relief, healing and rehabilitation in most medical and surgical conditions. The goal of physiotherapy is to restore functional ability to those who have suffered from injuries, physical impairments, or disabilities. Our physiotherapists treat the underlying cause of your pain with a combination of manual therapies and clinically proven pain relief technologies. We can also customise exercise programmes to cater to specific needs for speedy recovery and injury prevention. Raffles Physiotherapy & Fitness Centre offers treatment solutions for the following: ● Back Pain ● Neck Pain ● Rotator Cuff Injury ● Sciatica ● Slipped Disc ● Soft Tissue Sprains & Strains ● Sports Injuries ● Nerve Problems Hospital For more information or to book an appointment, please call 6311 2351 or email specialist@raffleshospital.com 585 North Bridge Road | Level 13 | Raffles Hospital | Singapore 188770 Contents NewsRoom New Docs on the Block | New Medical Clinics | Healthcare Privileges for American Express | You Don’t Have to Live With Joint Pain | Taking Down Hypertension | Latest Procedure In Managing Breast Abnormalities 4 Supplements 28 Ask a Raffles Doc 29 Promotions 30 Features Don’t Let Sickness Get You Down 7 Having a sickness or chronic condition does not mean you can’t exercise. We share some tips on what sufferers can do to stay physically and mentally active. Getting Back into Shape 11 Were you once lean and trim? Do you think about those “good old days”? Read on to gear yourself with what you need to know about becoming active again. Dealing with Sports Injuries 14 Injuries are often synonymous with sports. Let us share with you some of the more common types of injuries and what can be done about them. UpClose 18 Dr Michael Lee was once obese and led a sedentary lifestyle. Find out how he’s turned his life (and weight) around to help him become a better doctor. DIRECTORY www.rafflesmedicalgroup.com Corporate Accounts Enquiries Fax No. 6311 1333 6311 2383 www.rafflesmedical.com General Enquiries Fax No. • Anchorpoint • Ang Mo Kio • Anson Centre • Asia Square • Bedok North • Bishan • Capital Tower • Causeway Point* • Centrepoint* • Changi Business Park • Changi City Point • Clementi* • Compass Point* • Harbour Front • Hougang Central • Jurong East • Lot 1 Shoppers’ Mall • Loyang Point • Mapletree Business City • Marina Square • Millenia Walk • Nex • Ngee Ann City* • Northpoint 6311 6311 6479 6453 6225 6636 6441 6456 6323 6894 6733 6781 6636 6872 6881 6273 6386 6899 6765 6585 6570 6339 6337 6634 6734 6755 2222 2392 3818 2288 2188 0160 1736 7122 5212 0777 8775 7337 1251 9043 7337 3078 7896 6688 3363 3333 6970 6644 6000 2585 7355 0049 • One Marina Boulevard • One Raffles Place* • Raffles Airport Medical Centre Passsenger Terminal 2* Passsenger Terminal 3* Airport Transit 1 Airport Transit 2 Changi Cargo Complex • Raffles City • Raffles Medical@Raffles Hospital* • Robinson Point • Science Park I • Sembawang Way • Siglap Centre • Sixth Avenue • Tampines 1* • TechPlace II • Toa Payoh Central * Clinics near / with X-ray facilities 6225 2776 6535 2222 6543 6241 6543 6543 6543 6339 6311 6223 6776 6853 6442 6462 6260 6556 6254 1118 8818 1113 1118 1038 6911 2233 1188 7155 7703 0488 3426 5116 2318 7667 Raffles Medical Hong Kong Central Li Dong (852) 3168 2102 Taikoo Place (852) 2525 1730 Hong Kong International Airport (852) 2261 2626 Raffles Medical Shanghai Innov Tower (86) 21 6197 2300 www.raffleshospital.com General Enquiries 6311 1111 Call Centre Fax No. 6311 2136 24 Hour Emergency 6311 1555 Admissions / Business Office 6311 1888 Raffles International Patients Centre 6311 1666 International Patients Centre Fax No. 6311 2333 Before the Next Teardrop Falls 20 Find out about the different types of exercises that can help to condition and strengthen various body parts. To Be One Step Ahead 22 Injuries in sports are common. But did you know that most are avoidable? We tell you about what you can do to prevent these from taking over. Get Sporty in Unique Ways 23 Fencing? Equestrian? Underwater hockey? Do you know about these sports and how they can benefit you? We delve deeper into this realm of unusual activities. What’s in Your Gym Bag 27 We explore the contents of Dr Lim Kok Bin’s gym bag and find out what makes it to the gym with him. Editorial: Dr Prem Kumar Nair, Magdalene Lee, 6311 1222 24 Hour Appointments Hotline Fax No. 6311 2136 Email specialist@raffleshospital.com Raffles Aesthetics Raffles Cancer Centre Raffles Children’s Centre Raffles Chinese Medicine Raffles Counselling Centre Raffles Dental Raffles Dialysis Centre Raffles ENT Centre Raffles Executive Medical Centre Raffles Eye Centre Raffles Fertility Centre Raffles HealthScreeners Raffles Heart Centre Raffles Internal Medicine Centre Raffles Japanese Clinic Raffles Orthopaedic Centre Raffles Pain Management Centre Raffles Skin Centre Raffles Surgery Centre Raffles UroRenal Centre Raffles Women’s Centre Physiotherapy Centre Radiology Joanna Lee, Jasmin Pillai, Fann Khoo, Edmond Loh & Tay Jiaqi Creative: Edd Chua, Jenny Cheok & Ho Yeong Shing The information contained in this publication should not be regarded as a substitute for detailed medical advice in individual cases. All rights reserved. No part of this publication may be reproduced in any form or by any means without the written permission of the publisher. Please address all correspondence to The Editor, Raffles HealthNews, Fax no. 6311 2378 Email: healthnews@rafflesmedical.com Raffles HealthNews is published by Raffles Medical Group Ltd 585 North Bridge Road, Raffles Hospital #11-00, Singapore 188770 www.rafflesmedicalgroup.com Printed by Xpoprint (Asia) Pte Ltd Regional Representative Office Raffles International Office Jakarta 62 21 5785 3979 Liaison Centres Offices Jogyakarta Solo 62 215 7853979 62 271 3020033 Nov 11 4 Newsroom Raffles HealthNews 1 New Docs on the Block Prior to joining Raffles Hospital, Dr Dutton was Assistant Professor of Orthopaedic Surgery and a Consultant at the Division of Hip and Knee Surgery at the National University Hospital (NUH). He was also the Head of the Sports Clinic and Fellowship Director for Sports Surgery at NUH. He was a volunteer doctor at Dover Park Hospice and the Kim Seng Community Clinic. As an examiner for the Final Professional MBBS examination, he is currently teaching medical students and training residents as a Visiting Consultant at NUH. Dr Dutton’s clinical interests are in knee and hip replacements; using minimally invasive techniques and computer navigation, arthroscopic surgery for the knee and hip, as well as cartilage regeneration and stem cell therapy. Dr Andrew Quoc Dutton Specialist in Orthopaedic Surgery & Consultant, Raffles Orthopaedic Centre Dr Harneet graduated from the Faculty of Medicine, University of Malaya in 2000. She became a member of the Royal College of Physicians, London in 2004 and was awarded a DFID scholarship by the British Government to pursue a Masters in Dermatology at St John’s Institute of Dermatology, St Thomas and Guy’s Hospital, London, where she wrote a thesis on female pattern hair loss. She further trained in dermatology and sexually transmitted diseases at the National Skin Centre, Singapore. She worked at Singapore General Hospital and the National Skin Centre for 5 years prior to joining Raffles Hospital. Dr Harneet has a keen interest in hair related disorders. Her research has been published in international dermatological, dermatosurgical and sexually transmitted infection journals. She has also written a chapter in a textbook on sexually transmitted infections. 2 New Clinic at Asia Square 2 8 Marina View, #07-02 Asia Square Tower 1 Singapore 018960 Tel: 6636 0160 Fax: 6636 0159 Operating Hours Monday - Friday: 8.30am – 1.00pm, 2.00pm – 5.30pm Saturday: 8.30am – 1.00pm Relocation for Millenia Walk Clinic New Address 9 Raffles Boulevard, #02-05 Singapore 039596 Tel: 6337 6000 Fax: 6334 8607 Operating Hours Dr Harneet Kaur Ranu Specialist in Dermatology & Consultant, Raffles Skin Centre Raffles Hospital Partners American Express for Healthcare Privileges 3 As an American Express Cardmember, you can now enjoy the following healthcare privileges by simply presenting your passport and American Express® Card when you visit Raffles Hospital for the following services. Raffles HealthScreeners • • • Specialist Consultation Fee from S$78 In-patient admission room rates from S$443 Raffles Enhanced Packages from S$366 Raffles Chinese Medicine • • First Consultation with Chinese Physician from S$39 First a la carte acupuncture session from S$53 Monday - Friday: 8.30am – 1.00pm, 2.00pm – 5.30pm Saturday: 8.30am – 1.00pm For more information, visit www.amexnetwork.com.sg/tourist * For tourists only. * Prices include GST. Terms and conditions apply. Raffles HealthNews Newsroom 5 4 You Don’t Have to Live With Joint ain Most people assume that having pain in the joints is a normal process of ageing, and they just have to learn to live with it. All too often, instead of seeking professional advice, many turn to pain killers or assume the pain will just go away. The causes of joint pain are diverse and range from inflammation, traumatic injuries, infections, overloading or even genetic factors. It is also commonly perceived that severe joint pain comes with age. However, this is not necessarily true as people in their twenties and thirties can also start to experience joint problems. Take 36-year-old Sue, an Administrative Executive, as an example. As a running enthusiast, Sue jogs regularly and leads an active lifestyle. So, when she felt stiffness and aches in her knees, she thought it might be due to long periods of sitting at work or over exercising. Arthritis is not a benign joint disease and this inflammation usually occurs in joints in a symmetrical fashion. If left untreated, it can cause her to develop cartilage and bone damage leading to joint deformities.” In Sue’s case, by seeking timely professional treatment, she was able to prevent disability. Arthritis is a catch-all term that simply means inflammation of the joints. However, it is not a simple diagnosis as generally perceived. There are many different forms of arthritis and getting the right diagnosis and treatment are crucial in helping sufferers to minimise discomfort and preventing permanent damage to their joints. While medications can relieve pain, they may also cause side effects such as stomach intolerance and kidney problems. Some other medications used to prevent further progression of the disease can also affect blood counts or the liver. After many visits to the general practitioner and consistently taking pain killers, her condition worsened and affected her daily life as she gradually had difficulty getting out of bed. She visited a specialist for advice when she noticed some swellings in her wrists and knees. From the results of a blood test and X-rays, she was told that she was suffering from Rheumatoid Arthritis. It is therefore recommended that sufferers of joint pain have a doctor monitor their condition regularly throughout the treatment process. Other than taking medications, they will also need to make some changes to their lifestyles by exercising and losing weight if they are overweight. They can work with a physiotherapist, who can develop an exercise programme that will aid them to improve strength and relieve pain. Dr Chong Yong Yeow, Specialist in Rheumatology & Consultant, Raffles Internal Medicine Centre comments, “Rheumatoid Dr Chong adds, “Some joint aches and pains should not be overlooked as they can signal more sinister conditions. They can be P related to connective tissue diseases such as Systemic Lupus Erythematosus, Sjogren’s Syndrome or underlying inflammatory muscle disease. These autoimmune diseases may also be associated with inflammation of other organ systems such as the kidney, lung, brain and heart. However, with early detection and diagnosis, the sufferer can receive appropriate treatment and reduce the risk of serious complications.” Although usually non-life threatening, it is important to seek help from a specialist when one experiences any kind of persistent joint pain or other unusual symptoms, for instance, prolonged joint stiffness which lasts through the day or persistent swelling of a joint as these can be features of an inflamed joint. Says Dr Chong, “At Raffles Internal Medicine Centre, we are equipped with the latest medical technology and systems for diagnosis and treatment. Together with personalised attention and support throughout their treatment, we can help our patients reduce their risks of potential complications and prevent permanent joint damage.” 6 Newsroom Raffles HealthNews 5 Taking Down Hypertension Raffles Hospital is offering Renal Denervation (RDN), a new procedure which can permanently reduce blood pressure levels by up to 30 mm/Hg in hypertensive patients who are resistant to traditional hypertension drugs. RDN is a minimally-invasive, once-off and lasting procedure, which can help to dramatically lower a patient’s cardiovascular risk and for some, even reduce the need for multiple lifelong medications. In addition, it has the potential to reduce the likelihood of prematurely contracting debilitating cardiovascular events such as strokes and heart attacks. RDN is a straight-forward procedure that is similar to an angioplasty. An interventionist threads a catheter into the renal artery under the guidance of radio imaging. Once in place, the catheter is activated and the kidney’s sympathetic nervous system (SNS) is disabled, thereby reducing traffic through it and lowering blood pressure. 6 Raffles Hospital Unveils Latest Procedure in Managing Breast Patients with suspicious clusters of small calcium deposits or lumps in the breast, and those with early stage breast cancer can now benefit from a novel technique that provides superior cosmetic outcome in breast conservation surgery. This technique was introduced to Singapore this year by Dr Felicia Tan Li Sher, Specialist in General Surgery & Consultant, Raffles Surgery Centre, who is also the pioneer of the procedure in the region. Known as Radioisotope Occult Lesion Localisation (ROLL), this relatively simple yet highly effective technique is a combination of both a radiological and a surgical procedure. ROLL is a useful method for locating the abnormal tissues, which allows the surgeon to perform a quicker and more precise surgical removal, as compared to the current gold standard, hookwire localisation. More importantly, there is minimal discomfort to the patient and is safe for clinical staff with no specific radiological protection needed. Dr Tan has successfully performed this technique on 50 patients since February this year. Kidney “Precise localisation of the abnormal tissues is critical as it allows the surgeon to better plan the skin incision for better cosmetic outcome, as well as optimising the results in breast conservation surgery. ROLL also allows minimal removal of healthy breast tissues while ensuring that the tumour is entirely removed,” says Dr Tan. An estimated 25 percent of cancerous breast tumours cannot be physically felt in clinical examination and these are usually early stage breast cancers. These abnormal breast tissues need to be accurately located using mammography and ultra-sonography for a successful surgical treatment. However, Suspicious microcalcifications / lump in the breast Step I Injection of radioactive material under image guidance Step II RDN catheter inserted into renal artery. “This new technology will improve the quality of life for most patients and help save costs by possibly negating medications altogether,” says Dr Alvin Ng Chee Keong, Specialist in Cardiology & Consultant, Raffles Heart Centre. According to Dr Yang Wen Shin, Specialist in Nephrology & Consultant, Raffles UroRenal Centre, “The procedure shows promise for treatment in many other chronic conditions including sufferers of kidney failure, who have heightened risks of cardiovascular events, if their blood pressure remains uncontrolled with conventional medication.” Currently, patients at Raffles Hospital will have to be referred by a specialist before they are able to undergo RDN. Around one in five Singaporeans aged 18 to 69 years has hypertension. Abnormalities traditional methods via hookwire localisation has complications such as inaccurate localisation with up to 30 to 40 percent miss rate, longer procedure time and pain to the patient. There is also potential risk of injuring the lungs during the procedure. ROLL was invented in Milan in 1996, based on the premise of placing radioactive chemicals within the abnormal breast tissues under clear image guidance. With the use of a gamma probe, the surgeon is able to locate them during the surgery, and based on the location of radioactivity, ensures a smooth and successful surgical removal. Gamma probe used to detect area of radioactivity Suspicious lump is removed and sent to the laboratory for testing Step III Step IV Raffles HealthNews Feature 7 Don’t Let Sickness Get You Down Exercises for a Healthier You e all know the importance of exercise for healthy persons. However, do you know what exercises are appropriate for you if you have a medical condition? We speak to doctors from Raffles Hospital to learn more about exercises that would benefit you. W Any form of exercise is good for the body. If you have chronic conditions, you can still benefit from exercise. Exercise is not just for the healthy, but with care, it is safe for those with health conditions as well. Speak to your doctor to assess your health before starting out on any exercise regime. Benefits of exercise include blood pressure reduction, metabolism stimulation, weight maintenance, stress and anxiety reduction, temperature regulation, pain relief and insomnia management. It can help improve circulation and lung capacity, reduce the risk of getting diabetes mellitus, osteoporosis or hypertension, improve muscle tone and stamina, enhance self-esteem and confidence; and lift depression. So are you ready to start moving your body? Let’s move it! 8 Feature Raffles HealthNews Heart Health Being physically inactive is a major risk factor for developing coronary artery disease and other heart ailments. “As fatty deposits and cholesterol build up in the arteries, they cut off blood supply to your heart,” says Dr Alvin Ng Chee Keong, Specialist in Cardiology & Consultant, Raffles Heart Centre. “These lead to high blood pressure and lower levels of HDL, aka our ‘good’ cholesterol.” The good news is that you don’t have to run marathons to decrease these risk factors. Aerobic exercises such as brisk walking or swimming for 30 minutes a day can significantly decrease your heart disease risks. Aerobic exercises strengthen the heart and lungs and improve the body’s ability to use oxygen. Over time, aerobic exercise can help decrease your heart rate and blood pressure and improve your breathing. You should slowly work up to an aerobic session lasting 20 to 30 minutes, at least three to four times a week. Stretching before and after exercises are also recommended as they help prepare the muscles for activity and prevent injury and muscle strain. Regular stretching also increases your range of motion and flexibility. Diabetes Diabetes is a condition whereby the body has trouble taking glucose from the blood and delivering it to the rest of the body so that it can be used as energy. This is due to a lack of, or an inability to use insulin, the hormone required to “escort” glucose from the blood to cells of the body. Dr Stanley Liew, Specialist in Endocrinology & Consultant, Raffles Internal Medicine Centre, recommends both aerobic exercise and strength training for diabetic patients. “Along with proper nutrition, aerobic exercise can increase insulin sensitivity and restore normal glucose metabolism by decreasing body fat. Strength training (resistance or weight training) also decreases body fat by raising the metabolism and more importantly, increases glucose uptake by the muscles and enhance the ability to store glucose.” Diabetic patients should take special care of their feet by wearing comfortable shoes during their exercise routines as a small open wound may lead to infection. “Check your feet daily for scratches, cuts, blisters, ingrown toenails, corns, and calluses. If you notice ingrown toenails, athlete’s foot, and cuts or sores that are not healing, contact your doctor right away,” added Dr Liew. Raffles HealthNews Feature 9 Back Pain Are you suffering from back pain and as a result abstaining from strenuous activities? While this may be recommended for the short term, back exercise is actually the best way to rehabilitate the spine and help alleviate back pain. “A strong, well-conditioned back can tolerate more stress, and protect the spine better as compared to a back that has not been conditioned through exercise. Conditioning through flexibility and strengthening back exercises not only helps the back avoid injury, or minimise the severity of injury if the spine is traumatised, it also can help relieve the pain of many back conditions,” shares Dr David Wong, Specialist in Orthopaedic Surgery & Consultant, Raffles Orthopaedic Centre. Exercises that strengthen the spinal column and the supporting muscles, ligaments and tendons are most appropriate for back pain management. These exercises should focus not only on the back, but also the abdominal (stomach), gluteus (buttocks) and hip muscles. Taken together, these strong ‘core’ muscles can provide back pain relief because they provide strong support for the spine, keeping it in alignment and facilitating movements that extend or twist the spine. Bone and Joint Condition Want to slow down or prevent the onset of osteoporosis and osteoarthritis? According to Dr Lim Yeow Wai, Specialist in Orthopaedic Surgery & Consultant, Raffles Orthopaedic Centre, 30 minutes of physical activity three times a week can help. Exercises such as walking, cycling, swimming and strength training keep joints flexible and cartilage tissue from breaking down and weakening. “Weight-bearing exercises are the best ways to build strong bones. These include walking, stair climbing, running, hiking, and weight lifting. These exercises stimulate bone formation, and retain calcium in the bones that are bearing the load. The force of muscles pulling against bones stimulates this bone building process. So any exercise that places force on a bone will strengthen that bone,” he explains. Exercise also increases muscle strength, coordination, and balance. It decreases the likelihood of falls, especially for the elderly. That said, those with bone and joint conditions should avoid high impact exercises that can stress the joints, such as aerobic workouts that require bouncing, competitive sports or running. 10 Feature Raffles HealthNews Cancer For cancer survivors, exercise seems like the last thing on their mind. Yet studies have shown that exercise may prevent the disease returning for specific cancers including breast and colorectal cancer. Cancer patients should engage in exercise. Even moderate exercise such as brisk walking, heavy cleaning, lawn moving, cycling and badminton, can help. Dr Donald Poon, Specialist in Medical Oncology & Consultant, Raffles Cancer Centre explains, “Research has shown that engaging in vigorous physical activity for an equivalent of 30 to 45 minutes of brisk walking, five days a week, can help lessen many symptoms commonly experienced after cancer treatments, reduce the risk of relapse and improve the chance of a fulfilling survival.” Contrary to common perceptions, physical exercise does not make one feel more tired during treatment, but can in fact boost one’s energy after that. It can also lower your chances of getting heart disease and osteoporosis in the long term. “You should check with your attending doctor if you have doubts as to which exercise programme you can embark on because each condition may impose different exercise limitations,” adds Dr Poon. Depression Feeling down and lethargic? Depression can get one really down. But that’s no excuse to stop moving. In fact, exercise has psychological and physical benefits that help reduce anxiety and improve mood. According to Dr Lim Yun Chin, Specialist in Psychiatry & Consultant, Raffles Counselling Centre, “The links between depression and exercise is not clear. However, exercise probably helps ease depression by releasing feel-good brain chemicals, reducing immune system chemicals that can worsen depression and increasing body temperature, which may have calming effects. There’s a wide range of activities that you can engage in to boost your activity level and help you feel better. Certainly running, going to the gym, playing basketball and other fitness activities that get your heart pumping would help. So can gardening, washing your car, or strolling around the block and other less intense activities. Basically, the goal is to get you off the couch and moving. So wait no longer, get out and make exercise a part of your life. HN Raffles HealthNews Feature 11 Getting Back Into Sh 1 ap e T here are times in our lives where even the most sedentary of us were somewhat active. It is likely that we’ve all had a period where we were fit and healthy. Yet all this probably changed when adulthood hit. Now, the occasional glimpse of oneself in the mirror reminds us of those “glory” days. But why stop at reminiscing? You can get back that lifestyle and reap the benefits of fitness once again. Let Health News guide you on the road back to a fit lifestyle. Exercise Again – Why You Should Restarting a healthy fitness regime doesn’t mean picking up from where you left off. Chances are it’s been some time since you’ve worked up a sweat. It is therefore important to gradually build up momentum in one’s regime. Your age and health also make a difference now. Remember, you were younger and fitter then. However, do not let this discourage you; exercise has no age limit on its benefits. For starters, a simple target of 150 minutes of exercise a week is optimal. “You may be used to more previously, however 150 minutes per week or 30 minutes per day is sufficient to start feeling the benefits of exercise,” says Dr Peter Chen, Family Physician, Raffles Medical. And in case you’ve forgotten, here’s a quick recap from Dr Wong Wei Mon, Senior Physician, Raffles Medical on those benefits (as an incentive). Regular moderate exercise performed every three to five days a week can broadly: Improve your heart health • Reduce the risk of heart disease • Help your heart and cardiovascular system work more efficiently Improve your heart disease risk factors • Reduce risk of developing diabetes and high blood pressure • Improve blood sugar tolerance if you have diabetes • Help control high blood pressure, by as much as eight to 10 points • Improve cholesterol levels • Control weight and reduce body fat Improve your strength and feeling of well-being • Helps keep muscles, bones, and joints healthy • Increase your energy levels • Improve your balance and flexibility • Maintain muscle tone • Lessen feelings of anxiety or depression • Improve your sense of well-being 12 Feature Raffles HealthNews 2 Seeing a Doctor Now that you’re convinced that you should lead an active lifestyle once again, it is time to consider an important factor before starting your exercise regime. Understanding your health condition is vital in choosing the right exercise regime for you and can also possibly save your life by understanding what types of activities to avoid. Dr Rupert See, Senior Physician, Raffles Medical advises, “Anyone intending to start or restart an exercise regime after a long hiatus should see their doctor and make sure they don’t have any pre-existing medical condition. It is recommended that some level of health screening be conducted to rule out any underlying predisposition such as hypertension, diabetes, or heart conditions.” Dr See adds, “It goes without saying that pre-existing conditions such as heart disease or diabetes should be given an extra level of attention. Screening for pre-existing conditions should not only be limited to the old. Young people have been known to suffer from undiagnosed conditions that were “triggered” by strenuous activity, e.g. recent incidents of young people who have died suddenly from running marathon. Hence young people who have not had any exercise for some time should see a doctor before starting on a fitness regime.” Another important group that should consider screening is men aged over 40 and women aged over 50. Dr Carol Tan-Goh, Specialist in Geriatric Medicine & Consultant, Raffles Internal Medicine Centre explains, “As you get older, you become more susceptible to ailments and diseases. While an active lifestyle in one’s older years is encouraged, it is vital for such persons to check with a doctor before beginning especially if they suffer from any of the following: • Dizziness or shortness of breath • Chest pain or pressure, or the feeling that your heart is skipping, racing, or fluttering • Blood clots • An infection or fever with muscle aches • Unplanned weight loss • Foot or ankle sores that won’t heal • Joint swelling • A bleeding or detached retina, eye surgery, or laser treatment • A hernia • Recent hip or back surgery • Previous medical conditions such as heart disease, diabetes, hypertension etc.” Dr Wong also lists the following as some tests that can be conducted during screening to better gauge your risk level before embarking on an exercise regime. Type of Tests Description History and Cardiac risk assessment Questionnaire focused on personal risk factors and family history Physical examination Physical examination of heart, lungs, joints, etc Body Mass Index (BMI) A simple measurement to determine amount of body fat Blood pressure A measurement of the pressure exerted by circulating blood on the walls of blood vessels. Resting ECG Charts the electrical activity of the heart to detect any heart abnormalities/disorder Full lipids (cholesterol) profile Total cholesterol, HDL, LDL, cholesterol/HDL ratio, triglycerides Fasting blood glucose For diabetes screening Treadmill exercise stress test To detect coronary heart disease Medical report, with further referral and management if necessary Discussion of test results and appropriate health advice given to individual’s condition weight(kg) [height (m)]2 In addition to cardiovascular assessment of one’s health, an examination of the joints will also be useful. This is especially so for persons who’ve experienced joint pain previously or older persons who’ve possibly had some joints in their body replaced, suggests Dr Lim Lian Arn, Specialist in Orthopaedic Surgery & Consultant, Raffles Orthopaedic Centre. Dr Lim also adds, “Knowing the condition of one’s joints will provide a better guide to the types of exercises or sports a person should and should not take up. This makes it less likely that any problems will be exacerbated.” Raffles HealthNews Feature 13 3 One Last Step So you’ve made up your mind to go back to an active and healthy lifestyle. You’ve even gotten a clean bill of health to do so. But hold your horses, there’s one final part before you actually begin; the exercise(s) itself. “You might have been quite the soccer player or gymnast many years ago yet given your body’s lack of conditioning and (if any) ailments or medical condition, it may be wise to consider other forms of exercise,” advises Mr Lim Hun Teck, Principal Physiotherapist, Raffles Physiotherapy Centre. Mr Lim also provided some suggestions on the different types of exercises persons of different age groups can focus on. For those in their 20s: A mixture of moderate and vigorous exercise is recommended. Cardio should be 4 done at least three times a week for 20 to 30 minutes each time. Musclestrengthening exercises should also be done twice a week. For those in their 30s: At this age, it is more important to do short and intense bursts of activities instead of focusing on endurance training. Women at this age also start to lose bone and muscle mass. Therefore the focus here should be on building muscle and preserving bone density through strength training for about two to three times each week. Aerobic activity should now be a daily routine with stretching and balancing exercises included. On The Road to an Active Lifestyle In conclusion, re-adopting or embarking on an active and healthy lifestyle has many benefits. However, there are points of consideration one should take before execution. These include the person’s age, current level of fitness as well as current health condition. Always remember to check with your doctor if you’re unsure or if you have any worries. They can also provide suggestions for various types of exercises which will be more suitable. Most importantly however, have a goal in mind. Being clear about what you hope to achieve makes your path clearer. The journey may be tough but the rewards are endless and once you’ve reached your goal, stay active. HN For those in their 40s to 50s+: This is the time when a host of issues can start to plague one’s health. For example, joint wear and tear begins to occur more frequently. Lung function also declines at this age. Given these issues, it is more advisable to choose exercises based on personal risk factors. For example, cardiovascular disease is still the biggest threat so cardio exercises should still be considered. Additionally, strength training can be considered if one needs to protect and boost weak joints. These sentiments are also echoed by Dr Chen who advises, “A good workout should incorporate elements of both cardiovascular and resistance exercises to help address the inevitable issues that are brought on by aging such as a weakening heart and muscle loss.” Mr Lim however advises prudence within his recommendations, “While it serves as a good guide, you would know best about the types of suitable exercise. For example, don’t run too much if you have a bad hip. It’s all about finding the right balance of exercises that you enjoy doing and not putting your health at risk.” 14 Feature Raffles HealthNews Dealing with Sports Injuries If you think only sports stars like sprinter Tyson Gay, basketball player Yao Ming and golfer Tiger Woods are vulnerable to sprained joints and broken limbs, think again. For many health-conscious Singaporeans, being active in sports and exercise seem like the perfect way to keep fit. However for some people, particularly those who overdo it or those who do not train properly, instead of reaping the benefits, they may end up putting themselves at risk of getting injured. Raffles HealthNews Feature 15 Understanding Sports Injuries Common Sports Injuries and Causes The term ‘sports injuries’ refer to the kinds of injuries that usually occur during sports or exercise. So what are the common sporting injuries and their possible causes? Generally, it depends on your activity and current fitness level. Here are the most common ones in no particular order: Sports injuries may happen to those who are new to a sport, those who begin exercising after prolonged inactivity, or those who do not warm up properly before workout. They may result from accidents, poor training practices, improper equipment use, lack of conditioning, or insufficient warm up and stretching. According to Mr Lim Hun Teck, Principal Physiotherapist, Raffles Physiotherapy Centre, “A simple warm up exercise or stretching before launching into any intense session of exercise or sports like aerobics, running or football, does not ensure that you will be injury-free. In fact, the higher the intensity, the risk of injury to any part of the musculoskeletal system like the muscles and bones also increases. One way to prevent injuries is to start slowly and increase your exercise level gradually.” 1 Sprains and Strains Sprains are tears to the ligaments, the connective tissues that attach one bone to another. They are caused by trauma, such as a fall or blow to the body that knocks a joint out of position. Sprains can range from first degree (minimally stretched ligament) to third degree (a complete tear). The ankles, knees and wrists are areas of the body that are most vulnerable to sprains. Signs of a sprain include varying degrees of tenderness or pain, bruising, swelling, inflammation, inability to move a limb or joint and joint looseness. Strains are pulls or tears of muscles or tendons (tissues that attach the muscles to the bones).These acute and non-contact injuries are results from overstretching or overcontraction. Symptoms of a strain include pain, muscle spasm and loss of strength. While it’s hard to tell the difference between mild and moderate strains, severe strains that are not treated professionally can cause damage and loss of function. 2 Knee Injuries Because of its complex structure and weight-bearing capacity, the knee is the most commonly injured joint. Knee injuries can vary from mild to severe, affecting the knee bones, ligaments, tendons or cartilage. Mild knee injuries include runner’s knee (pain or tenderness on the sides and below the knee); illiotibial band syndrome (pain on the outer side of the knee), and tendinosis (degeneration of a tendon). They can also result from a traumatic injury like a blow or twist of the knee; improper landing after a jump; too much running, or overuse of the knee tissues. “If knee injuries are left untreated, it may result in more damage to the cartilage, ligaments or the bones,” says Dr Lim Yeow Wai, Specialist in Orthopaedic Surgery & Consultant, Raffles Orthopaedic Centre. 3 Achilles Tendon Injuries The Achilles tendon is one of the longer tendons in your body, stretching from the bones of your heel to your calf muscles. It is one of the more serious sports injuries for amateur and professional athletes alike. Many Achilles tendon injuries are cases of tendonitis (inflammation or irritation of a tendon), in which the tendon becomes swollen and painful. Besides middle and long distance runners, Achilles tendon injuries are also common in middleaged “weekend warriors” who may not exercise regularly or take time to stretch properly before an activity. In a severe case, too much force on the tendon causes it to tear partially or rupture completely. Other causes such as overuse, misalignment, improper footwear, medication side effects, and/or accidents can also contribute to the same Achilles tendon injury. 16 Feature Raffles HealthNews 4 Fractures Dislocations are usually caused by a sudden impact to the joint. This usually occurs following a blow, fall or other trauma. Sports which involve a lot of pushing or stretching, like basketball or football, can cause dislocations, with the shoulder joint being the most prone. Acute fractures can be simple (one break with little damage to the surrounding tissue) or compound (multiple cracks with the broken bone sticking out through the skin). Most acute fractures are emergencies. One that breaks the skin is especially dangerous because there is a high risk of infection. Compound fractures can be very dangerous as it also increases the risk of infection. Unlike a fractured bone, a dislocated joint can be resolved relatively quickly. It only involves realigning the bones. Many individuals are able to move their limbs almost immediately after having their bones realigned. However, if the injury is left untreated over a period of time, it may result in a permanent injury. A fracture occurs when a bone is cracked or broken, from either a quick one-time injury to the bone (acute fracture) or from repeated stress to the bone over time (stress fracture). Stress fractures occur mostly on legs and feet due to repetitive stress on those areas from sports like sprints, hurdles and gymnastics, that require constant running and jumping. 5 Dislocated Joints A dislocated joint is a joint that slips out of place which may result in damage to ligaments, nerves and blood vessels. It occurs when the ends of bones are forced from their normal positions. And when that happens, the joint no longer functions properly. What Should I Do If I Have Sports Injuries? There is never a good reason for anyone to try to “work through” the pain of an injury regardless of its severity. “When you are experiencing pain in any part of your body from a particular movement or activity, it is advisable to stop immediately as continuing the activity can possibly cause further harm,” advises Mr Lim. Did Y ou Know ? Duri n an in g the firs that jury, the t 24 to 4 m the a ust be a re are ce 8 hours afte rta pp vo use lication ided. T in actio r saun of hot o of heat hese inc ns (fo as int lud phys and spa ments, h r examp e le, s), d ot ba ical a ri Thes t c e ac tivity an nking alc hs, t dm oh io flow and ns increa assage ol, lead . s e b to sw lo elling od . Seek Medical Treatment Some injuries require prompt medical attention from a medical doctor, while others can be self-treated. You should seek immediate medical treatment if: • the injury causes severe pain, swelling, or numbness • the pain or dull ache of an old injury is accompanied by increased swelling or joint abnormality or instability • there is loss of function Raffles HealthNews Feature 17 Self-Treatment If you do not have any of the above symptoms, it is probably safe to selftreat the injury. Treatment often begins with RICE (Rest, Ice, Compression and Elevation) method to relieve pain, reduce swelling, speed up recovery time and also prevent further tissue damage. Follow these four steps immediately after injury and continue for at least 24 to 48 hours: R est. The injured area must remain relatively inactive. The duration of rest will depend on the severity of the injury. I ce. The application of ice causes blood vessels to constrict, thus decreases circulation and results in less inflammation at the site. A cold pack, ice bag or wet towel with crushed ice can be used over the injured site for periods of 20 minutes every two hours for the first 24 to 48 hours. If possible, ice should also be applied to the surrounding area. Note: Do not apply ice or a plastic bag containing ice directly onto the skin as this may cause ice burn. ompression. Compression of the injured area may help to reduce the swelling. This can be achieved with elastic wraps. Care should be taken to ensure that circulation is not constricted by bandaging too tightly. C E levation. If possible, keep the injured part on a pillow, above the level of the heart as this helps to reduce blood pressure and swelling. Who Can I See For An Injury? While severe injuries will need to be seen immediately in an emergency room, most sports injuries can be evaluated and, in many cases, treated by a doctor. Depending on your preference and the severity of your injury, you may want to see, or have your doctor refer you to either an orthopaedic surgeon, who is able to diagnose and provide treatment for any part of the musculoskeletal system like the bones, joints, ligaments, tendons, muscles, and nerves, or a physiotherapist, who can develop a rehabilitation program for you. Alternative Treatment In addition to using conventional RICE method, many sport injuries sufferers also seek treatment from a traditional Chinese medicine (TCM) physician. Physician Stephen Lau, TCM Physician, Raffles Chinese Medicine shares, “Most patients who seek treatment for sportsrelated injuries at the clinic are usually those with long-term injuries. TCM-based therapies such as acupuncture and massage (Tui Na) are effective treatment for these patients because they help to reduce pain and increase their range of motion. Together with herbal medical treatment, they can expect a faster recovery time.” Although people who exercise and participate actively in sports are more likely to experience injuries to their muscles, bones and joints as compared to those who don’t, this certainly does not mean you should avoid sports as the health benefits far outweigh the cost in terms of sports injuries. Most sports injuries can be treated effectively and those who suffer injuries can return to a satisfying level of physical activity after an injury. In fact, many of these common sports injuries could be prevented if people take the proper and necessary precautions. HN 18 UpClose Raffles HealthNews UpClose Dr Michael Lee with Family Physician, Raffles Medical Clinic D r Michael Lee Khai Weng, 44, who joined Raffles Medical more than eight years ago, runs in half marathons at least twice a year. This active daddy of two girls tells UpClose about his exercise plan and how he keeps himself fit and looking good. Having worked in RafflesMedical for many years, what do you enjoy in your work here? First, the deep sense of camaraderie and support amongst the staff; from the management, fellow family physicians, specialists to the nursing and support staff. Second, I get to meet people from all walks of life and nationalities. Why did you decide to become a doctor? The human body has never failed to fascinate me: The intricacies of its myriad functions and the problems (illnesses) that can develop when it breaks down. It was then I decided that I wanted to become a doctor. Why did you choose to specialise in family medicine? As physicians, we are called to treat patients holistically. That means the emotional, psychological, social and spiritual aspects, as well as the physical illnesses. Family medicine is the only speciality that encompasses all of that. It allows me to build relationships with my patients and their families, thereby understanding their health needs better. It is the most satisfying way of practising medicine. What are the challenges in family medicine? These days’ patients are more well-informed with easy access to medical information on the internet. Often because of less than credible websites, they are given biased views and inaccurate information. Hence, family physicians has to be internet savvy and to keep abreast of the latest medical information and research, in order to meet patients’ higher expectations and to correct any misinformation. I certainly do not know everything but armed with my laptop, I have explored websites and answered my patients’ queries. There must be many fulfilling moments at work, share with us a memorable incident. Many years ago, there was a patient who saw me for headaches and insomnia. Further into the consultation, the patient revealed that she was having relationship issues with her boyfriend. Apparently that was the precipitating factor for her symptoms. Besides treating the symptoms, I provided a few sessions of counselling. Her moods became better and her symptoms resolved. After that, I did not hear from her until two years later when I received a letter of gratitude. She explained that she had since met another person and is now happily married. The counselling sessions had given her clear markers when starting and maintaining this new relationship. I’m really happy for her! How do you find a balance between your career, exercise and spending time with your family? I just have to make time for each activity. It’s always the tyranny of the urgent that crowds out what is really important. I try not to bring work home so that I have time to spend with my wife and two girls. Over dinner, we might share our day’s events, talk about the latest ‘gossip’ in the newspapers or tell jokes. It’s never a dull moment with my girls (including my wife) clowning around. Occasionally it’s a ‘movie night’ when everyone has done their chores or homework. I try to date my wife at least once a week; mostly checking out some popular eatery or catching a critically acclaimed movie. I usually exercise in the evenings before dinner. Can you share with us your exercise plan? I do my runs at least twice a week. Each run is about seven to 10km. Closer to the Army Half and the StanChart Marathons, I’ll push up the frequency of training and distances. Once a month, it might be swimming or badminton with family and friends. What is your diet like? Generally I try to avoid fried and oily foods when eating out. My wife, who is my ‘Master Chef’, would ensure that my diet is healthy and balanced. She’s always ‘experimenting’ with recipes to come up with say for example, a low fat/low cholesterol mee rebus. And it’s pretty authentic and tasty!! As a doctor, do you feel challenged to keep fit and look good? Yes indeed. Not much credibility if I don’t walk the talk. At 84kg, I used to be obese four years ago. Some Raffles HealthNews UpClose 19 wonderful colleagues in Raffles Medical encouraged me to take up running and I was hooked. It wasn’t easy at first: I was only managing one to two km before running out of breath. It did not help that I have exercise-induced asthma. But perseverance and proper training paid off. I have lost almost 10kg and am doing the half marathons twice a year. Any advice for our reader who wants to start an exercise program? What is the most recommended exercise? Well, you are never too old or too late to start exercising. However do see your friendly family physician for a health screening to ensure that you are medically fit to embark on a suitable exercise programme. The easiest and most recommended exercise would be brisk walking. Incorporate the exercise into your daily routine; like getting from your home to the bus-stop or MRT station. A total of 30 min brisk walking spread throughout the day is a good start. HN At 84kg, I used to be obese four years ago. Some wonderful colleagues in Raffles Medical encouraged me to take up running and I was hooked. 20 Feature Raffles HealthNews Before Teardr p F ‘ The Next rustrated’, ‘agonised’, ‘irritated’ and ‘down’ are probably some of the words that most people would use to describe their feelings after suffering from exercise injuries, such as sprains and strains. For some who work out regularly, they may wonder how they have acquired a particular injury from doing a familiar exercise, since they must have repeated the same set of actions for countless number of times without being injured. Falls Well, the point is, no body part is equal in strength and some parts are weaker than the rest. Therefore, one of the most practical ways to avoid injuries is to strengthen the muscles around the weaker areas. Let Dr Andrew Quoc Dutton, Specialist in Orthopaedics Surgery & Consultant, Raffles Orthopaedics Centre, share with you some effective exercises and tips that can help to strengthen your body parts. A rms Recommended exercises for the arms are: • Working on a cross trainer or elliptical machine • Swimming Other useful tips: • Stretching the flexor and extensor muscles of the forearm is important as they can help pervent golfer’s or tennis elbow. • People above 40 years old should be extra careful and go easy with the use of dumb bells. A nkles Use a resistance band while performing the following exercises. Repeat each of the following exercises for at least 10 times with both left and right feet. • Ankle Dorsiflexion and Plantarflexion – These refer to the upward and downward movement of the foot at the ankle joint. • Ankle Eversion and Inversion – These refer to the inward and outward movement of the foot at the ankle joint. Much diligence and persistence are required for these strengthening exercises. However, do note that you should take it slow and not overdo them. Other useful tips: • Buy good footwear with adequate arch support. • If you are a regular runner, change shoes every six months. • Avoid running on uneven surfaces or side slopes. This can lead to abnormal pressure and posture. • If you have had a previous injury, wear an ankle guard or high cut sports shoes when playing games. • Use a wobble board to improve joint sense and proprioception. • Stretch before a workout. Raffles HealthNews Feature 21 N eck Isometric Paravertebral Muscle Strengthening Exercises: • Chin Tuck – (1) Stand or sit in an upright position. (2) Place the first and middle fingers on your chin and push inwards. You will feel a slight stretch in the back of your neck. (3) Hold this position for at least five seconds before returning it to the neutral position. • Isometric Neck Exercise (Sides) – (1) Stand in a relaxed position with back straight. (2) Place right hand on right side of the head and push head towards hand. (3) Hold for at least five seconds and repeat the same on the left. Other useful tips: • Ensure that you use a firm pillow support for the neck when sleeping. • Keep computer screen at eye-level when at work. Take a break from the computer every hour and stretch the neck for five to 10 minutes. • U se gentle muscle massage and heat rubs to relief neck muscle aches. S houlders • Scapular Mobilisation Exercises – An example is ‘overhead straight arm pull down with resistance band’: (1) Hold the resistance band, about 15cm apart. (2) Raise arms fully with palms facing away from you. (3) Stretch the band by pulling it to both sides until your arms reach the shoulder height. Repeat this 10 times. • Isometric Shoulder Exercises – (1) Put your palms together and press against each other. (2) You may place them close to the body or slightly further away from it. (3) Hold this position for at least 10 seconds and repeat. Other useful tips: • Be extra careful when travelling with heavy luggage, especially when taking luggage down from the over-head storage. • Take 20 minutes to stretch before playing racquet sports or golf. B ack These are helpful exercises to strengthen the back muscles as well as the core muscle groups: • Swimming • Pilates • Yoga Other useful tips: • Lift objects by squatting rather than bending. • Tie shoe laces by sitting or kneeling. • Ensure adequate lumbar support with good sitting posture especially for desk bound jobs. K nees Try these knee strengthening exercises: • Cycling on a stationary bike • Straight leg raise with ankle weights • Leg presses and leg curls Other useful tips: • Conduct hamstring and quadriceps stretching before exercise or sports. Step To Be One Ahead 22 Feature Raffles HealthNews e welcome all the benefits that exercise has to offer but definitely not the injuries, and we know for sure that there is always a chance of getting injured while exercising. W So, the question is, how can you prevent yourself from these unwanted injuries that hinder us from engaging in the sports and exercises that keep you going? Consider the following tips from Mr Lim Hun Teck, Principal Physiotherapist, Raffles Physiotherapy Centre, before you re-engage in your favourite workouts. Increase time and intensity gradually Due to different health conditions and age, everyone’s fitness level differs from person to person. We usually find ourselves beginning an exercise programme with lots of enthusiasm, and may go too hard and too fast. Identify the weak areas of your body and avoid the type of activities that place too much stress on them. Therefore, it is wise to begin with moderate exercise of about 30 minutes, three times a week and gradually build on it. If you experience pain and discomfort during a workout, stop and rest, don’t work through the pain. Most importantly, be patient and listen to your body. Get the right gear Wearing the correct attire or additional support for different types of activity is important. This can enable you to carry out your workout more smoothly and enhance your performance. If required, additional support such as knee bands can help prevent recurring sports injuries. Have a mix routine Hire a pro More often than not, we learn better through demonstrations. When starting a new activity, it is advisable to learn the right techniques from a certified and experienced trainer. It is also one of the best ways to prevent an unwanted injury when you receive proper guidance and attention while working out. Add variety and fun to exercising by having a mixture of two or more types of physical activity that include aerobic exercise, strength training, stretching, core stability and balance training elements in your routine. This not only makes exercising interesting, you also get to work on different muscle groups and prevent overuse injuries. Warm up and stretch We have been taught that stretching and warm-up exercises prevent injuries. However, there is little scientific evidence to show that they can improve exercise performance, reduce delayed-onset muscular soreness, or prevent injuries. On the other hand, many experts in health and athletics have had positive clinical and practical experiences with stretching, and have thousands of anecdotal reports of injuries that occurred on the rare occasions when previously injury-free athletes neglected to stretch before exercise. In addition, multiple studies have shown that this decreases the injury rate, especially in females. Controversial as it may seem, what’s notable is that these warm-up routines do help to put people in the right frame of mind to begin and relax after an exercise session, thus benefiting them in staying focused and alert during workouts. HN Raffles HealthNews Feature 23 Get Sporty in Unique Ways An athlete can gain self-confidence and resilience through both major or minor sporting achievements. Beyond the physical and fitness benefits to playing sports, it can improve your mental well-being too. We explore some non-traditional sports activities and hear our experts share their experience on these sports. 24 Feature Raffles HealthNews I ndoor & Rock Climbing Rock climbing is a sport in which participants climb up or across natural rock formations or artificial rock walls. The goal is to reach the summit of a formation or the endpoint of a predefined route without falling. Rock climbing competitions have objectives of completing the route in the quickest possible time or the farthest along an ever increasingly hard route. It is a physically and mentally demanding sport, testing a climber’s strength, endurance, agility and balance along with his mental control. It can be a dangerous sport and knowledge of proper climbing techniques and usage of specialised climbing equipment is crucial for the safe completion of routes. Benefits Set in a controlled environment, it is like a training ground for outdoor rock climbing but safer than it. Indoor climbing is a sport that deals with both the body and mind. It takes a lot of will power to be able to withstand the challenges it gives and nothing short of mere determination to achieve the goal of reaching the top. Yet, there is a lot to learn with regards to the art of indoor climbing. You can lose a lot of weight with this sport without even noticing it. It is simply a fun environment and an amazing outlet to burn fat in the process, and it involves intense muscular activity just by climbing up and down the walls, especially if you are carrying the gears as well. Thus, some indoor climbers who have tried the sport found themselves loving it. S Rock climbing is fun and challenging. Although it would seem that you are using a lot of upper limb strength, you need to be strong in your lower limbs as well. You also have to trust your partner when you climb. So it helps to build up team spirit, friendship and trust. - Dr Lim Yeow Wai, Specialist in Orthopaedics & Consultant, Raffles Orthopaedic Centre cuba Diving Self-contained underwater breathing apparatus (SCUBA) is now widely considered a word in its own right. Scuba diving is a form of underwater diving in which a diver uses a scuba set to breathe underwater. Benefits • A great exercise for increasing upper body strength; notably the arm muscles. • Helps develop the cardiovascular system, with the heart and lungs pumping oxygen round the blood stream. • Improves agility and flexibility. • Refreshes and focuses the mind from everyday distractions. • Tones muscles and improves posture. Learning to scuba dive can deliver the perfect balance of stillness of mind and a physical workout. Water is heavier than air and provides a greater resistance against your movements. The water helps develop and strengthen your muscles without the physical impact of other sports. So you benefit from the exercise without risking your joints. The health benefits of deep breathing techniques are numerous and studies show that yogic deep breathing is extremely effective in handling depression, anxiety and stress-related disorders. Moreover, deep breathing techniques stimulate the lymphatic system, which is key for the removal of toxins from the body. The good thing about learning to dive is that it allows you to take your mind off work. Scuba divers need training on the proper use of equipment, as well as an understanding of the physics and medicine behind descent and ascent during diving. Something most dive schools do not emphasise enough. You need to understand seawater conditions in order to have a safe dive. - Dr Ho Kok Yuen, Specialist in Anaesthesiology & Consultant, Raffles Pain Management Centre Raffles HealthNews Feature 25 E questrian (Horseback Riding) having to do anything but by just holding onto the reins. In addition, horseback riding does not stress the knees and other lower body parts as compared to other forms of exercise such as walking or swimming. Horseback riding has the ability to help people develop, tighten and strengthen those hardly-used muscles with little or no strain. It can also help us burn calories and lose weight without us having to break a sweat. Anyone can opt for a ride on the pony for a weekend of family fun, while the disabled can engage in physiotherapy. Riding is a unique sport. Unlike others, men and women can compete on equal terms. It is an activity suitable for all ages, both young and old. Unlike many other sports, you can continue riding and improving your skills for a lifetime. It is important to be taught well from the beginning. Establishing good core skills early is essential, and every ride will bring new knowledge. Benefits Horseback riding stimulates muscles in the dorsal and abdominal regions that are seldom used in everyday living. Imagine setting that six-pack you’ve always wanted without U Although it is suitable for all ages, it is best started while young. Safety is paramount and it is ideal to perform horse back riding at an accredited stable to ensure that the horses are healthy and have predictable temperament. Another important factor is a good instructor who can guide you to improve with time. A good stable or riding academy will also have safety gear that is well maintained and meets safety standards. On top of helmet and protective leg wear such as jeans or riding pants, if riding at a faster pace or jumping hurdles, a mouth guard is also recommended. - Dr Rachel Chan, Dentist, Raffles Dental nderwater Hockey Underwater hockey is a non-contact sport that combines elements of swimming, diving, hockey and snorkelling. Two teams compete to manoeuvre a puck across the bottom of a swimming pool into goals. Players wear a diving mask, fins, protective gloves and a snorkel for play. They play with small, foot-long sticks and a hockey-type puck. Players from each team try to score goals. Benefits Underwater hockey is an excellent way to stay in shape. The constant swimming will improve your cardio as well as your stamina. This game is also very fun and allows you to play something that is unique as underwater hockey is unlike anything you will ever experience! Underwater hockey`s health benefits can extend to cardiovascular rehabilitation. I would recommend sports to anyone; it can range from mainstream activities like running and swimming to lesser known sports such as underwater hockey. Some general guidelines should be borne in mind: 1. If there is any doubt about one’s cardiac or general health, get that clarified first. 2. Whatever the activity, start slowly and gradually build up duration and intensity. 3. Windsurfing and underwater hockey sound interesting and certainly have obvious health benefits such as cardiovascular exercise, as well as core and strength exercise. 4. Perhaps a minor discouragement would be the fact that these can be done only in specific and limited places and settings. There will be recurrent costs or expensive initial outlays. - Dr Lim Lian Arn, Specialist in Orthopaedic Surgery & Consultant, Raffles Orthopaedic Centre 26 Feature Raffles HealthNews W indsurfing Windsurfing is a water sport that combines surfing and sailing. The windsurfing board is a combination of a surf board with a sail fixed on it, hence the name of the sport. The board is used to surf on the waves, while the sail is used for acceleration. Windsurfers are able to perform various stunts like jumps, inverted loops, spinning and manoeuvres, and other freestyle moves. Benefits Windsurfing works your core muscles as you balance on the board. You use your entire body to manoeuvre the sail rigging and steer, so you work your arms, back and legs as you sail. If you’re out on a sunny day, you’ll also soak up some Vitamin D, which is known to combat depression. Just make sure you wear plenty of sunscreen to protect your skin from sun damage. This beach sport combines high speed with extreme manoeuvres and tricks, requiring you to handle a mast while carving through sometimes choppy water. You will need a combination of balance, skill and fitness just to hang on. F encing Whether for recreation or competition, fencing is an interactive sport that develops physical fitness, quick reactions, speed, agility and excellent hand and body co-ordination. It is also one of the few physical sports where both men and women compete on equal terms. Fencing has an advantage over other sports, as it is not physically selective and anyone can fence. Fencing can be likened to a high intensity kind of sport combining both combat and ballet. Fencing, a western martial art, demands total concentration and calls for craftiness. It has been described as ‘physical chess’ at lightning speed. This is because the sport requires both physical and mental skills. This is similar to the intensive physical state of a computer game in which the mind must act quickly to meet unforeseen challenges, strategising to a variety of attacks and defences. People who like to fence also develop themselves to make their own decisions rather than have decisions made for them. Benefits Physical • Keeps you fit. You cannot perform “swordplay” without a good bit of movement. • Helps to train quickness, reflexes and agility. Well trained fencers learn to have excellent balance and poise. • Helps to improve coordination of both hands and legs. Mental • Stimulates the competitive spirit and the determination to win. • Develops focus and concentration skills. • Challenges you to be calm and quick witted under pressure; overcoming adversaries with intelligence. I started fencing to defend myself at home when my two kids started jabbing me with their “weapons”. They started learning fencing at a very early age. Fencing tones up the core muscles in the body and certainly builds up physical fitness. “I almost collapsed from physical exhaustion at the first formal training session under an ex-Hungarian international fencing coach. The mental focus and agility comes in once stamina builds up. It is so fun that there is never a dull moment in fencing. - Dr Donald Poon, Specialist in Medical Oncology & Consultant, Raffles Cancer Centre Raffles HealthNews Special 27 Gym Bag Special Despite his busy schedule, Dr Lim Kok Bin, Specialist in Urology & Consultant, Raffles UroRenal Centre, goes to the gym near Raffles Hospital two times a week during his lunch hour to stay in the prime of health. He shares with HealthNews on what he brings to the gym and why. 1 Bag 2 Water bottle Choose a sturdy bag. As my bag can get quite heavy, I use a backpack for better back support. It’s important to rehydrate before, during and after the workout. I keep a 700ml bottle. A rough rule-of-the-thumb is to drink a glass of water for every 15 minutes of work out. Another useful measurement is to drink whenever you feel thirsty. 3 Towel 8 Gloves My gloves are a useful repertoire whenever I do my weights in the gym. They give me a better grip and help prevent sore palms. A wellfitting pair is important. The gym provides a towel but I bring my own hand towel to wipe my perspiration from the workout. It is basic courtesy to clean the equipment before the next user. 4 Toiletries I’m a simple man. Just some shower foam, a comb and hair wax for the clean-doctor-look after the workout, and I’m all set to go. 7 Heart rate monitor This is a must-have for my gym gear. I use it to measure my exercise intensity. It allows me to maximise my gym session, as it gives me faster progress and less wasted effort. It motivates me sometimes to work harder to surpass my past record. 6 Comfy clothing I opt for comfort over style when it comes to my gym wear. I usually don a simple t-shirt and a pair of shorts, nothing fancy or expensive. 5 Plastic bag This separates my clean stuff from my dirty stuff. I use it after the workout to store my soiled clothes. 28 Supplements Raffles HealthNews Essentials of Sports Nutrition and Supplements Many athletes have turned to various dietary strategies, including the use of supplements to gain a competitive edge. While vitamin supplements may not be necessary for those on a well-balanced diet, they are highly recommended for athletes and sports enthusiasts involved in strenuous exercises. For example, those who are undergoing heavy training may require more of vitamin B Complex, as they are needed for energy production. Although there are many benefits to exercising, strenuous exercise may lead to oxidative stress and result in oxidative damage to muscle tissues. Preventing muscle tissue damage during exercise training may help optimise the training effect and eventual competitive sports performance. Antioxidant supplements like Vitamins C and E, Beta Carotene, and Coenzyme Q10 may help to enhance exercise performance or prevent exercise-induced muscle tissue damage. Glucosamine, a popular supplement for joint health, can also benefit those who are active in sports as it can help maintain the cushioning in joints that are used heavily. Research has shown that for sports injuries, glucosamine can provide some pain relief as it has anti-inflammatory properties. Promotions Essential Antioxidant 60’s (UP: S$37.90) Now: S$29.90* Glucosamine 1000mg 90’s (UP: S$37.90) Now: S$29.90* * Prices are valid till 31 December 2011 and are not applicable with other discounts and promotions. * This promotion is only available at Raffles Health Retail Pharmacy, Level 1, Raffles Hospital. 585 North Bridge Road | Level 1 | Raffles Hospital | Singapore 188770 For more enquiries, please contact us at 6311 1641 or 6311 1108. Raffles HealthNews Q&A 29 My 10 year old child is asthmatic and I am concerned as he participates in sports like swimming. While I would like him to run around and have fun like all the other children, I am worried that this might trigger an asthmatic attack. Am I being overly cautious and pessimistic? What special care and precautions should I take for my boy? Asthmatic patients may participate in any sports, as long as their asthma is adequately controlled. This allows children to be “normal” and goes a long way to ensure normal psychological and emotional development. In addition, swimming is a good form of exercise as it increases the capacity of the lungs. There are, however, some patients who need to take some precautions before they conduct any exercise. Asthmatic patients that have exercise induced asthma (i.e. asthma attacks during and after exercise) would need to circumvent the problem by taking their Salbutamol (Ventolin) inhaler 15 to 30 minutes before any sports. Otherwise, there is really no special precaution EXCEPT for: • No exercises in polluted environment (stay indoors when PSI is elevated). • Avoid exercising in the cold (as it will cause constriction of the airways). • No exertion when unwell (e.g. flu, fever). Dr Wong Wei Mon, Senior Physician, Raffles Medical I am 45 this year and I am starting to feel stiffness in my joints especially when climbing a flight of stairs. I feel that I can no longer move my body as fast and as flexibly now as compared to a couple of years back. Is this normal? Is there anything I can do to get better? If so, what is it? As we enter our forties, muscle bulk tends to reduce and it becomes more difficult to build and maintain muscle mass. Muscles and tendons become stiffer and are more prone to injuries. Weight bearing joints, especially the knee start to “show their age” as well. This is directly related to the way we use our joints. If we overuse them, they tend to age or wear faster. For example, overweight people tend to have earlier degeneration than their average weight friends. Similarly, sportsmen are prone to wearing out their joints faster. As we age, muscle fibres decrease in size but not in number; tendons become less elastic and become more plastic, hence are more susceptible to injury. Joint cartilage becomes thinner and produces less lubricating fluid. Ageing is not reversible. Cartilage never heals back to its previous state. As we get older our body replaces injured cartilage with either abnormal “scar” cartilage or it doesn’t succeed in replacing the cartilage at all. You cannot prevent ageing but you can reduce the effects of ageing on your joints, tendons and muscles healthy by having a regular programme of the right amount and types of exercise. Too little or too much exercise are both not recommended. Despite not being able to stop or prevent ageing, most of the time our muscles and joints can function well enough to enable locomotion and for the continuation of activities of daily living. Dr Lim Lian Arn, Specialist in Orthopaedic Surgery & Consultant, Raffles Orthopaedic Centre 30 MarketPlace Raffles HealthNews BRACES PACKAGE for students Spine Joint and According to TCM theory, pain can be caused by “Qi” and blood stagnation, dampness-cold obstruction in the meridians and kidney deficiency. A combination of acupuncture, acupressure and herbal medicine can restore the above imbalances to promote natural healing. The World Health Organization recognises the use of acupuncture for more than 70 types of conditions, including acute spine pain, neck and back pain, rheumatoid arthritis, sciatica and temporo-mandibular joint dysfunction. Arthritis Management For managing inflammation due to osteoarthritis, rheumatoid arthritis and other damages to the joints. ● 6 acupuncture sessions $321 Spine and Joint Pain Management For relief of pain due to scoliosis, spondylosis, herniated disc, sciatica and other spine and joint conditions. ● 6 acupuncture sessions $321 Raffles Dental is offering a Braces Package for full-time students.* Braces are used in Orthodontic treatment to “straighten” teeth that are displaced or misaligned. Brace yourself for a future of great smiles. Braces for Students at $4,588 • No waiting list • Treatment by specialists • Evening & Saturday clinics • Progressive payment plan Option of Herbal Medicine at $10 per day. Your TCM Specialist Centre For enquiries or to make an appointment, please call 6311 2388/2322 or email specialist@raffleshospital.com * Package prices include GST. * Packages must be utilised within 6 months from date of purchase and are not transferable or refundable. * Raffles Chinese Medicine reserves the right to withdraw or revise the packages without prior notice. * Other terms and conditions apply. Please call for more details. For more information or to make an appointment, please call 6311 2360/2365 or email dental@raffleshospital.com * Terms & conditions apply * Excludes consultation fees and X-rays * Package price is only applicable to local Singaporeans / PR students under 18 years of age, currently studying in local schools * Present your matriculation or student card upon registration * Price is inclusive of GST Raffles HealthNews MarketPlace 31 Muscle Pain? Feeling Fatigue? Young Athlete Cardiac Screening If you are feeling widespread muscle pain throughout the body, experiencing general fatigue and disturbed sleep, you may have fibromyalgia. It may co-exist with other medical conditions such as headache, irritable bowel syndrome, depression and jaw pain. Fibromyalgia commonly affects middle-aged women. Those with rheumatoid arthritis or other autoimmune diseases are also more likely to develop it. So, if you experience muscle pain, tension or stiffness, or if your muscles are sensitive to touch or pressure, screen to check if you have fibromyalgia. Fibromyalgia Screening Package at $160.50 This includes: • Specialist consultation for pain management • Physical examination • Laboratory tests (Full blood count, thyroid function test, rheumatoid factor, antinuclear antibody, creatinine kinase, erythrocyte sedimentation rate, c-reactive protein) PainManagementCentre For more information or to make an appointment, please call 6311 2310 or email enquiries@raffleshospital.com * Package includes GST. * This package is not to be used in conjunction with any other promotions. For Ages 16 - 35 It is always tragic when a young athlete dies during physical training or sports participation. The heartrending sense of loss can sometimes be compounded when the cause of death is discovered to be a cardiac condition that could have been diagnosed earlier. Cardiovascular conditions are the leading causes of nontraumatic, exercise-induced deaths. These are usually due to hypertrophic cardiomyopathy (a condition in which the heart muscle thickens, making it harder for blood to leave the heart) and non-atherosclerotic coronary arteries anomalies. Medical Clearance If you or your loved ones are preparing to undergo physical training or participate in sports, it is important to find out the risks for sudden cardiac death, and also to seek medical clearance from your doctor before embarking on any exercise regime. With foreknowledge of the risks, preventive measures or necessary treatments can be initiated to reduce mortality. Cardiac Screening Package Cardiac screening for young athletes is available at Raffles Heart Centre at a package price of $500.76*. The screening includes a consultation and review with a Cardiologist, blood tests, electrocardiogram and 2D echocardiogram. HeartCentre For more information or to make an appointment, please call 6311 1222 (24-hour service) or email enquiries@raffleshospital.com * Package includes GST. MedicalGroup Make a Medical Stopover at Raffles For Your Wellness and Medical Needs Raffles provides a comprehensive range of medical services through our islandwide network of 76 Raffles Medical Clinics, and Raffles Hospital. Put your health in good hands with Raffles Medical. Raffles Hospital One-Stop Tertiary Hospital in the Heart of the City Raffles Hospital offers 24-hour emergency and a comprehensive range of specialist services. •Ear, Nose & Throat •Eye •Fertility •Health Screening •Heart •Internal Medicine •Japanese Clinic •Aesthetics •Cancer •Children •Chinese Medicine •Counselling •Dental •Dialysis •Orthopaedics •Pain Management •Physiotherapy •Skin •Surgery •UroRenal •Women You can expect personalised services that are tailored to your needs. Raffles is a Joint Commission International accredited hospital. Raffles Medical Clinics There’s One Near You For general medical services, vaccination or health screening, visit any of our family medicine clinics located across the island. Our Executive Medical Centre offers medical solutions for busy executives. To bring medical services closer to you, we also provide house/hotel call services. Changi Airport Beyond Basics For medical services in the Singapore Changi International Airport, visit any of our six clinics located in the terminals. In addition, our 24-hour clinic at Passenger Terminal 3 provides executive health screening and dental services. For more information on our services or for an appointment, please call (65) 6311 1111 or email to enquiries@rafflesmedical.com. www.rafflesmedicalgroup.com Follow us on: www.facebook.com/RafflesMedGrp | twitter.com/RafflesMedGrp