7.DEC.2018 7 MIN READ | 7 MIN READ

Dr Leslie Leong, orthopaedic surgeon at Gleneagles Hospital, answers important questions on how to stay safe and injury-free during the holidays.

Q: Does unfamiliarity of a holiday sport cause a higher risk of injury?

Yes. If you have no experience with the activities you signed up for, or you are not regularly active, there is a higher risk of injury because your muscles are not well-conditioned and your reflexes are absent. However, if you have been fairly active in a related sport prior to the holiday, you can transfer the skills over – for example, from skateboarding to wakeboarding.

Q: What can we do to reduce our risk of holiday injuries?

Prevent injury while on holiday - Reduce risk
You should always research on the physical demands of your sport. For example, if you’re intending to go for a run or hike in a mountainous area, make sure your quadriceps, hamstrings, and core muscles are toned and prepared for it. Do this at least 1 – 2 months before your trip.

It is very important to have an exercise programme to prepare your body, especially if you don’t exercise regularly. Even active individuals tend to neglect their core muscles – such as the abdominals, back and hips – and focus on extremity training. It is crucial to vary your workout routine to include strength, agility, and flexibility training to prepare the body for a wide range of movements.

Be aware of the environment you’re going to be in and the equipment you’ll be using. Get sufficient rest the night before your activity and stay well hydrated throughout the day to decrease your chance of injury. Start the sport slowly, with a smaller range of motion, and increase speed and range of motion gradually. Ease into the activity instead of going full steam ahead.

Q: Do injuries happen more often among children?

Yes, children’s bodies can be stiffer than adults because their bones are growing and their muscles have not yet stretched. They are also more flexible in the joints, so they can be more prone to dislocation.

Children are slightly more reckless because they may not fully understand the risks involved in sports and have a weaker sense of awareness. Some children may also tend to not complain about pains and aches they are having because of authority-child relationships. Therefore, it’s really important that we listen to what children say. If they don’t like to do something, or complain about aches and pains, listen to them. Don’t assume that they’re trying to wriggle out of the activity.

Q: Is it harder for children to recover from injuries?

Prevent injury while on holiday - Children and recovery
Children have a growth plate at either end of most bones, such as at the knee and the ankle for the shin bone. When an injury occurs, these growth plates are more vulnerable to damage, and if a fracture goes through it, it can affect the growth of the bones, especially if it can’t be put back properly.

For this small minority of children, their bones can actually grow at an angle, or sometimes only halfway. In other cases, fractures can cause the limb to grow a bit longer, causing bone alignment issues. These can only show up in later years, so you might not even notice that this was linked to an injury in their youth. However, in most fractures, children generally heal faster than adults, and issues such as joint stiffness are usually less problematic.

Q: What are the risks of injury for a working adult who hasn’t been training or exercising often?

Parents who are working adults in their 30s to 40s tend to be at risk. If you do not have a regular exercise programme and are doing something new, you are at risk of injury. As parents try to catch up with their excitable children, they can fail to realise the limitations of their bodies and push themselves too hard.

Q: How about senior travellers such as grandparents aged over 65? What do they need to bear in mind?

Prevent injury while on holiday - Senior travellers
It is good for them to engage in regular activity, such as light walks in the park, to keep their muscles active. Elderly females tend to have osteoporosis, too, which means they are at higher risks of bone fractures if they fall. It’s important to use proper footwear, and to ensure the holiday itinerary doesn’t include activities they cannot manage, to avoid putting themselves in danger.

Q: If I injure myself on holiday, will I need to cut my trip short and return home for treatment?

It depends on the injury you have. If it’s a broken bone, you have to see a doctor. For a sprain or neck pain, try having some anti-inflammatories or paracetamol and rest. If you’re fine after a few hours of rest, carry on with your activities. You don’t necessarily have to delay your holiday or end it prematurely. You can still enjoy it, but obviously in a decreased capacity.

If you can’t move your legs because they’re swollen, or you have a sudden weakness in your limbs (which could indicate a spine problem), seek medical attention. Always remember to buy your travel insurance before you go on holiday, because it can sometimes come in handy when accidents happen.

Q: What should I do if I suffer a sprain or injury while on holiday?

Prevent injury while on holiday - What to do
For knee or ankle sprains, you can relieve pain and swelling with RICE (rest, ice, compress, elevation) therapy. After that, give it time and see how it recovers. If the pain is tolerable and you can walk on it, observe it for 1 – 2 weeks.

If after 1 – 2 weeks, the injury is still very swollen, consult a doctor and get an x-ray to make sure it’s not a fracture. If it doesn’t recover after a few weeks, an MRI scan may be needed to further assess the injury. You may find that it is due to reason such as a torn ligament, which can result in knee or ankle instability, often making it difficult and painful to walk.

Q: What happens if I don’t seek proper treatment for my injuries?

Some patients have said to me: “I’ve sprained my ankle, and this is the 3rd or 4th time.” These are usually patients who have previously suffered a severe sprain that was conservatively managed, and have returned to sports after a few weeks.

Although the ligaments may have eventually recovered, they may not have healed in a proper manner. When ligaments tear, they usually stretch before tearing. Hence, when a ligament that was stretched beyond its original length has healed, it may not function well as a restraint. The ankle is not a very strong joint, so people with torn ligaments tend to suffer from recurring sprains, especially on uneven surfaces, or due to improper footwear. This scenario can apply to the knee and shoulder too.

Q: Besides the ankle, the knee is another problematic joint for most people. To what extent will my knee pain warrant a visit to the doctor’s?

Prevent injury while on holiday - Doctor visit
Knee pain often originates from problems arising in the knee cap. The knee cap, one of the many parts that make up the knee joint, is the circular bone located in front of the knee.

For example, while cycling, many people often don’t put the seat high enough, so they end up bending their knees more than they need to. Feeling pain going up and down stairs is also quite common. When walking, the knee joint has to carry about 1.5 times of a person’s body weight, and when climbing stairs, it is about 3 – 5 times. When rising from a squat unaided, a whopping 5 – 7 times of a person’s body weight can go through the knee joint, with forces placed mostly on the cartilage and menisci, causing injuries. These injuries can cause sensation of jamming or crackling, or pain with certain activities, and may require surgery to correct them.

You can treat knee pain with medication (anti-inflammatories), supplements and physiotherapy to train the muscles and allow the knee to rest and recover before resuming an activity. Sometimes, as the knee caps wear out, many people do not experience much pain. If they find the pain tolerable, they can put on a knee brace and carry on.

However, if there is recurrent sharp pain, or if the pain is affecting your mobility, get it examined to prevent further deterioration.

 

Adapted from radio recording with Dr Leslie Leong, orthopaedic surgeon at Gleneagles Hospital

7.DEC.2018
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Leong Chi Sern Leslie
Orthopaedic Surgeon
Mount Elizabeth Hospital

Dr Leslie Leong is an orthopaedic specialist practising at Gleneagles Hospital, Singapore. His clinical interests include adult reconstruction and joint replacement surgery.