Speaker 1: Now, health matters with Daniel Martin. Welcome to Health Matters
Speaker 1: right here on CN A 938. Everybody. I'm getting into
Speaker 1: the festive spirit of things, so to speak, because we're
Speaker 1: gonna be talking about the kinds of injuries that can
Speaker 1: occur during the holiday season
Speaker 1: and the end of year period. I mean, with your
Speaker 1: end gatherings, festivities and trips, how could a fun loving
Speaker 1: activity also lead to unhappy mishaps from stress fractures and
Speaker 1: broken bones to other holiday mishaps. We're joined on today's
Speaker 1: edition by Doctor Ananda Kumar Vela Ai, who's an orthopedic
Speaker 1: specialist surgeon from Ortho care orthopedics and sports medicine based
Speaker 1: at Fair Park Medical. This is health matters.
Speaker 1: Welcome to the show. Thanks for coming into the studio,
Speaker 1: happy holidays,
Speaker 2: happy holidays and thanks for having me.
Speaker 1: Is this a busy time for you usually? Yes,
Speaker 2: actually, unfortunately, sometimes it's busy during the holiday season with
Speaker 2: some injuries happening more commonly during this period. Right. Well,
Speaker 2: I mean, you know the school holidays, firstly, so Children
Speaker 2: out parents are also having leave and bring them out
Speaker 2: for events and activities
Speaker 2: in Singapore and also overseas. So a couple of times
Speaker 2: sometimes maybe they're not aware, they're so enthusiastic and they
Speaker 2: actually may have accidents and mishaps.
Speaker 1: Why? Who do you see more of adults or the
Speaker 1: Children injuries?
Speaker 2: I see more adults generally sometimes in the festive season.
Speaker 2: I do see a couple of Children with injuries as well.
Speaker 1: Gosh, ok, let's run through what are most likely to happen?
Speaker 1: Like you said, a lot of people taking trips, family
Speaker 1: trips as well. We'll talk about the overseas accidents that
Speaker 1: can occur.
Speaker 1: But in terms of what's happening, those of us not
Speaker 1: lucky enough to travel. So the home festivities and the
Speaker 1: home activities, I mean, we've had the dia celebrations going
Speaker 1: into the Christmas celebrations, going into the New Year's and
Speaker 1: then Chinese New Year, what are the incidences that tend
Speaker 1: to lead to injuries that you end up seeing?
Speaker 2: Yeah. So in the festive season, usually there's a little
Speaker 2: bit of merry making dancing, you know, and people are
Speaker 2: usually just out and about and they are enjoying themselves
Speaker 2: and sometimes they may just not be aware of their
Speaker 2: surroundings and accidents do happen. And many a time, the
Speaker 2: most common things that occur are like, you know, injuries
Speaker 2: leading to fractures, for example. And that's commonly one of
Speaker 2: the most common holiday injuries or bread and butter
Speaker 2: thing that an orthopedic surgeon sees. And it's all, it's
Speaker 2: almost always in the holiday season that we actually tend
Speaker 2: to see a spike of these fractures as well.
Speaker 1: You told me early on because I read the weather
Speaker 1: out like four or five times a day. That's part
Speaker 1: of my job and, and the wet weather has begun.
Speaker 1: You were telling me interest
Speaker 1: before the interview that the wet weather contributes to this
Speaker 1: as well.
Speaker 2: Certainly, I mean, you see most slips, I mean, I
Speaker 2: just recently saw a patient who just basically slipped and
Speaker 2: actually had a very bad ankle fracture, you know, and
Speaker 2: then he had needed surgery done. So, things like that
Speaker 2: are probably more common whenever it's wet
Speaker 2: patients are, I mean, not really aware that it, we,
Speaker 2: and they actually have accidents more easily.
Speaker 1: Yeah, I thought because we're so used to that. We,
Speaker 1: we sleep all the time. Our sleeper. Not very good.
Speaker 2: Yeah, exactly. So, footwear is so important when you talk
Speaker 2: about these injuries because it's the single, most important thing
Speaker 2: that I see that patients or people generally don't get. Right.
Speaker 2: And that actually leads to increased risk of
Speaker 2: falls and injuries actually. Gosh,
Speaker 1: ok. So where do we tend to see one of
Speaker 1: the sites of injury that you tend to see? You see,
Speaker 1: you tend to see a lot of ankle
Speaker 2: and foot, is it? Yes, that's right. I see a
Speaker 2: lot of ankle and foot injuries and also a lot
Speaker 2: of knee injuries as well.
Speaker 1: How about hand and wrist? Because you would be stopping
Speaker 1: the
Speaker 2: fall. So it's also very common certainly when patients break
Speaker 2: their fall, they use their hands and I do see
Speaker 2: some fractures and injuries of the ligaments of the hands
Speaker 2: as well.
Speaker 1: Yeah. Can we recover well from these, with proper surgery
Speaker 1: and intervention?
Speaker 2: Yeah. So surgery is usually the last resort whenever it
Speaker 2: comes to these injuries. I mean, for most patients with injuries,
Speaker 2: especially if it is not so serious, we usually can
Speaker 2: tend to treat them conservatively or expectantly with measures such
Speaker 2: as maybe a cast or immobilization for a certain period
Speaker 2: of time. Of course, this has to be also combined
Speaker 2: with proper physiotherapy so that they actually don't lose strength
Speaker 2: and don't lose movement because stiffness is such a very
Speaker 2: common
Speaker 2: a consequence of immobilization. So it has to be a
Speaker 2: balance between immobilization and early range of motion and strengthening
Speaker 1: because obviously the last thing you want is pain to
Speaker 1: be set to be a part of your life from
Speaker 1: then on and your quality of life being affected because
Speaker 1: of improper healing and things like that. Absolutely. Yeah. Gosh.
Speaker 1: And obviously things are different depending on the age group
Speaker 1: you're in. If it's an author, if it is an
Speaker 1: osteoporotic fracture, that's even more worrying. Right.
Speaker 2: Yes, that's right. So osteoporotic fractures unfortunately are very common
Speaker 2: in Singapore due to the aging population.
Speaker 2: And I mean, interestingly, one of the things that I
Speaker 2: usually advise a lot of I would, I would, I
Speaker 2: would say elderly patients, but maybe just maybe above the
Speaker 2: age of 45 years old, you tend to have a
Speaker 2: decline in your bone mass after the age of 35.
Speaker 2: And that's like 1% a year. So
Speaker 2: after the age of 35 I usually will tell my
Speaker 2: patients concentrate on strengthening. Strengthening is a very, very important
Speaker 2: part of your daily exercise and activity that can actually
Speaker 2: help to preserve your bone mass as you age,
Speaker 1: your muscle mass psych opinion would be all this playing apart.
Speaker 2: Absolutely. Right. Yeah. And also a lot of a lot
Speaker 2: of people, they basically do, they should be doing a
Speaker 2: lot more load bearing activities such as walking.
Speaker 2: And as much as people do say that running may
Speaker 2: be bad for your knees in the long run. But actually,
Speaker 2: if you do it properly pace yourself and do it
Speaker 2: sensibly giving yourself adequate rest and recovery is actually a
Speaker 2: very good activity to actually keep your bone mass actually high.
Speaker 2: So that you don't actually develop osteoporosis in the future
Speaker 1: and exercises that enhance your sense of balance, mobility aspects,
Speaker 1: your yoga, your Pilates, your things like that because it's
Speaker 1: less about the aesthetics of how you look and weight
Speaker 1: loss and things like that. It really is more about
Speaker 1: making sure you prevent a fall
Speaker 2: more. Absolutely right. And you brought up the very important
Speaker 2: point that then
Speaker 2: you see the thing is that a lot of times
Speaker 2: accidents happen because there's this lack of coordinating, which is
Speaker 2: actually neuromuscular. If you think about it and a lot
Speaker 2: of times we think about strengthening, but we don't think
Speaker 2: about the neuromuscular aspect of it because, you know, you're
Speaker 2: just going to the gym and you're just pushing as
Speaker 2: hard away as you can, but you're not getting the
Speaker 2: form right. You're not actually practicing balance, you know, and
Speaker 2: these are very important things because what is more important
Speaker 2: to prevent injuries, actually, how your brain
Speaker 2: connects with your muscles, how you actually prevent yourself from
Speaker 2: falling by activating the right muscles to prevent injuries.
Speaker 1: So these isolated movements in the gym may not be
Speaker 1: creating the brain body connection. Really?
Speaker 2: Exactly. That's why we usually hear compound movements, the gym
Speaker 2: that are usually better for building strength and that's the
Speaker 2: reason why compound movements actually Trump isolated movements in any day.
Speaker 1: Yeah. Ok. Ok. I stop my hi again. Let's talk
Speaker 1: about the overseas injuries that you tend to see around
Speaker 1: this period. You spent many years, I understand training as
Speaker 1: an orthopedic surgeon in Switzerland. Yes, I did. That's a
Speaker 1: hot tourist destination recently for Singaporeans as well. You see
Speaker 1: a lot of skiing accidents. There are not.
Speaker 2: Yes, when I was training in Switzerland, that was very
Speaker 2: common for me to see skiing accidents, locals and tourists alike,
Speaker 2: locals and tourists alike, but mostly in tourists because I mean,
Speaker 2: the fact of the matter is that
Speaker 2: when we go as tourists to a certain destination, I mean,
Speaker 2: we are excited about skiing. It's something new. But the
Speaker 2: thing is that a lot of them who actually ski, well,
Speaker 2: they have spent many years actually training for this since childhood. Yeah. And,
Speaker 2: and so when Singaporeans go there they do take lessons
Speaker 2: but these lessons, they may be peppered with some falls
Speaker 2: and tumbles. It's part of the learning. I get it,
Speaker 2: part of the learning, but unfortunately it can lead to
Speaker 2: injuries and that's what we see sometimes. Isn't that
Speaker 1: such a first world problem? So many Singaporeans now are
Speaker 1: enjoying the skiing holiday,
Speaker 1: but because we haven't had the long term experience with
Speaker 1: it and we're just picking it up, it can lead
Speaker 1: to an injury. Yes, certainly. Yeah, you are saying some
Speaker 1: things interesting, like sometimes even just putting on the boot
Speaker 1: got problem. Yeah.
Speaker 2: So the ski boots, I mean, when you wear a keyboard,
Speaker 2: the skibo is actually very tight and it actually puts
Speaker 2: your ankle in a very,
Speaker 2: in a position that's uncomfortable if you're not used to it. And,
Speaker 2: you know, when you're actually trying to ski with this, it's,
Speaker 2: it's very, it can be very easy for you to
Speaker 2: actually twist your ankle. And since the ski board is
Speaker 2: so stiff, your ankle will give way where the stiffness
Speaker 2: is lost and just above the keyboard. That's where injuries
Speaker 2: tend to happen above the shin, just above the shin,
Speaker 2: it can happen there. So these are the kind of
Speaker 2: injuries that skiers usually get. And the other kind of
Speaker 2: injuries they get is because they break their fall with
Speaker 2: their hand. So, distal radius fractures, wrist fractures,
Speaker 2: these are common injuries as well. I had
Speaker 1: no need to go skiing. Don't go. But something else
Speaker 1: that Singaporeans love to do now, I notice I've done
Speaker 1: lots of stories on the rise of the foldable bicycle
Speaker 1: and the foldable bicycle tours and cycling tours. So many
Speaker 1: cyclists in Singapore now and traveling to cycle as well.
Speaker 1: Do you see a lot of cycling related injuries? What
Speaker 1: kind can emerge?
Speaker 2: Oh, yeah, I'm actually a very avid cyclist myself. Yeah,
Speaker 2: that's right. So certainly as a lot of my friends,
Speaker 2: they do get cycling injuries and one thing that I
Speaker 2: noticed about very, very avid cyclist that they like to challenge.
Speaker 2: So when they go overseas, they like to climb mountains and,
Speaker 2: you know, things that you can't do in Singapore, things
Speaker 2: that you can't do in terrain that you can't find
Speaker 2: in Singapore.
Speaker 2: And though it's a really, it's really very challenging to
Speaker 2: actually climb mountains. But actually the more challenging aspect I feel,
Speaker 2: especially if you're not used to, it is descending the
Speaker 2: mountain because that's when you really can, you won't get
Speaker 2: used to it because it's long kilometers of descending
Speaker 2: and it's fast speeds and you may not be used
Speaker 2: to this and that's where tumbles happen and that's where
Speaker 2: injuries can happen, like falls and fractures.
Speaker 1: The problem with the injuries that can occur on a
Speaker 1: cycling trip like that. For example, is you're far away
Speaker 1: from your doctor, you're far away from your health facilities.
Speaker 1: You might be in a remote outskirt area. It's challenging
Speaker 1: to get emergency treatment. Yes, that's
Speaker 2: right. So that's, that's usually the problem if there's a
Speaker 2: serious injury. I mean, if it's a minor injury, of course,
Speaker 2: it can be treated and you can seek treatment non urgently.
Speaker 2: But if it's something that requires urgent treatment,
Speaker 2: there can be some anxieties involved because like, you know,
Speaker 2: you're not sure whether that particular country system is able
Speaker 2: to cope with the kind of injury or the location
Speaker 2: you're in language barrier. You may be in a very
Speaker 2: remote location which is usually the case if it's mountainous
Speaker 2: and scenic. So you may not be near a city
Speaker 2: where the injury may be treated better in a city
Speaker 2: hospital perhaps. So there are some challenges involved. But I mean,
Speaker 2: you know, with the day the age of tele consultation,
Speaker 2: I mean, we are always available
Speaker 2: available to actually give some advice to patients who may
Speaker 2: be stranded overseas with injuries,
Speaker 1: get your health insurance he evacuation if possible. Ok. And
Speaker 1: just to wrap it up, I'm curious whether this is
Speaker 1: an interesting trend as well. All go for the trips
Speaker 1: and then develop the injury sometimes, maybe not so major
Speaker 1: but minor. But then January all come and see you
Speaker 1: like a dog. I got this pain a good dog.
Speaker 1: I got this a does that happen a lot actually?
Speaker 2: So certainly there are some kind of injuries that may
Speaker 2: be very insane
Speaker 2: in their cause in the sense that patients may not
Speaker 2: realize it when they are on their trip. I see
Speaker 2: this especially in patients who may not really be extremely sporty,
Speaker 2: but they like walking and taking long walks during the trip.
Speaker 2: And sometimes in the trip, you forget yourself and you
Speaker 2: may be walking more than actually, you usually are walking
Speaker 2: in normal situations. So I do see like injuries such
Speaker 2: as stress
Speaker 1: fractures just from walking and shopping in Taiwan or something
Speaker 1: like that.
Speaker 2: Really? Yeah, that's possible. Yeah, because maybe shoe wear could
Speaker 2: be something that could be improved
Speaker 2: and many of them may not have a very tight
Speaker 2: calf muscles leading to even extra pressures on the fore foot.
Speaker 2: And that can lead to stress fractures, stress injuries. It
Speaker 2: usually happens with some swelling and pain and you know,
Speaker 2: usually X rays will not catch it. So they may
Speaker 2: have done an X ray and they think it's normal.
Speaker 2: Everything is ok. But the thing is that sometimes these
Speaker 2: injuries linger and they may not be shown X ray.
Speaker 2: Only certain decisions such as an MRI scan
Speaker 2: might pick them up. Gosh, you know,
Speaker 1: I need to do, I need to come up with
Speaker 1: a conditioning training program for people going on holiday. It
Speaker 1: sounds like we need to condition our body before going
Speaker 1: on holidays.
Speaker 2: Then that's really true. Actually, because, you know, in this
Speaker 2: day and age we all mostly in very sedentary kind
Speaker 2: of jobs. We don't get enough stretching and strengthening done sometimes.
Speaker 2: And you know, when we leave the sedentary job, we
Speaker 2: are going on holiday straight away
Speaker 1: and boom, you go 0 to 100. Exactly. Ok. Coming soon,
Speaker 1: the health matters conditioning program for shopping in Tokyo. It's
Speaker 1: been a pleasure. Thanks for coming on the show. Thanks
Speaker 1: and really pleasure to be here. Having me joining me
Speaker 1: for this conversation. Doctor Nadi Kumar Asami, who is an
Speaker 1: orthopedic specialist surgeon at or care orthopedics and sports medicine
Speaker 1: located at Fair Park Medical. This has been health matters.
Speaker 1: Thanks for joining us. Be safe. Everyone
Speaker 1: before making any decisions based on the information in our program,
Speaker 1: please consult a medical professional.