WEBVTT - Holiday injuries

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<v Speaker 1>Now, health matters with Daniel Martin. Welcome to Health Matters

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<v Speaker 1>right here on CN A 938. Everybody. I'm getting into

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<v Speaker 1>the festive spirit of things, so to speak, because we're

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<v Speaker 1>gonna be talking about the kinds of injuries that can

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<v Speaker 1>occur during the holiday season

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<v Speaker 1>and the end of year period. I mean, with your

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<v Speaker 1>end gatherings, festivities and trips, how could a fun loving

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<v Speaker 1>activity also lead to unhappy mishaps from stress fractures and

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<v Speaker 1>broken bones to other holiday mishaps. We're joined on today's

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<v Speaker 1>edition by Doctor Ananda Kumar Vela Ai, who's an orthopedic

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<v Speaker 1>specialist surgeon from Ortho care orthopedics and sports medicine based

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<v Speaker 1>at Fair Park Medical. This is health matters.

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<v Speaker 1>Welcome to the show. Thanks for coming into the studio,

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<v Speaker 1>happy holidays,

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<v Speaker 2>happy holidays and thanks for having me.

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<v Speaker 1>Is this a busy time for you usually? Yes,

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<v Speaker 2>actually, unfortunately, sometimes it's busy during the holiday season with

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<v Speaker 2>some injuries happening more commonly during this period. Right. Well,

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<v Speaker 2>I mean, you know the school holidays, firstly, so Children

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<v Speaker 2>out parents are also having leave and bring them out

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<v Speaker 2>for events and activities

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<v Speaker 2>in Singapore and also overseas. So a couple of times

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<v Speaker 2>sometimes maybe they're not aware, they're so enthusiastic and they

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<v Speaker 2>actually may have accidents and mishaps.

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<v Speaker 1>Why? Who do you see more of adults or the

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<v Speaker 1>Children injuries?

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<v Speaker 2>I see more adults generally sometimes in the festive season.

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<v Speaker 2>I do see a couple of Children with injuries as well.

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<v Speaker 1>Gosh, ok, let's run through what are most likely to happen?

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<v Speaker 1>Like you said, a lot of people taking trips, family

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<v Speaker 1>trips as well. We'll talk about the overseas accidents that

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<v Speaker 1>can occur.

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<v Speaker 1>But in terms of what's happening, those of us not

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<v Speaker 1>lucky enough to travel. So the home festivities and the

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<v Speaker 1>home activities, I mean, we've had the dia celebrations going

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<v Speaker 1>into the Christmas celebrations, going into the New Year's and

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<v Speaker 1>then Chinese New Year, what are the incidences that tend

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<v Speaker 1>to lead to injuries that you end up seeing?

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<v Speaker 2>Yeah. So in the festive season, usually there's a little

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<v Speaker 2>bit of merry making dancing, you know, and people are

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<v Speaker 2>usually just out and about and they are enjoying themselves

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<v Speaker 2>and sometimes they may just not be aware of their

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<v Speaker 2>surroundings and accidents do happen. And many a time, the

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<v Speaker 2>most common things that occur are like, you know, injuries

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<v Speaker 2>leading to fractures, for example. And that's commonly one of

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<v Speaker 2>the most common holiday injuries or bread and butter

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<v Speaker 2>thing that an orthopedic surgeon sees. And it's all, it's

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<v Speaker 2>almost always in the holiday season that we actually tend

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<v Speaker 2>to see a spike of these fractures as well.

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<v Speaker 1>You told me early on because I read the weather

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<v Speaker 1>out like four or five times a day. That's part

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<v Speaker 1>of my job and, and the wet weather has begun.

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<v Speaker 1>You were telling me interest

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<v Speaker 1>before the interview that the wet weather contributes to this

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<v Speaker 1>as well.

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<v Speaker 2>Certainly, I mean, you see most slips, I mean, I

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<v Speaker 2>just recently saw a patient who just basically slipped and

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<v Speaker 2>actually had a very bad ankle fracture, you know, and

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<v Speaker 2>then he had needed surgery done. So, things like that

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<v Speaker 2>are probably more common whenever it's wet

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<v Speaker 2>patients are, I mean, not really aware that it, we,

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<v Speaker 2>and they actually have accidents more easily.

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<v Speaker 1>Yeah, I thought because we're so used to that. We,

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<v Speaker 1>we sleep all the time. Our sleeper. Not very good.

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<v Speaker 2>Yeah, exactly. So, footwear is so important when you talk

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<v Speaker 2>about these injuries because it's the single, most important thing

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<v Speaker 2>that I see that patients or people generally don't get. Right.

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<v Speaker 2>And that actually leads to increased risk of

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<v Speaker 2>falls and injuries actually. Gosh,

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<v Speaker 1>ok. So where do we tend to see one of

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<v Speaker 1>the sites of injury that you tend to see? You see,

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<v Speaker 1>you tend to see a lot of ankle

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<v Speaker 2>and foot, is it? Yes, that's right. I see a

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<v Speaker 2>lot of ankle and foot injuries and also a lot

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<v Speaker 2>of knee injuries as well.

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<v Speaker 1>How about hand and wrist? Because you would be stopping

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<v Speaker 1>the

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<v Speaker 2>fall. So it's also very common certainly when patients break

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<v Speaker 2>their fall, they use their hands and I do see

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<v Speaker 2>some fractures and injuries of the ligaments of the hands

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<v Speaker 2>as well.

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<v Speaker 1>Yeah. Can we recover well from these, with proper surgery

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<v Speaker 1>and intervention?

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<v Speaker 2>Yeah. So surgery is usually the last resort whenever it

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<v Speaker 2>comes to these injuries. I mean, for most patients with injuries,

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<v Speaker 2>especially if it is not so serious, we usually can

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<v Speaker 2>tend to treat them conservatively or expectantly with measures such

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<v Speaker 2>as maybe a cast or immobilization for a certain period

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<v Speaker 2>of time. Of course, this has to be also combined

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<v Speaker 2>with proper physiotherapy so that they actually don't lose strength

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<v Speaker 2>and don't lose movement because stiffness is such a very

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<v Speaker 2>common

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<v Speaker 2>a consequence of immobilization. So it has to be a

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<v Speaker 2>balance between immobilization and early range of motion and strengthening

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<v Speaker 1>because obviously the last thing you want is pain to

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<v Speaker 1>be set to be a part of your life from

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<v Speaker 1>then on and your quality of life being affected because

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<v Speaker 1>of improper healing and things like that. Absolutely. Yeah. Gosh.

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<v Speaker 1>And obviously things are different depending on the age group

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<v Speaker 1>you're in. If it's an author, if it is an

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<v Speaker 1>osteoporotic fracture, that's even more worrying. Right.

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<v Speaker 2>Yes, that's right. So osteoporotic fractures unfortunately are very common

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<v Speaker 2>in Singapore due to the aging population.

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<v Speaker 2>And I mean, interestingly, one of the things that I

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<v Speaker 2>usually advise a lot of I would, I would, I

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<v Speaker 2>would say elderly patients, but maybe just maybe above the

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<v Speaker 2>age of 45 years old, you tend to have a

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<v Speaker 2>decline in your bone mass after the age of 35.

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<v Speaker 2>And that's like 1% a year. So

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<v Speaker 2>after the age of 35 I usually will tell my

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<v Speaker 2>patients concentrate on strengthening. Strengthening is a very, very important

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<v Speaker 2>part of your daily exercise and activity that can actually

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<v Speaker 2>help to preserve your bone mass as you age,

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<v Speaker 1>your muscle mass psych opinion would be all this playing apart.

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<v Speaker 2>Absolutely. Right. Yeah. And also a lot of a lot

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<v Speaker 2>of people, they basically do, they should be doing a

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<v Speaker 2>lot more load bearing activities such as walking.

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<v Speaker 2>And as much as people do say that running may

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<v Speaker 2>be bad for your knees in the long run. But actually,

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<v Speaker 2>if you do it properly pace yourself and do it

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<v Speaker 2>sensibly giving yourself adequate rest and recovery is actually a

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<v Speaker 2>very good activity to actually keep your bone mass actually high.

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<v Speaker 2>So that you don't actually develop osteoporosis in the future

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<v Speaker 1>and exercises that enhance your sense of balance, mobility aspects,

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<v Speaker 1>your yoga, your Pilates, your things like that because it's

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<v Speaker 1>less about the aesthetics of how you look and weight

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<v Speaker 1>loss and things like that. It really is more about

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<v Speaker 1>making sure you prevent a fall

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<v Speaker 2>more. Absolutely right. And you brought up the very important

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<v Speaker 2>point that then

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<v Speaker 2>you see the thing is that a lot of times

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<v Speaker 2>accidents happen because there's this lack of coordinating, which is

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<v Speaker 2>actually neuromuscular. If you think about it and a lot

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<v Speaker 2>of times we think about strengthening, but we don't think

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<v Speaker 2>about the neuromuscular aspect of it because, you know, you're

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<v Speaker 2>just going to the gym and you're just pushing as

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<v Speaker 2>hard away as you can, but you're not getting the

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<v Speaker 2>form right. You're not actually practicing balance, you know, and

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<v Speaker 2>these are very important things because what is more important

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<v Speaker 2>to prevent injuries, actually, how your brain

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<v Speaker 2>connects with your muscles, how you actually prevent yourself from

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<v Speaker 2>falling by activating the right muscles to prevent injuries.

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<v Speaker 1>So these isolated movements in the gym may not be

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<v Speaker 1>creating the brain body connection. Really?

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<v Speaker 2>Exactly. That's why we usually hear compound movements, the gym

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<v Speaker 2>that are usually better for building strength and that's the

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<v Speaker 2>reason why compound movements actually Trump isolated movements in any day.

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<v Speaker 1>Yeah. Ok. Ok. I stop my hi again. Let's talk

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<v Speaker 1>about the overseas injuries that you tend to see around

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<v Speaker 1>this period. You spent many years, I understand training as

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<v Speaker 1>an orthopedic surgeon in Switzerland. Yes, I did. That's a

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<v Speaker 1>hot tourist destination recently for Singaporeans as well. You see

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<v Speaker 1>a lot of skiing accidents. There are not.

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<v Speaker 2>Yes, when I was training in Switzerland, that was very

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<v Speaker 2>common for me to see skiing accidents, locals and tourists alike,

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<v Speaker 2>locals and tourists alike, but mostly in tourists because I mean,

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<v Speaker 2>the fact of the matter is that

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<v Speaker 2>when we go as tourists to a certain destination, I mean,

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<v Speaker 2>we are excited about skiing. It's something new. But the

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<v Speaker 2>thing is that a lot of them who actually ski, well,

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<v Speaker 2>they have spent many years actually training for this since childhood. Yeah. And,

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<v Speaker 2>and so when Singaporeans go there they do take lessons

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<v Speaker 2>but these lessons, they may be peppered with some falls

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<v Speaker 2>and tumbles. It's part of the learning. I get it,

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<v Speaker 2>part of the learning, but unfortunately it can lead to

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<v Speaker 2>injuries and that's what we see sometimes. Isn't that

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<v Speaker 1>such a first world problem? So many Singaporeans now are

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<v Speaker 1>enjoying the skiing holiday,

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<v Speaker 1>but because we haven't had the long term experience with

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<v Speaker 1>it and we're just picking it up, it can lead

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<v Speaker 1>to an injury. Yes, certainly. Yeah, you are saying some

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<v Speaker 1>things interesting, like sometimes even just putting on the boot

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<v Speaker 1>got problem. Yeah.

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<v Speaker 2>So the ski boots, I mean, when you wear a keyboard,

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<v Speaker 2>the skibo is actually very tight and it actually puts

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<v Speaker 2>your ankle in a very,

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<v Speaker 2>in a position that's uncomfortable if you're not used to it. And,

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<v Speaker 2>you know, when you're actually trying to ski with this, it's,

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<v Speaker 2>it's very, it can be very easy for you to

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<v Speaker 2>actually twist your ankle. And since the ski board is

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<v Speaker 2>so stiff, your ankle will give way where the stiffness

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<v Speaker 2>is lost and just above the keyboard. That's where injuries

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<v Speaker 2>tend to happen above the shin, just above the shin,

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<v Speaker 2>it can happen there. So these are the kind of

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<v Speaker 2>injuries that skiers usually get. And the other kind of

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<v Speaker 2>injuries they get is because they break their fall with

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<v Speaker 2>their hand. So, distal radius fractures, wrist fractures,

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<v Speaker 2>these are common injuries as well. I had

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<v Speaker 1>no need to go skiing. Don't go. But something else

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<v Speaker 1>that Singaporeans love to do now, I notice I've done

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<v Speaker 1>lots of stories on the rise of the foldable bicycle

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<v Speaker 1>and the foldable bicycle tours and cycling tours. So many

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<v Speaker 1>cyclists in Singapore now and traveling to cycle as well.

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<v Speaker 1>Do you see a lot of cycling related injuries? What

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<v Speaker 1>kind can emerge?

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<v Speaker 2>Oh, yeah, I'm actually a very avid cyclist myself. Yeah,

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<v Speaker 2>that's right. So certainly as a lot of my friends,

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<v Speaker 2>they do get cycling injuries and one thing that I

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<v Speaker 2>noticed about very, very avid cyclist that they like to challenge.

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<v Speaker 2>So when they go overseas, they like to climb mountains and,

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<v Speaker 2>you know, things that you can't do in Singapore, things

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<v Speaker 2>that you can't do in terrain that you can't find

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<v Speaker 2>in Singapore.

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<v Speaker 2>And though it's a really, it's really very challenging to

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<v Speaker 2>actually climb mountains. But actually the more challenging aspect I feel,

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<v Speaker 2>especially if you're not used to, it is descending the

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<v Speaker 2>mountain because that's when you really can, you won't get

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<v Speaker 2>used to it because it's long kilometers of descending

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<v Speaker 2>and it's fast speeds and you may not be used

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<v Speaker 2>to this and that's where tumbles happen and that's where

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<v Speaker 2>injuries can happen, like falls and fractures.

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<v Speaker 1>The problem with the injuries that can occur on a

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<v Speaker 1>cycling trip like that. For example, is you're far away

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<v Speaker 1>from your doctor, you're far away from your health facilities.

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<v Speaker 1>You might be in a remote outskirt area. It's challenging

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<v Speaker 1>to get emergency treatment. Yes, that's

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<v Speaker 2>right. So that's, that's usually the problem if there's a

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<v Speaker 2>serious injury. I mean, if it's a minor injury, of course,

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<v Speaker 2>it can be treated and you can seek treatment non urgently.

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<v Speaker 2>But if it's something that requires urgent treatment,

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<v Speaker 2>there can be some anxieties involved because like, you know,

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<v Speaker 2>you're not sure whether that particular country system is able

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<v Speaker 2>to cope with the kind of injury or the location

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<v Speaker 2>you're in language barrier. You may be in a very

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<v Speaker 2>remote location which is usually the case if it's mountainous

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<v Speaker 2>and scenic. So you may not be near a city

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<v Speaker 2>where the injury may be treated better in a city

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<v Speaker 2>hospital perhaps. So there are some challenges involved. But I mean,

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<v Speaker 2>you know, with the day the age of tele consultation,

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<v Speaker 2>I mean, we are always available

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<v Speaker 2>available to actually give some advice to patients who may

0:10:13.190 --> 0:10:14.820
<v Speaker 2>be stranded overseas with injuries,

0:10:14.830 --> 0:10:20.049
<v Speaker 1>get your health insurance he evacuation if possible. Ok. And

0:10:20.059 --> 0:10:21.770
<v Speaker 1>just to wrap it up, I'm curious whether this is

0:10:21.780 --> 0:10:24.299
<v Speaker 1>an interesting trend as well. All go for the trips

0:10:24.309 --> 0:10:26.500
<v Speaker 1>and then develop the injury sometimes, maybe not so major

0:10:26.510 --> 0:10:28.330
<v Speaker 1>but minor. But then January all come and see you

0:10:28.650 --> 0:10:30.510
<v Speaker 1>like a dog. I got this pain a good dog.

0:10:30.520 --> 0:10:32.809
<v Speaker 1>I got this a does that happen a lot actually?

0:10:32.820 --> 0:10:36.229
<v Speaker 2>So certainly there are some kind of injuries that may

0:10:36.239 --> 0:10:36.809
<v Speaker 2>be very insane

0:10:37.119 --> 0:10:38.880
<v Speaker 2>in their cause in the sense that patients may not

0:10:38.890 --> 0:10:41.179
<v Speaker 2>realize it when they are on their trip. I see

0:10:41.190 --> 0:10:44.799
<v Speaker 2>this especially in patients who may not really be extremely sporty,

0:10:44.809 --> 0:10:47.880
<v Speaker 2>but they like walking and taking long walks during the trip.

0:10:47.890 --> 0:10:49.710
<v Speaker 2>And sometimes in the trip, you forget yourself and you

0:10:49.719 --> 0:10:52.270
<v Speaker 2>may be walking more than actually, you usually are walking

0:10:52.280 --> 0:10:55.530
<v Speaker 2>in normal situations. So I do see like injuries such

0:10:55.539 --> 0:10:55.940
<v Speaker 2>as stress

0:10:55.950 --> 0:10:58.590
<v Speaker 1>fractures just from walking and shopping in Taiwan or something

0:10:58.599 --> 0:10:58.770
<v Speaker 1>like that.

0:10:58.780 --> 0:11:02.319
<v Speaker 2>Really? Yeah, that's possible. Yeah, because maybe shoe wear could

0:11:02.330 --> 0:11:03.640
<v Speaker 2>be something that could be improved

0:11:04.010 --> 0:11:06.210
<v Speaker 2>and many of them may not have a very tight

0:11:06.219 --> 0:11:10.239
<v Speaker 2>calf muscles leading to even extra pressures on the fore foot.

0:11:10.250 --> 0:11:13.039
<v Speaker 2>And that can lead to stress fractures, stress injuries. It

0:11:13.049 --> 0:11:15.270
<v Speaker 2>usually happens with some swelling and pain and you know,

0:11:15.309 --> 0:11:17.319
<v Speaker 2>usually X rays will not catch it. So they may

0:11:17.330 --> 0:11:19.270
<v Speaker 2>have done an X ray and they think it's normal.

0:11:19.289 --> 0:11:21.919
<v Speaker 2>Everything is ok. But the thing is that sometimes these

0:11:21.929 --> 0:11:24.140
<v Speaker 2>injuries linger and they may not be shown X ray.

0:11:24.150 --> 0:11:26.390
<v Speaker 2>Only certain decisions such as an MRI scan

0:11:26.645 --> 0:11:28.555
<v Speaker 2>might pick them up. Gosh, you know,

0:11:28.565 --> 0:11:29.786
<v Speaker 1>I need to do, I need to come up with

0:11:29.796 --> 0:11:33.045
<v Speaker 1>a conditioning training program for people going on holiday. It

0:11:33.056 --> 0:11:35.444
<v Speaker 1>sounds like we need to condition our body before going

0:11:35.455 --> 0:11:36.395
<v Speaker 1>on holidays.

0:11:36.505 --> 0:11:39.296
<v Speaker 2>Then that's really true. Actually, because, you know, in this

0:11:39.306 --> 0:11:42.166
<v Speaker 2>day and age we all mostly in very sedentary kind

0:11:42.176 --> 0:11:45.315
<v Speaker 2>of jobs. We don't get enough stretching and strengthening done sometimes.

0:11:45.325 --> 0:11:47.405
<v Speaker 2>And you know, when we leave the sedentary job, we

0:11:47.416 --> 0:11:48.835
<v Speaker 2>are going on holiday straight away

0:11:49.021 --> 0:11:52.432
<v Speaker 1>and boom, you go 0 to 100. Exactly. Ok. Coming soon,

0:11:52.442 --> 0:11:56.081
<v Speaker 1>the health matters conditioning program for shopping in Tokyo. It's

0:11:56.091 --> 0:11:57.921
<v Speaker 1>been a pleasure. Thanks for coming on the show. Thanks

0:11:57.952 --> 0:12:00.341
<v Speaker 1>and really pleasure to be here. Having me joining me

0:12:00.351 --> 0:12:02.530
<v Speaker 1>for this conversation. Doctor Nadi Kumar Asami, who is an

0:12:02.541 --> 0:12:06.280
<v Speaker 1>orthopedic specialist surgeon at or care orthopedics and sports medicine

0:12:06.291 --> 0:12:09.632
<v Speaker 1>located at Fair Park Medical. This has been health matters.

0:12:09.642 --> 0:12:11.471
<v Speaker 1>Thanks for joining us. Be safe. Everyone

0:12:16.359 --> 0:12:19.979
<v Speaker 1>before making any decisions based on the information in our program,

0:12:19.989 --> 0:12:21.979
<v Speaker 1>please consult a medical professional.