AGONY MEDIC

DR. Lutful Aziz, FCPS, PHD, Consultant "analgesia", Pain relief centre

Q. Dear doctor I would like to know about injury prevention during sports participation?
Conditioning and training
Physical conditioning for sports participation, besides preparing athletes for high-level performance, also prevents injuries. Coaches and trainers alike now recognise that improper conditioning is one of the major causes of sports injuries. Muscular imbalance, improper timing due to faulty neuromuscular co-ordination, inadequate ligamentous or tendinous strength, inadequate muscle or cardiovascular endurance, inadequate muscle bulk, problems of flexibility and problems related to body composition are some of the primary causes of sport injury directly attributable to insufficient or improper physical conditioning and training.
Training is usually defined as a systematic process of repetitive, progressive exercise or work, involving the learning process and acclimatisation. Dr. S.E. Bilik stated that, "To put the body with extreme and exceptional care under the influence of all agents which promote its health and strength in order to enable it to meet extreme and exceptional demands upon it".
Conditioning Seasons:
No longer do serious athletes engage only in preseason conditioning and in-season competition. Sports conditioning is now a year-round endeavour, often encompassing four training seasons: post-season, off-season, pre-season, and in-season.
Post-Season: The post-season period is immediately after a sport season. It is often dedicated to physical restoration, especially when athletes have been injured during the season.
Off-season: It is a good idea for the athlete to engage in another sport during this period.
Pre-season: During this period the athlete should achieve the highest possible level of conditioning and training specific to the position played.
In-season: It should be noted that the intensive pre-season conditioning training programme that brought the athlete to the competitive season may not be maintained by the sport itself. Unless there is conditioning throughout the season, a problem of deconditioning may occur.
Ten Cardinal Conditioning Principles:
The following ten cardinal principles can be applied to sports conditioning:
Warming up, Gradualness, Timing, Intensity, Capacity level, Strength, Motivation, Specialisation, Relaxation, Routine.
Warm up: The use of warm up procedures has been traditional in sports and is still advocated as the means of preparing the body physiologically and psychologically for physical performance, in the belief that it will not only improve performance but will lessen the possibilities of injury. The term warming up in this discussion refers to the use of preliminary exercise procedures rather that the use of hot showers, massage, counterirritants, diathermy or other forms of passive warm-up. The main purpose of warming up is to raise both the general body and the deep muscle temperatures and to stretch connective tissues to permit greater flexibility. This reduces the possibility of muscle tears and ligamentous sprains and helps to prevent muscle soreness.
The process of warm-up is considered as falling into two categories.
General warm-up which consists of activities that bring about a general warming of the body without having any relationship to the skills to be performed.
Specific which is mimetic, that is similar to or the same as skills to be performed in competition.
More to come in the following week.

INTERPRETER OF MALADIES

Dr. Nighat Ara, Psychiatrist

Q: Recently one of my friend went to rehab on her own account and is trying to rid herself of a drug problem that started in the early nineties. Last time she was sniffing brown sugar. Right now she says she feels ok and we are all trying to help her; can you tell us how else we can help her come back to normalcy? She is in her early thirties.

A: Your friend is suffering from addiction for quite a long time. Addiction treatment basically consists of different phases to address different aspects of this Bio-psycho-social disorder. In a rehab center, programs are offered according to the need of a particular client. However, recovery from addiction is not an event but a process. It is not a straight line course, rather a bumpy road. It is quite likely that your friend will require some support network to help her remain sober. Trust, self-esteem, anger management and social reconnection are some of the crucial factors in recovery. In fact, friends can be of immense help to restore her normal life-style, a drug free peer group can exert positive pressure on her to remain clean. A friend who really cares, listens to her and offers support in whatever way possible (maybe just standing beside her when she is struggling with some internal pain), can become a blessing for her. Apart from social support, she should never hesitate to reach out for professional help when the need arises.

Dental wise

Dr. Mahfujul Haq Khan BDS, DDS(Dhaka), PHD(Japan) Oral & Dental Surgeon BIRDEM Hospital

Dear Doctor,
I am 22 years old. Unfortunately, I have a gap-toothed upper gum. As the days are passing the gaps are becoming wider and the gum is lowering to fill the empty spaces. This is really getting me down. I cannot even laugh. What is the treatment for this? In addition, where can I get the best quality treatment, and how much would it cost?
Md. Alamgir Latif
48, Billpar, Lama Bazar
Sylhet

A: It seems that you have spacing (Gap) in between upper incisor teeth. There are techniques to fill spaces between teeth;

Individual porcelain cap: Offers the most exciting and revolutionary advancement in Aesthetic Dentistry. Dynamic results can usually be achieved within a week or ten days to correct somewhat misaligned, spaced, broken, discoloured or misshapen teeth.
Tooth colour filling: Was one of the first and most promising techniques developed for "instant" smile enhancement. It is still suitable in many circumstances to correct broken or misshapen teeth, but is neither as durable as porcelain cap, nor as spectacular in addressing more complex cosmetic concerns.
So which direction you will go? It depend on your oral heath condition, teeth alignment, age, time and expenses. As you mentioned that your gum is lowering to fill the spaces, in that case you may need a minor surgical intervention to repair the excess gum tissue before going for any cosmetic treatment. You can consult with me at BIRDEM hospital any time.