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