World of Hurt

Play without pain

Prof Wayne Derman is associate professor of sport medicine at the UCT/Sports Science Institute of South Africa.

I have an irritating problem – every time I open and close my jaw it squeaks! Could it have been from a knock I took in the past and what can I do to make it stop?

This click and squeak is probably coming from the temporomandibular joint, also called the TMJ, situated just under the opening to your ear canal. Trauma or a blow to the jaw could have predisposed you to this problem and subtle jaw grinding at night can make the condition worse. The bad news is that the condition can deteriorate causing joint dysfunction, pain and eventual arthritis. So get it checked out by a dentist and make sure you don’t grind your teeth while sleeping. A good chiropractor or physiotherapist can also help with the problem.

I’ve heard that cycling can lead to a decrease in bone density. Is this true and what exactly are the risks?

Cycling per se will not decrease your bone density. However, cycling is a non-weight bearing exercise and, therefore, although there are many benefits, maintenance of bone density is not one. Try cross-training with jogging or running. Don’t forget two resistance training sessions per week as well, to assist the bones maintain calcium and density. It’s important to remember that other factors, including sufficient calcium intake in the diet, vitamin D (exposure to sunlight), avoiding cigarette smoke and excessive alcohol intake are also important for optimal bone health.

I broke my nose in high school (five years ago) and I’m now having chronic sinus problems. Could there be a link and what can I do about it?

There’s definitely a link! A blow to the nose can cause the cartilaginous and bony structures to change their shape and can cause a blocking of the small openings of the sinuses. If these become blocked, the mucus cannot drain freely and the sinuses become infected leading to pain, discomfort and ill health. This is usually worse if you suffer from allergies. Medication is necessary and if your problem still persists, a small surgical procedure conducted by an ENT surgeon is usually successful.

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My hip muscles get sore after about five kays when I run. What does this mean?
- My hip muscles get sore after about five kays when I run. What does this mean?
  
  There are many pain receptors in the muscles, tendons, ligaments, bones and other structures of the hip region. The pain you’re experiencing could, therefore, be coming from any of those structures. Pain generally means that tissues are under some form of biological stress or breakdown and is a warning mechanism that something is wrong. Listen to your discomfort and consult with a physiotherapist or doctor and let them examine you to get to the correct diagnosis.
On the downhill I get a sharp pain under my kneecap. Do I need surgery?
- I seem to have injured my knee. It’s fine on the uphill but on the downhill I get a sharp pain under my kneecap. Do I need surgery?
  
  Large studies have shown that the vast majority of sports injuries (more than 80 percent) do not require surgery. Both the intrinsic (foot biomechanics and muscle balance) and extrinsic (training factors, shoes, surfaces) factors leading to the injury should be evaluated and identified. Finally your doctor must make an anatomical (which structure is injured?), pathological (what has gone wrong with the tissue?) and functional (how did it occur?) diagnosis before appropriate management can be instituted. Bottom line: you are probably a long way from surgery, but get your injury properly assessed.
What can I do to improve the stability of my shoulder?
- I dislocated my shoulder three months ago, and now it feels like it is going to pop out every time I extend it out above my head. What can I do to improve the stability of my shoulder?
  
  Strengthening and rehabilitation of all the muscles surrounding the shoulder can assist in stabilising the ball of the arm in the shoulder socket. A good biokineticist or physiotherapist could help you here. However, if the instability continues and the shoulder keeps popping out, you will probably require surgery to stabilise the shoulder to avoid arthritis in the future.
How should I treat blisters on my hands from rowing?
- I often get blisters on my hands from rowing. How should I treat them?
  
  You are either rowing too infrequently or using an incorrect grip. Never remove the skin off the blister. If it’s very painful due to fluid accumulation, after carefully disinfecting the area, gently release the fluid by piercing with a sterile needle once or twice, but leave the blister skin as a natural cover. Cover the area with a plaster to give it some compression and protection. Over time and with regular use the area in question should form tough callous skin, which should not blister anymore.
What's the best recovery from an intense workout?
- Is sitting infront of the TV good-enough rest for muscle recovery from an intense workout, or do I need to sleep?
  
  Restorative rest involves two components: firstly, removal of the exercise stimulus and, secondly sleep. While sitting in front of the TV might qualify for one of these criteria, it is only through good sleep that the repair hormones – including the body’s natural growth and repair hormones – are released. A minimum of six to eight hours is required for optimal function and recovery of the human body when you have been training hard.
I breath heavily when I run but don't have asthma, what's wrong?
- Whenever I go running, I get short of breath and light-headed. I don’t have asthma, but it feels like that when I exert myself. What’s the problem?
  
  You might have a condition called exerciseinduced asthma. During exercise with this condition, the airways go into spasm after a fewminutes of cardio-respiratory exercise. Symptoms include: being short of breath, coughing, fatigue or light-headedness. It can be diagnosed by performing lung function tests before and after exercise and can be easily and effectively managed. A heart condition should also be excluded by your doctor.
How do I know if I sprained my ankle or torn a ligament?
- I hurt my ankle playing soccer, and I haven’t gone to a doctor yet. Is there some way I can check to find out if I have sprained my ankle, or if it’s worse and I’ve torn a ligament?
  
  Don’t underestimate an ankle sprain. If you were unable to bear weight on your ankle after your injury, it deserves an evaluation by either your physio or doctor. If you have been able to manage without professional opinion and your ankle remains swollen, painful when running or tends to lock, grate or give way, you will need to get a proper diagnosis and appropriate management.
How long after my hernia op may I train?
- I recently had a hernia operation. When can I lift weights again?
  
  A hernia is a break in the abdominal wall with protrusion of the abdominal contents through the break. These can occur at various places in the wall. How soon after surgery you can place stress on the repaired area will be dependent on the size of the repair, the method of repair used and the speed of healing of the individuals’ tissues. You will need to get clearance from the surgeon, who will assess the above mentioned factors. A return to heavy stress movements will usually not be allowed until six weeks after surgery.
Is there a way to avoid blood blisters when wearing soccer boots?
- I play a lot of soccer, and wear boots when I play. I end up with black toenails and blood blisters. Is there any way to avoid these painful conditions?
  
  This is a mechanical problem as a result of incorrect fit of the toe box of the boot. As the toes and nails abut against the toe box there is trauma resulting in blisters and black nails. You need to find a boot with a wider or higher toe box.
Are there reliable stockists of good tri-suits?
- I’ve just started triathlon training with the long-term goal of racing. I want to buy a good tri-suit. Are there any reliable stockists that can deliver nationwide?
  
  Triathlon is a boom sport at the moment, so there are a number of wetsuit stockists fi ghting for a share of the market. The brand that has been in South Africa the longest is Orca and its suits are available in most centres around the country. Next came Ironman wetsuits, which are manufactured under license by Blue Seventy. They make excellent suits and are provided by the Ironman shops in PE and Cape Town. Both will deliver once you have sized yourself correctly for a suit. The other brands fighting for market share that have moved in more recently include: 2XU (Australian), Quintana Roo (American), Zoot and AquaMan. All of them have a range of wetsuits that vary in price. The best advice I can give you is get the best one you can afford. As you become more competitive you will be looking for better equipment and wetsuits are not a good resale item. Check out the site www.sbrshop.co.za for some online options.

*Men's Health does not give out contact information for experts featured in our magazine or on our web site, and queries addressed to these individuals cannot be forwarded on your behalf. If you require professional health and lifestyle advice, we strongly recommend that you contact your local service providers.

District 9 and Invictus got stuffed at the Oscars. What other great films were robbed of the Best Picture Oscar over the years?
	Citizen Kane (lost to How Green Was My Valley in 1941)
	Dr Strangelove (lost to My Fair Lady in 1964)
	2001: A Space Odyssey (wasn't even nominated, and lost to Oliver! in 1968)
	Star Wars (lost to Annie Hall in 1977)
	Apocalypse Now (lost to Kramer vs Kramer in 1979)
	Raging Bull (lost to Ordinary People in 1980)
	Raiders of the Lost Ark (lost to Chariots of Fire in 1981)
	ET (lost to Ghandi in 1982)
	Saving Private Ryan (lost to Shakespeare In Love in 1998)
	The Gangs of New York (lost to Chicago in 2002)

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