Don`t Let Sickness Get You Down Don`t Let Sickness Get You Down

A PUBLICATION BY REGISTRATION No. 198901967K
MICA (P) 034/11/2010
COMPLIMENTARY COPY
ISSUE 04 / 2011
Sports
Medicine
Don’t Let Sickness
Get You Down
Exercise to improve your health
Getting Back into Shape
Steps to help you relive your glory days
Dealing with Sports Injuries
Putting you on the road to recovery
Get Sporty in Unique
Get Sporty
Ways
in
Unique sports and
why they’re
great
Unique
Ways
Unique sports and why
they’re great
OrthopaedicCentre
Stop
Living With
Pain
Physiotherapy is a holistic approach
to healthcare and plays a vital part in
pain relief, healing and rehabilitation in
most medical and surgical conditions.
The goal of physiotherapy is to
restore functional ability to those who
have suffered from injuries, physical
impairments, or disabilities.
Our physiotherapists treat the
underlying cause of your pain with
a combination of manual therapies
and clinically proven pain relief
technologies. We can also customise
exercise programmes to cater to
specific needs for speedy recovery
and injury prevention.
Raffles Physiotherapy & Fitness
Centre offers treatment solutions
for the following:
● Back Pain
● Neck Pain
● Rotator Cuff Injury
● Sciatica
● Slipped Disc
● Soft Tissue Sprains & Strains
● Sports Injuries
● Nerve Problems
Hospital
For more information or to book an appointment, please call 6311 2351 or email [email protected]
585 North Bridge Road | Level 13 | Raffles Hospital | Singapore 188770
Contents
NewsRoom
New Docs on the Block | New Medical Clinics |
Healthcare Privileges for American Express | You Don’t Have
to Live With Joint Pain | Taking Down Hypertension |
Latest Procedure In Managing Breast Abnormalities
4
Supplements 28
Ask a Raffles Doc
29
Promotions
30
Features
Don’t Let Sickness Get You Down
7
Having a sickness or chronic condition does not mean you can’t
exercise. We share some tips on what sufferers can do to stay
physically and mentally active.
Getting Back into Shape 11
Were you once lean and trim? Do you think about those “good
old days”? Read on to gear yourself with what you need to
know about becoming active again.
Dealing with Sports Injuries
14
Injuries are often synonymous with sports. Let us share with
you some of the more common types of injuries and what can
be done about them.
UpClose 18
Dr Michael Lee was once obese and led a sedentary lifestyle.
Find out how he’s turned his life (and weight) around to help him
become a better doctor.
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Before the Next Teardrop Falls 20
Find out about the different types of exercises that can help to
condition and strengthen various body parts.
To Be One Step Ahead 22
Injuries in sports are common. But did you know that most are
avoidable? We tell you about what you can do to prevent these
from taking over.
Get Sporty in Unique Ways
23
Fencing? Equestrian? Underwater hockey? Do you know about
these sports and how they can benefit you? We delve deeper
into this realm of unusual activities.
What’s in Your Gym Bag
27
We explore the contents of Dr Lim Kok Bin’s gym bag and find
out what makes it to the gym with him.
Editorial: Dr Prem Kumar Nair, Magdalene Lee,
6311 1222
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Raffles Eye Centre
Raffles Fertility Centre
Raffles HealthScreeners
Raffles Heart Centre
Raffles Internal Medicine Centre
Raffles Japanese Clinic
Raffles Orthopaedic Centre
Raffles Pain Management Centre
Raffles Skin Centre
Raffles Surgery Centre
Raffles UroRenal Centre
Raffles Women’s Centre
Physiotherapy Centre
Radiology
Joanna Lee, Jasmin Pillai, Fann Khoo,
Edmond Loh & Tay Jiaqi
Creative: Edd Chua, Jenny Cheok &
Ho Yeong Shing
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Nov 11
4 Newsroom Raffles HealthNews
1 New Docs on the Block
Prior to joining Raffles Hospital, Dr Dutton was Assistant Professor of Orthopaedic Surgery
and a Consultant at the Division of Hip and Knee Surgery at the National University Hospital
(NUH). He was also the Head of the Sports Clinic and Fellowship Director for Sports Surgery at
NUH. He was a volunteer doctor at Dover Park Hospice and the Kim Seng Community Clinic.
As an examiner for the Final Professional MBBS examination, he is currently teaching medical
students and training residents as a Visiting Consultant at NUH.
Dr Dutton’s clinical interests are in knee and hip replacements; using minimally invasive
techniques and computer navigation, arthroscopic surgery for the knee and hip, as well as
cartilage regeneration and stem cell therapy.
Dr Andrew Quoc Dutton
Specialist in Orthopaedic Surgery &
Consultant, Raffles Orthopaedic Centre
Dr Harneet graduated from the Faculty of Medicine, University of Malaya in 2000. She became
a member of the Royal College of Physicians, London in 2004 and was awarded a DFID
scholarship by the British Government to pursue a Masters in Dermatology at St John’s Institute
of Dermatology, St Thomas and Guy’s Hospital, London, where she wrote a thesis on female
pattern hair loss. She further trained in dermatology and sexually transmitted diseases at the
National Skin Centre, Singapore. She worked at Singapore General Hospital and the National
Skin Centre for 5 years prior to joining Raffles Hospital.
Dr Harneet has a keen interest in hair related disorders. Her research has been published in
international dermatological, dermatosurgical and sexually transmitted infection journals.
She has also written a chapter in a textbook on sexually transmitted infections.
2
New Clinic at Asia Square
2
8 Marina View, #07-02 Asia Square Tower 1
Singapore 018960
Tel: 6636 0160 Fax: 6636 0159
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Relocation for Millenia Walk Clinic
New Address
9 Raffles Boulevard, #02-05
Singapore 039596
Tel: 6337 6000 Fax: 6334 8607
Operating Hours
Dr Harneet Kaur Ranu
Specialist in Dermatology & Consultant,
Raffles Skin Centre
Raffles Hospital Partners
American Express for
Healthcare Privileges
3
As an American Express Cardmember, you can now enjoy the
following healthcare privileges by simply presenting your passport
and American Express® Card when you visit Raffles Hospital for
the following services.
Raffles HealthScreeners
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Specialist Consultation Fee from S$78
In-patient admission room rates from S$443
Raffles Enhanced Packages from S$366
Raffles Chinese Medicine
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First Consultation with Chinese Physician from S$39
First a la carte acupuncture session from S$53
Monday - Friday:
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Saturday: 8.30am – 1.00pm
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* For tourists only.
* Prices include GST. Terms and conditions apply.
Raffles HealthNews Newsroom 5
4 You Don’t Have
to Live With
Joint ain
Most people assume that having pain in the
joints is a normal process of ageing, and
they just have to learn to live with it. All too
often, instead of seeking professional advice,
many turn to pain killers or assume the pain
will just go away.
The causes of joint pain are diverse and
range from inflammation, traumatic injuries,
infections, overloading or even genetic
factors. It is also commonly perceived that
severe joint pain comes with age. However,
this is not necessarily true as people in
their twenties and thirties can also start to
experience joint problems.
Take 36-year-old Sue, an Administrative
Executive, as an example.
As a running enthusiast, Sue jogs regularly
and leads an active lifestyle. So, when she
felt stiffness and aches in her knees, she
thought it might be due to long periods of
sitting at work or over exercising.
Arthritis is not a benign joint disease and this
inflammation usually occurs in joints in
a symmetrical fashion. If left untreated, it
can cause her to develop cartilage and bone
damage leading to joint deformities.” In
Sue’s case, by seeking timely professional
treatment, she was able to prevent disability.
Arthritis is a catch-all term that simply means
inflammation of the joints. However, it is not
a simple diagnosis as generally perceived.
There are many different forms of arthritis
and getting the right diagnosis and treatment
are crucial in helping sufferers to minimise
discomfort and preventing permanent
damage to their joints.
While medications can relieve pain, they
may also cause side effects such as
stomach intolerance and kidney problems.
Some other medications used to prevent
further progression of the disease can also
affect blood counts or the liver.
After many visits to the general practitioner
and consistently taking pain killers, her
condition worsened and affected her daily life
as she gradually had difficulty getting out of
bed. She visited a specialist for advice when
she noticed some swellings in her wrists and
knees. From the results of a blood test and
X-rays, she was told that she was suffering
from Rheumatoid Arthritis.
It is therefore recommended that sufferers
of joint pain have a doctor monitor their
condition regularly throughout the treatment
process. Other than taking medications,
they will also need to make some changes
to their lifestyles by exercising and losing
weight if they are overweight. They can work
with a physiotherapist, who can develop an
exercise programme that will aid them to
improve strength and relieve pain.
Dr Chong Yong Yeow, Specialist in
Rheumatology & Consultant, Raffles Internal
Medicine Centre comments, “Rheumatoid
Dr Chong adds, “Some joint aches and
pains should not be overlooked as they can
signal more sinister conditions. They can be
P
related to connective tissue diseases such
as Systemic Lupus Erythematosus,
Sjogren’s Syndrome or
underlying inflammatory
muscle disease.
These autoimmune
diseases may also
be associated with
inflammation of other
organ systems such as
the kidney, lung, brain and
heart. However, with early
detection and diagnosis,
the sufferer can receive
appropriate treatment and
reduce the risk of serious
complications.”
Although usually non-life threatening, it is
important to seek help from a specialist
when one experiences any kind of persistent
joint pain or other unusual symptoms, for
instance, prolonged joint stiffness which lasts
through the day or persistent swelling of a
joint as these can be features of an inflamed
joint.
Says Dr Chong, “At Raffles Internal
Medicine Centre, we are equipped with
the latest medical technology and systems
for diagnosis and treatment. Together
with personalised attention and support
throughout their treatment, we can help
our patients reduce their risks of potential
complications and prevent permanent joint
damage.”
6 Newsroom Raffles HealthNews
5
Taking Down Hypertension
Raffles Hospital is offering Renal Denervation
(RDN), a new procedure which can
permanently reduce blood pressure levels by
up to 30 mm/Hg in hypertensive patients who
are resistant to traditional hypertension drugs.
RDN is a minimally-invasive, once-off
and lasting procedure, which can help to
dramatically lower a patient’s cardiovascular
risk and for some, even reduce the need
for multiple lifelong medications. In addition,
it has the potential to reduce the likelihood
of prematurely contracting debilitating
cardiovascular events such as strokes and
heart attacks.
RDN is a straight-forward procedure that is
similar to an angioplasty. An interventionist
threads a catheter into the renal artery
under the guidance of radio imaging. Once
in place, the catheter is activated and the
kidney’s sympathetic nervous system (SNS)
is disabled, thereby reducing traffic through it
and lowering blood pressure.
6
Raffles Hospital Unveils Latest
Procedure in Managing Breast
Patients with suspicious clusters of small
calcium deposits or lumps in the breast,
and those with early stage breast cancer
can now benefit from a novel technique
that provides superior cosmetic outcome in
breast conservation surgery. This technique
was introduced to Singapore this year by
Dr Felicia Tan Li Sher, Specialist in General
Surgery & Consultant, Raffles Surgery
Centre, who is also the pioneer of the
procedure in the region.
Known as Radioisotope Occult Lesion
Localisation (ROLL), this relatively simple yet
highly effective technique is a combination of
both a radiological and a surgical procedure.
ROLL is a useful method for locating the
abnormal tissues, which allows the surgeon
to perform a quicker and more precise
surgical removal, as compared to the current
gold standard, hookwire localisation. More
importantly, there is minimal discomfort to
the patient and is safe for clinical staff with no
specific radiological protection needed. Dr Tan
has successfully performed this technique on
50 patients since February this year.
Kidney
“Precise localisation of the abnormal tissues
is critical as it allows the surgeon to better
plan the skin incision for better cosmetic
outcome, as well as optimising the results
in breast conservation surgery. ROLL also
allows minimal removal of healthy breast
tissues while ensuring that the tumour is
entirely removed,” says Dr Tan.
An estimated 25 percent of cancerous
breast tumours cannot be physically felt in
clinical examination and these are usually
early stage breast cancers. These abnormal
breast tissues need to be accurately located
using mammography and ultra-sonography
for a successful surgical treatment. However,
Suspicious
microcalcifications /
lump in the breast
Step I
Injection of radioactive
material under image
guidance
Step II
RDN catheter
inserted into
renal artery.
“This new technology will improve the quality
of life for most patients and help save costs
by possibly negating medications altogether,”
says Dr Alvin Ng Chee Keong, Specialist in
Cardiology & Consultant, Raffles Heart Centre.
According to Dr Yang Wen Shin, Specialist in
Nephrology & Consultant, Raffles UroRenal
Centre, “The procedure shows promise for
treatment in many other chronic conditions
including sufferers of kidney failure, who have
heightened risks of cardiovascular events, if
their blood pressure remains uncontrolled with
conventional medication.”
Currently, patients at Raffles Hospital will
have to be referred by a specialist before
they are able to undergo RDN. Around one in
five Singaporeans aged 18 to 69 years has
hypertension.
Abnormalities
traditional methods via hookwire localisation
has complications such as inaccurate
localisation with up to 30 to 40 percent miss
rate, longer procedure time and pain to the
patient. There is also potential risk of injuring
the lungs during the procedure.
ROLL was invented in Milan in 1996,
based on the premise of placing radioactive
chemicals within the abnormal breast tissues
under clear image guidance. With the use
of a gamma probe, the surgeon is able to
locate them during the surgery, and based
on the location of radioactivity, ensures a
smooth and successful surgical removal.
Gamma probe used
to detect area of
radioactivity
Suspicious lump is
removed and sent
to the laboratory
for testing
Step III
Step IV
Raffles HealthNews Feature 7
Don’t Let Sickness
Get You Down
Exercises for a Healthier You
e all know the importance of exercise for healthy
persons. However, do you know what exercises
are appropriate for you if you have a medical
condition? We speak to doctors from Raffles Hospital to
learn more about exercises that would benefit you.
W
Any form of exercise is good for the body. If you have chronic conditions, you can still benefit from
exercise. Exercise is not just for the healthy, but with care, it is safe for those with health conditions
as well. Speak to your doctor to assess your health before starting out on any exercise regime.
Benefits of exercise include blood pressure reduction, metabolism stimulation, weight
maintenance, stress and anxiety reduction, temperature regulation, pain relief and insomnia
management. It can help improve circulation and lung capacity, reduce the risk of getting diabetes
mellitus, osteoporosis or hypertension, improve muscle tone and stamina, enhance self-esteem
and confidence; and lift depression.
So are you ready to start moving your body? Let’s move it!
8 Feature Raffles HealthNews
Heart Health
Being physically inactive is a major risk factor for developing coronary artery
disease and other heart ailments. “As fatty deposits and cholesterol build
up in the arteries, they cut off blood supply to your heart,” says Dr Alvin Ng
Chee Keong, Specialist in Cardiology & Consultant, Raffles Heart Centre.
“These lead to high blood pressure and lower levels of HDL, aka our ‘good’
cholesterol.”
The good news is that you don’t have to run marathons to decrease
these risk factors. Aerobic exercises such as brisk walking or swimming
for 30 minutes a day can significantly decrease your heart disease risks.
Aerobic exercises strengthen the heart and lungs and improve the body’s
ability to use oxygen. Over time, aerobic exercise can help decrease
your heart rate and blood pressure and improve your
breathing. You should slowly work up to an aerobic
session lasting 20 to 30 minutes, at least three to four
times a week.
Stretching before and after exercises are also
recommended as they help prepare the muscles for activity
and prevent injury and muscle strain. Regular stretching
also increases your range of motion and flexibility.
Diabetes
Diabetes is a condition whereby the body has trouble taking glucose
from the blood and delivering it to the rest of the body so that it can be
used as energy. This is due to a lack of, or an inability to use insulin, the
hormone required to “escort” glucose from the blood to cells of the body.
Dr Stanley Liew, Specialist in Endocrinology & Consultant, Raffles
Internal Medicine Centre, recommends both aerobic exercise and
strength training for diabetic patients.
“Along with proper nutrition, aerobic exercise can increase insulin sensitivity
and restore normal glucose metabolism by decreasing body fat. Strength
training (resistance or weight training) also decreases body fat by raising the
metabolism and more importantly, increases glucose uptake by the muscles
and enhance the ability to store glucose.”
Diabetic patients should take special care of their
feet by wearing comfortable shoes during their
exercise routines as a small open wound may lead to
infection. “Check your feet daily for scratches, cuts,
blisters, ingrown toenails, corns, and calluses. If you
notice ingrown toenails, athlete’s foot, and cuts or
sores that are not healing, contact your doctor right
away,” added Dr Liew.
Raffles HealthNews Feature 9
Back Pain
Are you suffering from back pain and as a result abstaining from
strenuous activities? While this may be recommended for the short
term, back exercise is actually the best way to rehabilitate the spine
and help alleviate back pain.
“A strong, well-conditioned back can tolerate more stress, and protect the
spine better as compared to a back that has not been conditioned through
exercise. Conditioning through flexibility and strengthening back exercises
not only helps the back avoid injury, or minimise the severity of injury if
the spine is traumatised, it also can help relieve the pain of many back
conditions,” shares Dr David Wong, Specialist in Orthopaedic Surgery &
Consultant, Raffles Orthopaedic Centre.
Exercises that strengthen the spinal column and
the supporting muscles, ligaments and tendons are
most appropriate for back pain management. These
exercises should focus not only on the back, but also
the abdominal (stomach), gluteus (buttocks) and hip
muscles. Taken together, these strong ‘core’ muscles
can provide back pain relief because they provide
strong support for the spine, keeping it in alignment and
facilitating movements that extend or twist the spine.
Bone and Joint
Condition
Want to slow down or prevent the onset of osteoporosis and osteoarthritis?
According to Dr Lim Yeow Wai, Specialist in Orthopaedic Surgery & Consultant,
Raffles Orthopaedic Centre, 30 minutes of physical activity three times a week can
help. Exercises such as walking, cycling, swimming and strength training keep
joints flexible and cartilage tissue from breaking down and weakening.
“Weight-bearing exercises are the best ways to build strong bones. These
include walking, stair climbing, running, hiking, and weight lifting. These
exercises stimulate bone formation, and retain calcium in the bones that
are bearing the load. The force of muscles pulling against bones stimulates
this bone building process. So any exercise that places force on a bone will
strengthen that bone,” he explains.
Exercise also increases muscle strength, coordination, and
balance. It decreases the likelihood of falls, especially for
the elderly.
That said, those with bone and joint conditions should
avoid high impact exercises that can stress the joints, such
as aerobic workouts that require bouncing, competitive
sports or running.
10 Feature Raffles HealthNews
Cancer
For cancer survivors, exercise seems like the last thing on their mind. Yet
studies have shown that exercise may prevent the disease returning for specific
cancers including breast and colorectal cancer. Cancer patients should engage
in exercise. Even moderate exercise such as brisk walking, heavy cleaning, lawn
moving, cycling and badminton, can help.
Dr Donald Poon, Specialist in Medical Oncology & Consultant, Raffles Cancer
Centre explains, “Research has shown that engaging in vigorous physical activity
for an equivalent of 30 to 45 minutes of brisk walking, five days a week, can help
lessen many symptoms commonly experienced after cancer treatments, reduce
the risk of relapse and improve the chance of a fulfilling survival.”
Contrary to common perceptions, physical exercise does not
make one feel more tired during treatment, but can in fact
boost one’s energy after that. It can also lower your chances
of getting heart disease and osteoporosis in the long term.
“You should check with your attending doctor if you
have doubts as to which exercise programme you
can embark on because each condition may impose
different exercise limitations,” adds Dr Poon.
Depression
Feeling down and lethargic? Depression can get one really down. But
that’s no excuse to stop moving. In fact, exercise has psychological
and physical benefits that help reduce anxiety and
improve mood.
According to Dr Lim Yun Chin, Specialist in Psychiatry
& Consultant, Raffles Counselling Centre, “The links
between depression and exercise is not clear. However,
exercise probably helps ease depression by releasing
feel-good brain chemicals, reducing immune system
chemicals that can worsen depression and increasing
body temperature, which may have calming effects.
There’s a wide range of activities that you can engage in to boost your activity level and help you feel better. Certainly
running, going to the gym, playing basketball and other fitness activities that get your heart pumping would help. So can
gardening, washing your car, or strolling around the block and other less intense activities. Basically, the goal is to get you
off the couch and moving. So wait no longer, get out and make exercise a part of your life. HN
Raffles HealthNews Feature 11
Getting Back
Into
Sh
1
ap e
T
here are times in
our lives where even the most
sedentary of us were somewhat active.
It is likely that we’ve all had a period
where we were fit and healthy. Yet all this
probably changed when adulthood hit. Now,
the occasional glimpse of oneself in the mirror
reminds us of those “glory” days. But why stop
at reminiscing? You can get back that lifestyle
and reap the benefits of fitness once again.
Let Health News guide you on the road
back to a fit lifestyle.
Exercise Again – Why You Should
Restarting a healthy fitness regime
doesn’t mean picking up from where
you left off. Chances are it’s been some
time since you’ve worked up a sweat. It
is therefore important to gradually build
up momentum in one’s regime. Your age
and health also make a difference now.
Remember, you were younger and fitter
then. However, do not let this discourage
you; exercise has no age limit on its
benefits.
For starters, a simple target of 150
minutes of exercise a week is optimal.
“You may be used to more previously,
however 150 minutes per week or 30
minutes per day is sufficient to start
feeling the benefits of exercise,” says Dr
Peter Chen, Family Physician, Raffles
Medical.
And in case you’ve forgotten, here’s a
quick recap from Dr Wong Wei Mon,
Senior Physician, Raffles Medical on
those benefits (as an incentive).
Regular moderate exercise performed
every three to five days a week can
broadly:
Improve your heart health
• Reduce the risk of heart disease
• Help your heart and cardiovascular
system work more efficiently
Improve your heart disease risk
factors
• Reduce risk of developing diabetes
and high blood pressure
• Improve blood sugar tolerance if you
have diabetes
• Help control high blood pressure, by
as much as eight to 10 points
• Improve cholesterol levels
• Control weight and reduce body fat
Improve your strength and feeling of
well-being
• Helps keep muscles, bones, and joints
healthy
• Increase your energy levels
• Improve your balance and flexibility
• Maintain muscle tone
• Lessen feelings of anxiety or
depression
• Improve your sense of well-being
12 Feature Raffles HealthNews
2
Seeing a Doctor
Now that you’re convinced that you should
lead an active lifestyle once again, it is
time to consider an important factor before
starting your exercise regime.
Understanding your health condition is vital
in choosing the right exercise regime for
you and can also possibly save your life
by understanding what types of activities
to avoid.
Dr Rupert See, Senior Physician, Raffles
Medical advises, “Anyone intending to
start or restart an exercise regime after a
long hiatus should see their doctor and make
sure they don’t have any pre-existing
medical condition. It is recommended
that some level of health screening be
conducted to rule out any underlying
predisposition such as hypertension,
diabetes, or heart conditions.”
Dr See adds, “It goes without saying that
pre-existing conditions such as heart
disease or diabetes should be given an
extra level of attention. Screening for
pre-existing conditions should not only
be limited to the old. Young people have
been known to suffer from undiagnosed
conditions that were “triggered” by
strenuous activity, e.g. recent incidents
of young people who have died suddenly
from running marathon. Hence young
people who have not had any exercise
for some time should see a doctor before
starting on a fitness regime.”
Another important group that should
consider screening is men aged over
40 and women aged over 50. Dr Carol
Tan-Goh, Specialist in Geriatric Medicine
& Consultant, Raffles Internal Medicine
Centre explains, “As you get older, you
become more susceptible to ailments
and diseases. While an active lifestyle
in one’s older years is encouraged, it is
vital for such persons to check with a
doctor before beginning especially if they
suffer from any of the following:
• Dizziness or shortness of breath
• Chest pain or pressure, or the
feeling that your heart is skipping,
racing, or fluttering
• Blood clots
• An infection or fever with muscle aches
• Unplanned weight loss
• Foot or ankle sores that won’t heal
• Joint swelling
• A bleeding or detached retina, eye
surgery, or laser treatment
• A hernia
• Recent hip or back surgery
• Previous medical conditions such as
heart disease, diabetes, hypertension etc.”
Dr Wong also lists the following as some tests that can be conducted during screening
to better gauge your risk level before embarking on an exercise regime.
Type of Tests
Description
History and Cardiac risk
assessment
Questionnaire focused on personal risk factors and
family history
Physical examination
Physical examination of heart, lungs, joints, etc
Body Mass Index (BMI)
A simple measurement to determine
amount of body fat
Blood pressure
A measurement of the pressure exerted by circulating
blood on the walls of blood vessels.
Resting ECG
Charts the electrical activity of the heart to detect any
heart abnormalities/disorder
Full lipids (cholesterol) profile
Total cholesterol, HDL, LDL, cholesterol/HDL ratio,
triglycerides
Fasting blood glucose
For diabetes screening
Treadmill exercise stress test
To detect coronary heart disease
Medical report, with further referral
and management if necessary
Discussion of test results and appropriate health advice
given to individual’s condition
weight(kg)
[height (m)]2
In addition to cardiovascular assessment of one’s health, an examination of the joints
will also be useful. This is especially so for persons who’ve experienced joint pain
previously or older persons who’ve possibly had some joints in their body replaced,
suggests Dr Lim Lian Arn, Specialist in Orthopaedic Surgery & Consultant, Raffles
Orthopaedic Centre.
Dr Lim also adds, “Knowing the condition of one’s joints will provide a better guide to
the types of exercises or sports a person should and should not take up. This makes it
less likely that any problems will be exacerbated.”
Raffles HealthNews Feature 13
3
One Last Step
So you’ve made up your mind to go
back to an active and healthy lifestyle.
You’ve even gotten a clean bill of health
to do so. But hold your horses, there’s
one final part before you
actually begin; the
exercise(s) itself.
“You might have
been quite the
soccer player or
gymnast many
years ago yet given
your body’s lack of
conditioning and (if
any) ailments or medical
condition, it may be wise
to consider other forms
of exercise,” advises Mr
Lim Hun Teck, Principal
Physiotherapist, Raffles
Physiotherapy Centre.
Mr Lim also provided some
suggestions on the different
types of exercises persons of
different age groups can focus
on.
For those in their 20s: A mixture
of moderate and vigorous exercise
is recommended. Cardio should be
4
done at least three times a week for
20 to 30 minutes each time. Musclestrengthening exercises
should also be done
twice a week.
For those in their
30s: At this age, it
is more important to
do short and intense
bursts of activities
instead of focusing
on endurance
training. Women
at this age also
start to lose
bone and
muscle mass.
Therefore the
focus here
should be
on building
muscle and
preserving
bone
density through
strength training for about two
to three times each week. Aerobic
activity should now be a daily routine
with stretching and balancing exercises
included.
On The Road to an Active Lifestyle
In conclusion, re-adopting or embarking
on an active and healthy lifestyle has
many benefits. However, there are
points of consideration one should take
before execution. These include the
person’s age, current level of fitness as
well as current health condition. Always
remember to check with your doctor if
you’re unsure or if you have any worries.
They can also provide suggestions for
various types of exercises which will be
more suitable. Most importantly however,
have a goal in mind. Being clear about
what you hope to achieve makes your
path clearer. The journey may be tough
but the rewards are endless and once
you’ve reached your goal, stay active.
HN
For those in their 40s to 50s+:
This is the time when a host of issues
can start to plague one’s health. For
example, joint wear and tear begins to
occur more frequently. Lung function
also declines at this age. Given these
issues, it is more advisable to choose
exercises based on personal risk factors.
For example, cardiovascular disease
is still the biggest threat so cardio
exercises should still be considered.
Additionally, strength training can be
considered if one needs to protect and
boost weak joints.
These sentiments are also echoed by
Dr Chen who advises, “A good workout
should incorporate elements of both
cardiovascular and resistance exercises
to help address the inevitable issues
that are brought on by aging such as a
weakening heart and muscle loss.”
Mr Lim however advises prudence within
his recommendations, “While it serves
as a good guide, you would know best
about the types of suitable exercise.
For example, don’t run too much if you
have a bad hip. It’s all about finding the
right balance of exercises that you enjoy
doing and not putting your health at risk.”
14 Feature Raffles HealthNews
Dealing
with
Sports Injuries
If you think only sports stars like sprinter Tyson Gay,
basketball player Yao Ming and golfer Tiger Woods are
vulnerable to sprained joints and broken limbs, think again.
For many health-conscious Singaporeans, being active in
sports and exercise seem like the perfect way to keep fit.
However for some people, particularly those who overdo it
or those who do not train properly, instead of reaping the
benefits, they may end up putting themselves at risk of
getting injured.
Raffles HealthNews Feature 15
Understanding Sports
Injuries
Common Sports Injuries
and Causes
The term ‘sports injuries’ refer to the
kinds of injuries that usually occur during
sports or exercise.
So what are the common sporting
injuries and their possible causes?
Generally, it depends on your activity and
current fitness level. Here are the most
common ones in no particular order:
Sports injuries may happen to those
who are new to a sport, those who begin
exercising after prolonged inactivity,
or those who do not warm up properly
before workout. They may result from
accidents, poor training practices,
improper equipment use, lack of
conditioning, or insufficient warm up
and stretching.
According to Mr Lim Hun Teck, Principal
Physiotherapist, Raffles Physiotherapy
Centre, “A simple warm up exercise or
stretching before launching into any
intense session of exercise or sports
like aerobics, running or football, does
not ensure that you will be injury-free. In
fact, the higher the intensity, the risk of
injury to any part of the musculoskeletal
system like the muscles and bones also
increases. One way to prevent injuries
is to start slowly and increase your
exercise level gradually.”
1 Sprains and Strains
Sprains are tears to the ligaments, the
connective tissues that attach one bone
to another. They are caused by trauma,
such as a fall or blow to the body that
knocks a joint out of position. Sprains
can range from first degree (minimally
stretched ligament) to third degree
(a complete tear). The ankles, knees
and wrists are areas of the body that
are most vulnerable to sprains. Signs
of a sprain include varying degrees of
tenderness or pain, bruising, swelling,
inflammation, inability to move a limb or
joint and joint looseness.
Strains are pulls or tears of muscles
or tendons (tissues that attach the
muscles to the bones).These acute
and non-contact injuries are results
from overstretching or overcontraction.
Symptoms of a strain include pain,
muscle spasm and loss of strength.
While it’s hard to tell the difference
between mild and moderate strains,
severe strains that are not treated
professionally can cause damage and
loss of function.
2 Knee Injuries
Because of its complex structure and
weight-bearing capacity, the knee is the
most commonly injured joint.
Knee injuries can vary from mild to
severe, affecting the knee bones,
ligaments, tendons or cartilage. Mild
knee injuries include runner’s knee (pain
or tenderness on the sides and below
the knee); illiotibial band syndrome
(pain on the outer side of the knee), and
tendinosis (degeneration of a tendon).
They can also result from a traumatic
injury like a blow or twist of the knee;
improper landing after a jump; too much
running, or overuse of the knee tissues.
“If knee injuries are left untreated, it may
result in more damage to the cartilage,
ligaments or the bones,” says Dr Lim
Yeow Wai, Specialist in Orthopaedic
Surgery & Consultant, Raffles
Orthopaedic Centre.
3 Achilles Tendon Injuries
The Achilles tendon is one of the longer
tendons in your body, stretching from the
bones of your heel to your calf muscles.
It is one of the more serious sports
injuries for amateur and professional
athletes alike.
Many Achilles tendon injuries are cases
of tendonitis (inflammation or irritation of
a tendon), in which the tendon becomes
swollen and painful. Besides middle and
long distance runners, Achilles tendon
injuries are also common in middleaged “weekend warriors” who may not
exercise regularly or take time to stretch
properly before an activity. In a severe
case, too much force on the tendon
causes it to tear partially or rupture
completely.
Other causes such as overuse,
misalignment, improper footwear,
medication side effects, and/or accidents
can also contribute to the same Achilles
tendon injury.
16 Feature Raffles HealthNews
4 Fractures
Dislocations are usually caused by a
sudden impact to the joint. This usually
occurs following a blow, fall or other
trauma. Sports which involve a lot of
pushing or stretching, like basketball or
football, can cause dislocations, with the
shoulder joint being the most prone.
Acute fractures can be simple (one break
with little damage to the surrounding
tissue) or compound (multiple cracks
with the broken bone sticking out through
the skin). Most acute fractures are
emergencies. One that breaks the skin
is especially dangerous because there
is a high risk of infection. Compound
fractures can be very dangerous as it
also increases the risk of infection.
Unlike a fractured bone, a dislocated
joint can be resolved relatively quickly. It
only involves realigning the bones. Many
individuals are able to move their limbs
almost immediately after having their
bones realigned. However, if the injury
is left untreated over a period of time, it
may result in a permanent injury.
A fracture occurs when a bone is
cracked or broken, from either a quick
one-time injury to the bone (acute
fracture) or from repeated stress to the
bone over time (stress fracture).
Stress fractures occur mostly on legs
and feet due to repetitive stress on those
areas from sports like sprints, hurdles
and gymnastics, that require constant
running and jumping.
5 Dislocated Joints
A dislocated joint is a joint that slips out
of place which may result in damage to
ligaments, nerves and blood vessels.
It occurs when the ends of bones are
forced from their normal positions. And
when that happens, the joint no longer
functions properly.
What Should I Do If I Have
Sports Injuries?
There is never a good reason for anyone
to try to “work through” the pain of an
injury regardless of its severity.
“When you are experiencing pain in
any part of your body from a particular
movement or activity, it is advisable
to stop immediately as continuing the
activity can possibly cause further harm,”
advises Mr Lim.
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Seek Medical Treatment
Some injuries require prompt medical
attention from a medical doctor, while
others can be self-treated. You should
seek immediate medical treatment if:
• the injury causes severe pain,
swelling, or numbness
• the pain or dull ache of an old
injury is accompanied by increased
swelling or joint abnormality or
instability
• there is loss of function
Raffles HealthNews Feature 17
Self-Treatment
If you do not have any of the above
symptoms, it is probably safe to selftreat the injury. Treatment often begins
with RICE (Rest, Ice, Compression and
Elevation) method to relieve pain, reduce
swelling, speed up recovery time and
also prevent further tissue damage.
Follow these four steps immediately
after injury and continue for at least 24
to 48 hours:
R
est. The injured area must remain
relatively inactive. The duration of rest
will depend on the severity of the injury.
I ce. The application of ice causes
blood vessels to constrict, thus
decreases circulation and results in less
inflammation at the site. A cold pack, ice
bag or wet towel with crushed ice can be
used over the injured site for periods of
20 minutes every two hours for the first
24 to 48 hours. If possible, ice should
also be applied to the surrounding area.
Note: Do not apply ice or a plastic
bag containing ice directly onto the
skin as this may cause ice burn.
ompression. Compression of
the injured area may help to reduce
the swelling. This can be achieved with
elastic wraps. Care should be taken to
ensure that circulation is not constricted
by bandaging too tightly.
C
E levation. If possible, keep the
injured part on a pillow, above the level
of the heart as this helps to reduce blood
pressure and swelling.
Who Can I See For
An Injury?
While severe injuries will need to be
seen immediately in an emergency
room, most sports injuries can be
evaluated and, in many cases, treated
by a doctor.
Depending on your preference and the
severity of your injury, you may want to
see, or have your doctor refer you to
either an orthopaedic surgeon, who is
able to diagnose and provide treatment
for any part of the musculoskeletal
system like the bones, joints, ligaments,
tendons, muscles, and nerves, or a
physiotherapist, who can develop a
rehabilitation program for you.
Alternative Treatment
In addition to using conventional RICE
method, many sport injuries sufferers
also seek treatment from a traditional
Chinese medicine (TCM) physician.
Physician Stephen Lau, TCM Physician,
Raffles Chinese Medicine shares, “Most
patients who seek treatment for sportsrelated injuries at the clinic are usually
those with long-term injuries. TCM-based
therapies such as acupuncture and
massage (Tui Na) are effective treatment
for these patients because they help to
reduce pain and increase their range
of motion. Together with herbal medical
treatment, they can expect a faster
recovery time.”
Although people who exercise and
participate actively in sports are more
likely to experience injuries to their
muscles, bones and joints as compared
to those who don’t, this certainly does
not mean you should avoid sports as
the health benefits far outweigh the cost
in terms of sports injuries. Most sports
injuries can be treated effectively and
those who suffer injuries can return to a
satisfying level of physical activity after
an injury. In fact, many of these common
sports injuries could be prevented if
people take the proper and necessary
precautions. HN
18 UpClose Raffles HealthNews
UpClose
Dr Michael Lee
with
Family Physician, Raffles Medical Clinic
D
r Michael Lee Khai Weng, 44, who joined Raffles Medical more than eight years ago, runs
in half marathons at least twice a year. This active daddy of two girls tells UpClose about his
exercise plan and how he keeps himself fit and looking good.
Having worked in RafflesMedical for
many years, what do you enjoy in
your work here?
First, the deep sense of camaraderie
and support amongst the staff; from the
management, fellow family physicians,
specialists to the nursing and support
staff. Second, I get to meet people from
all walks of life and nationalities.
Why did you decide to become a
doctor?
The human body has never failed to
fascinate me: The intricacies of its
myriad functions and the problems
(illnesses) that can develop when it
breaks down. It was then I decided
that I wanted to become a doctor.
Why did you choose to specialise in
family medicine?
As physicians, we are called to treat
patients holistically. That means
the emotional, psychological, social
and spiritual aspects, as well as the
physical illnesses. Family medicine is
the only speciality that encompasses
all of that. It allows me to build
relationships with my patients and
their families, thereby understanding
their health needs better. It is the most
satisfying way of practising medicine.
What are the challenges in family
medicine?
These days’ patients are more
well-informed with easy access to
medical information on the internet.
Often because of less than credible
websites, they are given biased
views and inaccurate information.
Hence, family physicians has to be
internet savvy and to keep abreast
of the latest medical information and
research, in order to meet patients’
higher expectations and to correct any
misinformation. I certainly do not know
everything but armed with my laptop, I
have explored websites and answered
my patients’ queries.
There must be many fulfilling
moments at work, share with us a
memorable incident.
Many years ago, there was a
patient who saw me for headaches
and insomnia. Further into the
consultation, the patient revealed
that she was having relationship
issues with her boyfriend. Apparently
that was the precipitating factor for
her symptoms. Besides treating the
symptoms, I provided a few sessions
of counselling. Her moods became
better and her symptoms resolved.
After that, I did not hear from her until
two years later when I received a letter
of gratitude. She explained that she
had since met another person and is
now happily married. The counselling
sessions had given her clear markers
when starting and maintaining this new
relationship. I’m really happy for her!
How do you find a balance between
your career, exercise and spending
time with your family?
I just have to make time for each
activity. It’s always the tyranny of
the urgent that crowds out what is
really important. I try not to bring
work home so that I have time to
spend with my wife and two girls.
Over dinner, we might share our day’s
events, talk about the latest ‘gossip’
in the newspapers or tell jokes. It’s
never a dull moment with my girls
(including my wife) clowning around.
Occasionally it’s a ‘movie night’ when
everyone has done their chores or
homework. I try to date my wife at
least once a week; mostly checking
out some popular eatery or catching
a critically acclaimed movie. I usually
exercise in the evenings before dinner.
Can you share with us your exercise
plan?
I do my runs at least twice a week.
Each run is about seven to 10km.
Closer to the Army Half and the
StanChart Marathons, I’ll push up the
frequency of training and distances.
Once a month, it might be swimming or
badminton with family and friends.
What is your diet like?
Generally I try to avoid fried and oily
foods when eating out. My wife, who
is my ‘Master Chef’, would ensure that
my diet is healthy and balanced. She’s
always ‘experimenting’ with recipes to
come up with say for example, a low
fat/low cholesterol mee rebus. And it’s
pretty authentic and tasty!!
As a doctor, do you feel challenged
to keep fit and look good?
Yes indeed. Not much credibility if I
don’t walk the talk. At 84kg, I used
to be obese four years ago. Some
Raffles HealthNews UpClose 19
wonderful colleagues in Raffles Medical
encouraged me to take up running and
I was hooked. It wasn’t easy at first: I
was only managing one to two km before
running out of breath. It did not help that
I have exercise-induced asthma. But
perseverance and proper training paid
off. I have lost almost 10kg and am doing
the half marathons twice a year.
Any advice for our reader who
wants to start an exercise program?
What is the most recommended
exercise?
Well, you are never too old or too late to
start exercising. However do see your
friendly family physician for a health
screening to ensure that you are medically
fit to embark on a suitable exercise
programme. The easiest and most
recommended exercise would be brisk
walking. Incorporate the exercise into your
daily routine; like getting from your home to
the bus-stop or MRT station. A total of 30
min brisk walking spread throughout the
day is a good start. HN
At 84kg, I used to
be obese four years
ago. Some wonderful
colleagues in Raffles
Medical encouraged
me to take up running
and I was hooked.
20 Feature Raffles HealthNews
Before
Teardr p
F
‘
The Next
rustrated’, ‘agonised’, ‘irritated’ and ‘down’ are probably some of the words
that most people would use to describe their feelings after suffering from
exercise injuries, such as sprains and strains. For some who work out
regularly, they may wonder how they have acquired a particular injury from
doing a familiar exercise, since they must have repeated the same set of
actions for countless number of times without being injured.
Falls
Well, the point is, no body part is equal in strength and some parts are
weaker than the rest. Therefore, one of the most practical ways to avoid
injuries is to strengthen the muscles around the weaker areas. Let Dr
Andrew Quoc Dutton, Specialist in Orthopaedics Surgery & Consultant,
Raffles Orthopaedics Centre, share with you some effective exercises and
tips that can help to strengthen your body parts.
A
rms
Recommended exercises for the arms are:
• Working on a cross trainer or elliptical machine
• Swimming
Other useful tips:
• Stretching the flexor and extensor muscles of the forearm is
important as they can help pervent golfer’s or tennis elbow.
• People above 40 years old should be extra careful and go easy
with the use of dumb bells.
A
nkles
Use a resistance band while performing the following exercises. Repeat each of
the following exercises for at least 10 times with both left and right feet.
• Ankle Dorsiflexion and Plantarflexion – These refer to the upward and
downward movement of the foot at the ankle joint.
• Ankle Eversion and Inversion – These refer to the inward and outward
movement of the foot at the ankle joint.
Much diligence and persistence are required for these strengthening exercises.
However, do note that you should take it slow and not overdo them.
Other useful tips:
• Buy good footwear with adequate arch support.
• If you are a regular runner, change shoes every six months.
• Avoid running on uneven surfaces or side slopes. This can lead to abnormal
pressure and posture.
• If you have had a previous injury, wear an ankle guard or high cut sports
shoes when playing games.
• Use a wobble board to improve joint sense and proprioception.
• Stretch before a workout.
Raffles HealthNews Feature 21
N
eck
Isometric Paravertebral Muscle Strengthening Exercises:
• Chin Tuck – (1) Stand or sit in an upright position. (2) Place the first and middle fingers on
your chin and push inwards. You will feel a slight stretch in the back of your neck. (3) Hold
this position for at least five seconds before returning it to the neutral position.
• Isometric Neck Exercise (Sides) – (1) Stand in a relaxed position with back
straight. (2) Place right hand on right side of the head and push head towards
hand. (3) Hold for at least five seconds and repeat the same on the left.
Other useful tips:
• Ensure that you use a firm pillow support for the neck when sleeping.
• Keep computer screen at eye-level when at work. Take a break from the computer
every hour and stretch the neck for five to 10 minutes.
• U
se gentle muscle massage and heat rubs to relief neck muscle aches.
S
houlders
• Scapular Mobilisation Exercises – An example is ‘overhead straight arm pull
down with resistance band’: (1) Hold the resistance band, about 15cm apart. (2)
Raise arms fully with palms facing away from you. (3) Stretch the band by pulling
it to both sides until your arms reach the shoulder height. Repeat this 10 times.
• Isometric Shoulder Exercises – (1) Put your palms together and press
against each other. (2) You may place them close to the body or slightly
further away from it. (3) Hold this position for at least 10 seconds and repeat.
Other useful tips:
• Be extra careful when travelling with heavy luggage, especially when
taking luggage down from the over-head storage.
• Take 20 minutes to stretch before playing racquet sports or golf.
B
ack
These are helpful exercises to strengthen the back
muscles as well as the core muscle groups:
• Swimming
• Pilates
• Yoga
Other useful tips:
• Lift objects by squatting rather than bending.
• Tie shoe laces by sitting or kneeling.
• Ensure adequate lumbar support with good sitting
posture especially for desk bound jobs.
K
nees
Try these knee strengthening exercises:
• Cycling on a stationary bike
• Straight leg raise with ankle weights
• Leg presses and leg curls
Other useful tips:
• Conduct hamstring and quadriceps stretching before
exercise or sports.
Step
To Be One
Ahead
22 Feature Raffles HealthNews
e welcome all the benefits that exercise has to offer but definitely not the injuries, and we know for
sure that there is always a chance of getting injured while exercising.
W
So, the question is, how can you prevent yourself from these unwanted injuries that hinder us from engaging in
the sports and exercises that keep you going?
Consider the following tips from Mr Lim Hun Teck, Principal Physiotherapist, Raffles Physiotherapy Centre,
before you re-engage in your favourite workouts.
Increase time and intensity gradually
Due to different health conditions and age, everyone’s fitness level
differs from person to person. We usually find ourselves beginning
an exercise programme with lots of enthusiasm, and may go too
hard and too fast. Identify the weak areas of your body and avoid
the type of activities that place too much stress on them.
Therefore, it is wise to begin with moderate exercise of about 30
minutes, three times a week and gradually build on it. If you experience
pain and discomfort during a workout, stop and rest, don’t work through
the pain. Most importantly, be patient and listen to your body.
Get the right gear
Wearing the correct attire or additional support
for different types of activity is important. This
can enable you to carry out your workout more
smoothly and enhance your performance. If
required, additional support such as knee bands
can help prevent recurring sports injuries.
Have a mix routine
Hire a pro
More often than not, we learn
better through demonstrations.
When starting a new activity,
it is advisable to learn the right
techniques from a certified and
experienced trainer. It is also
one of the best ways to prevent
an unwanted injury when you
receive proper guidance and
attention while working out.
Add variety and fun to exercising
by having a mixture of two or
more types of physical activity
that include aerobic exercise,
strength training, stretching, core
stability and balance training
elements in your routine. This
not only makes exercising
interesting, you also get to work
on different muscle groups and
prevent overuse injuries.
Warm up and stretch
We have been taught that stretching and warm-up exercises prevent injuries. However, there is little scientific
evidence to show that they can improve exercise performance, reduce delayed-onset muscular soreness, or
prevent injuries. On the other hand, many experts in health and athletics have had positive clinical and practical
experiences with stretching, and have thousands of anecdotal reports of injuries that occurred on the rare occasions
when previously injury-free athletes neglected to stretch before exercise.
In addition, multiple studies have shown that this decreases the injury rate, especially in females.
Controversial as it may seem, what’s notable is that these warm-up routines do help to put people in the right frame of
mind to begin and relax after an exercise session, thus benefiting them in staying focused and alert during workouts. HN
Raffles HealthNews Feature 23
Get Sporty
in Unique
Ways
An athlete can gain self-confidence and
resilience through both major or minor sporting
achievements. Beyond the physical and fitness
benefits to playing sports, it can improve your
mental well-being too.
We explore some non-traditional sports
activities and hear our experts share their
experience on these sports.
24 Feature Raffles HealthNews
I
ndoor & Rock Climbing
Rock climbing is a sport in which participants climb up or
across natural rock formations or artificial rock walls. The goal
is to reach the summit of a formation or the endpoint of a predefined route without falling. Rock climbing competitions have
objectives of completing the route in the quickest possible time
or the farthest along an ever increasingly hard route. It is a
physically and mentally demanding sport, testing a climber’s
strength, endurance, agility and balance along with his
mental control. It can be a dangerous sport and knowledge of
proper climbing techniques and usage of specialised climbing
equipment is crucial for the safe completion of routes.
Benefits
Set in a controlled environment, it is like a training ground for
outdoor rock climbing but safer than it. Indoor climbing is a
sport that deals with both the body and mind. It takes a lot of
will power to be able to withstand the challenges it gives and
nothing short of mere determination to achieve the goal of
reaching the top. Yet, there is a lot to learn with regards to the
art of indoor climbing.
You can lose a lot of weight with this sport without even noticing
it. It is simply a fun environment and an amazing outlet to burn
fat in the process, and it involves intense muscular activity just
by climbing up and down the walls, especially if you are carrying
the gears as well. Thus, some indoor climbers who have tried the
sport found themselves loving it.
S
Rock climbing is fun and challenging.
Although it would seem that you are
using a lot of upper limb strength, you
need to be strong in your lower limbs
as well. You also have to trust your
partner when you climb. So it helps to
build up team spirit, friendship and trust.
- Dr Lim Yeow Wai, Specialist in
Orthopaedics & Consultant,
Raffles Orthopaedic Centre
cuba Diving
Self-contained underwater breathing apparatus (SCUBA) is
now widely considered a word in its own right. Scuba diving is a
form of underwater diving in which a diver uses a scuba set to
breathe underwater.
Benefits
• A great exercise for increasing upper body strength;
notably the arm muscles.
• Helps develop the cardiovascular system, with the heart and
lungs pumping oxygen round the blood stream.
• Improves agility and flexibility.
• Refreshes and focuses the mind from everyday distractions.
• Tones muscles and improves posture.
Learning to scuba dive can deliver the perfect balance of
stillness of mind and a physical workout. Water is heavier than
air and provides a greater resistance against your movements.
The water helps develop and strengthen your muscles without
the physical impact of other sports. So you benefit from the
exercise without risking your joints.
The health benefits of deep breathing techniques are numerous
and studies show that yogic deep breathing is extremely
effective in handling depression, anxiety and stress-related
disorders. Moreover, deep breathing techniques stimulate the
lymphatic system, which is key for the removal of toxins from
the body. The good thing about learning to dive is that it allows
you to take your mind off work.
Scuba divers need training on the proper use of equipment, as
well as an understanding of the physics
and medicine behind descent and
ascent during diving. Something most
dive schools do not emphasise enough.
You need to understand seawater
conditions in order to have a safe dive.
- Dr Ho Kok Yuen, Specialist in
Anaesthesiology & Consultant,
Raffles Pain Management Centre
Raffles HealthNews Feature 25
E
questrian (Horseback Riding)
having to do anything but by just holding onto the reins.
In addition, horseback riding does not stress the knees and
other lower body parts as compared to other forms of exercise
such as walking or swimming.
Horseback riding has the ability to help people develop,
tighten and strengthen those hardly-used muscles with little
or no strain. It can also help us burn calories and lose weight
without us having to break a sweat. Anyone can opt for a ride
on the pony for a weekend of family fun, while the disabled can
engage in physiotherapy.
Riding is a unique sport. Unlike others, men and women can
compete on equal terms. It is an activity suitable for all ages,
both young and old. Unlike many other sports, you can
continue riding and improving your skills for a lifetime. It is
important to be taught well from the beginning. Establishing
good core skills early is essential, and every ride will bring new
knowledge.
Benefits
Horseback riding stimulates muscles in the dorsal and
abdominal regions that are seldom used in everyday living.
Imagine setting that six-pack you’ve always wanted without
U
Although it is suitable for all ages, it is best started while
young. Safety is paramount and it is ideal to perform horse
back riding at an accredited stable to ensure that the horses
are healthy and have predictable temperament.
Another important factor is a good
instructor who can guide you to
improve with time. A good stable or
riding academy will also have safety
gear that is well maintained and
meets safety standards. On top of
helmet and protective leg wear such
as jeans or riding pants, if riding at
a faster pace or jumping hurdles, a
mouth guard is also recommended.
- Dr Rachel Chan, Dentist, Raffles Dental
nderwater Hockey
Underwater hockey is a non-contact
sport that combines elements of
swimming, diving, hockey and
snorkelling. Two teams compete to
manoeuvre a puck across the bottom
of a swimming pool into goals.
Players wear a diving mask, fins,
protective gloves and a snorkel for
play. They play with small, foot-long
sticks and a hockey-type puck.
Players from each team try
to score goals.
Benefits
Underwater hockey is an excellent way to stay in shape.
The constant swimming will improve your cardio as well as
your stamina. This game is also very fun and allows you to
play something that is unique as underwater hockey is unlike
anything you will ever experience!
Underwater hockey`s health benefits can extend to
cardiovascular rehabilitation.
I would recommend sports to anyone; it can range from
mainstream activities like running and swimming to lesser
known sports such as underwater hockey. Some general
guidelines should be borne in mind:
1. If there is any doubt about one’s cardiac or general health,
get that clarified first.
2. Whatever the activity, start slowly and gradually build up
duration and intensity.
3. Windsurfing and underwater hockey sound interesting and
certainly have obvious health benefits such as
cardiovascular exercise, as well as
core and strength exercise.
4. Perhaps a minor discouragement
would be the fact that these can be
done only in specific and limited
places and settings. There will be
recurrent costs or expensive initial
outlays.
- Dr Lim Lian Arn, Specialist in
Orthopaedic Surgery & Consultant,
Raffles Orthopaedic Centre
26 Feature Raffles HealthNews
W
indsurfing
Windsurfing is a water sport that combines surfing and sailing.
The windsurfing board is a combination of a surf board with a
sail fixed on it, hence the name of the sport. The board is used
to surf on the waves, while the sail is used for acceleration.
Windsurfers are able to perform various stunts like jumps,
inverted loops, spinning and manoeuvres, and other freestyle
moves.
Benefits
Windsurfing works your core muscles as you balance on the
board. You use your entire body to manoeuvre the sail rigging
and steer, so you work your arms, back and legs as you sail.
If you’re out on a sunny day, you’ll also soak up some Vitamin
D, which is known to combat depression. Just make sure you
wear plenty of sunscreen to protect your skin from sun damage.
This beach sport combines high speed with extreme
manoeuvres and tricks, requiring you to handle a mast while
carving through sometimes choppy water. You will need a
combination of balance, skill and fitness just to hang on.
F
encing
Whether for recreation or competition, fencing is an interactive
sport that develops physical fitness, quick reactions, speed,
agility and excellent hand and body co-ordination. It is also one
of the few physical sports where both men and women compete
on equal terms. Fencing has an advantage over other sports,
as it is not physically selective and anyone can fence. Fencing
can be likened to a high intensity kind of sport combining both
combat and ballet.
Fencing, a western martial art, demands total concentration
and calls for craftiness. It has been described as ‘physical
chess’ at lightning speed. This is because the sport requires
both physical and mental skills. This is similar to the intensive
physical state of a computer game in which the mind must act
quickly to meet unforeseen challenges, strategising to a variety
of attacks and defences. People who like to fence also develop
themselves to make their own decisions rather than have
decisions made for them.
Benefits
Physical
• Keeps you fit. You cannot perform “swordplay” without a good
bit of movement.
• Helps to train quickness, reflexes and agility. Well trained
fencers learn to have excellent balance and poise.
• Helps to improve coordination of both hands and legs.
Mental
• Stimulates the competitive spirit and the determination to win.
• Develops focus and concentration skills.
• Challenges you to be calm and quick witted under pressure;
overcoming adversaries with intelligence.
I started fencing to defend myself at home when my two kids
started jabbing me with their “weapons”. They started learning
fencing at a very early age.
Fencing tones up the core muscles in the body and certainly
builds up physical fitness. “I almost collapsed from physical
exhaustion at the first formal training
session under an ex-Hungarian
international fencing coach. The mental
focus and agility comes in once stamina
builds up. It is so fun that there is never
a dull moment in fencing.
- Dr Donald Poon, Specialist in
Medical Oncology & Consultant,
Raffles Cancer Centre
Raffles HealthNews Special 27
Gym Bag
Special
Despite his busy schedule, Dr Lim Kok Bin, Specialist in
Urology & Consultant, Raffles UroRenal Centre, goes to
the gym near Raffles Hospital two times a week during
his lunch hour to stay in the prime of health.
He shares with HealthNews on what he brings to the
gym and why.
1 Bag
2 Water bottle
Choose a sturdy bag. As my
bag can get quite heavy, I use a
backpack for better back support.
It’s important to rehydrate before, during
and after the workout. I keep a 700ml
bottle. A rough rule-of-the-thumb is to drink
a glass of water for every 15 minutes of
work out. Another useful measurement is
to drink whenever you feel thirsty.
3 Towel
8 Gloves
My gloves are a useful repertoire
whenever I do my weights in the
gym. They give me a better grip and
help prevent sore palms. A wellfitting pair is important.
The gym provides a towel
but I bring my own hand towel
to wipe my perspiration from the
workout. It is basic courtesy to clean the
equipment before the next user.
4 Toiletries
I’m a simple man. Just some
shower foam, a comb and hair wax
for the clean-doctor-look after the
workout, and I’m all set to go.
7 Heart rate monitor
This is a must-have for my gym gear.
I use it to measure my exercise intensity.
It allows me to maximise my gym
session, as it gives me faster progress
and less wasted effort. It motivates me
sometimes to work harder to surpass
my past record.
6 Comfy clothing
I opt for comfort over style when it comes
to my gym wear. I usually don a simple
t-shirt and a pair of shorts, nothing fancy
or expensive.
5 Plastic bag
This separates my clean stuff from
my dirty stuff. I use it after the
workout to store my soiled clothes.
28 Supplements Raffles HealthNews
Essentials of
Sports Nutrition
and Supplements
Many athletes have turned to various dietary strategies,
including the use of supplements to gain a competitive edge.
While vitamin supplements may not be necessary for those on
a well-balanced diet, they are highly recommended for athletes
and sports enthusiasts involved in strenuous exercises. For
example, those who are undergoing heavy training may require
more of vitamin B Complex, as they are needed for energy
production.
Although there are many benefits to exercising, strenuous
exercise may lead to oxidative stress and result in oxidative
damage to muscle tissues. Preventing muscle tissue damage
during exercise training may help optimise the training effect
and eventual competitive sports performance. Antioxidant
supplements like Vitamins C and E, Beta Carotene, and
Coenzyme Q10 may help to enhance exercise performance or
prevent exercise-induced muscle tissue damage.
Glucosamine, a popular supplement for joint health, can also
benefit those who are active in sports as it can help maintain
the cushioning in joints that are used heavily. Research has
shown that for sports injuries, glucosamine can provide some
pain relief as it has anti-inflammatory properties.
Promotions
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* Prices are valid till 31 December 2011 and are not applicable with other
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* This promotion is only available at Raffles Health Retail Pharmacy,
Level 1, Raffles Hospital.
585 North Bridge Road | Level 1 | Raffles Hospital | Singapore 188770
For more enquiries, please contact us at 6311 1641 or 6311 1108.
Raffles HealthNews Q&A 29
My 10 year old child is asthmatic and I am concerned as he
participates in sports like swimming. While I would like him to run
around and have fun like all the other children, I am worried that
this might trigger an asthmatic attack. Am I being overly cautious
and pessimistic? What special care and precautions should I take for
my boy?
Asthmatic patients may participate in any sports, as long as their asthma is adequately controlled. This allows
children to be “normal” and goes a long way to ensure normal psychological and emotional development. In addition,
swimming is a good form of exercise as it increases the capacity of the lungs.
There are, however, some patients who need to take some precautions before they conduct any exercise.
Asthmatic patients that have exercise induced asthma (i.e. asthma attacks during and after exercise) would need
to circumvent the problem by taking their Salbutamol (Ventolin) inhaler 15 to 30 minutes before any sports.
Otherwise, there is really no special precaution EXCEPT for:
• No exercises in polluted environment (stay indoors when PSI is elevated).
• Avoid exercising in the cold (as it will cause constriction of the airways).
• No exertion when unwell (e.g. flu, fever).
Dr Wong Wei Mon, Senior Physician, Raffles Medical
I am 45 this year and I am starting to feel stiffness in my joints
especially when climbing a flight of stairs. I feel that I can no
longer move my body as fast and as flexibly now as compared
to a couple of years back. Is this normal? Is there anything I
can do to get better? If so, what is it?
As we enter our forties, muscle bulk tends to reduce and it becomes more difficult to build and maintain muscle mass. Muscles and
tendons become stiffer and are more prone to injuries. Weight bearing joints, especially the knee start to “show their age” as well.
This is directly related to the way we use our joints. If we overuse them, they tend to age or wear faster.
For example, overweight people tend to have earlier degeneration than their average weight friends.
Similarly, sportsmen are prone to wearing out their joints faster.
As we age, muscle fibres decrease in size but not in number; tendons become less elastic and become
more plastic, hence are more susceptible to injury. Joint cartilage becomes thinner and produces less
lubricating fluid.
Ageing is not reversible. Cartilage never heals back to its previous state. As we get older our body replaces
injured cartilage with either abnormal “scar” cartilage or it doesn’t succeed in replacing the cartilage at all.
You cannot prevent ageing but you can reduce the effects of ageing on your joints, tendons and muscles
healthy by having a regular programme of the right amount and types of exercise. Too little or too much
exercise are both not recommended.
Despite not being able to stop or prevent ageing, most of the time our muscles and joints can function
well enough to enable locomotion and for the continuation of activities of daily living.
Dr Lim Lian Arn, Specialist in Orthopaedic Surgery & Consultant, Raffles Orthopaedic Centre
30 MarketPlace Raffles HealthNews
BRACES PACKAGE
for students
Spine
Joint
and
According to TCM theory, pain can be caused by “Qi”
and blood stagnation, dampness-cold obstruction in
the meridians and kidney deficiency. A combination of
acupuncture, acupressure and herbal medicine can restore
the above imbalances to promote natural healing.
The World Health Organization recognises the use of
acupuncture for more than 70 types of conditions, including
acute spine pain, neck and back pain, rheumatoid arthritis,
sciatica and temporo-mandibular joint dysfunction.
Arthritis Management
For managing inflammation due to osteoarthritis,
rheumatoid arthritis and other damages to the joints.
● 6 acupuncture sessions
$321
Spine and Joint Pain
Management
For relief of pain due to scoliosis, spondylosis, herniated
disc, sciatica and other spine and joint conditions.
● 6 acupuncture sessions
$321
Raffles Dental is offering a Braces Package for full-time students.*
Braces are used in Orthodontic treatment to “straighten” teeth that
are displaced or misaligned.
Brace yourself for a future of great smiles.
Braces for Students at
$4,588
• No waiting list • Treatment by specialists
• Evening & Saturday clinics
• Progressive payment plan
Option of Herbal Medicine at $10 per day.
Your TCM Specialist Centre
For enquiries or to make an appointment, please call
6311 2388/2322 or email [email protected]
* Package prices include GST.
* Packages must be utilised within 6 months from date of purchase
and are not transferable or refundable.
* Raffles Chinese Medicine reserves the right to withdraw or revise
the packages without prior notice.
* Other terms and conditions apply. Please call for more details.
For more information or to make an appointment, please call
6311 2360/2365 or email [email protected]
* Terms & conditions apply
* Excludes consultation fees and X-rays
* Package price is only applicable to local Singaporeans / PR students
under 18 years of age, currently studying in local schools
* Present your matriculation or student card upon registration
* Price is inclusive of GST
Raffles HealthNews MarketPlace 31
Muscle Pain?
Feeling Fatigue?
Young Athlete
Cardiac
Screening
If you are feeling widespread
muscle pain throughout the body,
experiencing general fatigue and
disturbed sleep, you may have
fibromyalgia. It may co-exist with
other medical conditions such as
headache, irritable bowel syndrome,
depression and jaw pain.
Fibromyalgia commonly affects
middle-aged women. Those with
rheumatoid arthritis or other
autoimmune diseases are also
more likely to develop it.
So, if you experience muscle pain,
tension or stiffness, or if your
muscles are sensitive to touch or
pressure, screen to check if you
have fibromyalgia.
Fibromyalgia Screening
Package at $160.50
This includes:
• Specialist consultation for pain management
• Physical examination
• Laboratory tests (Full blood count, thyroid function test,
rheumatoid factor, antinuclear antibody, creatinine kinase,
erythrocyte sedimentation rate, c-reactive protein)
PainManagementCentre
For more information or to make an appointment, please call
6311 2310 or email [email protected]
* Package includes GST.
* This package is not to be used in conjunction with any other
promotions.
For Ages 16 - 35
It is always tragic when a young athlete dies during physical
training or sports participation.
The heartrending sense of loss can sometimes be
compounded when the cause of death is discovered to be a
cardiac condition that could have been diagnosed earlier.
Cardiovascular conditions are the leading causes of nontraumatic, exercise-induced deaths. These are usually due to
hypertrophic cardiomyopathy (a condition in which the heart
muscle thickens, making it harder for blood to leave the heart)
and non-atherosclerotic coronary arteries anomalies.
Medical Clearance
If you or your loved ones are preparing to undergo physical
training or participate in sports, it is important to find out the risks
for sudden cardiac death, and also to seek medical clearance from
your doctor before embarking on any exercise regime.
With foreknowledge of the risks, preventive measures or
necessary treatments can be initiated to reduce mortality.
Cardiac Screening Package
Cardiac screening for young athletes is available at Raffles Heart
Centre at a package price of $500.76*. The screening includes
a consultation and review with a Cardiologist, blood tests,
electrocardiogram and 2D echocardiogram.
HeartCentre
For more information or to make an appointment,
please call 6311 1222 (24-hour service) or email
[email protected]
* Package includes GST.
MedicalGroup
Make a Medical Stopover at Raffles
For Your Wellness and Medical Needs
Raffles provides a comprehensive range of medical services through our islandwide
network of 76 Raffles Medical Clinics, and Raffles Hospital.
Put your health in good hands with Raffles Medical.
Raffles Hospital
One-Stop Tertiary Hospital in the Heart of the City
Raffles Hospital offers 24-hour emergency and a comprehensive range of specialist services.
•Ear, Nose & Throat
•Eye
•Fertility
•Health Screening
•Heart
•Internal Medicine
•Japanese Clinic
•Aesthetics
•Cancer
•Children
•Chinese Medicine
•Counselling
•Dental
•Dialysis
•Orthopaedics
•Pain Management
•Physiotherapy
•Skin
•Surgery
•UroRenal
•Women
You can expect personalised services that are tailored to your needs. Raffles is a
Joint Commission International accredited hospital.
Raffles Medical Clinics
There’s One Near You
For general medical services, vaccination or health screening, visit any of our
family medicine clinics located across the island. Our Executive Medical Centre
offers medical solutions for busy executives. To bring medical services closer to
you, we also provide house/hotel call services.
Changi Airport
Beyond Basics
For medical services in the Singapore Changi International Airport, visit any of our six
clinics located in the terminals. In addition, our 24-hour clinic at Passenger Terminal 3
provides executive health screening and dental services.
For more information on our services or for an appointment, please call (65) 6311 1111 or email to [email protected].
www.rafflesmedicalgroup.com
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