Thank you from Dr Aston

I would like to thank all clients, athletes and coaches, friends and supporters in the industry for continuous support and the great ideas on improving athlete recovery from injury.

The most common question my clients pose to me is, "Where do we go from now onwards?". As always it would be prudent to seek out Sports Physicians, Orthopaedic Surgeons and Physiotherapist with a keen eye on sports performance. Spend time asking questions about the injury, how to prevent it and how you can get back to sports. A good clinician would not refuse to provide you with useful information.

Always remember that you need to return to sports gradually. Do not just do electrotherapy without rehabilitation exercises. Always get clearance from your attending physician to return to play. Discuss with your coach about reintroduction of sports specific skills gradually.

If you need help, talk to your doctor.

Extracorporeal Shock Wave Therapy (ESWT)

ESWT is a useful tool for treatment of plantar fasciitis, tennis elbow and Calcific tendinitis of the Achilles tendon. The treatment modality has been used for treatment of Acromioclavicular joint arthroses, ankle impingement syndromes and Iliotibial band syndrome. It works as an adjunct to the physiotherapy treatment and should not be solely administered without exercise therapy.

Ask your doctor if you want to know more about this treatment.

Taping Workshop for Beginners

If you coach or play sports, if you treat sports injuries, or if you are just a concerned parent with a child who plays sports, this is for you. Find out how to tape bad ankles and knees properly for injury prevention.

Registration fee RM50 (inclusive 1 roll athletic tape and tea). Limited to 30 participants only.

Date: 14th May 2011
Time: 2.00pm - 5.00pm
Venue: Dr Aston Sports Clinic

Contact us at 03-78774399 or draston@gmail.com for registration.

Low Intensity Pulsed Ultrasound for bone healing

Low Intensity Pulsed Ultrasound (LIPUS) is currently available as an additional tool to assist in the healing of new or non-healing fractures. Stress fractures due to repetitive overloading of joints (e.g. scaphoid bone , Tibial bone , navicular bone) and surgically treated fractures (Internal fixation) can also be treated with LIPUS.

Studies have indicated that it may heal fractures up to 38% faster* and reduce delayed unions by 83%. The daily 20 minutes treatment for several weeks increases frowth factors critical to bone healing process, including BMP-7, Alkaline Phosphotase and VEGF.

Talk to your surgeon or sports physician about the various options of treatment and you may find LIPUS helpful for your early return to sports. Every treatment should go along with a carefully designed rehabilitation program monitored by a physiotherapist or sports doctor.

*Heckman JD et al Acceleration of tibial fracture-healing by non-invasive low intensity pulsed ultrasound. J Bone Joint Surg Am. 1994 Jan:76(1):26-34.
*Kristensen et al Accelerated healing of distal radial fractures with the use of specific, low intensity ultrasound. J Bone Joint Surg Am. 1997 Jul;79(7):961-973.

ASEAN Basketball League video

After surgery - Injury Rehabilitation

Professional athletes who undergo surgery for sports injury would undergo a compulsory duration of a systematic and guided recovery process called injury rehabilitation. The process is initiated as soon as possible to ensure that the site of surgery is allowed to heal swiftly.
Initially, various modalities (e.g. cold therapy, electrotherapy) are used to reduce tissue oedema and pain. Soon afterwards, simple exercises are initiated to strengthen the affected limb while allowing a gradual increase in the range of motion. Over a series of carefully monitored evaluation of function, the physiotherapist and physician adjusts the design of the recovery program to suit the individual. Complications like reinjury, ligament or tendon laxity, instability may occur,if the athlete proceeds too quickly whereas the opposite may occur if the limb is kept immobilised for too long. The later phase of rehabilitation involves more vigourous physical exercises and more difficult skills.

Always check with your surgeon, physiotherapist or physician if you are unsure of what you are doing. Do not proceed if your exercises cause you too much pain. Plan your surgery with the injury rehabilitation in mind and you will have a more successful recovery.

Dance injury - Dance without pain!

Young children aged 5 to 7 years are often enrolled for dance and rhythmic gymnastics classes. A trained dance tutor or coach individualises the teaching of skills and exercise to ensure that exercises are introduced in stages when the child is stronger. More difficult skills would often require a longer duration to allow the dancer to mature and strengthen adequately while he or she practises diligently.

Dancers who have mild tendon inflammation are often prescribed simple exercises to strengthen the knees and feet while improving the posture and finesse of the art. Kinesiotape is used to assist those who require support to a weak and poorly balanced foot and ankle.

Work closely with your doctor, physiotherapist and dance tutor or coach to ensure that their skills progress without any complications of injury.

For more dance injury references, click here.

Injuries in young athletes and dancers

Young athletes and dancers often suffer from injury in the knees and foot due to excessive loading of the lower limb (e.g. long distance running, badminton, gymnastics, weightlifting). These injuries are often caused by a mismatch between the bone and muscle growth. These athletes would require a more gentle approach with the introduction of physical activity and skills. Some athletes who resort to excessive jumping and weightlifting may also suffer from low back pain due to degenerative changes in the vertebra of the spine.

Most of these injuries may be resolved by taking the athlete off such exercises for several weeks followed by careful gradual reintroduction of safe exercises. Consult your doctor if you need help.

Merry Christmas and A Happy New Year!

Wishing all the friends and clients, A Blessed Christmas and A Happy New Year! There are many more sporting events for the year 2011. Do keep up the fitness with some maintenance exercise until then. Do not overtrain but keep up the positive spirit and God bless you!

Lecture Series 2: Low Back Pain

Find out why people get low back pain and how to sort them out without a whole lot of trouble. Fimd out what needs expert intervention by your family physician, sports doctor, orthopaedic surgeon, physiotherapist or massage therapist*.

Date:    18th September 2010

Time:    2.00pm - 3.00pm

Venue:  Dr Aston Sports Clinic

If you are a parent, athlete, patient, working person, or therapist, you may be interested in attending this lecture. Call Ms Chooi at 03-78774399 to book in advance as we are limited to 30 places only. Registration is Free.

*This lecture is not designed to replace your doctor's advice or consultation

Shoe and Foot woes

Does everyone with a flat foot need a pair of expensive shoes or insoles? Does that mean that if I have knee pain, shin pain, hip pain or foot pain, I definitely need something fancy? Can I get a pair of footwear that would sort out every problem in the lower limb? Do I need to walk or run barefoot?

These are some questions that patients ask. My answer would be simple.
1. What kind of animal are you? Do you walk, run, jump, cycle, climb or etc?
2. Do you have an injury that requires sorting out?
3. Do you fancy getting a cut running barefoot on the road?
4. Do you want something that fits all your shoes? (If there's such an insole)

Tell us what you really want and we will try to sort it out for you!

Sports Massage for Delayed Onset Muscle Soreness

If you have done a workout or training and you seem sore the next day, you may need a sports massage. If you've planned your training and prepared well, you could avoid the ache. Often the soreness is non-specific but more focused on the muscles you have worked very heavily. Do check with your doctor or physiotherapist to rule out a muscle injury and if you need more help, get a sports massage.

Don't give up on your workout with your trainer!

Early return to sports?

Research has been carried out using various methods of injection techniques, surgical intervention and rehabilitation methods for ligament tears, muscle strains and tendon ruptures. Many of these research has the intention of shortening the duration of return to sports for the injured athlete.

Every injured athlete would love to return to training or play as soon as they can. Some may be concerned about the safety of doing so prematurely as they may not be strong enough or having the necessary balance and coordination required for play. Some professional athletes have been troubled by incessant injuries which recur almost every season due to injuries which have not adequately recovered.

Here are a few rules that you can follow to determine whether it is safe to return:
1. Pain-free full range of movement
2. Able to carry the weight of the body or sporting equipment without pain
3. Able to perform the skills required for the sports without pain
4. Completed the necessary rehabilitation program
5. Certified fit by the sports physician or physiotherapist after conducting a series of tests

Check with your doctor or therapist before you return to sports!

Low Back Pain - Keeping it from spoiling everything

Some sports enthusiasts suffer from very debilitating low back pain. Despite trying all sorts of ways to sort it out, nothing seemed to work. If the low back pain does not involve a fracture or nerve compression, it may resolve with a careful diagnoses followed by electrotherapy and rehabilitation exercises. Even those with mild disc prolapse could recover significantly to enjoy an active lifestyle. Once you are pain-free you need to ensure that you avoid obvious actions which could cause the injury to recur.

It doesn't mean that if you have low back pain, you need to live with it for life. Ask your doctor for advice and seek professional help. You may be able to keep it from spoiling everything!

Treating the cause...

It is often that one would find a swelling like this (see photo) and would not have had any falls or twists in the joints or limbs. Often it could be due to unaccustomed activity (e.g. sudden increase in training load) and an abnormal gait or poor footwear. If given the proper evaluation, it would be possible to rectify some of the causes to prevent re-injury.

Knee Osteoarthritis - early options

Patients are advised to diagnose their chronic knee pain early so that they may benefit from early intervention measures especially if they have osteoarthritis. However, the patient should always be assessed with the need to maintain a healthy lifestyle to prevent worsening of other medical conditions e.g. cardiovascular disease, diabetes and obesity.

Some of the early treatment options often offered to patients are:-
1. Individualised exercise programs and weight management
2. Electrotherapy
3. Daily Glucosamine Sulphate supplementation
4. Pain medication (under doctor's supervision)
5. Hyaluronic acid injection (3 - 5 weekly doses)

If the patient works closely with the treating physician and physiotherapist, such treatment would result in a better outcome.

Team Physician of the KL Dragons

Dr Aston has been appointed Team Physician to the KL Dragons in the Asian Basketball League (ABL). The league started on the 14th October 2009 as is expected to end in February 2010. Find out more about the match schedule to support the KL Dragons.

1ST MALAYSIA INTERNATIONAL ICE HOCKEY TOURNAMENT 2009

There's an exciting adrenaline pumping Ice-Hockey International event coming up this weekend. Paramedics and doctors volunteers are wanted during the whole tournament.


Important Details:
Sept 2-5 (Wednesday to Saturday)
Time: Sept 2 :8pm to midnight
Sept 3 & 4 :8am to midnight
Sept 5 :8am to 7pm
Venue: Sunway Pyramid Ice Rink
Estimated number of players: 180-200
Players' ages: 5-50
Organizer: Malaysia Ice Hockey Federation (MIHF)
Contact person: EeLaine (012-2261048) or Dr Aston (019-2103787)

See the video of launch and join us if you love the excitement!

Chronic knee pain

Serious recreational athletes are often advised to stop sporting activities (e.g. jogging, fultsal and badminton) without diagnosing the condition of their knee pain. A proportion of these people do not remember even having a fall or injury while playing sports but have eventually started having knee pain lasting from weeks to months.

Many of such patients would benefit from a visit to their Sports Physician or Orthopaedic doctors for a detailed examination. Even elderly folks have returned to an active lifestyle when they started doing regular simple rehabilitation exercises. Within weeks to months, some recreational athletes would be able to return to sports if they do not require surgery.

Read up more on knee injuries here.

Dance and Rhythmic Gymnastics: Injuries Revisited

We have seen our dancers and gymnasts suffer from injuries which are preventable. Many still suffer as they would not allow pain to stop them from performing. But the time has come for us to equip ourselves with knowledge which could set us apart from the others.

Find out what we should know about injuries in dance and rhythmic gymnastics. Why do these injury occur? How can we prevent such injuries? How do we treat such injuries?

Date: Postponed to a future date
Venue: Dr Aston Sports Clinic
No.6, Jalan SS2/3,
47300 Petaling Jaya,
Selangor.

Kindly contact me to indicate interest in attending this course. A minimum of 20 participants required. A registration fee of RM30 is chargeable.

Taping workshop for athletes and coaches

Athletes and coaches are invited for a taping workshop at DASC!

Date: 13th June 2009
Time: 2.00pm-5.00pm
Venue: Dr Aston Sports Clinic
No.6, Jalan SS2/3,
47300 Petaling Jaya,
Selangor.

Contact: 03-78774399 or draston@gmail.com

Registration Fee: RM30/participant (includes athletic tape)
Kindly RSVP before 6th June 2009.

Google Map

Vital Treatment for the First 24 hours

If you have just sprained your ankle or twisted your knee, remember to do RICE Treatment i.e. Rest, Ice, Compression, Elevation.

Rest the injured part and discontinue play.

Apply ice for 15 - 20 minutes only. Use ice cubes or crushed ice in a plastic bag and add water to ensure it isn't too cold! You may insulate it with a dry cloth. You would soon find the swelling less painful and swollen. Repeat the icing after every 4 hours for 2-3 days.

Apply a crepe bandage for compression. Ensure that it isn't too tight to restrict blood circulation of your toes or fingers.

Keep your injured limb elevated above the level of the heart. This would help it drain the swelling.

Do not try to massage the injured limb as it may worsen the condition. Check with your sports doctor first!

Athletic Taping - An option to feel more confident at play

Many athletes continue to suffer in silence despite having nagging injuries giving them recurrent soreness and instability during sports. Those who have the privilege of care from sports physicians or physiotherapists may have been offered athletic taping to reinforce weakened ligaments, support unstable joints or provide a pain-free range of motion during play.

In order to utilise this technique, you should do the following:-
1. Identify the injury and the problem
2. Determine the requirements of your sports
3. Obtain the skills to tape the injured part
4. Apply the tape and try out the skills required by the sports
5. Remove the tape after the training /match

Always seek the advice of trained personnel before attempting to tape on your own. Remember, practise makes perfect!

China Press: Interview with Dr Aston

Here's an interesting article in China Press on the 11th March 2009. You can find the link here.

Exercise therapy back to sports

Many athletes and patients suffer from recurring pain and injury due to inadequate exercise therapy. Most athletes would have been prescribed an exercise programme which takes a specified period of time by the sports physician or physiotherapist. However, some drop out of the programme once they are pain-free or more mobile before they are fully functional.

Various components of rehabilitation (e.g. strength, power, flexibility, endurance, sense of balance and position) have to be incorporated to the exercise therapy to ensure that the athlete does not re-injure himself or worsen the injury.

Talk to your sports physician and physiotherapist periodically to ensure that you are progressing well in your exercise therapy. Note that there is no short cut to full recovery as damaged tissue will take time to heal.

Former athletes who are now coaches get pointers on sports medicine

An exclusive interview with the Star Metro featured today (page M31) can be read here.

Here are some excerpts from the article: “Working with elite athletes during my tenure with the NSI from 1997 to 2005, we were required to be performance-orientated in getting the athletes back in action. Apply­ing a similar approach, we found that recreational and junior athletes also recuperate faster when they are given a specific target to meet in their recovery process,” he added.

Helping patients to get back on their feet and perform to their true potential is the most rewarding part of the job for Dr Ngai.

Sports Medicine Lecture & Workshop Series: 14th February 2009 - 21st March 2009

A series of Introductory Sports Medicine lectures / workshops was held at Dr Aston Sports Clinic every Saturday 3.00pm - 5.00pm from the 14th February 2009 - 21st March 2009. This event was held in collaboration with Sports Goodwill Ambassadors.

Venue: Dr Aston Sports Clinic (see Google Map)

Lecture 1: 14th February 2009

Title: Sports Participation - How can it be safer?

Lecture 2: 21st February 2009
Title: Sports Injury - The Do's and Dont's

Lecture 3: 28th February 2009

Title: Common Sports Injuries

Lecture 4: 7th March 2009
Injury Rehabilitation - The missing link

Workshop 1: 14th March 2009

Title: Athletic Taping Part I (Lower Limb)

Workshop 2: 21st March 2009
Title: Athletic Taping Part II (Upper Limb)

We would like to thank volunteers and participants who attended the lectures and workshops for making the educational event a success.

Sports Injury Consultation

Most sports injuries can be diagnosed by your sports physician or Orthopaedic Surgeon by asking a few questions followed by physical examination.

The following sports injuries are common amongst recreational and elite athletes:
1. Ankle sprain
2. Non-specific knee pain (knee)
3. Hamstring strain (thigh)
4. Rotator-cuff tendon injury (shoulder)
5. Low Back Pain
6. Tennis elbow and Golfer's elbow
7. Calf muscle strain (Gastrocnemius)
8. Adductor strain
9. Plantar fasciitis

It only takes your clinician 10 - 15 minutes to determine the nature and severity of the injury. Sometimes he may request for further investigations (e.g. X-ray, Ultrasound Scan or MRI) to obtain a more definite diagnoses and determine the extent of injury. These investigations may be useful to determine whether you require surgery.

Usually your clinician will suggest physiotherapy if the sports injury does not require surgery. Some injuries do very well without surgical intervention. If you are an elite athlete, you may undergo a more intensive rehabilitation programme required for your sports. Always discuss the options with your clinician, physiotherapist and coach before deciding on the options of treatment.

Internship and Vacancy: Physiotherapist & Sports Trainer

A Diploma / Graduate Physiotherapist with a keen interest in sports injury rehabilitation. Either Full-time or part-time. Able to work both in the clinic and in the field. Previous experience an added advantage.

Students who are interested to do a short internship at DASC are encouraged to write in with a letter from their university / college. Selected students will be offered a place for internship after an interview.

Send your CV to Dr Aston Ngai Seng Huey at draston@gmail.com.