October 11, 2021

Feeling pain after a workout? Don’t just ignore it

By brit

Agnes* (not her real name) works in the finance industry and keeps fit with weekly Zumba classes and twice weekly brisk walks with her husband. After one particular walking session, the 58-year-old felt pain and noticed mild swelling over her right knee.

Taking anti-inflammation medication from her GP helped relieve some of her symptoms, but her knee pain recurred quickly after she returned to her Zumba classes.

Getting a cortisone injection – which provides immediate relief to an inflamed area – helped ease the pain for about three months. But it soon returned and Agnes realised that she could no longer exercise without triggering pain in her knee. Her condition continued to deteriorate to the point where she was struggling to even climb stairs at work, so she decided to consult an orthopaedic surgeon.

Her MRI scan revealed that she had a posterior root tear with extrusion of the medial meniscus – which means she was no longer able to “bounce” load off the knee, and the increased stresses on the joint had led to cartilage damage.

Sports injuries on the rise among women

As a growing number of people turn to fitness as a way to establish some form of routine and normalcy during the pandemic, injury cases are also seeing an increase. For example, sports doctors and physiotherapists in Singapore have seen up to 50 per cent more new patients with running injuries since 2020 as more people start running to cope with boredom or stress.

While cases like Agnes sometimes also stem from factors such as age, the increasing popularity of fitness activities such as bouldering, CrossFit, spinning and high-intensity classes at gyms such as F45, especially among women, has contributed to a slew of injury types ranging from neck and back sprains to shoulder injuries.

Dr Lo Ngai Nung, orthopaedic surgeon at Gleneagles Hospital, says this is “not so much because of the nature of the exercises, but more because of the intensity of the exercises”.

He explains: “The same factors that make these intensive exercise classes attractive – such as the competitive camaraderie – are also potential factors for injury, as participants often push on without realising that they have hit their limits.”

Women are also more predisposed to injuries, he says, as “women have anatomical differences, less muscle mass, more lax ligaments, and lower bone mass”.

Fellow orthopaedic surgeon at Gleneagles Hospital, Dr Lim Yi-Jia, adds: “With the Covid-19 restrictions, many women are also teaching themselves exercises such as yoga, Pilates and weights training via online courses or YouTube videos. Without professional supervision, improper technique and accelerated progress can cause injuries.”

According to doctors, ​​sports-related injuries can be broadly divided into two types: acute traumatic injuries and chronic overuse injuries.

The former usually stems from a “high-energy injury”, such as a bad landing after a jump, resulting in acute swelling and pain that makes it difficult to use the limb.

Dr Lingaraj Krishna, also an orthopaedic surgeon at Gleneagles Hospital, notes that one of the most common acute traumatic injuries faced by women is an injury to the anterior cruciate ligament or ACL, a knee ligament that helps to stabilise the joint, or patella (knee cap) dislocation as a result of direct trauma or a twisting injury of the knee. In such cases, early medical attention should be sought.

The latter, on the other hand, arises due to repetitive stress to tendons, muscles and joints from a too-rapid increase in exercise intensity and volume. “Common overuse injuries include patellofemoral pain syndrome (runner’s knee) and shin splints,” says Dr Krishna.

“These injuries are generally treated with rest, anti-inflammatory painkillers and physiotherapy.”


Seeking prompt medical attention not only aids in your chances of recovery, but will also enable you to return to the lifestyle you enjoy sooner. PHOTO: GETTY IMAGES

However, he is quick to emphasise that if “symptoms do not improve in four to six weeks despite these measures, medical attention should be sought”. Chronic pain or aggravated injuries would likely follow if these symptoms are left untreated.

Also common among women are neck and back sprains. Gleneagles Hospital’s orthopaedic surgeon, Dr Yue Wai Mun, who has a special interest in spine surgery, advises seeking medical attention if there is pain even at rest, or if numbness or weakness occurs in the arms and legs.

“The latter could signify a slipped disc with compression of nerves. These could lead to permanent nerve damage if they are not attended to in time,” he cautions.

Prompt medical treatment aids recovery

In many cases, doctors find that women are generally aware of these sports injuries and the need for treatment. However, some have put off getting their injuries properly evaluated because of the demands of work and family, or simply do not perceive themselves as suffering from an acute injury.

Sometimes, there are also worries of a long downtime. To this, Dr Krishna reminds that “the potential for excellent recovery is greater when injuries are treated early rather than late”.

He shares the story of 27-year-old Samantha* (not her real name), who suffered a complete tear of her ACL and a severe tear in one of the menisci in her knee after a bad landing during a bouldering session. With timely reconstructive surgery to the knee, doctors were able to reconstruct her ACL and repair the meniscus effectively.

He says: “She is currently progressing very well in her rehabilitation, and is on the road to recovery. Given her improvement so far, I am confident that she will be able to return to bouldering soon.”

In Agnes’ case, it was the desire to return to her activities for good that convinced her to opt for a partial knee replacement. After two months of physiotherapy following her surgery, she was able to resume her brisk walks and Zumba classes.

“The surgery was done with a minimally invasive incision, and the recovery period is short,” says Dr Lo.

“Studies have shown that a high percentage of patients return to sports after surgery. A recent study from Oxford University also showed that the partial knee replacement will last a lifetime in 85 per cent of patients aged 55.”

Finding a medical provider that meets your needs

As with any medical treatment, it’s important to find a good medical provider to ensure that you are in the best possible hands, so that you can jump straight back into the activities you love and caring for the ones that are most important to you.

At Gleneagles Hospital, an all-rounded group of professionals – experienced orthopaedic surgeons, nurses, physiologists and occupational therapists – with a focus on medical outcomes, speed, technology and patient-centric care are on hand to help patients return to an active lifestyle.

Those who have concerns over the costs of seeking private care will also be glad to know that under Integrated Shield Plans (which, according to the Ministry of Health, about 70 per cent of Singaporeans are eligible), they are likely able to enjoy comprehensive coverage for in-hospital treatment at private hospitals.

Additionally, with a private Integrated Shield Plan complemented by a rider, the cash outlay is usually minimal.

Using the Gleneagles Hospital Bill Estimator, you will also be able to find out your approximate out-of-pocket medical expenses of your surgery by providing information on your Integrated Shield Plan and riders.

If you require more information, WhatsApp or call the Parkway Insurance Concierge hotline (+65 9834-0999) for clarifications related to the coverage of your shield plans and panel doctors. Hotline staff are on hand to help you make an appointment with the specialist of your choice.