Ask the Doctor - February columns

Sunday 28th February - Sports Injury

Mr Graham Lawson is an Orthopaedic Surgeon at Spire Murrayfield Hospital in Edinburgh.

The anterior cruciate ligament (ACL) is one of two internal ligaments of the knee. When damaged, patients often complain of episodes of instability.

ACL injury in the recreational skier is often a relatively low velocity twisting injury. As a “low energy” accident, for example if the ski bindings fail to release and you fall over with the foot fixed to the ski, all the stress transfers to the knee.

Patients often feel or hear a “pop” or click coming from the knee. The degree of pain associated with this injury is variable and often extremely short-lived. Within a couple of hours, the knee may be grossly swollen – indicating that the torn ligament has bled into the knee joint.
Treatment of these injuries is influenced by the degree of knee instability and the patient’s expectations. Management of such injuries ranges from physiotherapy or knee braces to surgical ligament reconstruction.

Sunday 21st February - Dupuytren's

Mr Chris Oliver is a Consultant Hand Surgeon and runs the Edinburgh Hand Surgery Clinic at Spire Murrayfield Hospital.

Dupuytren’s is a common hand condition. Firm nodules appear beneath the skin which can later grow into a thick cord that can prevent the finger straightening. The cause is unknown, but it is more common in Scottish men. While there is no cure, surgery can successfully straighten bent fingers, though not always to their original position, and can be helpful when it has become impossible to put the hand flat on a table. Surgical treatments include Fasciectomy, whereby, through a single incision, the entire cord is removed. Occasionally, Dermofasciectomy with a skin graft taken from the arm can also be successful. Surgery may be under local or general anaesthetic. Post surgery, the hand may be fitted with a splint. Recovery with respect to the final finger position is dependent on many factors including the extent and behaviour of the disease itself and the type of surgery required. You can find out more about Mr Oliver’s Clinic at www.orthodoc.aaos.org/chrisoliver.

Sunday 14th February - Skiing Injury

I’m going skiing but haven’t exercised recently - I’m worried I won’t be fit enough, any advice? Gareth, Livingston

 Sarah Paterson is Physiotherapy Team Leader at Spire Livingston Clinic.

Preparation is vital to ensure a happy and safe skiing holiday and avoid injury and muscle ache. If you don’t exercise regularly, improve your aerobic fitness running, power walking or using the elliptical trainer. Skiing is great exercise as it uses all the main muscle groups, but unless you strengthen them specifically, post-exercise soreness and fatigue will quickly affect you.

Strengthen thighs and buttocks with half squats, leg press or cycling. Prepare your body by staying flexible too. Stretch thighs, hamstrings (back of thigh), calves and lower back before and after skiing to help avoid muscle stiffness. Follow your day with a bath and/or a swim to relax tired muscles. Remember - always ski within your limits to avoid accidents and possible injury.

For further information contact Spire Murrayfield Hospital (0131 316 2537) or Spire Livingston Physiotherapy Clinic (01506 448181) or visit our Physiotherapy website: www.physiotherapyscotland.com

Sunday 7th February - Weight Loss

I have a healthy diet, look for reduced fat, no added sugar products and often buy vegetarian choices. Why can’t I lose weight? Rachel, Portobello

Lorraine McCreary is a dietician at Spire Murrayfield Hospital and for Weight Loss Surgery Scotland.

Weight loss relies on burning more energy than you intake from food and drink. If that balance is wrong you cannot lose weight. 

It is good to read labels but you must understand what you read. ‘Reduced fat’ simply means less fat than another similar product, calories can be added via sugars and total calories can be high. ‘No added sugar’ does not literally mean no sugar, this statement is often found on drink products that are naturally high in sugars and high sugar content equals high calorie content. Vegetarian choices can often be high in oil or nut content and ‘vegetarian’ is not synonymous with low calorie content.

Read your labels. Better still, steer clear of processed foods. Have lean meats, fish, lots of fruit and vegetables and cut down on your carbohydrates.

Lorraine is part of our Weight Loss team at Spire Murrayfield. You can learn more about Weight Loss management and surgery on our service webpage.