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Bones feel stress of bad break
Tiffany Fumiko Tay
Tue, Apr 15, 2008
The Sunday Times

Basketball fans the world over cheered when Yao Ming led the Houston Rockets to a 12-game winning streak this season.

But not many of them realised that all that time on court was taking its toll on the towering centre from China.

In late February, the 2.26m star of the Houston Rockets suffered a stress fracture in his left foot, which has been blamed on exhaustion from continuous playing. And the 27-year-old will now miss the rest of the NBA season.

Worse, he might miss the upcoming Olympic Games in his own country.

After going under the knife in Houston, Texas, last month, he has returned to Beijing to seek the help of Traditional Chinese Medicine (TCM) to speed up the recovery process.

'If I cannot play in the Olympics for my country this time, that would be the biggest loss of my career up to now,' he has been quoted as saying.

A stress fracture, unlike other fractures, does not result in the 'through and through' breaking of the bone, says Dr Patrick Goh, consultant sports physician from SportsMed Central at Gleneagles Hospital.

Rather, it is the result of repeated cycles of micro-trauma with inadequate repair to the bone, causing it to weaken over time.

Ms Lim Lay Beng, a TCM physician for YS Healthcare, calls it an 'overuse injury' which occurs when the muscles become fatigued and are unable to absorb added shock. The fatigued muscles then transfer the stress overload to the bone, causing a tiny crack, she says.

It is often the result of an increase in the amount of intensity or activity or improper equipment or shoes.

But that doesn't mean couch potatoes can heave a sigh of relief - this injury isn't restricted to just professional sportsmen and women. Tall stature, obesity, wearing high heels, osteoporosis, dietary abnormalities and menstrual irregularities can also contribute to stress fractures.

Military personnel are also prime candidates due to their intense training.

Symptoms include pain which persists even during rest, swelling and pain in a particular spot when touched.

As in the case of Yao, the problem can be treated with both Western medicine and TCM.

According to two Western doctors and two TCM practitioners LifeStyle spoke to, different emphasis is placed on treatment.

According to Dr Wu Yue, TCM physician for Raffles Chinese Medicine, TCM treatments for stress fractures do not require surgery. Instead, plasterboards and casts are used for immobilisation, followed by acupuncture and acupressure.

Herbs are also used to strengthen the tendons and bones, and promote blood circulation.

Ms Lim adds that the qi, or vital force that Chinese medicine considers essential to good health, of the injured area can be improved with these treatments and massage therapy.

In the world of Western medicine, however, treatments vary depending on the site and severity of the fracture.

They range from six to eight weeks of rest, to physiotherapy and muscle strengthening, to shock therapy and, in severe cases, surgery.

Dr Andrew Dutton, a consultant from the Division of Sports Medicine at the National University Hospital, says that recovery time could vary between four and 12 weeks, depending on the site and severity of the fracture and anticipated physical demands on the person.

Dr Wu estimates a general recovery time of three to six months with TCM treatments.

Ms Lim, however, recommends the combination of both Western and Chinese medicine to speed up the healing process.

'Western medicine treatment includes surgery with pain medication and Chinese medicine will help with the reduction of swelling, pain and scar healing,' she says.

Left untreated, the stress fracture can worsen and possibly become a complete fracture of the bone, says Dr Goh.

tiffanyt@sph.com.sg

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TAKE THESE STEPS

As they say, prevention is better than cure, so here are the steps doctors advise to take:

  • Use proper footwear to suit your foot type and the activity, avoid excessive training on hard surfaces such as roads
  • Replace your shoes every 500 to 1000 kilometres to ensure adequate mid-sole cushioning
  • Do muscle-strengthening exercises and address muscle imbalances that may result in the overloading of weight on the bones
  • Have a healthy diet with sufficient calcium and Vitamin D, which have been proven to significantly reduce the risk of stress fractures.

This story was first published in thesundaytimes on Apr 13, 2008.

 

 
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