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Ask Dr. Arun Phophalia Your Own Question
Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor (MD)
Category: Health
Satisfied Customers: 32545
Experience:  MBBS, MS (General Surgery), Fellowship in Sports Medicine
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My son, Arman, plays soccer a lot, and a few months back he

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My son, Arman, plays soccer a lot, and a few months back he had pain in his leg. I took him to a sports doctor and I was told that my son has hip adductor muscle pain due to overexercising. So my son was told to rest for 3 weeks and then go back to soccer. He did and he was fine for a while. But around 3 weeks ago the pain came back again after playing with cleated shoes on rough terrain. Again, he rested for 10 days this time, stretched daily and went back to playing. The pain is much lighter than 3 weeks ago, but it always hurts when he starts running fast. It does not hurt during stretching or regular jogging. What shall we do? We are very worried because he has a soccer trail coming up in 3.5 weeks.
Pateel (Arman's mom)

Hello Pateel,
I am Dr. Arun and will be helping you today.

Following measures collectively are likely to help him;

1) A specific and goal-directed Physical Therapy program; strengthening, apart from stretching exercises have significant role. This exercise plan ideally should be supervised by a physical therapist.

2) Transcutaneous electrical nerve stimulation (TENS) can be considered in resistant cases.

3) Iontophoresis and phonophoresis

4) Short wave diathermy; all these above are done at physical therapy centers.

5) Anti-inflammatory analgesics

6) Local analgesic cream / ointment / patch / spray

7) Swimming do help as water buoyancy helps in strengthening of the lower limb muscles.

 

An ultrasound or an MRI would diagnose the exact issue.

Please feel free for your follow up questions.

I would be happy to assist you further, if you need any more information.

Thanks for using Just Answer.

 

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Customer: replied 3 years ago.

Thank you for your prompt and helpful answers. I have four more questions please:


1. The doctor said that as long as my son is only feeling pain while running fast or kicking the ball strongly, it means there is no inflammation is that correct? Therefore he does not need anti inflammatory pills


2. If he takes pain killers like panadol or tylenol or aspirin before he exercises will that help minimize the pain?


3. He is doing a lot of swimming, basically crawl, is that enough? Or should he also do breaststrokes?


4. If he applies a local analgesic cream before exercising does that relieve the pain? And please send me the names of a couple of local analgesic creams


 


 

You are very welcome, Ms Pateel,

Following are the answers;

1. The doctor said that as long as my son is only feeling pain while running fast or kicking the ball strongly, it means there is no inflammation is that correct? Therefore he does not need anti inflammatory pills.


It is not right. Pain in any activity point that there is some inflammation. Sporting injuries usually are combination of muscle strain, ligament sprain and tendonitis.


2. If he takes pain killers like panadol or tylenol or aspirin before he exercises will that help minimize the pain?


Yes, that would help. Ideally he should take Panadol twice a day for about 10 days regularly. That would help in healing.


3. He is doing a lot of swimming, basically crawl, is that enough? Or should he also do breaststrokes?


Crawl and breast stroke (if it is not painful), both would be better.


4. If he applies a local analgesic cream before exercising does that relieve the pain? And please send me the names of a couple of local analgesic creams.


Creams with Diclofenac sodium would be best. Applying it before the exercises would help.

 

It is privilege assisting you.

Customer: replied 3 years ago.

Ok we are getting there:) Thank you.


As far as Question #1 goes, shall I resort to anti inflammatory pills just yet? Maybe I should try your other suggestions first? Because I believe anti inflammatory pills have side effects, am not sure.


As far as Question #2 goes, should he take one panadol each time or two? He is 15 years old


As far as Questions 3 and 4, it's clear


 

You are most welcome.

A supervised physical therapy program, local analgesic cream / spray, deep electrotherapy (short wave diathermy, electrical stimulation, iontophoresis), swimming can be tried initially for 5-7 days. If these give adequate pain relief, he may continue them. If the pain or discomfort returns during playing, Panadol, one tablet twice a day for 7-10 days should be tried.
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Customer: replied 3 years ago.

Hello again Dr


My son is asking should he stop playing soccer as soon as he feels a slight pain? Or should he continue playing? Also should he stop playing soccer for a few days while he is going to physiotherapy sessions?

Yes, a pain prohibits the activity. So a graded activity would be advised. All painless activities can be continued. So if he has no pain for playing sometime, he may continue it and once pain comes; he should stop it.
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Customer: replied 3 years ago.

ok thx a lot noted.

You are most welcome.
Customer: replied 3 years ago.

Hello Dr Arun,


 


My son is feeling better now, thank you. He continued doing the hip adductor stretches his physio therapist had told him to do. He also took a panadol and rubbed an analgesic cream this morning before going jogging, and he felt very well, no pain at all. He sprinted, shot some balls (soccer), etc. Felt normal.



So does this mean he is completely healed? I mean, can he go back to soccer practice as usual? He has one tomorrow for one and a half hour.


I am worried the pain will come back. Please advise.


Best,


Pateel

You are very welcome, Pateel.

This may be healed. But please remember, he needs to increase the game very slowly. Start with 5-10 minutes of sports participation. Increase 5-10 minutes every 3-4 days. So there won't be recurrence.

Best regards.

Dr. Arun
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Customer: replied 3 years ago.

Ok, makes sense, thanks again Dr Arun.


Pateel

You are very welcome, Pateel.
Customer: replied 3 years ago.

Hello again Dr Arun,



Follow up #2:) So my son did play soccer on Tuesday, and felt no pain at all, very relieving. He applied the analgesic cream you told us about, and took one panadol before practice. Yesterday, Thursday, he went to practice again. He did feel a slight pain once or twice, but as soon as he did a couple of stretches, the pain went away, and he continued. Now, he is fine no pain. What is your opinion on this?


I have another question: he applied the cream about an hour before practice yesterday, while on Tuesday he applied it 30 minutes before. Would that be the reason?


Looking forward to your suggestion.


Best,


Pateel

Hello and welcome Pateel,

 

The analgesic cream has a very small role, though he need to continue applying it. So definitely he is improving, which is heartening. Now the advise is just to go slow and very gradually increase the duration of participation is sports. That will prevent the recurrence of pain.

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Customer: replied 3 years ago.

Hello again Dr Arun,


Arman, my son, is doing much better now, thx for your advice. For the last 3-4 weeks or so he has been applying the Voltaren Emulgel three times a week, two times a day. So as of now he has applied it for a total of around 20 times. He has very slight pain rarely, but he still wants to use the gel (it may be psychological:)) Can he go on using it for a couple more weeks? Or is it unhealthy to do so? Please advise.


Thank you.

You are very welcome Ms Pateel. He can continue applying for the same frequency for next 1-2 weeks. The absorption in the body is small amount and is unlikely to be harmful.
Customer: replied 3 years ago.

Ok, great, thank you Dr.


Pateel

You are always welcome, Pateel.