The Association of Southeast Asian Nations (ASEAN) member states are Brunei Darussalam, Cambodia, Indonesia, Laos, Malaysia, Myanmar, the Philippines, Singapore, Thailand, and Vietnam. As of 2024, ASEAN countries have a combined population of 678 million, making it the third most populous region in the world.

Mental disorders rising sharply

More than 80 million people across ASEAN are currently living with mental disorders—an increase of 70% since 1990. Anxiety disorders were the most common, and the mental health burden has grown most among children, teenagers, elderly individuals, and women. The 15–19 age group experienced the sharpest rise in prevalence, and among adolescents aged 10–19, mental disorders now account for more than a quarter of the overall disease burden in high-income ASEAN countries. Singapore recorded the highest rates of burden in this age group. Although prevalence increased by less than 3% among people aged 70 and older, the number of older adults affected jumped by 183% in absolute terms.

Heart disease is the top killer

Cardiovascular disease (CVD) is now the leading cause of death and disability in ASEAN, with 37 million people affected and 1.7 million deaths recorded in 2021. From 1990 to 2021, cases rose by 148%, while prevalence saw a 3% increase. Laos, Indonesia, Myanmar, Cambodia, the Philippines, Vietnam, and Malaysia reported CVD death rates above the global average. Men had higher rates of both disease and mortality than women. Ischemic heart disease, stroke, and peripheral artery disease were the most common forms. Top contributing risks included high blood pressure, poor diet, air pollution, and smoking.

Tobacco Use Remains Widespread

Despite some progress in reducing smoking rates, the number of smokers in ASEAN increased by 63% since 1990, reaching 137 million in 2021—roughly 12% of global smokers. Smoking is highly prevalent among males, with nearly half of adult men smoking across the region and 58% in Indonesia. Youth smoking is on the rise, particularly in Cambodia, Malaysia, and Indonesia. Alarmingly, in Malaysia, 20% of boys aged 10–14 smoke. Smoking-related illnesses led to over half a million deaths in 2021—an increase of 231,000 since 1990—with ischemic heart disease, stroke, and chronic lung disease as the top causes.

Injuries, accidents, and violence

Accidental and intentional injuries continue to cause high levels of death and disability. Road injuries are the most common cause of injury-related deaths, especially in Thailand and Malaysia, where road fatalities are among the highest in the world. Falls, self-harm, drownings, and violence also pose significant health threats. Self-harm was the top injury-related cause of death in Singapore and a leading cause in several other countries. Children aged 5–9, especially girls, faced the highest burden from drowning and falls.

Researchers say without urgent intervention, these preventable causes of death and disability will only worsen as the region’s population ages and economies develop.

By Dr Abdul Razak Hussin, Consultant Orthopaedic and Sports Surgeon,  Ara Damansara Medical Centre (ADMC)

Who is at risk?

Knee injuries can affect anyone, not just athletes. Whether you run, play sports on weekends, or hike, a sudden twist or misstep can cause serious damage. The most commonly injured knee structures are the anterior cruciate ligament (ACL) and the meniscus, a C-shaped cartilage that cushions the joint.

Despite this, many ignore knee pain, assuming it will heal on its own. Unfortunately, untreated ACL or meniscus injuries can lead to instability, chronic pain, and early arthritis.

How do these injuries occur?

Knee injuries result from either direct impact (e.g., a football tackle) or sudden, non-contact movements (e.g., twisting while the foot remains planted). Many individuals report hearing a distinct “pop” at the time of injury, followed by swelling and pain. In severe cases, the knee becomes unstable, making movement difficult.

Mild injuries may allow continued activity, but without treatment, symptoms often worsen over time.

Do you need surgery?

Treatment depends on the severity of the injury. Mild cases may improve with physiotherapy and strengthening exercises, while severe ACL and meniscus tears often require surgery.

Doctors typically use X-rays to rule out fractures and MRIs to assess ligament and cartilage damage. If left untreated, a damaged ACL or meniscus can cause ongoing instability, especially during activities like descending stairs or walking on uneven surfaces. This can further damage the meniscus and cartilage, leading to persistent pain and arthritis.

What happens during surgery?

ACL reconstruction replaces the torn ligament with a tendon graft, usually from the hamstring or patellar tendon. Meniscus treatment varies based on severity—doctors aim to repair it when possible, but in cases of extensive damage, a partial meniscectomy may be necessary.

After surgery, most patients start walking with crutches almost immediately. Those undergoing meniscus repair may need to limit weight-bearing activities for proper healing. A knee brace is typically required for about six weeks.

Recovery and rehabilitation

Recovery takes time, and returning to high-impact sports should only be considered after a full year to allow proper healing. Post-surgical rehabilitation is crucial, with modern advancements like bioactive scaffolds, platelet-rich plasma (PRP), and robot-assisted therapy improving outcomes.

Emerging treatments, including stem cell therapy and virtual reality rehabilitation, also enhance recovery and make physiotherapy more engaging.

Early intervention matters

Persistent knee pain, swelling, and instability should never be ignored. Seeking medical attention early can prevent further damage and improve recovery outcomes.

While knee injuries can be accidental, understanding their causes and symptoms allows individuals to seek timely treatment. The goal is to restore function, prevent complications, and help patients return to daily activities pain-free.

By Dr Mazzre Mahmod, Consultant Orthopaedic, Sports & Trauma Surgeon at Bukit Tinggi Medical Centre (BTMC)

From diagnosis to rehabilitation for full recovery

Sports injuries are an inevitable aspect of an athlete’s life, from minor sprains to more serious conditions requiring surgical intervention. Whether they are weekend warriors or professionals, they face a high risk of injury due to the physical demands of their sports. When injuries are severe, orthopaedic surgery becomes essential in ensuring effective recovery and restoring full function.
Prompt diagnosis and intervention can make a world of difference in recovery times and outcomes for athletes. Understanding the nature of the injury is the first step toward successful rehabilitation.

Sports injuries are generally categorised into two main groups: bone injuries and soft tissue injuries. Both categories often require surgical intervention, depending on the severity of the damage.

Types of sports injuries

Bone Injuries – Bone and stress fractures are quite common, especially in high-impact sports like football or basketball. These injuries may occur due to sudden trauma, such as a fall or a direct blow during a game. These fractures must be addressed quickly to prevent long-term complications like improper bone healing or loss of function.

Soft Tissue Injuries-Ligament, tendon, and cartilage injuries comprise a significant portion of sports-related injuries. Anterior Cruciate Ligament (ACL) and Medial Collateral Ligament (MCL) injuries, often seen in athletes who play sports involving quick direction changes like football and badminton, typically require surgical repair to restore joint stability. These injuries can compromise the stability of the knee, and surgery is often necessary to restore normal function.

Meniscal tears are another common issue, particularly in sports, like running. When cartilage is damaged, minimally invasive procedures like arthroscopy are used to repair or remove the injured tissue.

Early diagnosis and treatment can significantly improve recovery times and outcomes. Athletes who delay treatment often face longer rehabilitation periods and increased risk of re-injury.

Common sports injuries and mechanisms of damage

Some of the most common sports injuries that require orthopaedic surgery include ligament injuries, cartilage damage, and ankle fractures. Injuries can result from direct contact, such as being tackled in football, or from indirect causes like twisting a joint during an awkward landing. Knowing the mechanism of injury helps us tailor the surgical approach and rehabilitation plan.

Ligament Injuries – Particularly to the ACL and MCL, ligament injuries are common in sports like football and basketball. These injuries typically occur during rapid direction changes or high-impact collisions. ACL injuries can be quite devastating for athletes because they compromise knee stability. Surgery helps restore the knee’s structural integrity.

Cartilage Injuries – High-impact sports can cause significant cartilage damage, especially in the knees and shoulders. Meniscal tears are common among athletes involved in repetitive stress activities like running. Arthroscopic surgery is often used to repair or remove damaged cartilage, which helps reduce pain and restore mobility.

Ankle Injuries – Ankle sprains and fractures are prevalent in almost all sports. Twisting injuries from a misstep or improper landing can result in severe ligament damage or fractures, often requiring surgical fixation.

Age and previous injuries as factors for injury severity, recovery

Age and past injuries play a significant role in determining the severity and recovery of sports injuries. As athletes age, their tissues naturally become less elastic, and healing processes slow down. Older athletes often experience more severe soft tissue injuries, which can take longer to heal, even with surgical intervention. The reduced regenerative capacity in older adults may mean that surgery is not just about fixing the immediate injury but also addressing degenerative changes in the joints and tissues.

Previous injuries also impact an athlete’s recovery. Recurrent injuries, particularly to the same joint or area, can cause long-term instability and weaken the surrounding structures. Surgery may need to be more extensive in these cases to restore full function and prevent future damage. Athletes with previous surgeries, especially involving ligaments or tendons, are more susceptible to re-injury, making prevention and thorough rehabilitation critical components of their long-term care.

MRI in sports injuries

Magnetic Resonance Imaging (MRI) plays a vital role in diagnosing sports injuries. “MRI allows us to see the soft tissues in great detail, which is essential for diagnosing ligament, cartilage, and tendon injuries. However, MRI is not a standalone diagnostic tool. It’s important to correlate MRI findings with the patient’s clinical symptoms and physical examination. This helps ensure that the surgery we plan is both necessary and beneficial for the patient.

Surgical techniques: traditional vs minimally invasive approaches

The evolution of orthopaedic surgery has seen significant advancements, particularly with the introduction of minimally invasive techniques. Traditionally, surgeries for sports injuries required large incisions, leading to longer recovery times. These methods were effective but came with more significant postoperative discomfort and longer rehabilitation periods.
Modern surgery has embraced arthroscopy, a minimally invasive technique that uses smaller incisions and specialised instruments. Arthroscopy allows us to treat injuries like ACL tears and meniscal damage with less trauma to the surrounding tissues. The recovery is faster, and patients can begin rehabilitation much sooner.
With the integration of advanced imaging technologies and more precise surgical tools, these procedures have improved significantly, enhancing both short-term recovery and long-term outcomes for patients.

Recovery and rehabilitation

After orthopaedic surgery, the focus shifts to rehabilitation. “The surgery itself is only half the battle. A comprehensive rehabilitation plan is crucial for regaining strength, flexibility, and mobility. One of the challenges athletes face is staying committed to physiotherapy. Physiotherapy should be viewed as part of the treatment, not just an add-on. I always remind my patients that what they do in rehabilitation will directly affect how quickly and how well they return to their sport.

A balanced diet also plays a vital role in supporting the healing process. Nutrients such as proteins, vitamins, and minerals aid in tissue repair and overall recovery. Structured return-to-sport protocols are key in ensuring athletes don’t push themselves too soon and risk re-injury. We follow evidence-based protocols that gradually reintroduce activity levels while monitoring the healing process. The goal is to get athletes back to their previous performance levels, but safely.

Athletes with a history of repeated injuries face potential long-term consequences. If an injury is not treated correctly or keeps recurring, it can lead to chronic conditions such as early-onset osteoarthritis or permanent joint instability. This makes it vital for athletes to not only recover fully but also focus on preventing future injuries through proper conditioning and training.

Takeaway points

Orthopaedic surgery for sports injuries is an essential tool in restoring athletes to their peak performance. With advancements in surgical techniques, early intervention, and structured rehabilitation, athletes can recover faster and more effectively.

Prevention is always better than cure, but when injuries happen, getting the right diagnosis and treatment quickly can make all the difference in an athlete’s career and long-term health. Maintaining a healthy lifestyle, focusing on injury prevention, and following through with recovery protocols are crucial steps toward long-term athletic success.