Physiotherapy Post Shoulder Surgeries: You should not be doing Hard Work!!

If you have undergone shoulder surgeries and if you are working hard initial days with exercises then probably you are not going anywhere!!   

Shoulder injuries have been one of the most frequently seen in sports enthusiasts as well in others. 

Shoulder dislocations and rotator cuff tear or injuries are most commonly seen in daily OPD. 

Non-surgical intervention especially Physiotherapy is highly effective in most of the problems. But sometimes major injuries need surgical interventions like Arthroscopic surgeries which helps needy patients to get back to normal shoulder function.

We see most of our patients doing hard work to get the strength & Flexibility to achieve early normal functionality and early recovery. At the same time, every patient says that "Sirrr, I am working hard but it's not getting better, What wrong" Ayyoorama...

After some time either patient will start feeling negative about the recovery or they will start living with pain & mild disability. That negative thought may not make him back to his potential functionality, Isn't it ??

Physiotherapy intervention in shoulder injuries or post surgeries rehabilitation needs to be very precise and skillful. The physiotherapist works deliberately with each and every muscle & joint in and around the shoulder complex.  

Every movement & muscles have their own specific role & responsibility in the functional activity. Re-training for those movement & muscle needs a specialized plan and execution in a specific manner and timely.

Why I specifically mentioned about the shoulder, because the shoulder is highly unstable and every movement is controlled by more than one specific muscle. 

Many a time, we see some of our patients come back with either increased pain or worsening the scenario of shoulder function. That does happen when we start working hard with exercises initial days. Un-knowingly we try to intent early recovery by doing too many exercises or too many reps. 

When the joint is operated or injured some of the tissue/muscles is not working appropriately and same time excessive exercises allow other muscles to compensate for the task and muscles functions start developing in the wrong way. 

That's where we say OMG!!

Dear Friends with shoulder problems and post-operative stage, please do not try to work hard it not healthy always. Under the skillful Physiotherapist, guidance gets your shoulder function back to the best potential level and enjoy a healthy life. 

Returning to sports after shoulder injuries need an integrated and comprehensive training of the joint. 

 Thank you

DR ARUN KUMAR RAWAL, PT

MPT {Musculo-Skeletal & Sports Injuries}

+91-9986855650

drrawal@peopletreehospitals.com

  

    

Pelvic Girdle Pain: Pregnancy & Post Delivery Induced Back Pain !!

What is Pelvic Girdle Pain?

Pelvic girdle pain (PGP) is an umbrella term that describes pain, instability, limitation of movement and function of the pelvic joints (Sacroiliac joint and Symphysis Pubis joint).  PGP is a most commonly reported musculoskeletal disorder during pregnancy, post-partum and in young adults although the degree of affliction spans over a wide range.

What is the prevalence?

Recent research suggests that almost every second pregnant women are suffering from PGP, it is highly prevalent in late pregnancy and falls substantially during the first 3 months post-partum. PGP is also highly prevalent in sportsperson due to high physical demand and minor repetitive strains to the pelvic joints.

What causes Pelvic Girdle Pain?

PGP arises most likely because of a combination of several factors allowing abnormal stress on the pelvic joints such as:

1. The weakness of muscles around the pelvis and Hip.
2. Uneven movements in the joints.
3. Minor trauma.
4. Tightness in muscles.
5. Strenuous Physical work.
6. Faulty sitting and Standing posture.

How does PGP affect a person?

PGP characterizes itself as a Dull ache or a Sharp pain in the lower back, groin, inner thigh and sometimes at the back of the thigh.

The most common complaints of people with PGP are:

1. Difficulty in lifting leg straight up.
2. Difficulty to stand on one leg.
3. Pain while turning on the bed.
4. Pain while trying to stand up from sitting.
5. Difficulty to sit/stand/walk for a long duration.
6. There can also be an association with bladder dysfunction (Urinary Incontinence)

What is the difference between Low Back Pain and PGP?

Differentiating between Low Back pain and PGP will require exquisite professional assessment skills. In general, Low back pain generally characterizes itself as a dull aching pain in the low back and aggravates with bending forward movement with tenderness in the spinal muscles. Whereas, PGP is experienced in between the posterior iliac crest and gluteal fold (typically near the Sacroiliac joint).

What is the treatment for PGP?

According to current evidence, the first line of treatment for PGP is Physiotherapy. The most commonly used treatment approaches are Manual therapy (to develop the normal function of joints); tailored exercise programs (to allow normal muscle and joint function); pain reduction using electrotherapy.

A sacroiliac belt is advised for a severely malfunctioning pelvic joint for time being to prevent further stress on joints.

In rare cases where physiotherapy is not beneficial, the patient might require intra or extra-articular injections.

Regards: Dr Arun Kumar Rawal, PT

+91-9986855650

Soccer Child With Knee Pain: IT CAN BE OSGOOD-SCHLATTER DISEASE

OSGOOD-SCHLATTER DISEASE

Name looks quite scary, isn't it!!

Truly speaking its very common in Bangalore especially in growing adolescents with vigorous sporting activity and its NOT A BIG DEAL.  

Osgood-Schlatter disease: Its a repetitive stress injury leading to inflammation of the area just below the knee where the tendon from the kneecap (patellar tendon) attaches to the shinbone (tibia).

It's quite common to see in the soccer players, runners and the jumping sports activities. 

It happens mostly due to growing bones and also sometimes due to improper warm-up, not doing flexibility exercises. 

Children usually represent with pain just below the knee, swollen area and inability to play and run. Its start slow and gradually and with few days or week it becomes bad disabling to continue sports if the appropriate action is not done. Over a period of time thigh muscles start developing weakness results in poor performance, balance, coordination, and pain become dominant. 

Some time X-ray may represent like a minor fracture, but in reality, it's not a fracture.

It's a growing bone which is getting repetitive tensile stress from the thigh muscles (called the quadriceps) and patella tendons. 

Osgood-Schlatter disease needs special care from Sports Physiotherapist or the doctor. 

Initially, Physio needs to off-load the tibial tubercle and patellar tendon by any external forces may be by taping.  Off-loading to reduce repetitive tensile stress and allow relative rest to the painful area while continuing graded physical activity. 

Following that, Physical rehabilitation to achieve muscular flexibility, strength, Proprioception and Balance, coordination and agility.

Most crucial to remember in growing adolescents bones are fragile and it does not need plyometric training. 

Thank you 

Dr. Arun Kumar Rawal, PT

Musculo-Skeletal & Sports Physiotherapist

+91-9986855650

Pain the Shins : STOP'S YOU TO RUN !!

Shin Pains, The most common exercises or running related problem, known as "Shin Splints". 

Mostly all runner's must be experienced !!

Shin pain is usually experienced during and after physical or sports activity in the front of your leg bones. Pain feels like a sharp throbbing variety of pain and some time shin pain does not allow you to stand and walk especially in runners and bowlers. 

It's primarily due to the muscles & soft tissue repetitive stress injury. Repetitive stress to the muscles could be due to many musculoskeletal possibilities like flat foot, tight calf muscles, poor ankle joint mobility or some time because of not doing an appropritate warm-up. 

Two muscles which are the culprit in the Shin Pains: 

• Tibialis anterior &
• Tibialis posterior 

Treatment and Rehabilitation are straight forward in case of Tibialis anterior originated shin pain as its commonly due to poor flexibility of the leg muscles. 

But in case of Tibialis posterior originated shin pain needs specific rehabilitation to recovery. Kinesio tap application, Ice, foot posture correction and muscle re-training become the main objective. 

Tibialis posterior involved shin pain takes a longer duration to recover as well need highly specific rehabilitation. 

Feel free to contact me personally for further details. 

Regards 

Dr. Arun Kumar Rawal, PT

MPT- Sports & Musculoskeletal Injuries

Mob: +91-9986855650

Athletes: Let's Check the sense of position, motion & muscles sense of Force or effort

Proprioception & Sports

Its body's own sense of position & motion, which includes body segment static position, displacement, velocity, acceleration, and muscular sense of force or effort.

Proprioception allows to good stability & move body segment efficiently, accurately, & effectively to accomplish a given task in a specific environment.

Compromised Proprioception can result in poor performance & can be a major cause of the high risk of injury during sports activity as at that moment body needs good stability, & effective body movement with appropriate muscles forces.

So, Let's Check sense of position, motion & muscles sense of Force or effort with the help of cost-effective & time-saving Biosensory analysis to excel in sports performance with minimal risk of injury.

Bio-Sensory Proprioception Analysis interpret: 

Ankle-Hip Stability, COM stability & movement, Cost-effective, Time-saving

Muscles Function Analysis interpret: 

Flexibility, Strength & Core

Proprioceptive Training:

Balance training, Posture correction and Muscle function Training 

Above 3 component are the core Physical parameters for an athlete to excel in performance with minimal risk of injury. 

Regards 

Dr Arun Kumar Rawal, PT

Sports & Musculoskeletal Rehabilitation

+91-9986855650

For Runner's: Joint Positional Sense & Injury Prevention

Running related sports injuries are most devastating as well as disabling to run. 

Minor most injury post running could be persistent soreness or major most could be serious Physical or Physiological injuries, can be prevented with specific sports injury preventive measures.   

Frequently seen Running sports injuries: 
We will have descriptive information about each in Future blogs.

• Shine pain in the legs
• Cramps 
• Runner's Knee pain 
• Acute Knee pains
• Groin pain 
• Back Sprain: Stiffness associated Back pain 
• Heel Pain
• Thigh pain: Hamstring Muscles pain 
• Persistent Tightness of muscles etc. 

Most of the running-related musculoskeletal injuries can be prevented or treated with appropriate running specific Physical & Physiological fitness testing. 

Proprioception (Joint positional sense) assessment of ankle & hip is crucial to effectively evaluate the stability and muscles function of the legs and trunk. 

Compromised Proprioception or Joint positional senses become the culprit for high risk for ankle, knee, hip and back injuries. As effective Joint positional senses are the result of good trunk and leg muscles function. This can happen in any sports or physical activity and can be the reason of injury.   

Bio-sensory proprioception analysis can tell us the descriptive values to holistically evaluate a running and stratify the risk of injury. 

Bio-sensory analysis is time saving and cost effective to prevent those devastating and disabiling sports injuries. 

Preventive Physical Therapy and fitness training can help to prevent the injury as well as improve the performance.

So, 

Don't get into pain, Enjoy the Run... 

For more details you can contact me directly to me on below mention number. 

Regards 

Dr. Arun Kumar Rawal, PT

Musculoskeletal & Sports Physiotherapist 

+91-9986855650

Ankylosing Spondylitis (AS): Missing Link to get Relief

Ankylosing Spondylitis (AS)

General information to understand What is Ankylosing spondylitis, how it affected and how to treat it.

AS is a form of arthritis which can make your neck, lower back and buttocks feel painful and stiff. In some people, gradually it can also affect the shape of the spine.“Ankylosing” means “fusing together”. “Spondylitis” means “inflammation of the spine”, which causes stiffness, tenderness, and discomfort.

The sacroiliac joints are commonly affected in AS. These joints connect the base of your spine to your pelvis. Other joints, such as the hips and shoulders, can also be involved. AS can also affect other parts of the body, such as the eyes, skin, bowel, and lungs. The symptoms of AS usually begin between the ages of 15 and 45 years.

The severity of AS symptoms varies greatly. Some people will have mild neck/back pain and discomfort for short periods; others will have severe pain and stiffness in several parts of the body for a long time. In severe cases, AS can seriously impact on everyday life and lead to disability.

Significant medical advances in recent years mean that new treatments and Physiotherapy Rehabilitation can reduce the pain associated with and symptoms of the condition and help improve the quality of life for people living with AS.

What causes Ankylosing Spondylitis?

At the moment, it is not known exactly what causes AS. However, a combination of environmental and genetic factors may make you more likely to have AS. Environmental factors such as infections may also be involved.

What are the symptoms?

Although the symptoms of AS vary from person to person, and between men and women, they include:

 Ref:LAUREN GELMAN

• Pain and stiffness in the lower back and buttocks, worsening over weeks or months.

• Pain and stiffness that is worse in the mornings and during the night, but may be improved by light exercise.

• Mild fever.

• Loss of appetite.

• Pain and tenderness in the ribs, shoulder blades, hips, thighs, and heels.

• Fatigue.

• Mild to moderate anemia (shortage of red blood cells), which can make people pale, tired and short of breath.

• Inflammation of the bowel.

• Inflammation of the eyes (iritis or uveitis), making them painful, watery, red and sensitive to bright light.

How is it diagnosed?

Many people in the early stages of AS think they have common back pain and do not seek help. However, it is important to have AS diagnosed as early as possible as there are many effective treatments available. Your doctor will diagnose AS from your symptoms, a physical examination, and blood tests to measure levels of inflammation. Your doctor may also order x-rays of your spine, but these tests can all be normal in the early stages. If your doctor suspects you have AS you should consult a Rheumatologist, a doctor who specializes in AS.

Can AS be cured?

Currently, there is no cure for AS. However treatment for AS has improved dramatically, with new medicines that are extremely helpful in controlling the condition. Be vary of any products or therapies that claim to cure AS.

What are the right treatments for AS?

A Rheumatology Team: 

• Patient himself
• Rheumatologist
• Specialized Physiotherapist

Your Rheumatologist will tailor your treatment to your symptoms and the severity of your condition. There is no way of predicting exactly which treatment will work best for you. Each treatment has its own benefits and risks. Your doctor may need to try several different treatments before finding the one that is right for you.

Treatment for AS usually involves: Advised medicine and Individually tailored exercise protocol by Physiotherapist.

DR.ARUN KUMAR RAWAL, PT

PHYSIOTHERAPIST

MPT- Musculoskeletal & Sports Injuries

Tips to Relieve from Painful Frozen Shoulder

Frozen Shoulder

5 tips to Relieve from Painful Frozen Shoulder

Note: Please click on below image files 

Regards

Dr Arun Kumar Rawal, PT
MPT (Musculoskeletal & Sports Injuries)

Athletes: Take care its Hot now !!

Weather is being hot and in this weather body and muscles demand more fluid & water.

Appropriate fluid intake is crucial for long lasting sports. Especially Runners, football and cricket etc.

Drinking water before, during and after workouts regulates your body heat, supplies nutrients and oxygen to your body and removes waste products.

But are you aware that proper hydration is also an important approach of preventing major injuries ?

Dehydration allows muscles to get fatigue faster and performance goes down significantly due to inadequate supply of nutrients and oxygen to the muscles & body.

In hot weather, fluid expenditure to control the body temperature become high and supply to muscles comparatively comes down. That allow muscles to fatigue faster. Fatigue muscles is highly prone to get injured as these muscles are not able to work at their level best due to no energy. Muscles have protective reaction to minor stress or injuries in musculoskeletal system normally but decrease in energy levels compromise this protective mechanism resulting in high risk of injury.

For recovery after sports activity, muscles and soft tissue need sufficient water intake. Insufficient water can affect the post physical exertion recovery. Muscles remain in soreness which results in myofacial tightness.This myofacial tightness affects generalised joint mobility and can be the reason for muscles cramps/catch in the back and hip region.

Symptoms of dehydration include:

• Dryness of the lips, mouth or tongue
• Reduced energy
• Urine changes: Infrequent urination, a small volume of urine, or dark urine
• A sudden decline in mood, strength, coordination, or the ability to make decisions

Many people don't realize that hydration affects the musculoskeletal system, as well.

Keep Calm and Drink Water.

Thank you

Work Related Musculo-Skeletal Problems

Please click on the image file. Thank you 

Heel Pains... PAINFUL STEPS !!!

Please click on the below image file. Thank you

Pelvic Girdle Pains: Its not always lower back

Please click on the image file. Thank you 

MOUSE SYNDROME

MOUSE INDUCED ELBOW PAIN

Computer is an part of our day today life and if we are not healthy then life can be difficult to live happily.

Computer users who spend maximum time with computers and mouse ie IT professionals, accountants etc, are always on risk to develop multiple work related musculoskeletal health disorders, Mouse syndrome is one of them.

Almost all variety of work related musculoskeletal health disorders are due to repetitive stress to muscles or joints because of poor posture during work or weak muscles strength and joint mobility as well as flexibility.

ELBOW PAIN INDUCED BY MOUSE USE LABELLED AS MOUSE SYNDROME.

Long duration work with pronated forearm and poor physical exercise does not allow pronator to maintain flexibility to have complete supination movement.

                                      

Tightness of pronator muscles induced repetitive stress to common wrist extensors at the side of the elbow and being the cause of irritation to the muscles (lateral epidonylitis) of the same.

Patient presents with elbow pain as in tennis elbow because the patho mechanics is the same in the joint and muscles, causative factor is mouse !!

                                                          

Best method to prevent mouse induce elbow pain is to start forearm muscles flexibility and regular exercises. 

To rehabilitate the pain, along with the flexibility and mobility you need to start correcting ergonomics, regular exercises and if required consult a Physiotherapist. 

Regards

Dr Arun Kumar Rawal, PT

MPT {Musculoskeletal & Sports Rehabilitation}

Arthritis of Knee: Should We do Exercises ?

Muscular weakness is the cause as well as complication of disabling arthritis or knee pain. Knee pain doesn't allow good joint movement and it get restricted and painful.

Muscular weakness, Pain and poor joint movement adversely affects individuals functional capabilities including walking, step climbing, standing for long hours become difficult. Lately, due to significant muscles weakness and arthritis joint start getting deformed either bow leg or knock knee. 

Additionally individuals start putting on weight as physical activity become very less and it further increases the systemic problem.

PHYSIOTHERAPY & Exercises become the crucial to stop this cycle of worsening of your knee pain/Arthritis and overall health.

Musculoskeletal Physiotherapist will Guide you to archive:

• Good muscles strength & Flexibility
• Improve the joint movement
• Weight Control
• Good endurance capacity
• Educate you about how take care of your knee joints
• Help you to develop good quality Healthy life style

Collectively your knee pain and Functional capabilities will improve at the greater extent where you feel active and healthy.

Exercise is Medicine for Arthritic Knee...

Dr Arun Kumar Rawal, PT

MPT (Musculoskeletal & Sports Rehabilitation)

Healthy Back for pain free life

Lower back pain most common as well as disabling, which can be prevented and rehabilitated easily with Physiotherapy and exercises. 

Some of the common exercises which can be performed on regular basis to avoid and live pain free life with our beloved one. 

Following video shows those some of those magical exercises.   

Thank you & Regards 

Dr Arun Kumar Rawal, PT
MPT (Musculoskeletal & Sports Science)

Groin Injuries : Career destroying Sports injury

Groin injuries has been one of the most common cause of stay out the game and/or for poor performance on field. 

Groin Pain or injuries found to be one of the most prevalent variety of Sports injury especially in contact sports like Running, football, badminton, tennis and also in golf. 

The incidence of groin pain is very high in Indian athletics probably due to incomplete information about preventive strategies or not following the preventive measures and also most of time due the inappropriate physical or physiological fitness.

Risk of groin injuries varies from different disciplines of sports and the intensity of Sports activity. Highly prone sports are soccer/Foot ball, tennis, badminton, running, cricket.

Source of groin injuries is commonly from musculoskeletal system involving either the pubic/ hip joint or lower abdominal/hip adductor muscles. Rarely it originate from the spine injury or intra-abdominal organs. 

Most frequently seen groin injuries are:

• Pubic strain/ ostitis pubis: Pubic symphysis (Pelvic Pain) injury due to twisting activity or repetitive loading of the joint with poor stability of core.

• Adductor tendon sprain: Repetitive stress injury to the inner thigh muscles due to poor physical fitness. {Especially poor warm-up}

• Hip joint Labral injury: Major or minor traumatic event involving twisting of leg during collisions or falls.

• Ilio-psoas muscle sprain: Poor physical fitness, less common.

• Inguvinal Hernia: Rarely seen in contact sports players

Diagnosis: 

Most of the groin injuries can be identified based on physical examination and may not need sophisticated investigation. But at the time we may need to evaluate further if physical examination does not revels concluding results or desire outcome after rehabilitation.

Prevention & Rehabilitation:

Fortunately, most of the groin injuries can be prevented as they are musculoskeletal and that needs appropriate strategies.

Preventive measures:

• Good physical fitness especially core stability of lumbo-pelvic-hip region which involve lower/upper abdominals, pelvic floor muscles, hip as well as lateral and back muscles.

• Muscular flexibility and strength of hip adductor and flexors.

• Having the knowledge of preventive strategies: "If I know something then I 'll care for it."

• Early detection and complete rehabilitation in the biggest step to prevent disability to participate in game. 

Sports specialized Physiotherapy rehabilitation is first line of management for almost all variety of groin but rarely it may need surgical procedures like in hip labral injuries. Rehabilitation is based on the stage of recovery, amount of injury.
 

 

Physiotherapist may opt for LASER therapy, Kinesio taping, Myofacial Release techniques and ultimately training the lumbo-pelvic-hip core stability training in most scientific way to achieve early and better results. 

Core stability training got some specific principles and stages (Motor control principles) to train which need a specific Musculoskeletal & sports physiotherapist or fitness trainers to help.

Warm Up: 15 to 20 warm up and warm up techniques is the one which allows you to excel in performance. Do not ignore it!!

Feels Free to contact us for all your queries.

Thank you & Regards 

Dr Arun Kumar Rawal, PT

MPT (Musculoskeletal & Sports)