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