Tuesday, June 12, 2012
FROZEN SHOULDER
When Alka Sharma, 51, developed a pain in her shoulder, she assumed she had been "sleeping on it wrong." When the pain didn't go away and her shoulder got so stiff she couldn't comb the back of her hair, she worried she might be developing arthritis.
It wasn't arthritis. Instead, Alka had developed a classic case of frozen shoulder — an excruciating pain, lost movement and, usually, a months-long recovery.
WHAT IS FROZEN SHOULDER??
A frozen shoulder is a shoulder that has become so stiff that the patient usually cannot lift their arm up past shoulder height, cannot put hand in back pocket or tuck in their shirt and has difficulty reaching across under the other arm (i.e. washing the opposite arm pit), Severe night pain and waking Inability to lie on your side at night.
The exact degree of shoulder stiffness present may be variable but in order for a shoulder to be classified as truly frozen there must be significant movement loss.
Clinically Frozen shoulder is also called Adhesive Capsulitis.When the connective tissue called the shoulder capsule becomes inflamed and stiff, it can cause pain and loss of movement.The shoulder capsule should not be confused with the rotator cuff which is made of muscles.
WHAT IS THE CAUSE
It can be of two types
1. primary or idiopathic - where there is no cause known.
2. Secondary - this is possible
*Trauma
*diabetes- Diabetics are more likely to suffer because it is thought that raised blood glucose levels make connective tissues thicker and more sticky, so more likely to adhere to bones.
* Immobilization of shoulder
* cervical spondylosis
* thyroid hormone imbalance
* old age possibly because of inflammation in the ligament and other soft tissues with the age related degeneration.
STAGES OF FROZEN SHOULDER
•Stage 1: The shoulder hurts, especially at night, and the pain worsens with time. "These patients do not sleep," This lasts up to three months. In the first stage, inflammation in the lining tissue triggers the growth of scar tissue.
•Stage 2: The pain continues and the shoulder stiffens; overhead movements are tough or impossible. This can last up to nine months.In the second phase, the sticky joint lining starts bonding to the bones in the joint, forming what are known as adhesions.
•Stage 3: The pain is gone, but the stiffness remains until a gradual thaw sets in. This can last up to 13 month .In the final "thawing" phase, the shoulder gradually regains movement.
PHYSIOTHERAPY TREATMENT FOR FROZEN SHOULDER
Electric Modalities like ultrasound /IFT / SWD can be used to reduce pain and inflammation.
Mobilisation to reduce stiffness and improve range of motion.
Exercises - stretching to improve flexibility , strengthening to improve the strength of shoulder muscles. swinging exercises or pendulum exercise to increase range of motion.Home exercise programme to get an optimal result.
Monday, March 22, 2010
OSTEOARTHRITIS
Today I am going to give certain details of the disease process for a lay man to understand In this post the journey to complete understanding of osteoarthritis and its treatment starts with as to how normal joints work, what happens to them in osteoarthritis and which of the body joints are more likely to develop osteoarthritis.
Osteoarthritis is the commonest form of arthritis or joint disease and is a very important cause of pain and disability in advancing years of life. Some degree of osteoarthritis will develop in everyone in old age .Osteoarthritis has no effect on longevity of persons affected with this disease, but can be quite debilitating in terms of limiting activities and diminishing overall quality of life.
How Healthy Joints Work
Joints are parts of body where one bone meets the other and movement occurs such as elbow, knee, hip and ankle. Backbone or spine also has large numbers of small joints, which allow us to move our neck, and back in all possible directions. Ends of bone which meet each other at joint are covered by cartilage. Cartilage is white, smooth, glistening material and is very specialized which functions as a cushioning material and a shock absorber so that hard bones do not rub against each other, and the cartilage also reduces friction during joint movement since its surface is very smooth. In fact no man made material can match the low friction and shock absorbing properties of healthy cartilage in the joint.
Cartilage is made up of tough fibres of a protein called collagen - Enmeshed in these fibres of collagen are the large molecules of another protein called proteoglycan. Proteoglycan molecules contain lot of water in their interior. Water keeps on moving in and out of the domain of proteoglycan molecules almost like water being sucked in and squeezed out of sponge. This property of ability to exchange water so easily gives an elastic characteristic to the cartilage. Collagen fibres give desired strength and proteoglycan molecules allow reversible compression. The combined structure thus makes up for the tough but not too rigid quality needed for this very specialized tissue.
The bone ends with cartilage covering are enclosed in a membrane called synovium. The synovium releases a slippery fluid know as synovial fluid and this fluid further reduces the friction between moving surfaces capped with cartilage and ensures that the joint moves easily and smoothly. The synovial fluid or joint fluid formed by synovial membrane is a special type of fluid that behaves like fluid when the joint is being moved and during walking when the joint is loaded its character changes to something like jelly to act as an additional shock absorber. The synovial fluid nourishes the cartilage. The cartilage has no blood vessels and relies on synovial fluid moving in and out to provide nutrients and take away the waste products.
Ends of bone, cartilage and synovium are further enclosed in a layer of tissue called capsule. Capsule is a thick and strong tissue but is capable of stretching when joint moves. The combination of bone ends with cartilage covering, synovium and capsule is the joint. The joint is further covered by muscles and tendons, which support the joint and also provide the power to move the joint.
What Happens in Osteoarthritis
In osteoarthritis changes occur both in the cartilage and the synovial fluid.The synovial fluid changes in character and composition and it loses its characteristic capacity to behave in a jelly like manner and act as a shock absorber when the joint is loaded. The cartilage therefore has to sustain more load and impact.
At the same time the cartilage also undergoes subtle changes in chemical composition in a way that proteoglycans decrease and water content increases. As a result the collagen fibrils become disrupted and disorganized. The cartilage has now become soft due to disorganization of tight collagen fibrils, and also swollen due to increased water content. It has thus become less resistant to forces gradually develops cracks or fissures, breaks into fragments usually known as fibrillations, becomes thin and completely disappears in places.
Over a period of time most or all of the cartilage covering at the end of bone may disappear. This is seen on x-ray as gradual decrease and then disappearance of joint space. The loss of cartilage leaves the bone end exposed. Similar changes occur on both sides of the joint and therefore now instead of cartilage moving against cartilage, a situation develops where bone is moving against bone. These changes abolish smooth and frictionless movement at the joint. The broken pieces of cartilage and bone fragments lie in the synovial fluid and this irritates synovial membrane to produce more fluid. This fluid, of course, is not of the same composition and physical character as the normal synovial fluid. The joint swells up due to excessive fluid in it.
Bone rubbing against bone, stretching of joint capsule due to excessive fluid and increased friction in the joint, all three elements produce pain and difficulty in moving the joint. This is perceived as stiffness in the joint as the increased effort required to move the joint. Along with this, the range of joint movements becomes less. The bone ends gradually become misshapen and develop bony spurn at the margins called osteophytes. With advancing disease a part of the end of bone may be extensively rubbed of and this produces severe deformity of the joint. The joint deformity is most easily seen at the knee joint. In advanced osteoarthritis of knee the leg does not remain straight but bends to one side commonly towards inside producing bow leg deformity or sometimes bends outwards to produce knock-knee deformity.
Most common joints affected by it are Knee, Hip, Spine and Hands.
Physical therapy can be used to improve strength in the muscles, splinting to support the joint during inflammation, Taping and elecrtic modalities to reduce pain and swelling.
Readers comments are welcome and also if you want me to write about any disorder which you are intrested to know please let me know.
Osteoarthritis is the commonest form of arthritis or joint disease and is a very important cause of pain and disability in advancing years of life. Some degree of osteoarthritis will develop in everyone in old age .Osteoarthritis has no effect on longevity of persons affected with this disease, but can be quite debilitating in terms of limiting activities and diminishing overall quality of life.
How Healthy Joints Work
Joints are parts of body where one bone meets the other and movement occurs such as elbow, knee, hip and ankle. Backbone or spine also has large numbers of small joints, which allow us to move our neck, and back in all possible directions. Ends of bone which meet each other at joint are covered by cartilage. Cartilage is white, smooth, glistening material and is very specialized which functions as a cushioning material and a shock absorber so that hard bones do not rub against each other, and the cartilage also reduces friction during joint movement since its surface is very smooth. In fact no man made material can match the low friction and shock absorbing properties of healthy cartilage in the joint.
Cartilage is made up of tough fibres of a protein called collagen - Enmeshed in these fibres of collagen are the large molecules of another protein called proteoglycan. Proteoglycan molecules contain lot of water in their interior. Water keeps on moving in and out of the domain of proteoglycan molecules almost like water being sucked in and squeezed out of sponge. This property of ability to exchange water so easily gives an elastic characteristic to the cartilage. Collagen fibres give desired strength and proteoglycan molecules allow reversible compression. The combined structure thus makes up for the tough but not too rigid quality needed for this very specialized tissue.
The bone ends with cartilage covering are enclosed in a membrane called synovium. The synovium releases a slippery fluid know as synovial fluid and this fluid further reduces the friction between moving surfaces capped with cartilage and ensures that the joint moves easily and smoothly. The synovial fluid or joint fluid formed by synovial membrane is a special type of fluid that behaves like fluid when the joint is being moved and during walking when the joint is loaded its character changes to something like jelly to act as an additional shock absorber. The synovial fluid nourishes the cartilage. The cartilage has no blood vessels and relies on synovial fluid moving in and out to provide nutrients and take away the waste products.
Ends of bone, cartilage and synovium are further enclosed in a layer of tissue called capsule. Capsule is a thick and strong tissue but is capable of stretching when joint moves. The combination of bone ends with cartilage covering, synovium and capsule is the joint. The joint is further covered by muscles and tendons, which support the joint and also provide the power to move the joint.
What Happens in Osteoarthritis
In osteoarthritis changes occur both in the cartilage and the synovial fluid.The synovial fluid changes in character and composition and it loses its characteristic capacity to behave in a jelly like manner and act as a shock absorber when the joint is loaded. The cartilage therefore has to sustain more load and impact.
At the same time the cartilage also undergoes subtle changes in chemical composition in a way that proteoglycans decrease and water content increases. As a result the collagen fibrils become disrupted and disorganized. The cartilage has now become soft due to disorganization of tight collagen fibrils, and also swollen due to increased water content. It has thus become less resistant to forces gradually develops cracks or fissures, breaks into fragments usually known as fibrillations, becomes thin and completely disappears in places.
Over a period of time most or all of the cartilage covering at the end of bone may disappear. This is seen on x-ray as gradual decrease and then disappearance of joint space. The loss of cartilage leaves the bone end exposed. Similar changes occur on both sides of the joint and therefore now instead of cartilage moving against cartilage, a situation develops where bone is moving against bone. These changes abolish smooth and frictionless movement at the joint. The broken pieces of cartilage and bone fragments lie in the synovial fluid and this irritates synovial membrane to produce more fluid. This fluid, of course, is not of the same composition and physical character as the normal synovial fluid. The joint swells up due to excessive fluid in it.
Bone rubbing against bone, stretching of joint capsule due to excessive fluid and increased friction in the joint, all three elements produce pain and difficulty in moving the joint. This is perceived as stiffness in the joint as the increased effort required to move the joint. Along with this, the range of joint movements becomes less. The bone ends gradually become misshapen and develop bony spurn at the margins called osteophytes. With advancing disease a part of the end of bone may be extensively rubbed of and this produces severe deformity of the joint. The joint deformity is most easily seen at the knee joint. In advanced osteoarthritis of knee the leg does not remain straight but bends to one side commonly towards inside producing bow leg deformity or sometimes bends outwards to produce knock-knee deformity.
Most common joints affected by it are Knee, Hip, Spine and Hands.
Physical therapy can be used to improve strength in the muscles, splinting to support the joint during inflammation, Taping and elecrtic modalities to reduce pain and swelling.
Readers comments are welcome and also if you want me to write about any disorder which you are intrested to know please let me know.
Sunday, January 17, 2010
What is Repetitive Strain Injury?
The Repetitive Strain Injury is called with diffrent names, computer related injuries, cumulative trauma disorder.
The term "repetitive strain injury (RSI)" and "cumulative trauma disorder (CTD) mean the same thing - a muscle that has been used so frequently, doing the same motion, that is has become injured
Muscles are the reason we can move - when a muscle pulls on a bone, the bone moves. When the bone moves, we can walk, lift our arms, turn our head, wiggle a finger or a toe, in fact it even takes a muscle to blink an eye. Our bodies have 300 pairs of muscles for a total of 600 muscles.
All muscles have similar characteristics
•all muscles pull - they never push
•muscles go in a straight line, not around corners
•muscle originate on one bone and cross over a joint
•muscles merge into fibers called tendons
•the muscle tendon attaches to a bone
•when the muscle pulls the tendon, the bone moves
Muscles are made of many small fibers all lying next to each other, in some cases there are thousands of fibers, merging into the tendon. Each individual fiber works exactly the same way - it contracts and pulls on the tendon. Depending on the amount of strength needed to perform a task, a variety of the fibers will contract (shorten and pull) causing the action to occur. With this amazing system we have the strength to pick up a feather - or a heavy weight. The more fibers contracted, the greater strength expended.
There is a phenomenon called "muscle memory". When a muscle is contracted repeatedly, the brain registers it as needing to be shorter, and it changes the "set-point" of the muscle, making it shorter. Likewise, when a person stretches on a regular basis, the brain registers the change and lengthens the muscle. This lengthening releases the tension on the insertion points of the muscle, and eliminates pain that is caused by the short muscle, or its tendon, pulling on the bone.
When you do the same motion over and over, contracting the muscle continuously, several things happen:
1.The muscle fiber responds to "muscle memory" and permanently changes the muscle to the new shortened length. When this happens a problem occurs because the origination point and the insertion point remain the same, but the muscle is now too short to easily make the distance, so tension is placed on the muscle. While the tension can be at either end, it is more frequently felt at the insertion point at, or just over, the joint.
2.As the muscle fiber is contracting, but the insertion points remain the same, the fiber may tear, causing pain in the muscle.
3.The tendon may begin to tear away from the bone. When this happens the body sends bone cells to the area to hold onto the tendon. The build-up of bone cells forms a "spur". Nothing will stop the growth of the spur while the tendon is being pulled away from its insertion point.
4.If you try to remove the spur, without first releasing the muscle's tension on the bone, it will either quickly return, or the tendon will tear. This is commonly seen when the calf muscles are putting strain onto the Achilles tendon. As the muscles tighten, the tendon is pulled away from the heel, and a spur is formed on the back of the heel.
5.In the case of muscles that insert onto the spine, the vertebre are pulled out of alignment, and pressure is placed on the spinal cord and nerves. While there are many muscles that cause this problem, it is clearly seen in the case of the psoas (pronounced "so-as") muscle. The psoas originates on the lumbar (low back) vertebre, goes around the inside of the hips, and inserts into the front of the thigh bone. When the muscle contracts normally, you bend over or lift your leg. However, when the muscle is shortened by muscle memory, the lumbar vertebre are pulled forward, and the spinal cord is pressed by the moving vertebre. You now have low back pain.
6.Muscles can also trap a nerve, causing pain far from the site of the spasm. This is clearly seen in the case of the muscles of the neck, the scalenes. When the scalenes are in spasm they trap the bundle of nerves that become the nerves of the arm and hand. While the spasm is in the neck muscle, the pain and numbness is felt in the wrist and fingers. Until the spasm is released in the neck, the pain in the hand will not go away.
7.Tight muscle tendons can also trap a nerve, causing the burning pain and tingling common with nerve damage. This is most clearly seen when the flexor (forearm) muscles are contracted, causing the tendons to become taut, and the nerve to the hand is trapped by the tendons. You have all the symptoms of carpal tunnel syndrome, but all you actually are experiencing is the result of muscle tension impinging on a nerve.
8.When a muscle is pulling tightly on a joint, it is common for the joint to become stiff. Many people are told to strengthen the muscles that move the joint - but this is exactly the opposite of what actually needs to be done. The muscles need to be stretched, not strengthened. This is often seen in all the major joints - especially the shoulders, hips, knees and elbows. People will be told to lift weights, squeeze balls, cycle, or exercise to strengthen the muscles that move the joint. As they continue to contract the muscle even further, the joint becomes less and less mobile, and the person is told they have "arthritis", "bursitis", or they may even tear a tendon or ligament.
Repetitive Strain Injury can, and does, happen to muscles throughout the body. Every muscle spasm has its own referred pain area, frequently far from the source of the spasm. The spasms are commonly called "trigger points".
The term "repetitive strain injury (RSI)" and "cumulative trauma disorder (CTD) mean the same thing - a muscle that has been used so frequently, doing the same motion, that is has become injured
Muscles are the reason we can move - when a muscle pulls on a bone, the bone moves. When the bone moves, we can walk, lift our arms, turn our head, wiggle a finger or a toe, in fact it even takes a muscle to blink an eye. Our bodies have 300 pairs of muscles for a total of 600 muscles.
All muscles have similar characteristics
•all muscles pull - they never push
•muscles go in a straight line, not around corners
•muscle originate on one bone and cross over a joint
•muscles merge into fibers called tendons
•the muscle tendon attaches to a bone
•when the muscle pulls the tendon, the bone moves
Muscles are made of many small fibers all lying next to each other, in some cases there are thousands of fibers, merging into the tendon. Each individual fiber works exactly the same way - it contracts and pulls on the tendon. Depending on the amount of strength needed to perform a task, a variety of the fibers will contract (shorten and pull) causing the action to occur. With this amazing system we have the strength to pick up a feather - or a heavy weight. The more fibers contracted, the greater strength expended.
There is a phenomenon called "muscle memory". When a muscle is contracted repeatedly, the brain registers it as needing to be shorter, and it changes the "set-point" of the muscle, making it shorter. Likewise, when a person stretches on a regular basis, the brain registers the change and lengthens the muscle. This lengthening releases the tension on the insertion points of the muscle, and eliminates pain that is caused by the short muscle, or its tendon, pulling on the bone.
When you do the same motion over and over, contracting the muscle continuously, several things happen:
1.The muscle fiber responds to "muscle memory" and permanently changes the muscle to the new shortened length. When this happens a problem occurs because the origination point and the insertion point remain the same, but the muscle is now too short to easily make the distance, so tension is placed on the muscle. While the tension can be at either end, it is more frequently felt at the insertion point at, or just over, the joint.
2.As the muscle fiber is contracting, but the insertion points remain the same, the fiber may tear, causing pain in the muscle.
3.The tendon may begin to tear away from the bone. When this happens the body sends bone cells to the area to hold onto the tendon. The build-up of bone cells forms a "spur". Nothing will stop the growth of the spur while the tendon is being pulled away from its insertion point.
4.If you try to remove the spur, without first releasing the muscle's tension on the bone, it will either quickly return, or the tendon will tear. This is commonly seen when the calf muscles are putting strain onto the Achilles tendon. As the muscles tighten, the tendon is pulled away from the heel, and a spur is formed on the back of the heel.
5.In the case of muscles that insert onto the spine, the vertebre are pulled out of alignment, and pressure is placed on the spinal cord and nerves. While there are many muscles that cause this problem, it is clearly seen in the case of the psoas (pronounced "so-as") muscle. The psoas originates on the lumbar (low back) vertebre, goes around the inside of the hips, and inserts into the front of the thigh bone. When the muscle contracts normally, you bend over or lift your leg. However, when the muscle is shortened by muscle memory, the lumbar vertebre are pulled forward, and the spinal cord is pressed by the moving vertebre. You now have low back pain.
6.Muscles can also trap a nerve, causing pain far from the site of the spasm. This is clearly seen in the case of the muscles of the neck, the scalenes. When the scalenes are in spasm they trap the bundle of nerves that become the nerves of the arm and hand. While the spasm is in the neck muscle, the pain and numbness is felt in the wrist and fingers. Until the spasm is released in the neck, the pain in the hand will not go away.
7.Tight muscle tendons can also trap a nerve, causing the burning pain and tingling common with nerve damage. This is most clearly seen when the flexor (forearm) muscles are contracted, causing the tendons to become taut, and the nerve to the hand is trapped by the tendons. You have all the symptoms of carpal tunnel syndrome, but all you actually are experiencing is the result of muscle tension impinging on a nerve.
8.When a muscle is pulling tightly on a joint, it is common for the joint to become stiff. Many people are told to strengthen the muscles that move the joint - but this is exactly the opposite of what actually needs to be done. The muscles need to be stretched, not strengthened. This is often seen in all the major joints - especially the shoulders, hips, knees and elbows. People will be told to lift weights, squeeze balls, cycle, or exercise to strengthen the muscles that move the joint. As they continue to contract the muscle even further, the joint becomes less and less mobile, and the person is told they have "arthritis", "bursitis", or they may even tear a tendon or ligament.
Repetitive Strain Injury can, and does, happen to muscles throughout the body. Every muscle spasm has its own referred pain area, frequently far from the source of the spasm. The spasms are commonly called "trigger points".
Friday, October 9, 2009
BATTLE WITH PAIN
I am writing it today because I think not only in my practise but all medical practises, we come across various patients who are stressed and they are told your pain is only in head and there's nothing wrong with you... stress leads to pain and pain leas to stress there seems no end to your vicious cycle of pain.
The more people you meet more advices you have professional and otherwise. Definitely some of them are useful and other frustrating.
This article reflects at what a person feels who has been struggling for days , months and years with pain, so I am trying to peep out of the window from the side of somebody who is suffering with pain and not as a physical therapist
"I think if you sit around thinking about your pain too much. Just get out of that house more and it may just heal itself." "If you really wanted to get well, you'd get serious about taking that juice I recommended. I don't understand why you won't at least try it."
Advices advices and here comes something more:-
MANAGING THE PAIN
[1] Release people from the expectations you have of them. This will likely be a life-long process, but without taking this step, you will consistently find that people will always disappoint you.Your illness is significant in your life. And even though people do care, they still will have significant things going on in their own lives. Don't expect them to always be at your call.
[2] Find supportive friends. Is there someone in your circle of friendships who is constantly belittling you or suspicious about your illness? Is he is beyond listening and instead spreading gossip about how he saw you last week and you looked perfectly fine? This should be a relationship to let go of or, if it's a relative, distance your self as much as possible. Illness can help us easily prioritize our friendships and that way we can spend our limited energies with those that mean the most to us.
[3] Find joy in your blessings. Rather than thinking about how badly you feel, find ways to bring more joy into your life. Appreciate the little things.
[4] Use your talents and skills for things you have a personal interest in. Don't allow yourself to feel like the skills you learned in a workplace are no longer valuable. Rather than focusing on what others aren't doing to comfort you, follow your dreams and give that gift to yourself. May be you always wanted to paint or sing ,this what my patient Sujata did , followed her dream , fought her battle of pain and is now an artist from being a computer engineer.
[5] Be a role model for someone else with an illness. You know how hard it is to live with pain and to feel like that no one understands what you are experiencing, so take time to be with someone else who is going through this. Make someones and your own journey easy.
You owe it to yourself to find joy despite your pain , and by focusing on how you can change your circumstances, instead of change other people, you'll be much more personally rewarded. And at the conclusion i would use the words of my friend and patient Azra give the best to yourself as you are worth it.
The more people you meet more advices you have professional and otherwise. Definitely some of them are useful and other frustrating.
This article reflects at what a person feels who has been struggling for days , months and years with pain, so I am trying to peep out of the window from the side of somebody who is suffering with pain and not as a physical therapist
"I think if you sit around thinking about your pain too much. Just get out of that house more and it may just heal itself." "If you really wanted to get well, you'd get serious about taking that juice I recommended. I don't understand why you won't at least try it."
Advices advices and here comes something more:-
MANAGING THE PAIN
[1] Release people from the expectations you have of them. This will likely be a life-long process, but without taking this step, you will consistently find that people will always disappoint you.Your illness is significant in your life. And even though people do care, they still will have significant things going on in their own lives. Don't expect them to always be at your call.
[2] Find supportive friends. Is there someone in your circle of friendships who is constantly belittling you or suspicious about your illness? Is he is beyond listening and instead spreading gossip about how he saw you last week and you looked perfectly fine? This should be a relationship to let go of or, if it's a relative, distance your self as much as possible. Illness can help us easily prioritize our friendships and that way we can spend our limited energies with those that mean the most to us.
[3] Find joy in your blessings. Rather than thinking about how badly you feel, find ways to bring more joy into your life. Appreciate the little things.
[4] Use your talents and skills for things you have a personal interest in. Don't allow yourself to feel like the skills you learned in a workplace are no longer valuable. Rather than focusing on what others aren't doing to comfort you, follow your dreams and give that gift to yourself. May be you always wanted to paint or sing ,this what my patient Sujata did , followed her dream , fought her battle of pain and is now an artist from being a computer engineer.
[5] Be a role model for someone else with an illness. You know how hard it is to live with pain and to feel like that no one understands what you are experiencing, so take time to be with someone else who is going through this. Make someones and your own journey easy.
You owe it to yourself to find joy despite your pain , and by focusing on how you can change your circumstances, instead of change other people, you'll be much more personally rewarded. And at the conclusion i would use the words of my friend and patient Azra give the best to yourself as you are worth it.
Tuesday, August 18, 2009
Neck and Back
Neck & back What is causing my spinal pain?
Spinal pain is something that many people experience at some stage during their life. It brings with it it distress and interruption to our work and social pursuits.
Fortunately serious or permanent damage is uncommon. Your spine is a solid structure of great strength. It is made of bony blocks (vertebrae) which are connected by discs and bands of tough tissue (ligaments) which give it strength, flexibility and shock absorbency. It is reinforced by strong supportive muscles. All these structures have an abundance of nerve endings. If they are under stress or injured they will let you know!
Most simple back strains do not cause any lasting damage. The pain experienced is your body telling you to do something about it!
Physiotherapy and Pain relief:
To bring relief of pain i may utilise any of the following: mobilisation, manipulation, exercises, and electrotherapy.
Spinal pain is something that many people experience at some stage during their life. It brings with it it distress and interruption to our work and social pursuits.
Fortunately serious or permanent damage is uncommon. Your spine is a solid structure of great strength. It is made of bony blocks (vertebrae) which are connected by discs and bands of tough tissue (ligaments) which give it strength, flexibility and shock absorbency. It is reinforced by strong supportive muscles. All these structures have an abundance of nerve endings. If they are under stress or injured they will let you know!
Most simple back strains do not cause any lasting damage. The pain experienced is your body telling you to do something about it!
Physiotherapy and Pain relief:
To bring relief of pain i may utilise any of the following: mobilisation, manipulation, exercises, and electrotherapy.
Tuesday, August 4, 2009
computer related injuries
If your job requires working long hours on the computer, there is a good chance that you have experienced some back, neck, shoulder, or arm pain at the end of your long working days. These are some of the common computer-related injuries caused by bad posture while using a computer and poor work station design. Sitting is not really a strenuous activity but since it requires your muscles and joints to remain in the same position for a long period, it can cause stiffness and fatigue. Some simple changes in your work habits can prevent computer related injuries.
Posture related injuries:
Back and neck pain, headaches, and shoulder and arm pain are common computer-related injuries. Such muscle and joint problems can be caused or made worse by poor workstation design, bad posture and sitting for extended periods of time due to reduction in circulation to the muscles, bones, tendons and ligaments and can result in stiffness and pain.
Prevention of muscle and joint injuries:
Use an adjustable desk designed for use with computers
•Position the monitor so that it is either at eye level or slightly lower
•Position your keyboard at a height that allows your elbows to rest comfortably at your side
•Forearms should be roughly parallel with the floor and level with your keyboard
•Adjust your chair so that your feet rest flat on the floor
•Use a footstool if your feet do not rest on the floor
•Switch to an ergonomic chair, which helps your spine to naturally hold its curve while sitting
•Use an ergonomic keyboard to offer your hands and wrists a more natural holding position
•Take frequent short breaks and go for a walk or perform stretching exercises at your desk or Stand often.
Prevention of upper limb related injuries:
Muscles and tendons can become painful with repetitive movements and awkward postures and symptoms of overuse injuries in the upper limbs include pain, swelling, and stiffness of the joints, weakness and numbness
•Keep your mouse at the same height as your correctly positioned keyboard
•Position the mouse as close as possible to the side of the keyboard
•Use your whole arm, not just your wrist, when using the mouse
•Type lightly and gently
•Mix your tasks to avoid long, uninterrupted stretches of typing
•Remove the hands from the keyboard when not actively typing, to allow the arms to relax.
Posture related injuries:
Back and neck pain, headaches, and shoulder and arm pain are common computer-related injuries. Such muscle and joint problems can be caused or made worse by poor workstation design, bad posture and sitting for extended periods of time due to reduction in circulation to the muscles, bones, tendons and ligaments and can result in stiffness and pain.
Prevention of muscle and joint injuries:
Use an adjustable desk designed for use with computers
•Position the monitor so that it is either at eye level or slightly lower
•Position your keyboard at a height that allows your elbows to rest comfortably at your side
•Forearms should be roughly parallel with the floor and level with your keyboard
•Adjust your chair so that your feet rest flat on the floor
•Use a footstool if your feet do not rest on the floor
•Switch to an ergonomic chair, which helps your spine to naturally hold its curve while sitting
•Use an ergonomic keyboard to offer your hands and wrists a more natural holding position
•Take frequent short breaks and go for a walk or perform stretching exercises at your desk or Stand often.
Prevention of upper limb related injuries:
Muscles and tendons can become painful with repetitive movements and awkward postures and symptoms of overuse injuries in the upper limbs include pain, swelling, and stiffness of the joints, weakness and numbness
•Keep your mouse at the same height as your correctly positioned keyboard
•Position the mouse as close as possible to the side of the keyboard
•Use your whole arm, not just your wrist, when using the mouse
•Type lightly and gently
•Mix your tasks to avoid long, uninterrupted stretches of typing
•Remove the hands from the keyboard when not actively typing, to allow the arms to relax.
Monday, July 27, 2009
Back Pain & Posture
For many people back pain is directly related to poor posture, in both standing and sitting. The majority of people will have at least one, usually more, postural abnormalities. Afterall, if you go back a few evolutionary steps, we walked on all fours! Evolving to walk on two legs has placed a large amount of stress on our spines.
How does poor posture contribute to back pain?
1. Poor posture places additional strain on the muscles, ligaments and discs of the back
2. Over time this additional strain can lead to structural changes to the discs, muscles and ligaments surrounding the spine
3. These structural changes are usually what causes mild to moderate back pain
4. Pain most often comes from strain to muscles and as a result of muscle imbalances
5. Poor posture is sometimes due to inherent factors. A leg length discrepancy can mean one hip is higher than the other. This can cause lower back pain due to some muscles having to work harder to compensate. This can be corrected by wearing a heel wedge.
6. Biomechanical factors such as over-pronation of the feet can also cause back pain. Over-pronation causes the shin to roll inwards, followed by the thigh, which in turn alters the position of the pelvis.
What are muscle imbalances?
All muscles have an optimum length and tension. When your posture is good the muscles surrounding and supporting your back are at this optimum length. When your posture is poor some muscles will be shortened and tight, others (usually the antagonist) will be lengthened and weak.
For example, those who spend all day hunched over a desk often develop shortened, tight chest muscles and weak, lengthened back muscles.
Similarly, in those with a lumbar lordosis (excessive curvature of the lower back) The hip flexors (rectus femoris, iliopsoas) and lower back become tight and short and the glutes (bum muscles) and abdominals become loose and weak.
What is good posture?
A good back posture does not involve a perfectly straight spine. The spine has natural curves which help it to transmit forces and so the key to good posture is maintaining what is known as a "neutral spine". The following is a list of the key points for a neutral spine in standing, from head to toe:
1. The head should be held up straight, with the chin tucked in. Earlobes are level so you know you are not tilting the head to the side.
2. Lift the sternum (breast bone). Imagine a piece of string attached to the sternum, pulling it towards the ceiling. As you do this you should notice your shoulders move back and down.
3. Maintain a slight hollow at the lower back as this is a natural curve of the spine.
4. Hips should be level.
5. The neutral spine should be maintained when standing and sitting.
In addition, when standing:
1. Knees should be straight and feet at shoulder width, toes pointing straight forwards.
2. When standing sideways on, it should be possible to draw a line straight through the centre of your feet, knees, hips, shoulders and earlobes.
When sitting:
1. Keep both feet flat on the floor
2. Make sure your chair has good lumbar (lower back) support or use an additional lumbar support.
When lifting:
1. Ensure the object to be lifted is close to you so that you are more stable.
2. Have your feet at shoulder width to provide a solid base of support.
3. Activate your core muscles to help stabilise the spine.
4. Keeping the back straight throughout, use the legs to push yourself up.
How can i improve my posture?
Posture can be improved by following a rehabilitation program which should include:
1. Core strength exercises
2. Stretching tight muscle groups
3. Strengthening weak muscle groups
4. Altering your working position (If you work mostly at a desk)
5. Correcting any biomechanical abnormalities
Here are some simple exercises you can do at your desk to help improve your posture:
1. Sit comfortably in your chair, with both feet on the ground. Relax your shoulders and look straight ahead. Pull your chin in towards your head and hold for 10 seconds initially, increasing to 30 seconds. Repeat 3 times
2. Again, sitting in your chair, rest your hands on your thighs. Slowly squeeze your shoulder blades together. Hold for 10 seconds, increasing to 30 seconds. Repeat 3 times
3. Whilst sitting at your desk practise activating your core muscles.
How does poor posture contribute to back pain?
1. Poor posture places additional strain on the muscles, ligaments and discs of the back
2. Over time this additional strain can lead to structural changes to the discs, muscles and ligaments surrounding the spine
3. These structural changes are usually what causes mild to moderate back pain
4. Pain most often comes from strain to muscles and as a result of muscle imbalances
5. Poor posture is sometimes due to inherent factors. A leg length discrepancy can mean one hip is higher than the other. This can cause lower back pain due to some muscles having to work harder to compensate. This can be corrected by wearing a heel wedge.
6. Biomechanical factors such as over-pronation of the feet can also cause back pain. Over-pronation causes the shin to roll inwards, followed by the thigh, which in turn alters the position of the pelvis.
What are muscle imbalances?
All muscles have an optimum length and tension. When your posture is good the muscles surrounding and supporting your back are at this optimum length. When your posture is poor some muscles will be shortened and tight, others (usually the antagonist) will be lengthened and weak.
For example, those who spend all day hunched over a desk often develop shortened, tight chest muscles and weak, lengthened back muscles.
Similarly, in those with a lumbar lordosis (excessive curvature of the lower back) The hip flexors (rectus femoris, iliopsoas) and lower back become tight and short and the glutes (bum muscles) and abdominals become loose and weak.
What is good posture?
A good back posture does not involve a perfectly straight spine. The spine has natural curves which help it to transmit forces and so the key to good posture is maintaining what is known as a "neutral spine". The following is a list of the key points for a neutral spine in standing, from head to toe:
1. The head should be held up straight, with the chin tucked in. Earlobes are level so you know you are not tilting the head to the side.
2. Lift the sternum (breast bone). Imagine a piece of string attached to the sternum, pulling it towards the ceiling. As you do this you should notice your shoulders move back and down.
3. Maintain a slight hollow at the lower back as this is a natural curve of the spine.
4. Hips should be level.
5. The neutral spine should be maintained when standing and sitting.
In addition, when standing:
1. Knees should be straight and feet at shoulder width, toes pointing straight forwards.
2. When standing sideways on, it should be possible to draw a line straight through the centre of your feet, knees, hips, shoulders and earlobes.
When sitting:
1. Keep both feet flat on the floor
2. Make sure your chair has good lumbar (lower back) support or use an additional lumbar support.
When lifting:
1. Ensure the object to be lifted is close to you so that you are more stable.
2. Have your feet at shoulder width to provide a solid base of support.
3. Activate your core muscles to help stabilise the spine.
4. Keeping the back straight throughout, use the legs to push yourself up.
How can i improve my posture?
Posture can be improved by following a rehabilitation program which should include:
1. Core strength exercises
2. Stretching tight muscle groups
3. Strengthening weak muscle groups
4. Altering your working position (If you work mostly at a desk)
5. Correcting any biomechanical abnormalities
Here are some simple exercises you can do at your desk to help improve your posture:
1. Sit comfortably in your chair, with both feet on the ground. Relax your shoulders and look straight ahead. Pull your chin in towards your head and hold for 10 seconds initially, increasing to 30 seconds. Repeat 3 times
2. Again, sitting in your chair, rest your hands on your thighs. Slowly squeeze your shoulder blades together. Hold for 10 seconds, increasing to 30 seconds. Repeat 3 times
3. Whilst sitting at your desk practise activating your core muscles.
Subscribe to:
Posts (Atom)
