Rehabilitation for Osteoarthritis of Knee

One of the most common causes of joint pain in old age "Osteoarthritis" is a result of general wear and tear of joints.Though it is mostly considered as an age related ailment,it may be seen in younger people due to various causes.Knee joint is one of the most commonly involved areas.Excessive body weight may further aggravate the problem.In early stages this may lead to intermittent pain after long walks or stair climbing,later pain may increase in intensity and frequency.Manual assessment,X rays and other radiology techniques are helpful in diagnosing the arthritic knee.One may feel a mild creaky sound while bending the knee,this is due to friction between the constituting parts of the knee(mainly bones).Pain can be controlled with use of Electrotherapy modalities including heat therapies but the rehabilitation remains incomplete without a proper exercise follow up.Most of the exercises are simple enough to be done at home after a few days of practice in presence of a physio.One should not try self exercise without proper medical advice.While doing self administered exercise generally you may not be able to judge -'how much is too much'.If the pain is ignored for a long time the joint continues to deteriorate further and may end up in a stage where conservative treatment remains no longer effective.

Physio Rehabilitation for ACL tear

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ACL tear is one of the common problems that knee injuries may cause.ACL is an important ligament which plays a major role in knee stability.Once its torn, various approaches of treatment may provide various suggestions.Surgery or no surgery is the biggest question that most patients face after a battery of tests.Recovery from such an injury purely by physiotherapy treatment depends on a few important factors.Few of these factors are:

-Time wasted before you see your physio
-Your trust on your physio
-Tear is complete or partial
-Are you an athlete or non athlete

Based on such factors,your physio may be able to decide what should be your course of treatment.Few cases may need surgical intervention,this is decided by your entire medical team after chain of referrals and discussion.Various approaches towards surgery do exist but that is best left to the surgical team.Among the recent cases at our clinic, we take pride in doing a complete post surgical rehab for an army officer who is joining his duty soon.A case of partial tear is on his way to his wedding soon without undergoing any surgery.So don't complicate your ACL tear by making a monster out of it.Take few opinions but make sure you take sincere opinion if anyone known to you suffers this problem.

The Physical Health Consultants,Koramangala, BENGALURU

At The Physical Health Consultants, Koramangala,we believe that simple is good.This is one of the oldest physio consultation in Koramangala area.

Add:#344,3rd Cross,20th Main,Opp Panchamukhi Anjaneya Temple(Near Koramangala Police Station),GanpathiTemple Road,Bangalore.


Call         9986370169
                7760616650

E mail     physiotherapist.post@gmail.com
                physio@physicalhealthconsultants.com

                
Cases that we get to handle on a regular basis include the following:

Sports Injuries
Bell's (facial)Palsy
Post surgical rehabilitation
Stroke/Cerebral Palsy rehabilitation
Arthritis & other joint related problems
Spondylosis-back pain,sciatica,neck pain
Muscular pain-spasm,injury or work related
Lymphoedema -swelling due to various factors
Diabetes related physical problems-diabetic foot
Post fracture,muscle tear,ligament tear rehabilitation

There are many other conditions where physiotherapy helps but all can not be covered in this small write up so I shall try to include that in future blogs.Our approach towards treatment has been mentioned in previous blogs. Quality of treatment and patient experience is something we do not talk about; we feel it may sound better when you talk about us after experiencing it yourself.Our simplicity by no means stops us from regularly updating ourselves to provide you treatment using the best physiotherapy techniques available.

PATIENT SAYS...

             13 August 2012
   From Tehemtan J. Dhabhar
   To whomsoever it may concern.
 An encomium for Dr. Shailender MPT.

 My first meeting with Dr. Shailender took place in late 2009 when I accompanied my wife for her physiotherapy following the opening of her plaster after she had fractured her wrist. The simple physiotherapy done on her wrist by an earlier PTT was unsatisfactory. She had a bare 60% of the movement and even that hurt.   We then referred to Dr. Shailender. It was a pleasure to watch the way he went about gently moving her arm and gave her simple exercises to do, encouraging her when she was impatient at the slow healing, . She ultimately regained nearly 100% of her movement.   Watching him work with my wife, I was encouraged to ask him to help me with a couple of my painful joints. I was helped considerably and I put a challenge to him. In 1975, whilst practicing judo I had injured the muscle of my right shoulder. This caused me agonizing pain the doctor whom I consulted had “set” it for me. This was followed by 2 weeks of massage and warm and cold water fomentation. However, complete cure never took place, and I could not raise my arm vertically, or to the back without pain.   Dr. S gently felt the muscle and found that a nerve had been trapped. He gently released the nerve and thereafter, within 2 days of PT, I could freely begin to move my arm and shoulder without pain for the first time in 34 years. He also recommended some muscle relaxing and strengthening exercises which would help me in the long run.   The above incident emboldened me to move to an even earlier injury. In 1957, (52 years before 2009), when I was 14 years old, I was doing barbell somersaults. Suddenly one of the supports slipped. I fell on my chest and belly and the rod came down on my spine with one end hitting a disc on my spine.   I recovered from the injury. However, as I grew till I was 18, apparently the disc did not grow. This would often cause me pain and over the years, on several occasions I had been immobilized by sciatic pain. I was unable to bend. At any time if any pressure was put on the area of this disk it would hurt. Dr. S felt the disk and did some (painful) manipulation and then put me on a regimen of 4 simple exercises. In a matter of 2 weeks the pain was gone and now any pressure on the disk or its neighbours causes no pain whatsoever.   He has done similar work on my sister and a few friends who I recommended his name to.  They are also very happy with his treatment and the way he deals with them.   The above referred only to his skills. Now, I would like to say something about him as a person. Dr. S comes across to all of us as a very gentle, polite and humorous person. All the time as he works with the patient he softly continues a conversation, encouraging, explaining and sometimes even joking with him/her. Secondly, aside from Physiotherapy he comes across as very knowledgeable in peripheral areas of human issues of pain, illness and cure including the psychology of human ailments. This makes him a well-rounded person. He has wide ranging interests and makes for a pleasant and interesting friend. In our family we refer to him as our “Magician”.   Speaking for all of us we recommend him to people who are seeking help without surgery, painkillers and other short-cuts.   Tehemtan Dhabhar   Tel: +91 2637 323220 Email: tehemtan@gmail.com  

TRAPEZITIS - A common cause of upper back and neck pain

The Physical Health Consultants,Bangalore

Trapezius is a large muscle that extends from edge of the skull to upper back area. It is of great functional importance during our day to day activities.Working long hours, using computers, writing drawing or even watching television without adequate breaks; may lead to inflamation /spasm of this muscle.This inflamation may lead to localized pain, radiating pain towards shoulder and sometimes headache as an indirect consequence.The best way to avoid this pain is taking rest between long working hours and folowing a relaxation routine of 2-3 minutes after every 45-60 minutes of work.If pain persists on a regular basis then muscle relaxation techniques used by your physio may help in reducing the pain.In case of severe inflamation, cryotherapy or electro modalities may be used by your physiotherapist to ease up the muscle structure and texture.Never allow such an inflamation to become chronic because that may craete problems to overall configuration and stability of upper back. We see a lot of patients who end up spending time, energy and money on unnecessary tests and treatment.The fact is that this condition can be easily diagnosed by an experienced practitioner and can be treated with some of the simplest physio techniques.At our clinic, this is one of the commonest problems treated.Particularly IT professionals get this pain very commonly as a consequence of overuse.All cervical pain is not due to trapezitis alone;particularly in elderly people pain may be due to degenerative changes of joint structure.Cervical spondylosis is becoming a common problem for all age groups.This is mainly due to changing lifestyle patterns.

Back pain...gone forever

Best wishes to all the patients who have completely recovered from back pain,in last six months at our  physio clinic.July 2012 to now has been a record of its sought, in terms of number of back pain cases.Back pain specialised treatment, tailor made for each patient, has worked to expectations and prevented a few surgeries as well.Thanks to all those who showed immense faith in our abilities and kept patience during the course of treatment.At the same time, we wish that all others understand the importance of back care in the present work situations and life style.
12/4/13 Last month, we started treating a couple of cases of slip disc where surgical intervention seemed inevitable but basic physiotherapy treatment was helpful to show relief within few days.Though the treatment is still continuing for both these patients,its time for us to thank them for trusting our abilities.Basic physiotherapy mentioned in above sentence means simplest of exercises and electrotherapy.Patients should be aware that anyone can complicate techniques used in physiotherapy by using terms and names that sound sophisticated, this should not confuse you. 

Slip Disc (IVDP) - Treatment without side effects

Back spasm does not always lead to Lumbar Spondylitis or Spondylosis.
Most of the times you don't even need to take X rays or MRI to get it diagnosed.
Muscle spasm and inflammation can be easily diagnosed with specialized manual tests.If any nerve compression or disc prolapse is present that may also show up in the manual tests.Only in case of disc/nerve issues you may be sent for MRI to understand the level of prolapse accurately.
Physiotherapy treatment is helpful in resolving these back related problems in the most appropriate manner.Best physiotherapy treatment for back pain involves modalities and techniques which not only subside the pain but treat the mechanical cause of pain completely.
Being a drug/medicine free treatment,physiotherapy will not temporarily mask or cover the pain but totally end the cause.One in many cases may be extreme IVDP or slip disc where physiotherapy alone may not be helpful,in such cases a multi pronged approach may be required.
Physio treatment can be continued even if a patient is on any other treatment such as Ayurveda,Homeopathy,Unani,Allopathy for same or other ailments.You should not expect medication from your physio,in fact physio treatment may help you stay away from medication.
Surgical intervention is needed in very few cases but that can be decided based on chain of referrals and discussion amongst the medical team taking care of the case.If surgical intervention fails to reduce the pain, it is called Failed Back Syndrome and the patient has to come back to conservative treatment.If you are suffering from pain even after surgery,you should seek physio treatment immediately.

Our treatment

TREATMENT METHOD

1)Detailed examination of the patient with a complete understanding/analysis of the existing condition and careful history taking.
2) Relevant manual assessment procedure, other clinical investigations are co-related with the existing clinical symptoms.
3)Comprehensive individualised treatment protocol is drawn up.
4)Effective self performing home program is taught.
5)After treatment is completed at the centre a series of self management and  maintenance program is explained to the individual to offer long term and comprehensive rehabilitation.

 TREATMENT MODES

 1) Electro Therapy is usually a choice for various conditions to help treat a patient. It could include the use of Ultra-sound therapy(UST), Interferential-therapy(IFT), trans cutaneous electro nervous stimulation (TENS), infra red rays (IRR), muscle stimulator(MST), cervical traction (ICT), intra pelvic traction(IPT),shortwave diathermy(SWD) 2) Exercise Therapy Unit comprises of treadmill, static cycle ergometer, abdominal exerciser, finger ladder, ropes and  pulley system, wall bar, weight cuffs, dum-bells, barbell, wand exerciser, thera bands, wall mirror for bio-feedback 3) Cryotherapy by usage of cold packs. 4) Heat therapy using heat packs. 5) Manual Therapy is used for various conditions depending on requirement.

RSI and Postural Syndrome

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RSI is largely a consequence of our day to day activities.Repetitive overuse or incorrect use of any muscular group over a long period of time is most often the cause of such problems.Some other terminologies such as Repetitive Movement Disorder and Cumulative Trauma are often interchangeably used to describe the same.Usage of computers in offices has increased the occurrence of such conditions in recent times. Upper back,wrist,neck region and lower back are most common areas of pain for computer professionals(software professional).Most of these pains are avoidable with frequent breaks between working hours,postural corrections and maintenance of regular exercise routines.Other causes of RSI can be attributed to incorrect prolonged postures such as prolonged standing in kitchen may relate to overuse syndrome or repetitive strain over the foot muscles.Watching television half lying on the bed or with the neck turned to one side also has same effect as computer usage.Some people get neck muscle spasm simply because of habit of holding the mobile phone between neck and shoulder. Overuse may also be a cause of shoulder,elbow,calf or back injuries for sportsmen but they are rarely classified under RSI and referred as "Sport Injuries".Most of these injuries being musculoskeletal in nature can be treated by Physiotherapy in the earlier stages.Generally few sessions of electrotherapy are followed by techniques involving myofascial or other such approaches.A good exercise protocol,tailor made according to injury helps in strengthening and complete rehabilitation.

Sciatica Treatment @The Physical Health Consultants, Bangalore

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Sciatica pain is often associated with slip disc (intervertebral disc prolapse) in the lower lumbar spine.Sciatic nerve that is the main nerve supply to legs, is compressed due to the above and thus the sensation passes down to the legs.Pain is mostly felt in the back near nerve roots and radiates towards the legs as a pricking or numbing sensation.Disc compression may be mild or complete,severity of pain depends on that.There are many other factors that lead to similar pain sensation.
On proper physical assessment with manual tests,your physio may be able to trace the cause of pain.If needed,MRI or X ray may be done for accurate diagnosis.Radiating sciatic pain that comes due to muscular causes such as hamstring tightness or piriformis muscle spasm may need different approach towards treatment than other reasons such as slip,disc or joint inflammation.Treatment duration varies depending on the cause of pain.Generally disc prolapse cases take longest time to be treated.Follow up with back strengthening exercises help in avoiding recurrence.Every case is different from the other so generalized group exercise and self taught exercise may end up in more complications.Always consult your physio before joining any exercise program even if you suffer the mildest back pain.