Author: Arunalaya

Physiotherapy In DelhiArticles by: Arunalaya
By Arunalaya Exercise

What is “Flat Foot” Actually ?

Flat foot is a foot deformity in which there is loss of medial longitudinal arch. It is also termed as
pes planus. Pes planus may be lifelong, or acquired through time. In this condition the entire sole
of the foot is in contact or near contact with the ground while standing.
flat foot is normal in infants and toddlers, because the foot’s arch hasn’t yet developed. Most
people’s arches develop throughout childhood, but some people never develop arches. This is a
normal variation in foot type, and people without arches may or may not have problems.
Some children have flexible flatfoot, in which the arch is visible when the child is sitting or
standing on tiptoes, but disappears when the child stands. Most children outgrow flexible
flatfoot without problems. Arches can also fall over time. Years of wear and tear can weaken the
tendon that runs along the inside of your ankle and helps support your arch.
Causes
Infants & children
Flat feet are common in children and are often caused by:
1)Heredity
2)Laxity of ligaments
3)Tight Achilles tendon
4)Lack of foot exercise
Typically a child’s arches begin developing in infancy and progress to normal arches in line with
normal growth patterns.
Adults can develop flat feet through injury, tight Achilles tendon, abnormal joint formation,
continued stresses on the foot and its arch, or simply as they age.
Some of the most common causes of flat feet in adults are:
1)Achilles Equinus contracture
2)Coalition of rearfoot joints
3)Failed or injured tendons
4)Arthritis
5)Marfan syndrome
6)Diabetes
7)Obesity
8)Pregnancy
9)Overuse & strain
10)Injury & fractures
The most identifiable symptoms and characteristics of flat feet are the decrease or lack of
arches in your feet (especially when weight bearing) and pain / fatigue along the inner side of
your feet and arches.Some issues caused by flat feet include:
1)Inflammation of soft tissue
2)Foot, arch, and leg fatigue
3)Heel, foot, and ankle pain
4)Knee, hip, and lower back pain
5)Rolled-in ankles
6)Abnormal walking patterns
7)Shin splints
8)Bunions
9)Hammertoe
10)Arthritis
11)Plantar fasciitis

Management of flat foot treatment
Treatment of flat feet will be started when you will start feeling pain or other foot, ankle
abnormality .
For children
At Advanced Foot & Ankle our podiatric specialists will conduct both a clinical exam and an
X-ray study to determine the type and cause of most flatfoot deformity.
Most cases of flat feet in children are genetic. However their feet are flexible in nature and can
be treated with:
1)Custom made insoles
2)Braces
3)Appropriate footwear
4)Exercise
5)Surgery – often the best treatment for preventing major developmental complications in the
future.
For Adults
Non-surgical treatment options for deterring the development of flat feet and its symptoms are:
1)Custom orthotics
2)Bracing & supports
3)Supportive footwear
4)Exercises
5)Physical Therapy
6)Weight loss
7)Daily activity modifications
8)Medication
9)Rest
Physiotherapy management will help to regain mobility of the foot, Strengthen the surrounding
muscles .Regain foot and ankle control Provide initial relief of pain by using ice pack wrapped
in a damp towel and placed on the foot or area of pain for 10-15 minute can help to reduce
soreness. Some patients prefer moist heat for pain relief.
1)Modalities : Heat and cold therapy is applied to enhance relaxation and reduces pain. Ultra
sound and pulsed electrical stimulation can also be used to relieve the pain. Electric stimulation
will helps to improve the blood circulation, thus enhancing the healing process and reducing any
swelling or discomfort.
2) Exercises: toe clawing exercises, arch muscle strengthening exercises, heel cord stretching,
calf and hammstring stretching, toe spreading exercises, toe walking, ankle ROM, Dorsiflexion
and plantar flexion of foot, gripping exercises. Releasing manually any tight muscles will also
develop arches and will bring the foot in shape. Kinesio taping to support and to avoid any
unwanted movement of muscle.
Advance techniques like dry needling on tendon and on trigger points will ease the pain .
If conservative treatment won’t help much in treating flat foot sign and symptoms then another
choice of treatment will be surgical.
Surgical interventions includes
1) tendon transfer
2) osteotomies
3) Arthrodesis.

By Arunalaya blog

PLANTAR FASCITIS

Heel Pain medically known as Plantar fasciitis is a very common condition in today’s fast paced lifestyle. Apart from plantar fasciitis there are other causes of heel pain as well.

8 causes of Heel Pain

1.            Plantar fasciitis

2.            Heel spur

3.            Calf strain

4.            Achilles tendonitis

5.            Heel neuritis

6.            Heel bursitis

7.            Due to wearing high heels

8.            Stress fracture of the calcaneus

What are the symptoms of Plantar Fasciitis?

             Severe pain and swelling over heel

             Numbness or tingling in the heel

             You are unable to walk normally

             You can’t stand on the back of the foot

             Morning Pain in the heel

             Difficulty in walking

Diagnosis

The therapist will ask the patient how much walking and standing the patient does, what type of footwear is worn, and details of his/her medical history. Often this is enough to make a diagnosis.

Physical Examination

On physical examination, patients may walk with their affected foot in an equine position to avoid placing pressure on the painful heel. Palpation of the medial plantar calcaneal region will elicit a sharp, stabbing pain. Passive ankle/first toe dorsiflexion can cause discomfort in the proximal plantar fascia; it can also assess tightness of the Achilles tendon. Other causes of heel pain should be sought if history and physical examination findings are atypical for plantar fasciitis.

PHYSIOTHERAPY MANAGEMENT

Cryotherapy 15-20min. for reducing pain and swelling.

Ultrasonic therapy

TENS(Transcutaneous Electrical Nerve Stimulation)

Plantar fascia stretching

Calf stretches

Ankle strengthening exercises

Advanced Physiotherapy

Myofascial Release

Dry needling

Taping

IASTM

Prevention

Dont’s

Avoid wearing high heels.

Avoid prolonged standing.

Avoid running.

Avoid walking on uneven hard surfaces.

Do not walk bare foot even at home.

Avoid driving for long hours.

Do’s

Do stretch your calves muscle twice daily.

Do wear comfortable shoes with soft and spongy insoles. Use silica gel heel cushion.

Do take rest while prolonged standing or walking.

the right shoe
By Arunalaya blog

Why you need “The right Shoe” ?

Are your daily wear shoes giving you pain and health problem?

We know once upon a time people walked and worked whole day without wearing any footwear but now we have lot of options in footwear. The shoes we wear are actually central to our everyday health. Poorly designed shoes or footwear that doesn’t fit properly can cause a number of short or long term pain and health problem that effect various part of our bodies and life ,so it’s important to know and be aware what you’re putting on your feet.

The cost of wearing heel –

Some kind of pains are difficult to avoid but one that can be easily prevented is foot pain. Much of the time you can trace foot pain directly to the shoes you decide to wear. Experts say a bad shoe can create potential foot, leg, low back or general health problems and high heeled shoes and improperly fitted shoes cause health problems such as bunions ,heel pain and deformed toes as well as nerve damage. A survey found that most women also experience leg cramps and  tired of wearing shoes that hurt’s their feet. As well as high heel gives you muscle pain and spasms in calves causing Plantar fasciitis and Calcaneal spur. Long term wear of high heels can shorten the muscles in your calves and back leading to backache.

Ill-fitting and high shoes wearing can cause damage to your feet can create nail and fungal problems, back, joint and hip pain, calf strains.

 Flip flops: Flat shoes with little or no arch support cause fallen arches, can be extremely painful and makes walking difficult and tiring for prolonged periods and on uneven surfaces such as hilly areas. One may also get inflamed and worn fascia at the bottom of the foot (plantar fasciitis) which can be debilitating for the patient as well as flats without arch support can cause lower back and ankle pain due to the flopping gait.

Ballet flats: Ballet flat shoes that are too tight across the toes and bell of the foot increase the pressure on the toenails and nail beds as the toes and nails themselves have no room for movement , the nails are often encouraged to bend and curl inwards. If the nail pierces the skin, an infection can occur. In particularly severe cases, this infection can lead to amputation.

Thigh high shoes: When it comes to foot pain, thigh high boots can cause some of the same foot health issue as shoes with stiletto heels, depending on their heel height and they present the additional risk of causing leg issues if the boots are too tight. Tight non stretchable thigh high boots can put pressure on the peroneal nerve in the knee and cause burning and tingling.

Take care of your feet:

It’s easy to take our feet for granted. They’re just there, handling with a lot of challenges, from being stiffened into high heels and elevated to heights to perspiration inside sweaty socks or tight nylon pantyhose.

While suffering those indignities, our feet take hundreds of tons of force impact just during an average day of walking.

You don’t need an expensive spa treatment to take care of your feet. Spending just a few minutes a day on foot care and choosing the right shoes can keep you free of problem that may lead to pain and even disability.

Make point to wash your feet with a washcloth carefully and regularly. Be sure to dry your feet completely, including between the toes. This can lessen problems such as athlete’s foot, odour, bacteria and fungus.

For soaking your feet, forget the Epsom salts as they’re too drying and are of least medical benefit. Instead, just use warm water and a little liquid soap containing skin softeners. Moisturize your feet after washing during winter months, you may need to moisturize several times a day. Nothing fancy is needed just basic lotions and creams are fine.

By Arunalaya blog

How does playing a sport improve quality of life?

There has been overwhelming evidence that physical exercise has its benefits on health.  But do we know it can do much more that? Especially playing a Sport can improve the overall quality of life.

Every kind of sports has its own health benefits. Having to maintain fitness with time, family and work pressure is getting more and more difficult. An easy and quick solution would be to inculcate games in your everyday lifestyle and rejuvenate yourself all throughout the day.

As we know our country is not known to be a sporting nation. Our recreation methods are limited to strolls, drives, shopping, movies, friendly gatherings etc. Sports is not seen as a part of our life and if it is, it is only for competitive or professional purpose.

However there has been a major shift in the paradigm in the last couple of years where everyone has started focusing on health and fitness in a major way. There has been a boom in the fitness industry over the last few years.

But does just exercising mechanically improve the quality of life? Physical activity definitely has its benefits but picking up a sport and playing a sport, part from the physical benefits boosts the mental health and also helps improve life skills in a big way.

Being a sports lover since childhood and cricket (a team sport) being my sport of choice (though now I work with Olympic Sports), I have been able to reap the benefits of having played it. I would just like to highlight a few Physical and mental benefits of playing a sport

Physical Benefits

  1. Weight management
  2. Improved cardiovascular health
  3. Reduced blood pressure
  4. Improved muscular strength and endurance
  5. Control cholesterol
  6. Improved Bone Health
  7. Improved Immunity

Mental Benefits

  1. Improved Concentration
  2. Improved sleep
  3. Reduce stress and depression

Life skills

  1. Improved self esteem
  2. Learning discipline
  3. Improved Time management skills
  4. Developing leadership quality
  5. Understanding Team work
  6. Dealing with tough life situations
  7. Perseverance is more important than winning or losing
  8. Goal setting

Pick up any sport you enjoy! Every sport gives you something to learn. You will reap mental and physical benefits if you play safe and smart. Sports improve in overall Personality development of an individual which reflects in every walk of their lives.

Happy Playing!!

By Arunalaya Physio

WHATSAPP THUMB SYNDROME

Whatsapp..hottest craze and necessity in today’s scenario. If we talk about youngsters their friends and group chatting and if we talk work then discussions on projects makes you involve in typing on mobile through your thumb resulting in pain in and around thumb.

The causative factor for Whatsapp syndrome is repetitive use of thumb musculature leading overuse strain. The muscles of thumb like flexor pollicis, Opponens pollicis and abductor pollicis gets repeated action leading to formation of trigger points.

Consequences –

Overuse syndrome can give rise to degeneration in the bones and joints.

Osteoarthritis in chronic cases can be caused.

How to avoid –

Pain in the thumb can be avoided by intermittent rest period.

Stretching the thumb musculature.

How Physiotherapy can help –

Muscle strain caused by repeated action of typing can be resolved by many advanced therapeutic techniques in physiotherapy like Dry needling, myofascial release and laser therapy.

Stretching of the musculature and taping the structures helps to resolve the problem sooner.

By Arunalaya Physio

SHIN PAIN

Shin pain is common exercise related injury refers pain along the inner edge of shin bone (tibia) or sometimes on front of lower leg. Physical activity such as running, jumping or any vigorous sports activity can bring on shin pain, in case if you are starting at fresh or after a long time gap.

There can be some of the factors which can correlate as shin pain such as Stress fracture of tibia, Periostitis, Contusion injury, Compartment syndrome and MTSS (Medial Tibial Stress Syndrome). What is more common in athletes or exercise beginners is MTSS, known as shin splints where due to stress loading on tissues develop inflammation of muscles, tendons and bone tissue along the medial border of tibia (inner edge of shin bone).

Occurence

Generally, shin splints develop by overworking of muscles and periosteum (outer most layer of bone) by repetitive activities or bio-mechanical faults or environmental factors (exercise surface). Sudden changes in duration, intensity, and frequency of physical exercise can lead to shin splints.

Other factors which can contribute to shin splints are:-

             Flat feet or abnormal rigid arches can create abnormal stress on medial border of tibia (inner edge).

             Pain can be sharp, throbbing or dull.

             Pain occurs during and after exercise.

             Pain aggravates by touching on sore area or tender area.

If you ask, Should I take any medicine or go for radiological tests?

Oh No! Taking medicines such as anti-inflammatory and pain killers will not sort out your injury. Pills only kill the pain for some time, it’s momentarily relief and will not resolve your injury.

Secondly if you choose to do X-Ray, MRI etc., you will be wasting your time and money. Instead if you won’t find anything in radiological findings you can increase your anxiety level (beware of that).

Seek expert advice for the best treatment and go ahead as per their advice.

What will Sports physio do?

Assessment is a vital part for any injury or condition to be diagnosed. Sports physio will discuss about your pain, history and symptoms.

Shall do keen observation on your pain area

Shall palpate the tissues

Shall examine your movements

Do physical skill tests to evaluate and making correct diagnosis

Most importantly explaining to you the whole condition in the easiest ways that what it is.

How it occurred?

Why it happened?

What is the cure?

We the “Pain free zone” is a hub of specialized sports physio or expert in sports injuries. We will assess, diagnose and will treat you.

We have

-dynamic approach and multidimensional knowledge base which is patient centered

-clinical reasoning process that is embedded in problem solving approach

-central focus on movement assessment

-consistent virtues in caring and commitments towards patient.

“To have the effective treatment there is a need of correct assessment and diagnosis”

Coming to the topic again stress fracture, tendinitis, chronic exertional compartment syndrome can be detected by physical tests, movements and palpatory skills.

And we “PFZ” are highly expert in these.

Can I do something at home to relieve my pain before coming to you?

 Yeah why not?

             Do ice- use cold packs for 15-20 mins several times a day , but be careful about time duration

             Compression – wear elastic compressive bandage over pain area

             Proper shoes – wear good cushioning shoes to reduce stress on shin bone while walking.

             Avoid running on hard surface or either stop vigorous activity for some days.

If these can relieve my pain what all different you will do?

 You can have relief in pain by these but in future this pain can come again and can be more severe.

Why you wear sweaters and blazers in winters! Well you are feeling cold or last time you suffered from chills and fever.

Above mentioned are just home advices, treatment and solving your problem is way far.

 *If your pain is due to bio-mechanical fault such as over pronation, flat feet so ice and home remedies won’t work for you at all. That needs to be corrected

Pain free zone apply most advanced techniques in physiotherapy management

             Modalities

             Dry needling

             IASTM- Instrument Assisted Soft Tissue Mobilization

             Therapeutic Taping

             Manual Therapy

             Specific Exercise Program

             Return to Activities

By Arunalaya blog

Ergonomics

Ergonomics is defined as information about human behaviour, abilities and limitations and other characteristics to the design of tools, machines, tasks, jobs and environments for productive, safe, comfortable and effective human use. Ergonomic assessments (workstation assessments), helps to make the workstation ergonomically designed so as to minimise the risk of injury and maximise output and productivity.

It also helps to minimize the effort and increase comfort and efficiency to work in case of an injured patient, people who work from home so as to make their home work environment is safe and ergonomically designed. As per Safety, health and welfare at Work Act 2005, an employer must provide a safe working environment to avoid all work hazards.

Work related upper limb disorders (WRULDs), Repetitive strain injuries (RSI), back and neck pains, muscle strains etc. can be avoided.

Ergonomics is the study of work in relation to the environment in which it is performed(the workplace) and those who perform it(workers).It is a broad science involving the wide variety of working condition that can affect worker’s comfort and health, including factors such as lighting, noise, temperature, workstation design, tool design, machine design, chair design, footwears, job design including factors such as shifts of work, breaks and meal schedules.

Employer as well as the employee, both are benefitted.

Employee – gets healthier and safer working conditions

Employer – increased productivity

Injuries associated with non-application of ergonomic principles proves costly to both workers and employers as ergonomically designed workplace can –

Reduce injury

Increase productivity

Increase morale of employee

Reduce absenteeism

In an ergonomic workplace, tasks and tools are designed to fit individual capabilities so people can do their jobs without being injured and foster highest level of function.

With 8 or more hours spent at the workplace each day, your body can be subjected to harmful repetitive motions and postures throughout the course of your workday.it involves the study of how body and mind can achieve optimal function while carrying out daily tasks within workplace.

Let a supervisor know immediately if you experience –

Pain or aches

Numbness/tingling

Stiffness

Burning

Swelling

Weakness

Fingers turning white and losing sensation

Reasons for workplace injuries –

Repeated use over time of vibrating tools and equipment

Tools and tasks which require twisting hand or joint movements

Applying force in awkward position

Applying excessive pressure

Working with arms outstretched or overhead or with bent back

Lifting or pushing heavy loads

It often develops slowly over period of months or years.

If workers ignore symptoms for too long , you may eventually be unable to perform your current job. They may have to permanently transfer jobs, undergo physiotherapy or even have surgery. In the very worst cases, they may develop such a major and painful disability that they’re unable to work. Without the application of ergonomic principles, workers are often forced to adapt themselves to poor working condition.

Ergonomic chair

It is designed to provide the maximum amount of comfort for the user. The objective is to “fit the workplace to the worker, not the worker to the workplace. Sitting for long periods of time places a great deal of stress on the body when it transfers full weight of upper body to buttocks, thighs and intervertebral discs.

Ergonomic Assessment Tools

These standard tools are used for assessing the ergonomics –

 WISHA Lifting Calculator

 NIOSH Lifting Equation

 Rapid Entire Body Assessment (REBA)

 Rapid Upper Limb Assessment (RULA)

 Liberty Mutual Manual Material Handling Tables

 Washington State Ergonomic and MSD Risk Assessment

The workplace must be comfortable for the employee to minimize the risk of injury and maximize the efficiency of the person. As we are aware that our body has a normal range of motion (ROM), movement within the proper range will help in maintaining optimal body health by providing proper blood circulation and maintaining flexibility while reducing excessive stress.

Good and bad zones

To simplify and avoid strain over the joints we can bifurcate the movement into 4 zones.

Zone 0(Green Zone): ​Most preferred zone for movements. It puts minimal stress on muscle and joints.

Zone 1(Yellow Zone): ​This is also comfortable zone to do the movements. It puts lesser stress on muscle and joints.

Zone 2(Red Zone):​ More extreme position. It puts greater strain on muscle and joints.

Zone 3(Beyond Red Zone):​ This is the most extreme position. It should be avoided if possible.

In today’s Uber and Swiggy era, most of the work is related to computers or mobiles only. Adding salt in the soup would be some sedentary office schedules. Sometimes there are heavy documents and papers which can lead to manual handling risks. You must have heard “Sitting is the new Smoking”.

Risk and hazards faced by employees

Postural problems

Continuous working over laptops and mobiles are leading to Text necks and Whatsapp thumbs. Moreover maximum people in corporates who are not stretching or aware of ergonomics can be seen with stooped postures.

Duration, Intensity and design of office work

Even the non-computer work which requires continuous and frequent wrist or hand movement can contribute to the risk of injury. Prolonged sitting leads to anterior pelvic tilting which leads to backaches. Overload due to targets and presentations lead to dedicated time in front of laptop even till late nights in awkward postures after an exhausted day in office.

Psychosocial factor

It includes excessive work load, conflicting demands, job insecurities. There are two ways how these factors can impact. Firstly they can have direct impact on mental and physical health and secondly this can contribute to musculoskeletal problems also.

The musculoskeletal system is the load bearing structure. These structures resist the gravitational forces and maintain the shape of the body.

Following structures are at maximum risk of getting strained or degenerated:

Bones

Ligaments and connective tissues

Tendons

Muscles

Intervertebral disc

Nerves

These can be easily avoided if an expert physiotherapist is there in the team to counsel and educate people about the good tensegrity and ergonomics.

Let’s check out your ergonomics in a while !!

Is your computer/laptop monitor screen at eye level?

Yes

No

Is the distance from monitor screen to your eyes is at least 20 inches (50 cm)?

Yes

No

Do you flex your wrist while typing?

Yes

No

Do you slouch in front while typing?

Yes

No

Are your feet flat on the floor with your hips at a 90–120° angle while sitting?

Yes

No

Can you adjust the height and angle of your monitor, keyboard and chair?

Yes

No

Do you stand at regular intervals while you work?

Yes

No

By Arunalaya Physio

DRY NEEDLING, What’s that?

DRY NEEDLING

Dry needling is an invasive procedure where a filamentous needle is inserted into the skin and muscle. It is aimed at myofascial trigger points which are hyperirritable spots in skeletal muscles that are associated with a hypersensitive palpable nodule in a taut band. It can be done on superficial fascia which is the topmost layer under skin, muscles, tendons and in the articular region to resolve pain and dysfunction. Dry needling is a new upcoming technique in the medical field and spreading at very fast pace because of its effectiveness. It is not at all same or similar as acupuncture. Acupuncture is part of traditional chinese medicine whereas dry needling is a western medicine technique. Dry needling works by changing the way your body senses pain(neurological effects) and by helping the body heal stubborn muscle spasm associated with trigger points (myofascial effects). Dry needling is a part of physiotherapy and it is very significant that the patient does his exercises for faster recovery.

The therapist will choose a length and thickness of needle appropriate for your condition and body size. The needle is inserted through the skin at appropriate place. A small pinprick is felt and depending on the type of technique chosen by the therapist, you may also feel a muscle ache and a muscle twitch. These are all normal and good sensations, and mean that you will experience good relief from your symptoms.

Generally there is no/very less risk involved with this technique if performed by a properly trained physiotherapist. You may have a little bruising around the needle side, same as after an injection but not always. There are no lasting side effects of dry needling. On rare occasions, people may feel very happy, tearful, sweaty or cold.

Dry needling can be useful in endless conditions including muscular, orthopaedic, neurological, sports, paediatric and women health as well. During pregnancy when there is no option left for pain relief, this is one of the best resort.

Though it can help in numerous diseases and conditions but to enumerate a few in sports and musculoskeletal conditions are osteoarthritis, frozen shoulder, back and neck pain (commonly known as sciatica and cervical), plantar fasciitis (heel pain), myofascial pain syndrome(1st stage of fibromyalgia), acute and chronic sports injuries, muscle and ligament strains and sprains, muscle, tendon and ligament repairs, tendonitis, foot or ankle conditions, Post-surgery rehabilitation, Aching and stiff joints and muscles, restriction in range of motion, vertigo, etc.

Small kids and adolescents suffering from Cerebral palsy, development delay, Developmental co-ordination disorder, Neuromuscular conditions, Acquired brain injury, and other musculoskeletal injuries can get a lot of improvement in their deformities.

People suffering from Stroke, Parkinson’s Disease, Multiple Sclerosis, Spinal Cord Injury, Neuromuscular Disorders, Guillain-Barre Syndrome, Chronic Inflammatory Demyelinating Polyneuropathy, Multifocal Motor Neuropathy, Inflammatory Myopathies, Muscular Dystrophies, Headaches etc. can improve their life.

The treatment given through dry needling can solve the tough, chronic problems with which the patient is suffering from. But don’t go to a novice as dry needling is a great technique which can do magic but only through a skilled therapist.

Wish you a Pain free life !!

Dr. Chakshu Bansal Kathuria

PhD(S)

By Arunalaya blog, Exercise

SQUATTING – ARE YOU DOING IT CORRECTLY?

SQUATTING – ARE YOU DOING IT CORRECTLY?

Squatting is one of the best exercise to gain strength and muscle mass in the leg.

Full squatting involves nearly all the muscles in the body as it is the basic human movement pattern. Daily activities such as picking up stuff off the floor, toileting or sitting in chair or low sitting box involves squatting.

Exercise science says squats are excellent for building strength, power, mobility and muscle mass. Researches shown that squatting creates more growth hormone compared to leg press exercise. Growth hormone is important aspect for muscle mass.

 But question arises here, are you squatting correctly?

Improper squatting can be result of less stability and mobility of spine or any of the joint problem (hip, knee, ankle, foot).

How to squat properly?

 Let’s talk about positioning –

Head – To be held straight in line with the shoulders

Thoracic spine – To be slightly extended or neutral

Lumbar spine – Neutral stable throughout the movement

Hip joints – Stable, no outwards or inwards movement (medio-lateral)

No drooping (drop down of hips) should stay aligned with knees.

Knees – Aligned with hips and feet, stable, no excessive movement inside or outside, forward or back

Feet & ankle – Flat feet and stable, heels in contact with the ground at all the times.

These are few basic steps to follow while you squat.

So after knowing these, what will be the key requirements to do squat properly?

             Balance , stability and mobility

             Keep hips mobile

             Knee follow toes

Does squats hurts or bad for knees or it is a myth?

It’s a myth, while you do full squatting, forces on the connective tissue increases which will not produce any injury. Full depth squatting in fact increases knee joint ligament stability.

This can turn out to be bad only when there is loss of strength of certain muscles, any injury to ligament or meniscus, or unstable joint. Then you need to seek advice from physiotherapist in particular.

Other major factors which can lead to injury are:

             Fatigue (tiredness of muscles)

             Poor technique

             Faster repetition speed

             More resistance ( over load)

What improper squat can lead to?

             Low back pain

             Upper & middle back pain

             Ligaments sprain ( knee and ankle)

             Muscle strains

Injuries can come suddenly or can take a period of time to indicate you such as sprains and strains can come suddenly but low back pain due to abnormal bio-mechanics can take few days or months to show pain.

How to prevent these injuries?

“Prevention is better than cure”

There is increased risk of injuries when there is lack of knowledge among trainers or those who do exercises watching videos online which do not always justify exercise physiology and movement patterns.

Right thing is to consult sports or musculoskeletal physiotherapist for correcting movement patterns and exercise. Physiotherapist evaluates all the muscles, joints and mechanics of the body. Physio can recognize the faulty patterns or weak links in the body.

What is best to do if any injury or pain occurs during squatting exercise?

             Initially if something happen you should stop doing exercise.

             For sudden injury, apply ice with compression and take rest

             Avoid any vigorous activity

             Do not massage over the strained part of the body

*Best option is to consult either Sports physio or Musculoskeletal physio.

We “Pain Free Zone” has witnessed many cases like these in the past many years. Faulty mechanics was the primary reason for body aches such as low back pain, upper – mid back pain etc.

It is needful that a physio should assess gym going clients by movement pattern analysis.

Squatting movement at different angles, faulty mechanics to be under stood and analyzing muscle function.

Solved over hundreds of cases, we concentrate on the faulty root which is causing pain instead of looking at pain only and treating that part.

Is there any problem or anomaly which can be diagnosed mistakenly in place of faulty mechanics?

Yes of course, one of the example is low back pain – after doing MRI, disc bulge is seen and any medical professional can blame disc to be reason which is not always true.

Faulty mechanics such as increased low back arch (lordosis curvature increased) during squatting can over stress back musculature, or butt wink or SI joint dysfunction.

Fact – Disc bulge can be seen in most of the gym going people no need to be worry always.

For any pain with or without any injury, for correcting exercise pattern, kindly visit “PAIN FREE ZONE” once. We will assess you the way it should be. We will describe in detail what is causing discomfort to you.

You can visit us at www.physiotherapistindelhi.com or can visit pain free zone fb page.

All the advance physiotherapy treatment is carried out here in PFZ such as

Dry needling

IASTM

Taping

Manual therapy

Exercise program

Deep tissue release/ Sports massage

*Exercise program can turn your wrong way of doing squat into right way.

*Deep tissue release will transform your tight – tensioned muscle into much more relaxed state and helps in doing movement and exercises fluently.

By Arunalaya Studies

Pre-habilitation, What’s that?

Pre-habilitation – A lateral thinking towards prevention of injuries

Rehabilitation of athletic injuries such as ligament and muscle injuries is common at present which takes longer period of time to get recovered and require great deal of patience throughout, ultimately leading to longer period out of play. On the other hand it is already known that tissue damage had been done.

Why not prevent injuries before it happen? There is a need of awareness and education among sporty and general exerciser individuals about pre-habilitation and its importance.

So what it actually is?

Pre-habilitation is a exercise program set for an individual knowing his/her weak links in body which can cause injury in near future. Pre-habilitation works on decreasing risk of injury, focuses on strength, flexibility & neuromuscular control of the areas vulnerable to injuries. This will also minimize the resting time or out of completion period due to injury and its recovery.

Pre-habilitation is sports specific and individual body based approach means it’s not common for all. Strengthening, flexibility, proprioception and agility exercises can reduce risk of injuries and also can help to enhance performance.

As according to American journal of Sports medicine , agility drills reduced ACL injuries among female soccer players by 88%.

Science behind Pre-habilitation –

Continuous training while having bio-mechanical fault can lead to injury, it becomes necessity to have a bio-mechanical approach towards athlete assessment. Pre-habilitation focuses on the regimes which will counter these faults. Biomechanical assessment follows functional activities to reach to weaker links in the body and the structures to be worked on. As for example pronation distortion syndrome can cause stress on ACL or PFPs over a period of time. Pre-habilitation works upon correcting the faulty mechanics thus reducing injury risks.

Beneficiaries of Pre-habilitation –

Elite athletes, occasional exercisers, gym going individuals & also those who are not regular exercisers are vulnerable to get injury , can benefit by pre-habilitation. Individuals having past injury can also have pre-habilitation program for themselves in order to prevent recurrence of same injury or other associated with it.

Why to get treated or rehabilitated after injury or any musculoskeletal pain when we can prevent it as it is rightly said “prevention is better than cure”.

Right choice of professional for pre-habilitation –

Physiotherapist is best choice when it comes to rehabilitation after injury similarly in prehabilitation physiotherapist is right selection. Biomechanical analysis is key for pre-habilitation for exercise planning and for that who can be better than physiotherapist.