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Physiotherapy In Delhiblog
Tension headache
By Arunalaya blog

Tension headache

Headache caused by tensions feels like a mild to moderate pain on forhead , scalp and neck and
are often relived by taking painkillers and paracetamol.
CAUSES
Tension headaches usually occurs when cervical muscles becomes stiff and contracts in
response to stress, workload, any headinjury or anxiety. Adults are more prone to tension
headaches.
When our neck is in uncomfortable position for long duration it can cause headaches. Some
activities like typing work on laptops , mobiles or any activitiy which keeps our neck flexed may
trriger headaches.
Other triggers could be –
1) taking lot of caeffine
2) emotional stress
3) viral infections
4) alcohol or smoking habbits
5) ophthal problems
6) dental problems
7) dehydration
Several types of tension headaches are as follows
1) Sinus : In this type of headache pain is feel behind the eyebrow bone and cheekbones.
2) Cluster: throbbing pain is feel in and around one eye.
3) tension: pain feels like tight band over the forhead.
4) migraine: pain, nausea and visual changes are typical of classic form.
Treatment
Painkillers are the first line of treatment for tension headaches.
Common treatment include acetaminophen, NSAIDS
Physical therapy sessions including manual muscle release, dry needling electrical stimulation
modalities may provide relief from headaches.
Tension headache prevention
1) meditation
2) yoga and daily exercises
3) adequate fluid intake
4) correct posture at work
5) limit stress
6) eat balanced and healthy meals

HAGLUND DISEASE
By Arunalaya blog

Haglund Disease

It is a painful condition of the heel caused by mechanically induced inflammation of the
retrocalcaneal bursa, supracancaneal bursa and Achillies tendon.
The bump is usually due to an abnormality in foot function or bone position that creates shoe
friction around the natural bony prominence at the back of the heel.
The primary symptoms of Haglund deformity are
A) bump on the back of the heel
B) pain
C) swelling
D) callouses on and around the bump
Haglund deformity is believed to be caused by
A) high arches
B) tight achillies tendon
C) walking on outer edges of foot
D) Tight or poor fitting shoes
E) Abnormal biomechanics of foot due to joint misalignment.
Management of Hanglund deformity
First Non surgical treatment will be recommended .
Although there is no treatment to cure this deformity. Surgical interventions may also cause
bony bump again.
Some nonsurgical treatment choices include:
1) wear a shoe having rigid back.
2)placing heel lifts in shoes to help bring the heel up and avoid friction.
3)using heel pads inside the backs of shoes to help reduce irritation and friction on the heel.
4)people having high arches can use arch support inside the shoes.
5) analgesics can help in releiving pain symptom
6)cryotherapy can be done to reduce the inflammation and pain.
7) stretching exercises should be done for tight Achilles tendon.
8)avoiding climbing and running up hill. It will put more friction on bony prominence and will
alleviate pain.
9)use a soft cast that will reduce friction on the bone.
● If conservstive treatments will not relieve symptoms, the doctor may recommend surgery to
remove the part of the heel bone that sticks out.
Exercises therapy
According to the american college of foot and ankle surgeons,
1) heel raise
Stand with both feet flat on the floor, shoulder width apart. If you need support, steady yourself
with your hand on a wall or table. Hold for a few seconds, then lower the heels.Hold for 5–10
seconds, and then slowly lower the heels to the ground.
Repeat this exercise 10 times twice a day.
2) Heel drop
Begin by standing with one foot on a step and the heel raised up. Slowly lower the heel down
keeping the leg straight untill the foot is parallel to the ground but not further. Then come to the
starting position. Hold for 5 to 7 secs. Repeat to the normal position and repeat 10 times twice
a day.
3) heelcord stretch
While sitting on the ground, place the center of the towel around the ball of your foot while
holding each end of the towel with your hands. Lay on your back and raise your affected leg
while you pull on the towel ends untill you feel a stretch behind your leg.Hold for 7seconds.
Repeat this exercise 10 times twice a day.
4) towel stretch
Sit on the floor with both legs out .
Wrap a towel around one foot, holding both ends.Gently pull on the towel, pulling the ball of
the foot toward the body. There should be a gentle stretch in the calf muscle.Hold for 30
seconds and relax for 30 seconds. Repeat this exercise 10 times twice a day.
5)Towel scrunches
Keep a towel on the ground in front of the chair, then sit down on the chair with your heels on
the edge of thetowel. With one foot, reach out and use your toes to grab the towel, then pull the
towel towards you under your feet. Repeat this until you run out of towel, then repeat the whole
exercise 10 times thrice a day.

Joint cracking
By Arunalaya blog

Joint cracking

Cracking a joint is manipulating one’s joints to produce a distinct cracking or popping sound. It
is sometimes performed by physical therapists, chiropractors, osteopaths
The cracking mechanism and the resulting sound is caused by nitrogen cavitation bubbles
suddenly partially collapsing inside the joints. To be able to crack the same knuckle again
requires waiting about 15 minutes before the bubbles will be able to form again.
NOTE- “Cracking of joints doesnot believe to cause arthritis”.
CAUSES
In 2015, research showed that bubbles remained in the fluid after cracking, suggesting that
the cracking sound was produced when the bubble within the joint was formed, not when it
collapsed. In 2018, a team in France created a mathematical simulation of what happens in a
joint just before it cracks. The team concluded that the sound is caused by bubbles’ collapse,
and bubbles observed in the fluid are the result of a partial collapse. Due to the theoretical basis
and lack of physical experimentation, the scientific community is still not fully convinced of this
conclusion.
The snapping of tendons or scar tissue over a prominence (as in snapping hip syndrome) can
also generate a loud snapping or popping sound.
For many decades, the physical mechanism that causes the cracking sound as a result of
bending, twisting, or compressing joints was uncertain. Suggested causes included:
1)Cavitation within the joint—small cavities of partial vacuum form in the synovial fluid and then
rapidly collapse, producing a sharp sound.
2)Rapid stretching of ligaments.
3)Intra-articular (within-joint) adhesions being broken.
4)Formation of bubbles of joint air as the joint is expanded.
Why do people do it?
Studies show that as many as 54 percent of people crack their knuckles. They do it for a lot of
reasons, including:
Sound. Some people like hearing the sound knuckle cracking makes.
The way it feels. Some people think cracking their knuckles makes more room in the joint, which
relieves tension and increases mobility. However, although it may feel like there’s more room,
there’s no evidence that there actually is.
Nervousness. Just like wringing your hands or twirling your hair, cracking your knuckles may be a
way to occupy your hands when you’re nervous.
Stress. Some people who are stressed need to take it out on something. Cracking knuckles may
allow for diversion and release without actually causing harm.
Habit. Once you start cracking your knuckles for any of these reasons, it’s easy to keep doing it
until it happens without even thinking about it. When you find yourself unconsciously cracking
your knuckles many times a day, it’s become a habit. People who do it five times a day or more
are called habitual knuckle crackers.
Tips to stop cracking
1)Although cracking your knuckles isn’t harming you, it may be distracting to people around you.
You might find it difficult to stop if it’s become a habit.
2) Some tips that might help you break the habit:
3)Think about why you crack your knuckles and address any underlying issues.
4)Find another way to relieve stress, such as deep breathing, exercise, or meditation.
5)Occupy your hands with other stress relievers, such as squeezing a stress ball or rubbing a
worry stone.
6)Become aware of each time you crack your knuckles and consciously stop yourself

SHORTNESS OF BREATH
By Arunalaya blog

Shortness of Breath

Introduction- shortness of breath is the uncomfortable sensation of not getting enough air
to breathe. This may occur while walking, climbing stairs, running or even when sitting still. It
is also termed as dyspnoea. Sometimes it can be harmless as the result of exercise or nasal
congestion. In other situation, it may be a sign of a more serious heart or lung diseases.
CAUSES –
1) Anaphylaxis ( allergic reaction)
2) Asthma
3) Carbonmonooxide poisoning
4) COPD
5)Coronavirus disease 2019
6) Heart attack
7)Heart arrhythmia
8) Pneumonia
9) Pneumothorax
10) Pulmonary embolism
Diagnosis
1) Blood tests- Arterial blood gases and blood oxygen saturation may be measured.
2) Exercises test- blood pressure, heart rate and changes in breathing rate can be measured
during exercises and rest
3) Electrocardiogram- An ECG records the electrical activity of the heart and shows abnormal
rhthym.
4) Echocardiogram- An echo uses ultrasound waves to produce a moving pictures of the heart
and heart valves
5) Chest x rays- An x ray will help assess lung conditions
6)Ct scan of the chest.
Severity of dyspnea
Modified Medical Research council dyspnoea scale.
Grade 0- strenous exercises
Grade 1- hurrying up or walking up a hill
Grade 2- walks slower than people of same age or stops for taking breath
Grade 3- stops for breath after walking 100m
Grade 4- breathless while dressing and underdressing breathless to leave the home.
Types of dyspnea
Orthopnea- it is the feeling of dyspnea in the recumbent position, releived by sitting or standing.
Paroxysmal nocturnal dyspnea- its a sensation of dyspnea that awakens the patient, often after
1 or 2 hours of sleep, and is usually relieved in the upright position.
Trepopnea – it is a sensation of dyspnoea that occurs in one lateral decubitus position as
opposed to the other.
Platypnea- it is a sensation of dyspnoea that occurs in the upright position and is releived with
recumbency.
Management
Treatment will depend upon the cause of the problem.
In severe cases , supplemental oxygen will be needed . Those with asthma or copd may have an
inhaled rescue bronchodilator to use when necessary.
If dyspnoea is linked to asthma, it typically responds well to medications such as bacterial
pneumoniae , antibiotics can bring relief.
Other medication such as opiates, NSAIDS and anti- anxiety drugs can also be effective.
Physiotherapy management
Physiotherapist can offer a variety of treatments to both adults and children who suffer from
shortness of breath, giving them back the independence and control of their symptoms. Some
of the treatments and techniques used are:
1) Breathing techniques
2) Manual techniques
3) Postural drainage
4) lifestyle advice
5) flutter valve
6) incentive spirometery
7) ACBT
Breathing exercises1) pursed lip breathing helps empty the lungs of dead spaces air that occurs in COPD.
To perform pursed lip breathing:
1) relax your neck and shoulder muscles.
2) slowly breathe in through your nose for two counts, keeping your mouth closed.
3) purse your lips as if you are about to whistle.
4) breathe out slowly and gently through your pursed lips to the count of four.
Sitting forward supported by a table.
1) Sit in a chair with your feet flat on the floor, facing a table.
2) lean your chest slightly forward and rest your arms on the table .
3) Rest your head on your forearms or on a pillow.
Diaphragmatic breathing
1) Sit in a chair with bent knees and relaxed shoulders, head and neck.
2) place your hand on your belly.
3) Breathe in slowly through your nose . You should feel your belly moving under your hand.
4) As you exhale, tighten your muscles . You should feel your belly fall inward. Breathe out
through your mouth with pursed lips.
5) Put more emphasis on the exhale than the inhale. Keep exhaling for longer than usual before
slowly inhaling again.
6) Repeat for about mins.

By Arunalaya blog

Rheumatoid arthritis

Rheumatoid arthritis is an autoimmune disease and inflammatory disease. RA commonly
afffects joints in the hand, wrist and knees. In a joint with RA the linings of the joint becomes
inflamed, causing damage to the joint tissue. This tissue damage leads to severe joint pain and
deformities.
RA can affect other tissues throughout the body and can cause problems in organs such as
lungs,heart and eyes.
Sign and symptoms of RA
1) pain in more than one joint
2) stiffness in more than one joint
3) tenderness and swelling in one or more than one joint.
4) deformities
5) the same symptoms on both sides of the body
6) weight loss
7) fever, fatigue, weakness.
Risk factors of RA
1) age- RA can begin at any stage , but the likelihood increases with advanced age. Most
common in sixties.
2) sex- women are more prone to this than men
3) genetics- people born with certain genes are more likely to develop RA . These genes are HLA
( human leukocyte antigens) class 2 genotypes, can also make your arthritis worse.
4) smoking- smoking increases a person’s risk of developing RA and can make the disease
worse.
5) history of giving birth- women who have never given birth may be at a greater risk of
developing RA.
6) obesity- being obese can increase the risk of developing RA.
Diagnosis of RA
Rheumatologists will look for sign and symptoms and medical history.
1) looking for swelling and redness.
2) examining joint function,ROM
3) to check warmth and tenderness
4) examining for skin nodules.
5) testing for reflexes and muscle strength.
Since no single test can detect RA. They may also request certain imaging test such as x ray,
MRI, Ultrasound.
Blood test for RA:
1) rheumatoid factor test- this check for a protein called rheumatoid factor. High level of
rheumatoid factor are associated with autoimmune disease .uu9uuu99uu9uu
2) Anticitrullinated peptide antibody test- this test looks for an antibody thats associated with
RA . People have this antinody usually have this disease . The anti ccp test is more specific for
RA then RF blood test and is often positive before the RF test.
3) Erthrocyte sedimentation rate: The ESR helps to determine the degree of inflammation
anywhere in your body. However it doesnot indicate the cause or site of inflammation.
4) C reactive protein test: A severe infection or significant inflammation anywhere in your body
can trigger your liver to make C reactive protein. Higher levels are associated with RA.
TREATMENT
Note- There is no cure for RA.
Treatment aims to reduce the inflammation and symptoms.
1) NSAIDS- it can releive pain and lessen inflammation . It includes ibuprofen and naproxen
sodium. Side effects could be heart problems, kidney damage, stomach irritations.
2) Steroids: prednisone reduces inflammation and slow joint damage side effects may include
thinning of bones, weight gain, diabetes.
3) Conventional DMARDs : these drugs can slow the process of joint damage. Common
DMARDs are methotrexate, lefluonomide, hydroxychloroquine. Side effects may include liver
damage and lung infections.
4) Surgery includes synovectomy, tendon repair, joint fusion, total joint replacement.
5) Exercises can improve joint range of motion, apply heat or cold to ease pain.
Rheumatoid hand: it includes the joint deformities of hand in RA.
1) Boutonniere deformity- it occurs when the middle or proximal interphalangeal joint of a finger
is flexed and the distal joint is extended.
2) swan neck deformity- the most common in RA . It occurs when there is weakness or tearing
of ligament due to inflammation . This laxes the joint of the finger and flexion of the distal joint.
3) Hitchhiker’s thumb: it occurs when the thumb flexes at the metacarpophalangeal joint
hyperextends at the interphalangeal joint. It is also called z shaped deformity.
4)Rheumatoid nodules: these are hard lumps that form under the skin near the joints. They can
occur in multiple areas, most commonly near your elbows. Usually these are not painful.
PHYSIOTHERAPY MANAGEMENT:
Assesment and evaluation
1) Assesment of posture
2) Testing muscle strength and power
3) Measuring joint movement
4) gait analysis
Treatment
1) cold therapy in acute phase for 10 to 20 mins twice a day.
2) Heat therapy in chronic phase for 20 to 30 mins twice a day
3) TENS will give short term pain releif.
Exercises for acute phases1) assisted movement through normal range .
2) static muscle contraction helps to maintain muscles tone without increasing inflammation.
3) for chronic cases we can progress the above exercises to include light resistance.
4) postural, core stability exercises.
5) Swimming, walking, cycling to maintain cardiovascular fitness.
6) gentle stretching of tight muscles.
7) maintaining muscle strength is important for joint stability & preventing injury.
8) Muscles can become weak following reduced activity.
9) Muscles length can be affected by prolonged positions and immobilization and tightness can
limit daily activities.
10) Splints will be provided for every deformity to keep the joint in correct position.
11) Advanced physiotherapy techniques like dry needling, manual muscle release will be
unbeatable in correcting muscle stiffness and releiving joint pains.
12) Iontophoresis is believed to work through the transcutaneous deleivery of charged
medications like lidocaine,corticosteroids, salicylate, antibiotics. It is used for deleivery of
substances that need local penetration in order to avoid systemic effects.
13) orthotic devices can make activities of daily living much easier, leading to a greater degree
of independence.

By Arunalaya blog

Reactive arthritis

Reactive arthritis is joint pain and swelling triggered by an infection in another part of the body
mostly in genitals, intestines, genitals and urinary tracts.
This condition usually targets the knees, ankles and feet. Inflammation also can affect the eyes,
skin and the tube that carries urine out of the body (urethra). Previously, reactive arthritis was
sometimes called Reiter’s syndrome.
Sign and symptoms
Incubation period is 1 to 4 weeks.
Pain and stiffness- pain in joints of knee, ankles, low back, heels.
Eye – people who have this arthritis develops an eye inflammation ( conjunctivitis ).
Urinary problems: inflammation of prostate gland and cervix, discomfort during urination.
● Reactive arthritis occurs in reaction to an infection by certain bacteria. Most often, these
bacteria are in the genitals (Chlamydia trachomatis) or the bowel (Campylobacter, Salmonella,
Shigella and Yersinia). Chlamydia most often transmits by sex. It often has no symptoms but can
cause a pus-like or watery discharge from the genitals. The bowel bacteria can cause diarrhea. If
you develop arthritis within one month of a gastrointestinal or a genital infection especially with
a discharge see a health care provider. You may have reactive arthritis.
Reactive arthritis tends to occur most often in men between ages 20 and 50. Some patients
with reactive arthritis carry a gene called HLA-B27. Patients who test positive for HLA-B27 often
have a more sudden and severe onset of symptoms. They also are more likely to have chronic
(long-lasting) symptoms. Yet, patients who are HLA-B27 negative (do not have the gene) can still
get reactive arthritis after exposure to an organism that causes it.
Patients with weakened immune systems due to AIDS and HIV can also develop reactive
arthritis.
Diagnosis
There is no specific test for diagnosing reactive arthritis, but the doctor may check the urtheral
discharge for STD. Stool samples may also be tested. Blood reports shows positive for the HLAB27 genetic marker and alongwith wbc count esr increases. Patient will also have less rbc.
X rays reports shows bone loss, signs of osteoporosis , bony spurs , back joints and pelvis may
show abnormalities.
Doctor will also test for eye and UTI which can confirm the disease.
Treatment/ Medical Management
Microbial therapy is strongly recomended for 3 to 6 months for an microbial infection.
Antibiotics should be started soon without any delay. NSAIDS are the first choice of treatment.
Main goal is to reduce the symptoms and prevent complication.
Mechanical devices like orthotics, insoles can be used.
Medical management:
Goal of physiotherapy management
1) reduce inflammation
2) reduce pain
3) improve rom
4) increase cardiovascular fitness
Cryotherapy should be intiated to intiated early at acute stage to control inflammation and
swelling around the affected joints.
Electrical stimulations like TENS, IFT to ease pain . Range of motion and stretching exercises
for all joints to avoid any stiffness in the joint, strengtheing exercises will be intiated to improve
power of muscles.
Patient education – this is necessary to promote joint protection and proper body mechanics
when performing daily activities to maintain joint integrity.
Aerobic exercises should include low impact activities such as swimming, walking depending on
patient’s age and cardiovascular level.
Other advance techniques like dry needling and taping have shown great benefits in releiving
pain and stiffness.
Physiotherapy management will target the affected joint and its attachments

By Arunalaya blog

How Physio can Help with Asthma?

Asthma is a long term condition affecting children and adults. The air passage in the lungs
becomes narrow due to inflammation and tightening of the muscles around the small airways.
This causes asthma symptoms: cough, wheeze, shortness of breath and chest tightness. These
symptoms are intermittent and are often worse at night or during exercise. Other common
“triggers” can make asthma symptoms worse. Triggers vary from person to person, but can
include viral infections (colds), dust, smoke, fumes, changes in the weather, grass and tree
pollen, animal fur and feathers, strong soaps, and perfume.
Symptoms of asthma
1) Coughing at night, laughing or during exercise.
2) tightness in the chest
3) shortness of breath
4) difficulty talking
5) anxiety and panicking
6) fatigue, chest pain
7) rapid breathing
8) sleep interruptions
9)confusion
10)dizziness, pale lips and fingernails
Triggers include:
Respiratory infections, exercise, allergens, pests, enviornmental irritants, intense emotions,
extreme weather conditions.
Diagnosing asthma:
Pulmonary function test confirms the asthma. This can detect the stenosis in the lumen of
airways. Asthma is usually suspected by a healthcare provider based on a pattern of symptoms
and response to medicine called a bronchodilator that can releif the squeezing of the muscles
around the airways. Blood test to check for increased levels of eosinophils and immunoglobulin
E .
Management of asthma:
1) Bronchodilators that relax muscles around the airways.
2) Antibiotics to fight for any bacterial pneumonia and bronchitis.
3) Anti- inflammatory medications such as inhaled corticosteroids for long term, and oral
steroids for acute attacks
PHYSIOTHERAPY MANAGEMENT
Main aim of physiotherapy management will be to ease breathing and remove lung secretions
through chest physiotherapy.
Instructions are given from the respiratory therapist to how to cope up with the dyspnoea.
1) Decreasing breaths taken ( reducing respiratory flow).
2) taking smaller breaths ( reducing tidal volume)
3) Deep breathing ( diaphragmatic breathing through use of abdominal muscles and lower
throacic chest movements).
4) pursed lip breathing . Deep inhale from nose and exhaling through mouth like blowing air out.
5) relaxation plays vital role in managing asthma attacks. Sitting in semi flexed position keeping
4 to 5 pillows on the back for support will ease breathing .
6) deep breathing techniques. Inhale deep for 4 sec hold for 5 sec and blow out through mouth
slowly in 6 sec.
7) removal of secretions is very important as it triggers cough. Removal of chest secretions
through
a) percussions ( frequency should be more than intensity, intensity should be extreme low in
osteoporotic patients, or use vibrators in such patients)
b) shaking
c) vibrations
d) postural drainage
e) FET by huff cough.
8) Range of motion exercises for bed ridden patients to avoid any contractures.
9) Educate the patient about use of bronchodilators and breathing exercises.
10) correct posture in standing and sitting which will assist in the management of asthma
attacks by allowing the chest to expand appropriately and lungs to function optimally.
INSPIRATORY MUSCLES TRAINING: it can be trained for both strength and endurance
with an external resistive device. Exercise induced bronchoconstriction as well as chronic
bronchoconstriction in asthmatics is associated with increased inspiratory muscle work. It is
reasonable to suggest that increasing the strength of the inspiratory muscles in people with
asthma may reduce the intensity of dyspnea and improves exercise tolerance.
Breathing exercises, inspiratory muscle training, physical training and airway clearence are the
most relevant treatment options for asthmatic patients.

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

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