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Diabetic Ulcers
By Arunalaya 0 Comments blog

Physiotherapy Management of Diabetic Ulcers

Diabetic ulcers are a significant complication of diabetes, affecting approximately 15% of individuals with the condition. This blog provides an overview of diabetic ulcers, including their types, causes, risk factors, clinical features, assessment, and physiotherapy management.

Introduction

A diabetic ulcer is an open sore or wound commonly located on the bottom of the foot. These ulcers arise from factors such as poor circulation, high blood sugar levels, and nerve damage. The condition is further complicated by delayed healing due to restricted blood supply and infections. Understanding the types, assessment, and management of diabetic ulcers is crucial for effective treatment and prevention.

Types of Diabetic Ulcers

Neuropathic Ulcers

  • Occur due to peripheral diabetic neuropathy without ischemia caused by peripheral artery disease.

Ischemic Ulcers

  • Arise where there is peripheral artery disease without diabetic neuropathy involvement.

Neuro-ischemic Ulcers

  • Result from a combination of peripheral neuropathy and ischemia.

Nature and Sites

  • Diabetic ulcers are deep and spreading, commonly affecting the toes, soles of the feet, and occasionally, the legs, hands, fingers, and arms.

Diabetic Foot Ulcers

Diabetic foot ulcers are full-thickness wounds on the plantar surface of the foot. They are characterized by neuropathy, ischemia, and infection. High plantar pressures often cause these ulcers, especially at the second metatarsal head.

Etiology of Diabetic Ulcers

Diabetes affects nerves through two primary pathways:

  1. Free Radical Damage
    • Rogue oxygen molecules damage cells, leading to inflammation.
  2. Reduced Vascular Supply
    • Narrowing of arteries restricts blood flow, delaying wound healing and causing nerve damage.

High blood sugar levels and associated conditions (e.g., high cholesterol, hypertension) exacerbate these effects, leading to neuropathy, impaired sensation, muscle weakness, and abnormal foot structures.

Risk Factors for Diabetic Foot Ulcers

  • Diabetes
  • High cholesterol levels
  • Coronary heart disease
  • Hypertension
  • Atherosclerosis
  • Previous history of foot ulcers or amputations
  • Poor glycemic control
  • Smoking

Classification of Diabetic Foot Ulcers

The Meggitt-Wagner Classification outlines the severity of diabetic ulcers:

  • Grade 0: No ulcer in a high-risk foot.
  • Grade 1: Superficial ulcer without underlying tissue involvement.
  • Grade 2: Deep ulcer penetrating to ligaments or muscle, no bone involvement.
  • Grade 3: Deep ulcer with cellulitis, abscess, or osteomyelitis.
  • Grade 4: Localized gangrene.
  • Grade 5: Extensive gangrene involving the whole foot.

Clinical Features of Diabetic Ulcers

  • Redness, swelling, or discoloration around the wound.
  • Break in the skin, discharge, or itching.
  • Dryness and pain.
  • Thickened or callused skin around the ulcer.
  • Fever and chills in advanced stages.

Assessment of Diabetic Ulcers

History Taking

  • Ulcer onset, self-treatments, history of infection, and prior interventions.
  • Medical history of diabetes, autoimmune, metabolic, or cardiac conditions.
  • Surgical history, including previous amputations or debridement.
  • Personal history, such as smoking or alcohol use.

Examination

  • Skin Status: Visual inspection for peeling, maceration, and fissures.
  • Neurological Status: Semmes-Weinstein monofilaments or 128 Hz tuning fork to assess sensation.
  • Vascular Status: Checking pedal pulses, capillary refill time, and Doppler ultrasound findings.
  • Ulcer Evaluation: Noting site, size, depth, discharge, and surrounding tissue condition.

Imaging

  • X-rays for deep wounds and MRI for detecting osteomyelitis or abscesses.

Physiotherapy Management

Physical Therapy Modalities

  1. Thermotherapy
    • Infrared lamps and ultrasound therapy improve blood flow and cell metabolism.
  2. Electrotherapy
    • Electrical stimulation enhances wound repair.
  3. Shockwave Therapy
    • Focuses sound waves to improve soft tissue healing.
  4. Laser Treatment
    • Effective for microcirculation and pain relief.
  5. Galvanic Current
    • Direct electrical current for tissue repair.

Exercises

  • Range of motion, stretching, Buerger-Allen, and proprioception exercises enhance blood flow and sensory input.

Shoe Modifications

  • Special shoes with rocker bars, plastazote insoles, and proper cushioning distribute pressure evenly and reduce injury risks.

Nutrition Advice

  • Adequate intake of iron, vitamins (A, B12, C), zinc, and proteins is essential for wound healing.

Prevention of Diabetic Ulcers

Primary Prevention

  • Improved glycemic control and reduced cardiovascular risk factors.
  • Routine foot examinations for early detection.

Secondary Prevention

  • Quit smoking and avoid activities that may injure the feet.
  • Daily foot inspections and proper hygiene.
  • Use appropriate footwear and moisturizers (avoiding application between toes).

Conclusion

Diabetic ulcers are a complex yet preventable complication of diabetes. With appropriate physiotherapy modalities, shoe modifications, and preventive measures, patients can achieve improved outcomes and a better quality of life. Early intervention and comprehensive care play a vital role in minimizing the risks associated with diabetic ulcers.

What is scars?
By Arunalaya 0 Comments blog

What are scars?

Introduction

Scars form as a natural part of the body’s healing process after skin damage. When the skin sustains an injury, it repairs itself by generating new tissue to close the wound and fill in any gaps created by the injury. This tissue, known as scar tissue, is primarily composed of collagen. The appearance of a scar depends on various factors such as the type of injury, the location of the wound, treatment methods, and even genetic factors.

What is Scar Tissue?

Scar tissue is a collection of cells and collagen that covers the site of an injury. Unlike normal skin, scar tissue has distinctive characteristics due to its unique structural makeup

Factors Influencing Scar Appearance

Several factors affect how a scar looks, including:

  • Cause of injury: Such as surgery, burns, or severe acne
  • Wound size, severity, and location
  • Treatment: Whether the wound received stitches or bandages
  • Individual differences: Age, genetics, ethnicity, and overall health

Characteristics of Scar Tissue

Scar tissue exhibits certain characteristics that differentiate it from normal skin:

  • Disturbed alignment of collagen fibers
  • Excessive dermal fibrosis
  • Absence of elastic fibers and skin appendages
  • Altered skin texture

Types of Scar Tissue

  • Mature Scars: These can be categorized into normal, atrophic (depressed), or hypertrophic (raised).
  • Contracture Scars: Typically caused by burns, contracture scars tighten the skin, limiting movement, especially when involving muscles, nerves, or joints.
  • Depressed (Atrophic) Scars: Sunken scars commonly result from chickenpox or acne and are often referred to as “ice pick scars.”
  • Flat Scars: These scars appear pink or red initially, eventually becoming lighter or darker than the surrounding skin.
  • Keloids: Raised scars that extend beyond the initial wound area; these can become quite large and may restrict movement.
  • Raised (Hypertrophic) Scars: Elevated scars that stay within the wound boundary but never completely flatten.
  • Stretch Marks: Form when the skin rapidly expands or contracts, damaging connective tissue beneath, often occurring during pregnancy, puberty, or significant weight changes.

Clinical Differences Between Keloids and Hypertrophic Scars

  • Keloids: Non-severe, commonly found on the chest, upper back, or earlobe. Symptoms include erythema, itching, and pain, and they spread beyond the wound area.
  • Hypertrophic Scars: Often due to burns or incisions, these can occur anywhere on the body and present symptoms like erythema and itching but remain within the wound area.

Physiotherapy Treatment for Scars

Physiotherapy offers effective methods to prevent scar adhesions, reduce discomfort, and improve tissue functionality. Techniques include:

  1. Lymphatic Drainage and Scar Mobilization: Reduces adhesions, improves skin pliability, and reduces scar thickness.
  2. Kinesiotaping: Helps relax fascia, improve nourishment, reduce edema, and prevent excessive tissue growth.
  3. Dry Needling: Effective for decreasing pain and improving scar mobility. In older scars, dry needling stimulates collagen formation and skin regeneration.
  4. Instrument-Assisted Soft Tissue Mobilization (IASTM): Removes scar tissue and promotes functional normalization of soft tissue by reinitiating the healing process and increasing blood flow.

Conclusion

Scar tissue formation is an essential part of the healing process, but it can often lead to pain, restricted movement, and aesthetic concerns. Physiotherapy plays a significant role in managing scar tissue by improving tissue flexibility, reducing scar thickness, and restoring function. Using techniques like scar mobilization, dry needling, and IASTM, physiotherapy can provide comprehensive care and rehabilitation for individuals dealing with scar tissue complications.

By Arunalaya 0 Comments blog, Exercise, Physio

Kegel Exercises: The Complete Guide

Kegel exercises are designed to strengthen the muscles of your pelvic floor, providing support for your bladder and bowel function. These exercises involve a simple clench-and-release technique that targets the pelvic floor muscles. The pelvic floor refers to a collection of muscles and tissues that form a sling or hammock-like structure at the bottom of your pelvis, supporting your reproductive organs. Weakness in the pelvic floor can contribute to problems like loss of bladder or bowel control. By regularly performing Kegel exercises, you can enhance the strength and functionality of your pelvic floor muscles.

Why Do Kegel Exercises?

  • Both women and men can benefit from performing Kegel exercises to strengthen their pelvic floor muscles.
  • Various factors, including pregnancy, childbirth, aging, and weight gain, can contribute to the weakening of the pelvic floor muscles in women.
  • The pelvic floor muscles are responsible for supporting the womb, bladder, and bowels. When these muscles are weak, the pelvic organs may descend into the vagina, causing discomfort and potentially leading to urinary incontinence.
  • Men can also experience a decline in the strength of their pelvic floor muscles as they age. This can result in both urinary and fecal incontinence, especially for those who have undergone prostate surgery.

Finding the pelvic floor muscles in Women

  • When beginning Kegel exercises, it can be challenging to identify the correct set of muscles to target.
  • One method to locate these muscles is by gently inserting a clean finger into the vagina and then tightening the vaginal muscles around the finger.
  • Another way is to attempt to halt the flow of urine while urinating. The muscles engaged in this action are the pelvic floor muscles.
  • Familiarize yourself with the sensation of contracting and relaxing these muscles.
  • However, it is important to note that stopping and starting urine regularly or frequently doing Kegel exercises with a full bladder is not recommended, as it can lead to incomplete bladder emptying and increase the risk of urinary tract infections (UTIs).
  • If you are unsure whether you have correctly identified the pelvic floor muscles, it is advisable to consult with your gynaecologist for guidance.
  • Your gynaecologist may suggest using a vaginal cone, which is inserted into the vagina and held in place using the pelvic floor muscles.
  • Biofeedback training is another helpful method for identifying and isolating the pelvic floor muscles. This procedure involves the insertion of a small probe into the vagina or the placement of adhesive electrodes on the external area of the vagina or anus.
  • During the training, you will be instructed to perform a Kegel contraction. A monitor will display whether you have engaged the correct muscles and the duration of the contraction.

Finding the pelvic floor muscles in Men

  • Men can encounter similar difficulties in identifying the appropriate group of pelvic floor muscles.
  • To locate these muscles, men can try inserting a finger into the rectum and attempt to squeeze it, while ensuring that the muscles of the abdomen, buttocks, or thighs are not tightened.
  • Another helpful technique is to contract the muscles responsible for preventing the release of gas.
  • If difficulties persist, practicing the interruption of urine flow can be a reliable method. However, it is important to note that this should not become a regular practice.

Goals and Benefits of Kegel Exercises

  • Always empty your bladder before performing Kegel exercises. As a beginner, find a quiet and private place to sit or lie down for your exercises. As you practice, you will discover that you can perform them anywhere.
  • When you start doing Kegel exercises, tense the muscles in your pelvic floor for a count of three, and then relax them for a count of three. Repeat this sequence for 10 repetitions. Over the next several days, continue practicing until you can hold the muscle tension for a count of 10. Aim to do three sets of 10 repetitions every day.
  • Do not be discouraged if you do not see immediate results. According to the Mayo Clinic, it may take a few months for Kegel exercises to have an effect on urinary incontinence.
  • Additionally, Kegels work differently for each person. Some people experience significant improvement in muscle control and urinary continence, while for others, Kegels may help prevent the condition from worsening.

Cautions

  • If you experience pain in your abdomen or back following a session of Kegel exercises, it indicates that you are not performing them correctly. Remember that while contracting your pelvic floor muscles, the muscles in your abdomen, back, buttocks, and sides should remain relaxed.
  • Lastly, it is important not to overexert yourself during Kegel exercises. Working the muscles excessively can lead to fatigue and hinder their ability to perform their essential functions.

How Can you do Kegel Exercises?

  • Both men and women can perform Kegel exercises using the same approach.
  • To begin, it is important to locate your pelvic floor muscles, often referred to as PC muscles. You can identify these muscles by interrupting the flow of urine while urinating.
  • The muscles engaged in stopping the urine flow are your PC muscles.
  • These muscles also play a role in controlling the release of gas. In men, contracting the PC muscles may cause the testicles to rise.

 

Try the Easiest Kegel Exercises

  • After locating your PC muscles, you can begin practicing flexing them.
  • Contract and hold your PC muscles for a duration of 5 to 20 seconds.
  • Subsequently, release the contraction.
  • Repeat this exercise 10 to 20 times consecutively, three to four times a day.
  • Gradually increase the number of contractions and the duration of each contraction.
  • Over time, this straightforward exercise can contribute to strengthening your PC muscles.
  • This, in turn, may lead to improvements in bladder control and sexual function.

Add Variety to your Workout

  • To add variety to your Kegel workout, consider trying different variations of the basic exercise.
  • For instance, you can contract and release your PC muscles rapidly, performing several repetitions in quick succession.
  • Another option is to practice contracting the muscles slowly, emphasizing control and endurance.
  • Additionally, you can experiment with different positions while performing Kegel exercises, such as standing, sitting, or lying down.
  • While engaging in Kegel exercises, make a conscious effort to avoid tightening other muscles, such as your abdominal muscles, buttocks, or thighs.
  • It is also important not to hold your breath. Instead, maintain a relaxed and steady breathing pattern while keeping the rest of your body still and relaxed.
By Arunalaya 0 Comments blog, Exercise, Physio, Therapy

Cyclist’s Palsy

Cyclist’s palsy, also known by various names such as handlebar palsy, ulnar tunnel syndrome, ulnar nerve compression, Guyon Canal Syndrome (GCS), bicycler’s neuropathy, or tardy ulnar palsy, is an overuse injury that primarily affects the hands and fingers. It occurs when the nerves in the wrist or the side of the palm near the pinky finger become compressed due to repetitive stress.

Cause of cyclist palsy

  • Cyclist’s palsy can cause both motor and sensory symptoms.
  • The motor symptoms can include weak hand grip and difficulty using fingers for precise tasks.
  • Whereas the common sensory effects include numbness, tingling, and pain.

Although cyclist’s palsy is increasingly common, it is often underreported among cyclists. In fact, a study revealed that 7 out of 10 participants reported experiencing motor or sensory symptoms. Severe nerve injury can lead to paralysis or irreversible loss of sensation in the affected hand.

The pressure exerted on the handlebars during prolonged cycling can irritate the nerves in the palm. The highest pressure occurs where the median and ulnar nerves enter the hand, which corresponds to positions like “tops,” “ramps,” “hoods,” and “drops.” The “drops” position applies the most pressure on the ulnar nerve, while the “hoods” position applies slightly less pressure. The “tops” position places significant pressure on the palm at the base of the ring finger. The “drops” position can also cause excessive wrist extension, increasing pressure on the carpal tunnel. If a cyclist already has nerve compression at the neck or elbow, it can be more easily triggered at the palm, potentially leading to carpal tunnel syndrome or cubital tunnel syndrome.

Signs and Symptoms

  • include numbness, tingling, and sensory changes in the little finger and the ring finger on the side closest to the little finger
  • the palm in that area may also become numb, while there is no numbness on the back of the hand.
  • The symptoms can vary depending on the location of pressure. Sometimes manifesting as numbness or weakness, or a combination of both.
  • When the median nerve is affected, numbness and tingling occur on the palm side of the thumb, index, long, and ring fingers (on the side closest to the middle finger). But there is no numbness on the back of the hand.
  • Prolonged or severe pressure on the nerves can also weaken the associated muscles. Some cyclists may experience pain along with hand numbness.

Treatment

Limiting cycling is the most effective treatment for cyclist’s palsies. However, there are other measures that can allow cyclists to continue their activity while reducing the risk of exacerbating the condition. These include :

  • Limiting the length or distance of the ride
  • Having enough rest between longer cycling sessions
  • Changing positions of grip on the handlebars
  • Changing to a transverse handlebar
  • Adjusting the seat height
  • Using gloves to reduce or distribute pressure. The pressure can be reduced with foam or gel padding in the palm of the glove.

Top 3 Cyclist Palsy Exercises

In addition to these measures, exercises play a crucial role in long-term recovery and preventing recurrence of cyclist’s palsy. These exercises primarily focus on strengthening the muscles, ligaments, and tendons in the hands. The top three recommended exercises for cyclist’s palsy are as follows:

  1. Finger bending exercise: Begin by stretching your hand and then bend the fingers of the affected hand at a right angle, holding them in that position for approximately 10 seconds. Ensure that your fingers remain straight during the exercise. Repeat this process five times.
  2. Finger squeeze: Take a small object like a coin or a sheet of paper and squeeze it between two fingers, holding the grip for 10 seconds. Repeat this exercise five times for each set of fingers.
  3. Grip strengthening exercise: This exercise targets a weak hand grip. Squeeze a rubber ball with the affected hand and hold for 10 seconds and then release. Repeat 10 times, and that’s one set. Aim for 3 sets of 10 as you gradually build up grip strength.

 

By Arunalaya 0 Comments blog, Physio, Therapy

Low Back Pain Relief

Most types of low back pain are often referred to physical therapy as one of the first-line treatments. Physical therapy for low back pain includes guided therapeutic exercises that strengthen the lower back muscles and condition the spinal tissues and joints.

The short- and long-term goals of physical therapy for back pain typically include the following:

  • Decrease painful symptoms in the lower back and/or leg
  • Improve low back function to tolerate daily activities as independently as possible
  • Increase the spine’s flexibility and improve its range of motion
  • Formulate a maintenance program to prevent the recurrence of back problems

The exercises are intended to provide flexibility and strength training to the entire kinetic chain—groups of body segments, joints, and muscles that work together to perform bodily movements.

Physical therapy helps restore the patient’s ability to perform daily activities with little-to-no discomfort. Large-scale studies have shown that physical therapy can provide up to 60% improvement in lower back pain and other symptoms.

Four Categories of Therapeutic Exercises for Back Pain

Therapeutic exercises are typically performed or learned under the guidance of a physical therapist and use a combination of the approaches described below.

  1. Core-Strengthening Exercises

In simple terms, the body’s core can be described as the area surrounded by the stomach muscles in front, the spinal and buttock muscles at the back, the bottom of the lungs or the diaphragm on top, and the muscles of the pelvis and hip at the bottom.  A weak core distributes weight unequally throughout the spine and into the legs, causing back pain or worsening existing back pain. Core-strengthening exercises help build strength and endurance in the core muscles, significantly reducing pain and improving functionality in the lower back.

Easy-to-perform core-strengthening exercises to relieve back pain include the pelvic tilt, cat-cow pose, bird dog, high and low planks, crunches, and exercises performed using a Swiss Ball.

  1. Lumbar Stabilizing Exercises

A strong spine needs strong hips and legs to support the lower body, and to walk, bend, and twist effortlessly. Inefficiency of the muscles in the hips and legs has been proven to cause spinal instability and pain. Stretching exercises can activate and strengthen these muscles, such as the iliopsoas and hamstrings; improve coordination between the hip and spine; and aid in the transfer of forces across the lower back, pelvis, and legs.

Hip and leg exercises for beginners with lower back pain typically include hamstring stretches, squats, downward dog, planks with leg lifts, and lunges.

  1. Aerobic exercises

Aerobic or cardiovascular exercise not only helps maintain a healthy heart but also heals the spinal muscles. Cardiovascular exercise involves synchronized movement in the body, which increases the heart rate, thereby improving circulation, oxygen content within the cells, and energy production in the tissues. Through these mechanisms, the painful spinal muscles respond by becoming less stiff and more mobile.

Simple aerobic exercises for back pain include brisk walking, a stationary bike, and an elliptical trainer. Low-impact aerobic conditioning can be achieved through aquatic exercise. The buoyancy of water supports the body’s weight, reducing stress on the spine and allowing for a greater range of motion.

  1. Postural Training

Supported posture minimizes strain on the body by maintaining a balance of the muscles and bones.  Unsupported posture can result from habit, painful symptoms, or ergonomics at work or home. Specifically in the spine, using incorrect posture can limit the movement of the tendons and muscles, making regular day-to-day movements difficult and painful.  Posture correction exercises aim to stretch and strengthen the back and abdominal muscles and the kinetic chain, which help stabilize the spine.

Common posture correction exercises include calf stretching, seated squats, pelvic tilts, and abdominal strengthening exercises.

Physical therapy is a multi-component program that includes education, training, strength, flexibility, and endurance. A physical therapist plays a key role in designing a program suitable to the needs and limitations of the patient. A therapist’s goal is to teach the proper exercise technique, so the patient can perform the exercise on their own.

Duration of a Physical Therapy Program for Low Back Pain

The total length of an exercise program depends on the severity and duration of the low back symptoms.

  • For chronic low back pain, physical therapy typically starts with an 8-week program performed under the guidance of a physical therapist.
  • A longer-term maintenance or rehabilitation therapy is prescribed after the guided phase, which can be done at home.

The duration of the guided program may increase or decrease based on the outcome of the treatment.

Physical therapy may be combined with other nonsurgical treatments for the lower back to improve the overall pain outcome. Hands-on alternative treatments, such as massage therapy, manual therapy, and accupuncture may be beneficial when performed in combination with a physical therapy regimen.

By Arunalaya 0 Comments blog, Physio, Therapy

Understanding Asperger’s Syndrome: Insights into a Unique Neurodevelopmental Condition

Asperger’s Syndrome is a developmental disorder characterized by challenges in social interaction and rigid, repetitive behavior and thinking patterns.

Children and adolescents with Asperger’s Syndrome generally have the ability to communicate verbally and perform reasonably well academically. However, they struggle with comprehending social situations and subtle forms of communication such as body language, humor, and sarcasm. They may exhibit a tendency to focus excessively on one particular topic or interest and prefer a limited range of activities. These intense interests can become all-consuming and disrupt daily life.

Symptoms

The symptoms of Asperger’s Syndrome include difficulties in social interactions, obsessions, unusual speech patterns, limited facial expressions, and other distinctive mannerisms. Children with Asperger’s Syndrome may engage in repetitive routines and display heightened sensitivity to sensory stimuli.

While every child with Asperger’s Syndrome is unique, their notable traits lie in their atypical social skills and fixated interests. When observing a child with Asperger’s Syndrome, one may notice one or more of the following symptoms:

  • Inappropriate or minimal social interactions
  • Conversations that almost always revolve around themselves or a certain topic, rather than others
  • Not understanding emotions well or having less facial expression than others
  • Speech that sounds unusual, such as flat, high-pitched, quiet, loud, or robotic
  • Not using or understanding nonverbal communication, such as gestures, body language and facial expression
  • An intense obsession with one or two specific, narrow subjects
  • Becoming upset at any small changes in routines
  • Memorizing preferred information and facts easily
  • Clumsy, uncoordinated movements, including difficulty with handwriting
  • Difficulty managing emotions, sometimes leading to verbal or behavioral outbursts, self-injurious behaviors or tantrums
  • Not understanding other peoples’ feelings or perspectives
  • Hypersensitivity to lights, sounds and textures

Children with Asperger’s Syndrome typically demonstrate normal language development without significant delays. They often exhibit strong grammar skills and possess an extensive vocabulary. However, their use of language may be characterized by a literal interpretation of meaning, making it challenging for them to navigate social contexts effectively.

Regarding cognitive development, there is typically no noticeable delay in children with Asperger’s Syndrome. While they may struggle with attention span and organization, their intelligence quotient (IQ) tends to fall within the average range.

Causes

  • The causes of Asperger’s Syndrome are unknown.
  • Genetics and brain abnormalities may be involved.
  • We do know that Asperger’s Syndrome is NOT the result of a child’s upbringing or poor parenting.
  • It is a neurobiological disorder, meaning it is just a part of the child’s brain development, whose causes are not fully understood.

Treatment

Treatment usually includes:

  • Social skills training
  • Behavior supports
  • Cognitive behavioral therapy
  • Parent education and training
  • Speech-language therapy
  • Occupational therapy

Physiotherapy Treatment

  • Physical therapy for individuals with Asperger’s Syndrome primarily focuses on improving gross motor skills such as crawling, sitting, rolling, walking, and running.
  • As children with Asperger’s Syndrome grow older, physical therapy may involve more advanced tasks like jumping, stair climbing, throwing, and catching.
  • These motor skills are crucial for both physical development and active participation in play and sports.
  • During physiotherapy sessions, the individual’s physical abilities will be assessed and evaluated to determine the nature and extent of any challenges, leading to the formulation of an appropriate treatment plan.
  •  The physiotherapist will develop a personalized treatment plan based on the individual’s specific needs and abilities.
  • Physiotherapy will encompass a range of exercises and therapeutic programs aimed at improving physical abilities, coordination, and balance.
  • Collaboration between physiotherapists and educational professionals is vital to ensure awareness of any gross motor skill challenges and to provide effective strategies and interventions for managing these difficulties.
By Arunalaya 0 Comments blog, Physio

Beyond Traditional Therapy: Harnessing the Potential of Dry Needling

Dry needling is a therapeutic technique that involves using a thin needle to target and treat muscular trigger points and areas of tissue tenderness.

It is commonly used to address various issues :

  • musculoskeletal issues like neck pain, low back pain
  • sciatica
  • muscle strains
  • IT band syndrome
  • plantar fasciitis
  • fibromyalgia, and more.

Every year, new treatment techniques claiming to be the latest and greatest in pain reduction and improved function emerge, but many of them fade away over time.

How is Dry Needling Different?

While dry needling may have recently caught your attention, it has been around for several decades. In the early 1940s, trigger points were injected with different substances to alleviate tender points. However, a study in 1979 revealed that needling alone, without injections, produced a unique pain-relieving effect. This discovery led to the development of dry needling as we know it today.

Understanding this brief history is crucial because it is not a new concept and has been used in some form for over 40 years. It is increasingly prevalent in physical therapy practice.

Effectively Releases Trigger Points

  • Dry needling specifically targets taut muscle bands known as trigger points, commonly referred to as muscle knots.
  • Trigger points can result from various factors such as tissue trauma, overuse, prolonged bed rest, stress, tension, and poor posture.
  • They can cause pain that radiates to other parts of the body. For example, a trigger point in the upper back can cause headaches, neck pain, back pain, or jaw pain.
  • By stimulating and releasing these muscle knots, it reduces tightness, alleviates pain, and improves muscle flexibility.

Reduces Reliance on Medications

Dry needling has become an integral part of pain management programs due to its effectiveness in addressing both acute and chronic pain, thereby reducing the need for medication reliance. It is often used in conjunction with other therapeutic modalities to achieve optimal outcomes such as :

  1. manual therapy
  2. massage
  3. exercise
  4. heat therapy/ hydrotherapy and
  5. kinesiology taping

The technique can also be employed to treat latent trigger points, which may not be causing evident pain yet but can become problematic if left untreated.

It is a generally well-tolerated procedure with very minor side effects, such as :-

  • soreness
  • discomfort, which subside just within a few hours after the treatment.

Dry Needling in Patel Nagar, Delhi

For exceptional physical therapy services in Delhi, we invite you to visit Arunalaya Health Care Physiotherapy Centre. We employ dry needling as one of our innovative treatment modalities to ensure the best possible outcomes for a wide range of musculoskeletal, neurological, and pediatric issues.

To learn more about dry needling and whether it is right for you, consult Dr. Chakshu Bansal (PhD. , MPT, BPT).

Contact us at: 8090080906, 8090080907

By Arunalaya 0 Comments blog, Exercise, Physio

ROLE OF PHYSIOTHERAPY IN HIP DYSPLASIA

Hip dysplasia or developmental dislocation of the hip (DDH), is an abnormal formation of the hip joint. In hip dysplasia, the femoral head (the ball) fits too loosely into the acetabulum (the socket), causing instability. The disorder typically develops during gestation or shortly after birth, but may develop later in childhood. In the past, this condition was referred to as congenital dysplasia of the hip (CDH).

CAUSES

Many people are born with hip dysplasia but are likely unaware because symptoms don’t often present themselves until adulthood.

Other times, it is typically developed within the first year of a person’s life.

Adults can develop hip dysplasia, but it is most often a diagnosis that wasn’t determined in childhood likely from a lack of symptoms.

PHYSICAL SYMPTOMS

Someone suffering from hip dysplasia may:

  • Have legs that are different lengths
  • Have a leg that turns outward
  • Have uneven skin folds on their groin or thigh
  • Lean to one side when standing
  • Have minimal or complete loss of range of motion in the hip
  • Limp when walking

INTERNAL SYMPTOMS

Someone suffering from hip dysplasia may have internal symptoms like:

  • Pain when sleeping on the affected hip
  • Pain in the groin that increases with activity
  • A sensation of popping, snapping or catching at the hip
  • A stiff hip joint

PHYSIOTHERAPY TREATMENT

Weight loss and other lifestyle changes can improve the condition.

Physiotherapy includes

  • leg stretching particularly hip abductions

  • Banded lateral walk

  • Glute activation

When engaging in physical therapy exercises, it is usual for patients to be provided with applied heat before the exercise regimen and ice packs afterwards.

Physical therapy is a great option for patients to help:

  • Strengthen muscles surrounding the hip
  • Joint mobility
  • Correct poor posture
  • Tendon inflammation
  • Gait
  • Body awareness

Advance physiotherapy treatment

  • MFR
  • Kinesiology tape
  • Dry needling

Medical professionals also may recommend:

  • Including low- or non-impact exercises into your weekly routine to strengthen muscles and increase range of motion like:
  • Swimming
  • Aquatic therapy
  • Cycling
  • Bodyweight exercises
  • Losing or maintaining weight to reduce the stress and pain in the hip
  • Hippotherapy to improve motor function
By Arunalaya 0 Comments blog, Exercise, Physio, Therapy

W-Sitting: The Negative Impact on your Child

The w-sitting posture is sitting on the floor with both thighs rotated inwards and the feet outwards on both sides of the body (the legs make a W shape, hence the name).”

As we age, achieving the w-sitting posture becomes challenging for adults due to the gradual loss of hip mobility. This decline in mobility can be attributed to the natural growth of our muscles and bones, as well as the lack of exposure to extreme hip flexion in Western cultures.

In contrast, children find it easier to adopt the w-sitting posture. Their hip joints possess greater mobility, and they often spend significant amounts of time in positions with flexed hips. It is common for many typically developing children to occasionally transition into this posture during their playtime.

Children who have low resting muscle tone and/or joint hypermobility, characterized by “floppy” muscles, often find it effortless to adopt the w-sitting posture. They may even find it comfortable. Children with tight leg muscles, such as those with cerebral palsy, may have limited options and find the w-sitting posture as the only sustainable position for them.

Why Do Toddlers/Children W Sit?

  • Bone alignment/positioning in utero (how your child is built can predispose them to W sit)
  • Core/trunk weakness
  • Excessive hip flexibility and/or joint hypermobility
  • Low muscle tone (check out these exercises for hypotonia)
  • It’s easier! A wider base is easier, requires less muscle work, and is less fatiguing

Why physiotherapist don’t like W sitting?

Physiotherapists generally discourage the practice of W sitting for the following reasons:

  1. Inward rotation of knees: W sitting places the knees in a position of increased inward rotation. This can result in added stress on the knee joints, potentially leading to knee pain and discomfort over time.
  2. Potential for in-toeing: W sitting has the potential to contribute to in-toeing, particularly in children who are already hypermobile. In-toeing refers to a tendency for the feet to turn inward instead of pointing straight ahead. W sitting can exacerbate this condition, affecting the alignment and stability of the lower limbs.
  3. Leads to turned in toes: Feet turning in while they W sit day after day for several years can lead to turned-in toes in other activities, like standing, cruising, and walking.
  4. Makes walking difficult
  5. Limits Core strength and rotation
  6. Decreases Mobility in hips and ankles

To promote optimal musculoskeletal development and minimize the risk of knee-related issues and in-toeing, physiotherapists generally encourage alternative sitting positions that maintain proper alignment and promote healthy joint positioning.

What Can You Do About W Sitting ?

  1. Stretch

 You won’t be successful getting rid of W sitting if your child is tight. A good stretch needs to last at least 30 seconds. Singing songs or watching short videos can help pass the time!

  • Butterfly stretch
  • Hamstring stretching
  • Ankle stretching
  • Prevent in-toeing of the foot

  1. MFR
  2. KINESIOLOGY TAPING
  3. DRY NEEDLING
  4. STRENGTHENING CORE
  5. Break the habit
By Arunalaya 0 Comments blog, Physio

Pain-Free Periods: The Transformative Influence of Physiotherapy on Menstrual Cramps

Menstrual cramps are a major problem for many women. The pain connected with the menstrual cycle can be debilitating in certain situations. Cramps are caused by a variety of factors, and understanding these factors might help you find relief.
Women are increasingly resorting to physiotherapy to alleviate period discomfort.
Many of the pain-related symptoms that women encounter each month can be reduced or eliminated with physiotherapy.

Minimising Menstrual Cramp Discomfort

Menstrual cramps can be relieved in a variety of ways:

  • Many women benefit from stretching treatments that focus on the low-back and abdominal muscles.
  • Furthermore, contract-and-relax techniques can be utilised to enhance blood flow to muscles and aid in the reduction of stress.

How Physiotherapy Helps with my Menstrual Cramps?

Muscle cramping is commonly felt in the lower back, abdomen, and hips soon before or during menstruation. Physiotherapy can help relieve cramps by using the therapies listed below.

1. Heat Pack

Heat packs help to relieve pain by increasing circulation and relaxing strained or tight muscles. Heating pads have the similar impact on uterine muscles when used to ease cramps, allowing them to relax more.

2. Modalities

Modality like transcutaneous electrical nerve stimulation (TENS) units can help reduce pain with periods. it is usually applied on the abdomen, hip, pelvis and low back.

3. Manual Therapy

If you are having pelvic pain with your periods, manual therapy like connective tissue release and massage done by physiotherapists can help in relieving the pain and also relaxing the tension around the pelvic area.

  • Pelvic floor muscles
  • to reduce muscle sensitivity and tenderness (both in the pelvic floor muscles as well as muscles around the pelvis) does seem to reduce cramping during menses.
4. Exercise

Period cramps can be relieved by exercises such as the cat cow and child pose. Pilates and breathing exercises can also help with menstruation cramps.

5. MOVEMENT- BASED APPROACHES

Movement is what we do in physical therapy, and certain exercises which help with movement of the spine and abdomen can be very helpful in improving pain levels.

There are few exercises that are contraindicated to do during menstruation cycle. Here is the list of few such exercises you should avoid.

To Avoid:

1. Intense cardio

    • Intense cardio can frequently cause excessive menstrual flow. As a result, this should unquestionably be avoided throughout periods. For healthy periods, some women must make little alterations to their workout.
    • Avoid engaging in strenuous cardiovascular exercises as they may place additional strain on your mind and body.

2. Cut the Duration

    • In addition to increasing the intensity, you should reduce the duration of your workout. It may take you a few days to get back into shape. So, for at least 4-5 days, *don’t workout for 90 minutes straight, but rather for 30-40 minutes with breaks.
    •  This reduces the likelihood of cramping and menstruation symptoms. Additionally, shortening the duration will allow your body to recoup and rest.

3. Weight Training

    • If you are suffering period cramps from the first day, skip the weight training portion.
    • Lifting weights will not help you and will instead disrupt your menstrual flow. This will also assist you in maintaining your strength and avoiding excessive exertion.
    • Lift light weights and take precautions to avoid injuries.