Thursday, June 15, 2017

What is Whiplash Injury? Role of physiotherapist......

What is whiplash injury?

      This injury usually happens as a result of acceleration and deceleration forces on the neck.  


The most common cause is owing to the road traffic accidents and the other causes are roller-coasters,sports related injuries etc.  As a result of this injury may damage the bony and soft tissue such as in disc, ligaments,nerves.

                 The symptoms often takes sometimes to develop it may take 72hrs for the symptoms to appear.The common symptoms includes neck pain and swelling, stiffness and tenderness, headaches.

There are different grades for the whiplash injuries,

Grade 1- patient complains the neck pain with tenderness and swelling but no physical signs.
Grade 2- patient has neck problem and the range of motion is reduced with point tenderness.
Grade 3-  in this grade patient has musculoskeletal and neurological problems like reflex and sensory deficits. 
Grade 4- problems in the neck with fracture or dislocation.

How the Whiplash is diagnosed?

      After the examination the X-ray,C.T or M.R.I scan can rule out any serious injury or fracture.
Surgery is not need for most of the cases and  commonly the injuries are limited to only the muscles, ligaments and tendons. 

How can physiotherapy help in Whiplash injury?

   The most important principle is to prevent the condition from becoming chronic. The most common whiplash grades one and two requires immediate physiotherapy intervention.
Physiotherapist are highly skilled and supporting with neck problems and they may give you hands on treatments like manual therapy, massages.They will help you by giving advises for doing exercises, and the tips for prevent further problems. In physiotherapy there are both the active and passive treatment for the whiplash injuries. The ultimate aim of the physiotherapist is to change the treatment from passive to active.

Passive treatments for whiplash are deep tissue massage, hot and cold therapy, and electrotherapy. In the active treatment includes various exercises. The physiotherapist will teach you various exercises to improve the range of motion and  muscle strength.To conclude the physical therapy aim is to increase blood circulation ,reduce spasm and promote tissue healing.

Tuesday, June 13, 2017

Attention Scuba divers--- May leads to Paralysis and Death.

        Scuba Diving may leads to paralysis and the role of physiotherapy 

              Decompression sickness,Diver's disease or caisson's disease is owing to the formation of bubbles in the blood and tissues. In the normal altitudes nitrogen and other gases exhaled or dissolves in the blood and tissues. Due to the altitude changes these gases don't dissolves and forms gas bubbles and these formation of bubbles make some obstruction in the blood circulation.

                              We can graded this disease according to the severity of the disease.In grade 1 there is only mild pain, swelling owing to the inflammation in the muscles and joints.The grade 2 affects the systems and the most severe forms will lead to paralysis even death.


                     It is extremely important to take treatment right away.If treated early there is significantly higher chance of successful recovery.
 In the severe forms of this disease , especially the patients who has the spinal and  cerebral symptoms require long term of rehabilitation. In this case the rehabilitation is same as like stroke or spinal injury cases, although the outcome is usually better. 
As same as other cases physiotherapists are more concentrates to improve the mobility and muscle strength, relearning walking and balancing skills.
Patients who needs long term ventilator care, the therapist should do chest physio to clear the lungs of mucus. The treatment Frequency and Duration will depends upon the severity of injury.The major improvement in motor areas will occur after six to twelve months following the treatment. Depression and psychiatric problems are common in  the cases of spinal injuries patients so psychological -rehabilitation plays an important role in these cases.

Saturday, June 10, 2017

What is De Quervains Syndrome? How to treat it?

What is De Quervains Syndrome?

                          De Quervains is a painful condition that affects the tendons of thumb and it will make discomfort when you turn the wrist or making a fist.


                   The etiology is idiopathic and mostly is seen in mothers of infants but some studies shows that it is caused by work activities.


                    The most common symptom is pain in the back side of the thumb tendons.Swelling in  the same area of the thumb and it will be very hard to grasp or pinching things.


                      Finkelstein test will help to rule out the dequevains disease,

 while doing this test you make a fist with the affected hand and move wrist to the side of little finger, in this movement if you feel pain you likely have De Quervains.

Physiotherapy Treatment:

There are various forms of physical therapy for the treatment of Dequervains. Mostly in the acute stage the ice packs are using to cease the edema and pain.Ultrasound is using to get a relief from local inflammation by means of iontophoresis and phonophoresis.
In the acute stage they provide splints for the support of hand and give advice in activities.

In the case of chronic Dequervains thermal modalities and massage can be given.The laser treatment also gives a good result from the pain and swelling. If the pain and swelling subsides the stretching and strengthening exercises can be started.

Saturday, March 25, 2017

Physiotherapy is a good option for Low Back Pain.

Low Back ache is a common and serious problem, ranked as the highest contributor to disability in the
Around five million people in Americans suffer from low back pain and the total expense of back pain treatments exceeds more than one billion a year.

Some interesting Facts about back pain:

This is one of the leading cause of disability globally. 

Back pain affects more than six hundred million people in world.

The average expense of treatment of back pain exceeds more than one billion a year in Australia.

Recent studies show that smoking increases the risk for back pain because nicotine decreases our circulation and blood flow. 

Do you want to prevent your back pain?

                     The people those who have back ache, try to do the following back stretching and strengthening exercises.Morning and night is a good time to do the back exercises often enough for them to be beneficial.These series of exercises helps to move back the bulging disc to the original position which will cease the pain and allow the spinal movement.


 Some recent research done in several countries shows that who suffer from  back pain have 14 percent increased risk of dying from any cause.

Tuesday, February 21, 2017

Cerebral Palsy and Physiotherapy.

What is Cerebral Palsy?

                          It is a non-progressive neuromotor disorder of cerebral origin.
The etiology of Cerebral palsy is owing to the brain damage, this damage caused by the brain injury or abnormal development  of brain.It oftenseems that the c.p is a congenital disease and it's very rarely gets after birth.There is no obvious reason why a child has cerebral palsy.The main causes include:
(1) Infection in early part of pregnancy. 
(2) Lack of oxygen to brain.
(3) Abnormal brain development.
                                                (4) A genetic link.

                                     1.Spastic C.P                                                                                                            2.Athetoid C.P
                              3.Ataxic C.P
                              4.Mixed C.P


                               This is the commonest type of C.P and it's common signs are stiff muscles,joint tightness and involuntary jerky movements. In spastic c.p the most common injured area in brain is motor cortex. The motor cortex is the area in the brain in charge of all body movements. 

The different types of Spastic C.P are:
1.Spastic Monoplegia.
2.Spastic Diplegia.
3.Spastic Hemiplegia.
4.Spastic Triplegia.
5.Spastic Quadriplegia.

                                     In this type of c.p any muscle groups can be affected and the symptoms will vary in different people but there are some common symptoms they are stiff and tight muscles, contractures, abnormal gait, crossed knees, walking on tiptoes, abnormal reflexes.


                      Another name of this c.p is dyskinetic c.p and it is associated with movement disorder owing to the damage in developing brain especially in the basal ganglia. In this type of c.p both hypotonia and hypertonia are present.The symptoms will vary between patients some have minor problems but other have lot of problems and disabilities. The different forms of athetoid c.p are Dystonia, Chorea, Athetosis,Chorea Athetoid, Ataxia,  Dyskinesia.

                       This is the least commonest type of c.p.In this typeof c.p children also have  problems in oral and speech.What ever problems they have, unfortunately we have no treatment to cure but we have some treatment that helps the children to cope up with their difficulties.


               Around 10% of children suffering from c.p have a combination of two or more types.The most common form is spastic and athetoid c.p, the main cause is injury to both the pyramidal and extrapyramidal tracts of brain.
                        As with other forms of c.p mixed one is also non progressive and the condition doesn't worsen, the level of disability depends upon the severity of the injuries within the brain.


            The people who have c.p are challenging the common problems like posture, gait and coordination:- the physical therapy mainly concentrates on gait & coordination.The ultimate aim of physiotherapy is to achieve the body control and motor function.Along with the child physiotherapy the parents should get training the ways to keep the child muscles strong and joint flexible.

The physiotherapist again classified the c.p according to the Gross Motor Functional Classification System(G.M.F.C.S).

G.M.F.C.S Level 1 - Walks without limitations
G.M.F.C.S Level 2 - Walks with limitations
G.M.F.C.S Level 3 - Walks with adaptive equipment assistance.
G.M.F.C.S Level 4 - Self mobility with use of powered mobility                                                                                      assistance 
G.M.F.C.S Level 5 - Transported in a manual wheelchair.
                       The child should get intensive physiotherapy as soon as possible to achieve the maximum potential. This is a lifelong condition and the persons get benefits of physiotherapy throughout his life.

Wednesday, January 25, 2017

Tennis Elbow & Physical Therapy

What is tennis elbow/lateral epicondylitis?

                      It is the most common overuse syndrome in elbow. In this injury the extensor muscles are involved and the common muscle involved is the extensor carpi radialis brevis. Tennis elbow affects people in other occupations like computer professionals, painters,weavers etc.. and it often seems that both the males and females are equally affected.

Symptoms of Tennis Elbow.

You may feel pain in the arm and tenderness in the elbow and the pain is getting worse when you try to lift an object,giving shake hands or grip an object. You may also find that you have a weak grip and stiff elbow. If your symptoms doesn't subside with in two weeks see your physiotherapist or G.P for advice. 


Cozen's Test:

It is one of the test to evaluate for tennis elbow. The test is positive  if it produce pain in the lateral side of the elbow.

Physiotherapy Management.
                    As per physiotherapy protocol there are several modalities for treatment of tennis elbow, includes, kinesio taping, electrotherapy, neural mobilization, muscle stretches, massage and strengthening, its aim is to reduce pain and improve function. 

In acute cases first  48 hours follows the P.R.I.C.E principle.(protection,rest,ice,compression and elevation).

Thursday, January 19, 2017

Cervical Spondylosis & Physiotherapy Management

What is Cervical Spondylosis?

Cervical Spondylosis or Cervical Osteoarthritis is a degenerative disorder of the cervical spine. It often seems in the middle and older ages due to the age related changes in the interverbral discs in the cervical region.

Owing to the degeneration of cervical region osteophytes are formed on the vertebrae. As a result of the narrowing of the spinal canal, gradually the spinal stenosis may develops.The main symptoms of the cervical spondylosis are neck pain and stiffness.In some cases pain radiates from the neck to the arms with a widespread called as cervical rhizopathy or cervical brachialgia. Some times this compression may lead to the muscle weakness, sensory disturbance and in the progressive stage there may be interference with the blood supply to the spinal cord.There are some risk factors for the sponsylosis like, extra strain on the neck, and positioning  the neck in uncomfortable position for long time.
An X-ray is the simplest form to diagnosis the spondylosis and the M.R.I shows the effects on soft tissues. 

Physiotherapy Management for Cervical Spondylosis.

                                      In the severe cases soft collar is recommend to cease the condition to getting worse. This immobilization helps to reduce the nerve irritation and reduce symptoms. 

Cervical Traction:

                             Cervical traction helps to increase the space between the joints and relieve the pressure on the disc and nerve roots. Traction can be done either   continuously or intermittently, alternating between shorts periods of pulling and time. 

In this traction pull is determined by patient comfort and the 10% of the body weight is the ideal weight for the traction to start, it is important that the traction weight don't exceeds more than 20kgs. This is also contraindicated in some cases like the patients having T.M.J problems, claustrophobia,spinal infections,tumors,arthritis, osteoporosis, and hyper mobility cases also.

Trans cutaneous Electric nerve Stimulation (T.E.N.S)

                                     T.E.N.S is using to alleviate the pain in the case of spondylosis. It is a noninvasive way to block the signals from the nerve to spinal cord and brain.

Moreover this, it improves the blood circulation and reduce the spasm and edema.In this treatment the electrodes are placed on the pain area or the nerve area by the physiotherapist and the intensity will slowly increase to the limit that you can override the pain signals.The tens is contraindicated in cases of dementia, pacemakers, other cognitive cases.

Soft Tissue Mobilization:

In this type of mobilization patient is in sitting position and it consist of upper thoraxic  and cervical  spine areas.

Manual pressure and traction for the upper cervical areas

Deep pressure to the motor  point of the upper trapezius musculature

HVLA thrust manipulation to the cervical or thoraxic segments

In this patient clasped his opposite shoulder with both hands and the therapist do it very carefully.