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Physio Masud, Manda (2025)

15/07/2025

🔥 Knock Knee (Genu Valgum)

🔍 Definition:
Knock knee, medically known as Genu Valgum, is a condition where the knees angle in and touch each other when the legs are straightened. The ankles remain apart.

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🎯 Causes:

🔸 Genetic or congenital deformity
🔸 Rickets (Vitamin D deficiency)
🔸 Osteoarthritis
🔸 Trauma or fracture
🔸 Obesity in growing children
🔸 Muscle imbalance
🔸 Bone diseases (like renal osteodystrophy)

---

⚠️ Risk Factors:

🚸 Children with vitamin D/calcium deficiency
🧬 Family history of skeletal deformities
⚖️ Obesity
🦴 Underlying metabolic bone diseases
🏃 Overuse or joint stress in sports

---

🔬 Pathomechanism:

Genu valgum results from:
🔹 Medial (inner side) soft tissue laxity
🔹 Lateral (outer side) structure tightness
🔹 Abnormal femoral or tibial angulation
🔹 Uneven growth in epiphyseal plates
This causes medial knee stress and lateral patellar tracking.

---

💥 Muscle Imbalance:

✅ Overactive/Tight Muscles:
🔹 Tensor fascia lata (TFL)
🔹 Iliotibial band (IT band)
🔹 Lateral hamstrings
🔹 Vastus lateralis
🔹 Gluteus minimus (sometimes)

❌ Weak/Inhibited Muscles:
🔸 Gluteus medius and maximus
🔸 Vastus medialis oblique (VMO)
🔸 Medial hamstrings
🔸 Adductors (sometimes)

---

💪 Strengthening Exercises:

🔥 Focus on weak medial and hip stabilizers
✅ Glute bridges
✅ Clamshells
✅ Side-lying hip abduction
✅ VMO activation (terminal knee extension)
✅ Wall sits with a ball between knees
✅ Single-leg balance & step-downs

---

🧘 Stretching Exercises:

🚨 Focus on tight lateral structures
✅ Tensor fascia lata stretch
✅ IT band foam rolling
✅ Lateral hamstring stretch
✅ Quadriceps stretch
✅ Dynamic hip opener stretches

---

🧑‍⚕️ Physiotherapy Management:

📌 Postural correction
📌 Gait re-education
📌 Custom orthotic prescription (medial wedge if required)
📌 Neuromuscular training
📌 Proprioceptive and balance training
📌 Taping technique (to support patella alignment)
📌 Electrotherapy (if pain/inflammation)

---

🏥 Surgical Management:

➡️ Reserved for severe or progressive deformity
🔹 Guided growth surgery (in children)
🔹 Osteotomy – bone is cut and realigned
🔹 Joint replacement (in advanced osteoarthritis)

---

🏠 Home Advice:

🏡
✅ Encourage barefoot walking (on soft ground)
✅ Weight management
✅ Avoid sitting cross-legged or in “W” position
✅ Vitamin D and calcium-rich diet
✅ Regular low-impact activity (e.g., swimming, cycling)
✅ Adherence to home exercise program prescribed by a physiotherapist

---✅ Physio Masud

14/07/2025

🦵 MENISCUS INJURY – A Common Knee Problem

💠 What is Meniscus?
The meniscus is a C-shaped cartilage in the knee that acts as a shock absorber, cushioning the joint and ensuring smooth movement.

🧠 History & Naming
🔤 Meniscus comes from the Greek word “meniskos” meaning crescent.
It resembles a crescent moon shape inside the knee joint.

---

⚠️ Causes
🔹 Twisting or rotating the knee forcefully
🏃‍♂️ Sports like football, basketball, skiing
👴 Age-related degeneration
❗ Sudden squat or heavy lifting

---

😖 Signs & Symptoms
🧊 Swelling or stiffness
🚫 Difficulty straightening the knee
🎯 Pain during twisting or squatting
🔊 Popping or clicking sound
🧷 Locking sensation in the knee

---

📉 Risk Factors
⏳ Age (wear and tear)
🏋️‍♂️ Heavy lifting or sports
⚖️ Obesity
🏃‍♀️ Previous knee injuries

---

🦠 Pathomechanism
The meniscus can tear due to:
➤ Shear forces during rotation
➤ Compression during impact
➤ Degeneration in older adults

---

🔍 Diagnosis
🧪 Physical Tests:
✔️ McMurray Test
✔️ Thessaly Test
✔️ Joint Line Tenderness

🖥️ Imaging:
✔️ MRI (best for visualizing tear)
✔️ X-ray to rule out bone injury

---

🩹 Conservative Treatment
🌿 Rest, Ice, Compression, Elevation (RICE)
💊 NSAIDs for pain
🦯 Knee brace or crutches if needed
🧘‍♂️ Activity modification

---

💪 Physiotherapy & Rehab
🌀 Strengthen quadriceps & hamstring
🏃‍♂️ Balance & proprioception training
🧘‍♂️ Range of Motion exercises
🧠 Avoid deep squats and twisting

---

🧧 Acupuncture Points (optional)
🪡 ST35, GB34, SP9, EX-LE4
👉 Used to relieve pain & reduce swelling

---

🏥 Surgical Options (if severe)
🔧 Arthroscopic meniscectomy
🔩 Meniscus repair
🧬 Meniscus transplant (in young adults)

---

🏡 Home Advice
✅ Use knee support during activity
🧊 Apply ice after activity
🚫 Avoid running, jumping, or deep squats
🪑 Use elevated chairs to reduce strain

---

🔁 Rehabilitation Timeline
📆 4–6 weeks for mild cases
📆 3–6 months for post-surgery recovery

---

📢 Remember!
Early diagnosis & proper rehab prevent future complications like osteoarthritis.

---

✅ Physio Masud
#✅PhysioMasud

14/07/2025

Big shout out to my newest top fans! 💎 Dina Svencioniene, Sameh Gayed, Avez Momin, Chris Etila, Mj Ramadhan, Dragana Vučić, Duy Pham, Gabriel Simasiku, Suvarna Ramabade Ramababe, শংকুরী হাওলাদার

Drop a comment to welcome them to our community,

13/07/2025

🔥Pronator Teres Syndrome (PTS)✅

🔍 Definition

Pronator Teres Syndrome is a condition caused by entrapment of the median nerve in the proximal forearm, particularly between the humeral and ulnar heads of the pronator teres muscle, leading to forearm and hand symptoms.

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🧠 Origin & History

📜 First described by Seyffarth in the 1950s.

Often confused with Carpal Tunnel Syndrome, but the compression in PTS occurs proximal to the elbow.

---

🎯 Causes

💪 Repetitive pronation and supination of the forearm (e.g., sports, manual labor)

💼 Occupational overuse (e.g., typists, factory workers)

⛔ Trauma or hypertrophy of pronator teres

🔁 Fibrous bands or ligament of Struthers (anatomical variants)

🧱 Muscle hypertrophy from weightlifting

---

⚠️ Signs & Symptoms

🔥 Pain and tenderness in the proximal volar forearm

⚡ Numbness and tingling in the thumb, index, middle, and radial half of the ring finger

✋ Weakness in thenar muscles

🛑 Symptoms worsen with resisted pronation or elbow flexion

❌ No night symptoms (unlike Carpal Tunnel Syndrome)

---

🧪 Diagnosis

🔍 Clinical Examination:

Resisted pronation test (reproduces symptoms)

Tinel’s sign over pronator teres

Resisted flexion of the FDS to middle finger causes pain

Negative Phalen’s test (differentiates from CTS)

📸 Imaging:

💡 MRI/Ultrasound (to rule out masses)

⚡ EMG/Nerve Conduction Study – confirms median nerve entrapment at the forearm level

---

🛠️ Conservative Treatment

🧊 Rest, ice, and activity modification

🧼 Ergonomic changes

💊 NSAIDs for inflammation

💪 Stretching and strengthening exercises

🧤 Splinting to reduce nerve tension (especially during work)

---

🧘‍♂️ Physiotherapy Management

🔄 Gentle nerve gliding exercises (median nerve flossing)

🤲 Soft tissue mobilization of pronator teres

💆 Manual therapy and deep transverse friction massage

⚡ TENS or Ultrasound for pain control

🧘 Stretching of forearm muscles

🏋️ Gradual strengthening of forearm flexors and extensors

---

🩺 Surgical Treatment

Considered if:

❌ No improvement after 3–6 months

🧪 Confirmed compression on EMG

✂️ Surgical decompression of the median nerve

---

🏠 Home Advice

❌ Avoid repetitive forearm twisting

🖐️ Take frequent breaks from hand-intensive work

🧘 Regular stretching

🧤 Use ergonomic tools (e.g., wrist rests, soft grips)

---

🔌 Acupuncture Points (Optional Integration)

LI4, PC6, HT7, LU5 – for local and referred pain

Ash points near the pronator teres region

--✅ Physio Masud

12/07/2025

🔴 ACL Injury (Anterior Cruciate Ligament Injury)

🦵 The ACL is one of the major stabilizing ligaments of the knee that connects the femur (thigh bone) to the tibia (shin bone). It prevents the tibia from sliding out in front of the femur and provides rotational stability.

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🔍 Types of ACL Injury
🔸 Grade 1 (Mild): Ligament is stretched but still intact.
🔸 Grade 2 (Moderate): Partial tear of the ACL.
🔸 Grade 3 (Severe): Complete tear or rupture of the ligament.

---

⚠️ Signs & Symptoms (According to Grade)
✅ Grade 1
• Mild pain
• Slight swelling
• Minimal joint instability
• Can walk with discomfort

✅ Grade 2
• Moderate swelling
• Pain during walking or activity
• Feeling of instability
• Limited range of motion

✅ Grade 3
• Sudden "pop" sound
• Immediate swelling
• Severe pain
• Instability/“giving way” of knee
• Difficulty in walking or weight-bearing

---

🧘‍♂️ Conservative Treatment (For Grade 1 & 2)
• RICE protocol (Rest, Ice, Compression, Elevation)
• Pain management (NSAIDs)
• Bracing & Support
• Avoid sports & twisting movements

---

🧑‍⚕️ Physiotherapy Management (Stage-wise)

📍Acute Phase (0–2 weeks)
• Pain control
• Cryotherapy
• Gentle ROM exercises
• Quadriceps isometrics

📍Subacute Phase (2–6 weeks)
• Progress ROM
• Strengthening exercises (quad, hamstring, glutes)
• Proprioception & balance training

📍Advanced Phase (6–12 weeks)
• Functional training
• Closed-chain exercises
• Single leg squats, step-ups

📍Return to Sport (3–6 months)
• Plyometrics
• Agility drills
• Sport-specific drills
• Functional bracing if needed

---

🦿 Orthosis/Bracing Support
• Hinged knee brace for Grade 2 & 3
• Functional braces during return-to-sport phase
• Prevents re-injury during rehab

---

🏡 Home Advice
• Avoid twisting or pivoting movements
• Use stair rails
• Elevate leg with pillow under ankle
• Follow home exercise plan regularly
• Use knee brace during walking initially

---

🔪 Surgery: When Needed?
Surgical reconstruction may be needed if:
🔸 Grade 3 complete tear
🔸 Associated meniscus injury
🔸 Knee instability during daily activity
🔸 Athlete or highly active individuals
🔸 Failure of conservative treatment

---

✅ Physio Masud

11/07/2025

🌟 Spinal Canal Stenosis 🌟
A Comprehensive Overview for Awareness & Treatment 💡

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🔹 1. Definition:
Spinal canal stenosis is a condition where the spinal canal narrows, putting pressure on the spinal cord and nerves 🧠🔧. It mostly affects the cervical and lumbar regions.

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🔹 2. Causes: 🕵️‍♂️
✔️ Age-related degeneration (Osteoarthritis, disc bulge)
✔️ Herniated discs 💥
✔️ Thickened ligaments (ligamentum flavum)
✔️ Bone spurs (osteophytes) 🦴
✔️ Congenital spinal stenosis (narrow canal from birth) 👶
✔️ Trauma or injury 🤕
✔️ Tumors or infections (rare) ⚠️

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🔹 3. Signs & Symptoms: ⚠️
🧍‍♂️ Low back pain
⚡ Radiating leg pain (sciatica-like)
🔌 Numbness or tingling in legs/feet
🦵 Weakness in lower limbs
🚶 Difficulty walking (neurogenic claudication)
🪑 Relief when sitting or bending forward

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🔹 4. Physical Examination / Special Tests: 🩺
🧪 Straight Leg Raise Test (SLR) – rule out nerve root tension
🧪 Walking Treadmill Test – worsens neurogenic claudication
🧪 Flexion vs Extension Test – flexion improves symptoms
🧪 Neurological screening: reflexes, muscle power, sensation

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🔹 5. Radiological Findings: 🧠
🔍 X-ray – Shows bone spurs or disc space narrowing
🔍 MRI – Best for soft tissue & nerve compression
🔍 CT scan – Detailed bony anatomy
🔍 Myelogram – Shows spinal cord impingement with contrast

---

🔹 6. Conservative Treatment: 🌿
💊 NSAIDs to reduce inflammation
🧊 Ice/heat therapy
⚖️ Weight loss for pressure reduction
🛌 Short-term rest (no prolonged bed rest)
🩹 Epidural steroid injections (for inflammation)

---

🔹 7. Physiotherapy Management: 🧘‍♂️
🌀 Core strengthening (e.g., pelvic tilt, bird-dog)
🧘 McKenzie flexion-based exercises
🚶 Gait training and balance exercises
🏋️ Postural correction & ergonomics
👐 Manual therapy (joint mobilization, stretching)
🌬️ Breathing and relaxation techniques

LUMBER STENOSIS EXERCISE PROTOCOL

Acute phase:
1. Supine knees-to-chest,
2. posterior pelvic tilts,
3. Walking in a flexed posture

Exercise for Subacute
1. Bird dog,
2. bridges,
3. Modified squats with support

Exercise for the Chronic phase
1. Core strengthening,
5. resisted gluteus medius,
6. Walking uphill,
7. cycling

---

🔹 8. Acupuncture Treatment: 🧵
📍Acupuncture helps by relieving pain and improving circulation.
Common points:
🔸 BL23 (Kidney Shu)
🔸 BL25 (Large Intestine Shu)
🔸 GV3 (Yaoyangguan)
🔸 GB30 (Huantiao)
🔸 Ashi points around lumbar spine
✨ Electroacupuncture can enhance outcomes.

---

🔹 9. Orthosis Support: 🦾
✅ Lumbar corset or brace for temporary support
✅ Reduces mechanical stress
❗ Use should be monitored to prevent muscle atrophy

---

🔹 10. Lifestyle Modifications: 🧬
🥗 Maintain healthy weight
🚴‍♀️ Engage in low-impact exercises like swimming, cycling
🛋️ Avoid prolonged standing or walking
💺 Use lumbar support cushions
🧎‍♂️ Practice daily flexibility routines
🚭 Avoid smoking (affects spinal disc health)

---11. Surgery

✅ Physio Masud

10/07/2025

♨️ TMJ Dysfunction (Temporomandibular Joint Dysfunction)

🔍 Definition:
TMJ Dysfunction refers to a group of conditions affecting the temporomandibular joint, which connects the jawbone to the skull. It leads to pain, dysfunction, or limitation in jaw movement.

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📜 Name & History:

TMJ = Temporomandibular Joint

First studied in detail in the 1930s as a distinct clinical condition.

Also known as TMD (Temporomandibular Disorders).

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🧠 Causes:

🦷 Teeth grinding or clenching (bruxism)

💥 Jaw injury or trauma

📏 Malalignment of teeth or jaw (malocclusion)

🧘 Stress and muscle tension

👄 Poor posture (esp. head-forward posture)

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⚠️ Signs & Symptoms:

🌀 Pain in the jaw, ear, face, or temples

🔊 Clicking, popping, or grinding noise while chewing

❌ Restricted jaw movement or locking

🧠 Headaches or neck pain

🔄 Deviation of jaw during opening/closing

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⚠️ Risk Factrelief

✅ Chronic stress

✅ Previous jaw trauma

✅ Arthritis (e.g., RA or OA)

✅ Poor dental habits or orthodontic history

✅ Females aged 20–40 more commonly affected

✅ Speaker

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🧬 Pathomechanism:

✅ TMJ dysfunction may involve:

✅ Inflammation of joint capsule or disc

✅ Muscle spasm or imbalance (especially masseter, temporalis, and pterygoid muscles)

✅ Internal derangement of the articular disc

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♨️ Biomechanics:

✅ TMJ allows hinge (rotation) and glide (translation) movements.

✅ Dysfunction alters this pattern, creating abnormal stress and pain.

---

♨️ Conservative Treatment:

✅ Rest and soft diet

✅ Cold/heat therapy

✅ Use of splints or mouthguards

✅ NSAIDs or muscle relaxants

---

🏃 Physiotherapy Rehabilitation:

✅ Soft tissue mobilization (e.g., masseter, temporalis)

✅ TMJ joint mobilization

✅ Postural correction exercises (esp. cervical spine)

✅ Jaw relaxation & control exercises

✅ Dry needling or trigger point therapy

✅ Ultrasound or TENS for pain relief

✅Chiropractic Adjustment

---

🪡 Acupuncture Points:

ST6 (Jiache) – Masseter region

ST7 (Xiaguan) – Anterior to the TMJ

LI4 (Hegu) – Distant point for facial/jaw pain

GB20 (Fengchi) – For referred pain/headache

SI19 – Just in front of ear, near TMJ

---

🏠 Home Advice:

Avoid hard chewing or yawning wide

Use moist heat or cold packs

Practice jaw stretching and relaxation exercises

Maintain good posture, especially when working at a desk

Reduce stress with breathing and relaxation techniques

---

✅ Physio Masud

09/07/2025

🔄 Snapping Hip Syndrome (SHS)

📖 Definition

Snapping Hip Syndrome (also called Coxa Saltans) is a condition where you feel or hear a snapping or popping sensation in the hip during movement—especially walking, rising from a chair, or swinging the leg.

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🧠 Name & History

🔹 Name Origin:

Coxa = Hip (Latin)

Saltans = Jumping or Snapping (Latin)
🔹 First documented in orthopedic texts in the early 20th century
🔹 Commonly seen in dancers, athletes, and gymnasts

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🎯 Causes

There are 3 main types of SHS:

1️⃣ External Type
➤ Iliotibial band or gluteus maximus tendon snapping over greater trochanter

2️⃣ Internal Type
➤ Iliopsoas tendon sliding over the iliopectineal eminence or femoral head

3️⃣ Intra-articular Type
➤ Labral tears, loose bodies, or hip impingement within the joint

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🚨 Signs & Symptoms

🔸 Audible snapping/popping during hip flexion-extension
🔸 May or may not be painful
🔸 Tightness or discomfort in the hip
🔸 Clicking when walking, running, or standing up
🔸 Weakness in hip abduction/flexion

---

⚠️ Risk Factors

✅ Repetitive hip movements (e.g., sports 🏃‍♀️, ballet 🩰)
✅ Muscle imbalances (tight/weak hip muscles)
✅ Limb length discrepancy
✅ Joint laxity or instability
✅ Young age and female gender
✅ Poor biomechanics

---

🔍 Pathomechanism

💥 Muscle or tendon rubs over a bony prominence, creating friction or tension. Repeated motion leads to thickening or inflammation, triggering snapping and discomfort.

External type ➝ IT band moves over greater trochanter

Internal type ➝ Iliopsoas moves over pelvic rim

Intra-articular ➝ Internal hip damage causes catching/snapping

---

🦿 Biomechanics

⚙️ Snapping occurs when there is abnormal alignment, tightness, or repetitive motion causing tendons to "slip" over bone.
Common during:
✅ Hip flexion-extension
✅ Rotation or circumduction
✅ Load-bearing postures or transitions

---

🔥 Differential Diagnosis
✅ Intra-articular hip disorders
✅ Trochanteric bursitis
✅ Iliopsoas bursitis
✅ Iliotibial band syndrome
✅ Iliopsoas syndrome[3]: A hip pathology characterized by internal snapping hip, iliopsoas tendonitis, and iliopsoas bursitis

🧴 Conservative Treatment

🔸 Rest 🛌
🔸 Ice packs 🧊
🔸 NSAIDs for pain/inflammation 💊
🔸 Activity modification 🚫
🔸 Proper stretching & warm-up 🧘

---

🧑‍⚕️ Physiotherapy Rehabilitation

🌟 Goal: Reduce snapping, correct biomechanics, restore function.

✅ Stretching

Iliopsoas stretch

IT band stretch

Gluteal stretch

✅ Strengthening

Core & pelvic stabilizers

Hip abductors (e.g., clamshells, side-lying lifts)

Glutes and hamstrings

✅ Manual Therapy

Myofascial release

Trigger point release

Soft tissue mobilization

✅ Neuromuscular Re-education

⭐ Gait correction
⭐Proprioceptive training

✅ Modalities

⭐Ultrasound
⭐ TENS/IFT
⭐ Dry needling (if myofascial tightness exists)

---

🈶 Acupuncture Points (for pain & muscle release)

📌 GB 29 (Juliao) – Hip joint pain
📌 GB 30 (Huantiao) – Sciatic & gluteal pain
📌 ST 31 (Biguan) – Hip flexor release
📌 LI 10 – Local point for soft tissue
📌 Ashi/Trigger points – Iliopsoas, TFL, ITB

---

🏡 Home Advice

🧘 Gentle stretching twice daily
🪞 Postural correction exercises
🚶‍♂️ Avoid sudden changes in activity
🧴 Use foam roller to release tight muscles
🍽️ Stay hydrated and maintain healthy weight
🪑 Sit with hips at 90° to avoid shortening iliopsoas
👟 Use supportive footwear

-- ✅Physio Masud

08/07/2025

Shout out to my newest followers! Excited to have you onboard! Peerapon Srmk, Florence Bilasa Cachola, Jayson Diocales, Sabih Sayyed, Minh Hai, Monika Adamska, HokLam Lei, Joshua Mbeki, Farhan Lashari, Navin Varma, Dilip Joydhar, Thiago Hizioka, Syed Amir Firdaus Al-Qadri, Parveen Kamboj, Kaay P Kaay, Charmi Sanandres, Alaa Soliman Abdulbar, Boonprakong James, Venkatesh Damodar, Salma Elembaby, Mohamed Amine Aissaoui, Muhammad Akram, Ranbir Jaswal, Pedro Ferreira, Anna Jagoda, Nittaya Sribut, ชนาดา อรศรี, Laura Milroy, Tudor Lucian Demian, Farah Belhajali, Țîrlea Stefan, د. أنس مصطفى الحلبي, Azeem Gill Gill, Rim Missaoui, Nuwan Randika, Irada Tajarern, Făthăllă Řęhặb, Sunita Mithonglang, Habiba Elshafie, Ghady Harb, Pasoon Khan, Arai Tatsuya, Rejath Kgv, Vimukthi De Zoysa, DrSuman Shashi, Kamal Kant Jain, Moatasim Shah, Lecluse Geraldine, Ismail Dhagey, Jutatip Kokmas

08/07/2025

♨️ PAINFUL ARC SYNDROME♨️

Painful Arc Syndrome refers to shoulder pain that occurs within a specific arc of arm elevation, typically between 60° and 120° of abduction. Outside this range, movement is usually less painful or pain-free.

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🎯 Common Causes:

1. Supraspinatus tendinopathy or partial tear

2. Subacromial bursitis

3. Shoulder impingement syndrome

4. Calcific tendinitis

5. Acromioclavicular (AC) joint pathology (pain > 160°)

---

📌 Clinical Features:

Pain during active shoulder abduction, especially between 60°–120°

No pain during passive abduction

Pain subsides after 120°

Often worse with overhead activities

May have night pain or difficulty sleeping on affected shoulder

---

🧪 Diagnosis:

Observation during shoulder abduction

Hawkins-Kennedy test, Neer’s impingement test

MRI or ultrasound may reveal rotator cuff or bursa involvement

---

🧠 Differential Diagnosis:

Rotator cuff tear

Frozen shoulder (adhesive capsulitis)

Labral tear

AC joint arthritis (if pain at >160° abduction)

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💪 Physiotherapy Treatment:

✅ Acute Phase:

Rest and avoid painful arc movements

Ice therapy 🧊

Anti-inflammatory medications (if prescribed)

✅ Subacute to Chronic Phase:

Postural correction

Strengthening exercises for rotator cuff and scapular stabilizers

Stretching of tight shoulder muscles

Manual therapy techniques to reduce subacromial pressure

Therapeutic modalities (ultrasound, TENS, laser)

---

✳️ Electrotherapy:

TENS for pain

Ultrasound to reduce inflammation

IFT to stimulate blood flow

---

🎯 Exercise Examples:

Pendulum exercises

Wall crawls

Isometric rotator cuff strengthening

Scapular setting exercises

✅ Physio Masud

❗ Important Note:

If untreated, painful arc syndrome can progress to chronic rotator cuff tear or frozen shoulder.

07/07/2025

📚 Re**us Femoris comes from Latin:

⬇️ Re**us = "Straight"

Femoris = "Of the femur (thigh)"
It is one of the four muscles of the quadriceps femoris group, known for its role in knee extension and hip flexion. Unique among the quadriceps, it crosses two joints — the hip and the knee.

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📌 Origin (Attachment)

🦴 Anterior Inferior Iliac Spine (AIIS)
➕ A groove above the acetabulum (hip socket)

🎯 Insertion

📍 Base of the patella via the quadriceps tendon,
then continues as the patellar ligament to attach to the tibial tuberosity

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⚡ Nerve Supply

🧠 Femoral nerve (L2, L3, L4)

---

💪 Actions

✔️ Knee extension
✔️ Hip flexion
(Re**us femoris is the only quadriceps muscle that acts on the hip)

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🤝 Synergists

🔹 Vastus medialis, intermedius, lateralis (for knee extension)
🔹 Iliopsoas, sartorius, tensor fasciae latae (for hip flexion)

🚫 Antagonists

🔸 Hamstrings group – e.g., biceps femoris, semitendinosus, semimembranosus (for knee flexion and hip extension)
🔸 Gluteus maximus (for hip extension)

---

🧠 Clinical Anatomy

⚠️ Strain or injury often occurs in sports with sudden kicking, sprinting, or jumping (common in soccer or football).
⚠️ Trigger points may refer pain to the front of the hip, anterior thigh, and even the knee.
⚠️ Can be involved in anterior pelvic tilt, patellofemoral pain syndrome, or hip impingement.

🩺 In physiotherapy, overuse or imbalance involving re**us femoris should be addressed with stretching, manual therapy, and neuromuscular re-education.

💥 Possible Causes

🔹 A fall or accident causing sudden eccentric contraction
⛷️ Skiing accident
🪑 Sitting for a long time with a heavy object on the lap
🏥 Post-hip surgery recovery phase

---

⚠️ Symptoms / Indications

🦵 Weakness during knee extension
🌙 Waking at night with pain in front of the patella
⬇️ Knee giving out while going downstairs

---

🔴 Pain Patterns

📍 Most intense over the patellar region
📍 Spreads to the distal, anterior thigh

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🎯 Associated Trigger Points (TPs)

🔥 Gluteus minimus
🔥 Tensor fasciae latae (TFL)
🔥 Other quadriceps muscles
🔥 Biceps femoris

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🩺 Differential Diagnoses

🔍 Hip joint disease
🔍 Pain related to hip surgery

✅---Physio Masud

**usFemoris

05/07/2025

🛑 SUBSCAPULARIS MUSCLE 🔍

📚 Name Origin & History
The name "Subscapularis" comes from Latin:
🔤 Sub = under
🔤 Scapulae = shoulder blade
This muscle was first described in early anatomical texts as a part of the rotator cuff muscles stabilizing the shoulder joint.

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📍 ORIGIN:
The Subscapularis lies on the anterior (costal) surface of the scapula.
🦴 It originates from the medial two-thirds of the subscapular fossa of the scapula.

📍 INSERTION:
The muscle fibers form a tendon that inserts into the lesser tuberosity of the humerus and also blends with the anterior part of the shoulder joint capsule.

📐 SHAPE:
🔺 Large, flat triangular-shaped muscle

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⚡ NERVE SUPPLY:
🔌 Upper Subscapular Nerve
🔌 Lower Subscapular Nerve (C5, C6)

💉 BLOOD SUPPLY:
🩸 Subscapular Artery

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🎯 ACTION:
💪 Medial rotation of the humerus
⬇️ Depression of the humeral head
🤲 Adduction of the shoulder
🛡️ Stabilizes the glenohumeral joint as part of the rotator cuff

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🤝 SYNERGISTS:
Teres Major, Pectoralis Major, Latissimus Dorsi

❌ ANTAGONISTS:
Infraspinatus, Teres Minor

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🧠 CLINICAL ANATOMY:
As one of the four rotator cuff muscles, Subscapularis plays a crucial role in shoulder stabilization, especially during dynamic upper limb movements.
👉 Its dysfunction is often underdiagnosed due to deep location and overlap with other shoulder pathologies.
👉 Subscapularis tightness can contribute to shoulder impingement, limited internal rotation, and painful arc syndrome.

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🦠 PATHOMECHANISM:
Subscapularis dysfunction occurs due to:
🔸 Overuse in repetitive internal rotation (e.g., swimming, throwing)
🔸 Adhesions after surgery or immobilization
🔸 Rotator cuff strain or imbalance
🔸 Scapular dyskinesis
Leads to:
❗ Shoulder joint instability
❗ Compression of anterior structures
❗ Limitation in ROM & strength

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🚨 COMMON SYMPTOMS:
🌙 Pain worse at night
💪 Weakness in shoulder or arm
🎯 Pain in posterior shoulder & upper arm
🖐️ Strap-like pain pattern around the wrist
🚫 Pain at rest or during movement
🧍 Pain during cross-body movement
📐 Painful arm elevation at ~45°

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🔥 TRIGGER POINT ACTIVATING FACTORS:
🏊 Swimming
🏋️ Overhead lifting
🛑 Reaching back to stop a fall
💥 Shoulder joint capsule tear
⛓️ Immobilization post-injury
🧍 Poor posture (rounded shoulders)
🛏️ Sleeping on the affected shoulder with arm across the chest

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❌ COMMON MISDIAGNOSES:
⚠️ Frozen Shoulder (Adhesive Capsulitis)
⚠️ Rotator Cuff Tear
⚠️ C7 Radiculopathy
⚠️ Thoracic Outlet Syndrome

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🛠️ TREATMENT OPTIONS:
💉 Dry Needling
🤲 Myofascial Release
🔄 Muscle Energy Technique (MET)
🎯 Soft Tissue Release (STR)
🧘 Stretching Exercises
🧑‍⚕️ Postural correction & scapular control training

---Physio Masud

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