What are the opening hours?

Monday 09:00 - 23:00 Tuesday 09:00 - 23:00 Wednesday 09:00 - 23:00 Thursday 09:00 - 23:00 Friday 09:00 - 23:00 Saturday 09:00 - 23:00 Sunday 09:00 - 23:00

https://www.facebook.com/104918981599943/

S.D Physiotherapy and rehabilitation center, Jatrabari (2025)

26/09/2025

🦶 النتوء العظمي العقبي (النتوء العقبي):

🔹 ما هو؟
النتوء العظمي العقبي هو نتوء عظمي صغير أسفل عظم الكعب (النتوء العقبي).
👉 عادةً ما يحدث هذا النمو العظمي بسبب الإجهاد المتكرر أو التهاب اللفافة الأخمصية.
👉 أحد الأسباب الرئيسية لآلام الكعب.

⚠️ الأسباب:
1. التهاب اللفافة الأخمصية - عند وجود ضغط مطول على اللفافة الأخمصية.
2. زيادة الوزن/السمنة - عندما يكون وزن الجسم مرتفعًا، يزداد الضغط على الكعب.
3. أحذية غير مناسبة - ارتداء أحذية لا توفر الدعم المناسب.
4. القدم المسطحة أو التقوس المرتفع - خلل في آلية القدم.
5. المشي المفرط، والجري، والقفز (أكثر شيوعًا لدى الرياضيين).
٦. عامل السن - يزداد شيوعه بعد سن الأربعين.

🩺 الأعراض
• ألم في الكعب (خاصةً عند المشي لأول مرة بعد الاستيقاظ صباحًا).
• يزداد الألم عند المشي أو الوقوف.
• عادةً ما يكون الألم أسفل الكاحل.
• في الحالات المزمنة، قد تشعر بشيء صلب، مثل العظم، في الكاحل.

🏥 التشخيص:
التاريخ السريري + الفحص البدني
صورة بالأشعة السينية للكعب ← يمكن رؤية نتوء عظمي أسفل العظم.

🏋️‍♂️ العلاج الطبيعي:
العلاج الطبيعي هو العلاج الأكثر فعالية للنتوء العظمي الكعبي:

🔹 التمارين والتمدد:
1. تمدد اللفافة الأخمصية (تمدد بمنشفة، تمدد عضلة الساق)
2. ثني ظهر الكاحل وتمدد أصابع القدم
3. تقوية عضلات الساق (رفع الكعب، تمدد الجدار)
4. تمرين اللف - لف القدم بزجاجة باردة / كرة تنس
5. تقوية عضلات القدم الداخلية

🔹 الوسائل العلاجية:
• العلاج بالموجات فوق الصوتية - يقلل الالتهاب
• العلاج بالتحفيز الكهربائي للعصب عبر الجلد (IFT/TENS) - لتخفيف الألم
• العلاج بالليزر - يُسرّع الشفاء

🔹 الدعم:
• استخدام وسادة كعب / نعل داخلي ناعم
• ارتداء أحذية مناسبة مع دعم لقوس القدم
• العلاج الليلي جبيرة (في بعض الحالات)

🩹 العلاج الطبي:
• مضادات الالتهاب غير الستيرويدية (تسكين الألم)
• حقن الكورتيكوستيرويد (في حالات الالتهاب الشديد)

🩺 الخيار الجراحي:
👉 إذا لم يُجدِ العلاج المحافظ طويل الأمد نفعًا، فقد يُجرى استئصال النتوء العظمي جراحيًا.

🔑 أهم النقاط:
• يُعد النتوء العظمي سببًا شائعًا جدًا لألم الكعب.
• يُعد تعديل نمط الحياة والعلاج الطبيعي كافيين لمعظم المرضى.
• قد يؤدي الإهمال طويل الأمد إلى ألم مزمن وصعوبة في االمشي

علاج الطبيعي : سيد مظهر الحسين ديدار 🥼
مستشفي القروي ككله. ليبيا
🔊0931460168.

🦶 Calcaneal Spur (ক্যালকেনিয়াল স্পার) :

👉 What is it?
Calcaneal Spur হলো heel bone (calcaneus)-এর নিচে একটি ছোট হাড়ের বৃদ্ধি (bony outgrowth)।
👉 সাধারণত plantar fascia-এর repetitive strain বা inflammation এর কারণে এই হাড়ের অতিরিক্ত বৃদ্ধি হয়।
👉 Heel pain (গোড়ালির ব্যথা)-এর অন্যতম প্রধান কারণ।

⚠️ Causes (কারণ) :
1. Plantar Fasciitis – দীর্ঘদিন plantar fascia তে চাপ পড়লে।
2. Overweight / Obesity – শরীরের ওজন বেশি হলে heel এ চাপ বাড়ে।
3. Improper footwear – সঠিক সাপোর্ট নেই এমন জুতা ব্যবহার।
4. Flat foot or high arch – abnormal foot mechanics।
5. Excessive walking, running, jumping (athletes এ বেশি দেখা যায়)।
6. Age factor – ৪০ বছরের পর বেশি হয়।

🚫Symptoms (লক্ষণ)
• Heel pain (বিশেষ করে সকালে ঘুম থেকে ওঠার পর প্রথম হাঁটার সময়)।
• Walking or standing করলে ব্যথা বাড়ে।
• ব্যথা সাধারণত গোড়ালির নিচের দিকে।
• Chronic case এ গোড়ালিতে হাড়ের মতো শক্ত কিছু অনুভূত হতে পারে।

🏥 Diagnosis (নির্ণয়) :
Clinical history + Physical examination
X-ray of heel → হাড়ের নিচে spur দেখা যায়

🥼 Physiotherapy Treatment (চিকিৎসা) :
Physiotherapy হলো Calcaneal Spur এর সবচেয়ে effective treatment:

👣 Exercise & Stretching :
১. Plantar fascia stretch (towel stretch, calf stretch)
২. Ankle dorsiflexion & toe stretching
৩. Calf muscle strengthening (heel raises, wall stretch)
৪. Rolling exercise – cold bottle / tennis ball দিয়ে পা ঘোরানো
৫. Foot intrinsic muscle strengthening

🔌Electrotherapy :
• Ultrasound therapy – inflammation কমায়
• IFT / TENS – pain relief
• Laser therapy – healing দ্রুত করে

🔹 Support :
• Heel pad / Soft insole ব্যবহার
• Proper footwear with arch support
• Night splint (কিছু ক্ষেত্রে)

💉 Medical Management :
• NSAIDs (pain relief)
• Corticosteroid injection (severe inflammation এ)

✂️ Surgical Option :
👉 খুব severe এবং long-term conservative treatment কাজ না করলে surgical removal of spur করা হতে পারে।

🔩Key Takeaways :
• Calcaneal spur হলো heel pain এর খুব common cause।
• Lifestyle modification + Physiotherapy treatment বেশিরভাগ রোগীর জন্য যথেষ্ট।
• দীর্ঘদিন অবহেলা করলে chronic pain এবং walking difficulty হতে পারে।
S.D Physiotherapy and rehabilitation center.
Physio Syed Didar.
🔊0931460168.

09/09/2025

The difference in your neck weight when using mobile.
الفرق في وزن رقبتك عند استخدام الهاتف المحمول

মোবাইল ব্যবহার করার সময় আপনার ঘাড়ের ওজনের পার্থক্য।
Physio Syed Didar.
S.D Physiotherapy and rehabilitation center.

31/08/2025

Case Discussion: -
Pronator Teres Syndrome
Title: A Case of Wrist Pain and Weakness: Looking Beyond the Carpal Tunnel
Chief Complaint: "Aching pain in my right forearm and numbness in my thumb that's getting worse, along with weakness in my grip."

History of Present Illness:

A 45-year-old, right-handed female administrative assistant presents with a 6-month history of progressive right forearm discomfort. She describes the pain as a deep, aching sensation in the proximal volar (front) aspect of her forearm, exacerbated by repetitive pronation and supination motions (e.g., using a screwdriver, pouring from a heavy pot). She also reports numbness and paresthesia (tingling) in her thumb, index finger, and middle finger.
Recently, she has noticed significant difficulty with tasks requiring fine motor skills, such as buttoning her shirt and writing. She has dropped her coffee cup on several occasions due to a loss of grip strength. She denies neck pain, recent trauma, or similar symptoms in the contralateral hand.

Relevant Risk Factors:

Repetitive Pronation/Supination: Her job involves extensive data entry and frequent filing of heavy, bound manuals, which requires a forceful pronation motion.

Anatomical Variants:
(Theoretical, but a common RF) Potential fibrous bands or a tight tendinous arch of the Flexor Digitorum Superficialis muscle.

Muscular Hypertrophy: Possible hypertrophy of the Pronator Teres muscle itself from repetitive use.

Physical Examination:
Inspection: Mild, but noticeable atrophy of the thenar eminence is observed on the right hand compared to the left.

Palpation: Tenderness to deep palpation over the Pronator Teres muscle belly in the proximal forearm. No tenderness at the volar wrist crease (over the carpal tunnel).

Sensory Exam: Diminished light touch and pinprick sensation in the thumb, index, and middle fingers (the median nerve distribution). Crucially, sensation is also diminished over the thenar eminence.

Motor Exam:
4/5 strength in thumb abduction and opposition.
4/5 strength in flexion of the index finger DIP joint (Flexor Digitorum Profundus) and IP joint of the thumb (Flexor Pollicis Longus).

Provocative Tests:
Tinel's Sign: Negative at the wrist. Positive when percussed over the Pronator Teres muscle in the forearm.

Phalen's Test: Negative.
Pronator Compression Test (PCT): Positive. Resistance to forced pronation and flexion of the elbow against resistance for 30 seconds reproduces her pain and paresthesia.
Resisted Flexion of the Superficialis to the Middle Finger: Positive. Reproduction of symptoms.
Electrodiagnostic Studies (EMG/NCS):
Nerve Conduction Studies (NCS): Showed slowed sensory and motor conduction across the forearm segment (through the Pronator Teres). Distal motor and sensory latencies across the wrist (carpal tunnel) were within normal limits.
Electromyography (EMG): Revealed active denervation (fibrillation potentials, positive sharp waves) and chronic reinnervation changes in the Pronator Teres muscle itself, the Flexor Pollicis Longus, and the Abductor Pollicis Brevis.
Diagnosis: Pronator Teres Syndrome (Median Nerve Entrapment at the Elbow/Forearm)

Discussion: PTS vs. CTS - Atrophy, Numbness, and Key Differentiators
This case exemplifies the classic presentation of Pronator Teres Syndrome (PTS) and highlights its critical distinctions from the more common Carpal Tunnel Syndrome (CTS). The confusion arises because both conditions involve compression of the median nerve, but at different locations.

1. The Critical Anatomical Difference:
CTS: Compression occurs at the wrist, within the rigid carpal tunnel.
PTS: Compression occurs in the proximal forearm, typically under the Pronator Teres muscle or the fibrous arch of the Flexor Digitorum Superficialis.

2. The "Thenar Atrophy AND Thenar Numbness" Paradox (The Key Differentiator):
This is the most reliable clinical feature to distinguish PTS from CTS.
In Carpal Tunnel Syndrome (CTS):
The palmar cutaneous branch of the median nerve arises proximal to the carpal tunnel and travels over it. Therefore, it is not compressed in CTS.
Result: Patients with CTS have thenar muscle atrophy and weakness (due to compression of the motor branch within the tunnel) but preserved sensation over the thenar eminence itself. They feel numbness in the digits, but not on the palm at the base of the thumb.
In Pronator Teres Syndrome (PTS):
The compression site is proximal to the origin of the palmar cutaneous branch. This branch, along with the main trunk and the anterior interosseous nerve branch, is affected.
Result: Patients with PTS experience BOTH thenar muscle atrophy/weakness AND sensory loss over the thenar eminence. This is a hallmark sign that the lesion is proximal to the wrist.

3. Nature of Pain and Provocative Maneuvers:
CTS Pain: Typically nocturnal, burning, tingling, centered at the wrist and hand, often relieved by shaking the hand.
PTS Pain: Aching, exertional pain localized to the proximal forearm, exacerbated by repetitive pronation/supination. Provocative tests like the Pronator Compression Test are positive, while Phalen's and Tinel's at the wrist are negative.

4. Motor Involvement:
CTS: Only affects muscles distal to the wrist (Abductor Pollicis Brevis, Opponens Pollicis, superficial head of Flexor Pollicis Brevis).
PTS: Can also affect the Pronator Teres (though weakness may be masked by the Pronator Quadratus), Flexor Carpi Radialis, Flexor Digitorum Superficialis, and the anterior interosseous nerve-innervated muscles (Flexor Pollicis Longus, Flexor Digitorum Profundus for index/middle, Pronator Quadratus). This explains the weakness in thumb and index finger flexion seen in our case.
A. Conservative (First-Line) Management
Activity Modification & Rest: Avoid repetitive pronation, gripping, and elbow flexion; workplace ergonomics.
Splinting: Long-arm splint (elbow 90°, forearm neutral), especially at night or during aggravating tasks.
Physical/Occupational Therapy:
Modalities: ultrasound, iontophoresis, soft tissue mobilization.
Stretching: Pronator Teres and forearm flexors.
Strengthening: Shoulder/scapular stabilizers after pain subsides.
Pharmacological:
NSAIDs for pain/inflammation.
Corticosteroid injection (diagnostic + therapeutic).
B. Surgical Management
Indications:
Failed conservative treatment (≥3–6 months).
Progressive/severe weakness or atrophy.
Procedure: Median nerve decompression:
Release lacertus fibrosus.
Free fibrous bands in Pronator Teres.
Possibly divide superficial head of Pronator Teres or FDS tendinous arch.
Outcome: Good pain/paresthesia relief; motor recovery may be incomplete if longstanding.

S.D Physiotherapy and rehabilitation center.
Physio Syed Didar.

31/08/2025

Suture removal timings...
S.D Physiotherapy and rehabilitation center.
Physio Syed Didar.

26/08/2025

Anatomic spine.....
S.D Physiotherapy and rehabilitation center.
Physio Syed Didar.

08/08/2025

𝙂𝙪𝙞𝙡𝙡𝙖𝙞𝙣-𝘽𝙖𝙧𝙧𝙚́ 𝙎𝙮𝙣𝙙𝙧𝙤𝙢𝙚 (GBS) :-

👉 𝘿𝙚𝙛𝙞𝙣𝙞𝙩𝙞𝙤𝙣

Guillain-Barré Syndrome (GBS) is an acute, immune-mediated polyneuropathy that affects the peripheral nervous system. It typically presents with rapid-onset muscle weakness and areflexia, often starting in the lower limbs and ascending upwards.

👉 𝙀𝙩𝙞𝙤𝙡𝙤𝙜𝙮 & 𝙋𝙖𝙩𝙝𝙤𝙥𝙝𝙮𝙨𝙞𝙤𝙡𝙤𝙜𝙮

GBS is often preceded by an infection or immune trigger. Common triggers include:

1) Campylobacter jejuni (most common bacterial trigger)

2) Viral infections (e.g., Epstein-Barr virus, CMV, HIV)

3) Recent vaccinations (rare)

4) Surgery or trauma

5) Immune Mechanism:

-The body’s immune system mistakenly attacks myelin sheaths or axons of peripheral nerves.

-This causes demyelination (AIDP) or axonal damage (AMAN, AMSAN variants).

-This impairs signal transmission, resulting in weakness and sensory loss.

---

👉 𝙏𝙮𝙥𝙚𝙨 𝙤𝙛 𝙂𝘽𝙎

Variant--> Features

1) AIDP (Acute Inflammatory Demyelinating Polyneuropathy)--> Most common; affects myelin; causes ascending weakness.

2) AMAN (Acute Motor Axonal Neuropathy)--> Pure motor; axonal damage; rapid onset.

3) AMSAN (Acute Motor and Sensory Axonal Neuropathy)--> Motor + sensory involvement; severe form.

4) Miller Fisher Syndrome Triad: Ophthalmoplegia, ataxia, areflexia.

---

👉 𝘾𝙡𝙞𝙣𝙞𝙘𝙖𝙡 𝙁𝙚𝙖𝙩𝙪𝙧𝙚𝙨

1)Rapidly progressive ascending muscle weakness

2) Areflexia (loss of deep tendon reflexes)

3) Paresthesias (tingling/numbness), usually mild

4) Autonomic dysfunction:

-Fluctuating BP
-Cardiac arrhythmias
-Urinary retention

5) Cranial nerve involvement (e.g., facial palsy)

6) Respiratory muscle weakness (can lead to ventilator dependence)

---

👉 𝘿𝙞𝙖𝙜𝙣𝙤𝙨𝙞𝙨

1. Clinical evaluation:

-Symmetric limb weakness

-Reduced/absent reflexes

-Rapid progression (days to weeks)

2. Investigations:

-Nerve conduction studies (NCS)/EMG: Shows demyelination or axonal damage.

-CSF analysis: Albuminocytologic dissociation (↑ protein, normal WBC count)

-MRI spine: May show enhancement of nerve roots.

---

👉 𝘿𝙞𝙛𝙛𝙚𝙧𝙚𝙣𝙩𝙞𝙖𝙡 𝘿𝙞𝙖𝙜𝙣𝙤𝙨𝙞𝙨

-Myasthenia Gravis

-Poliomyelitis

-Transverse Myelitis

-Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

---

👉 𝙈𝙚𝙙𝙞𝙘𝙖𝙡 𝙈𝙖𝙣𝙖𝙜𝙚𝙢𝙚𝙣𝙩

•Hospitalization (often ICU if respiratory risk)

•IV Immunoglobulin (IVIG) – First-line treatment

•Plasmapheresis (Plasma Exchange) – Removes harmful antibodies

•Supportive care:

-Respiratory support (ventilator if needed)

-Pain management

-DVT prophylaxis

-Nutritional support

-Bowel/bladder care

---

👉 𝙋𝙝𝙮𝙨𝙞𝙤𝙩𝙝𝙚𝙧𝙖𝙥𝙮 𝙈𝙖𝙣𝙖𝙜𝙚𝙢𝙚𝙣𝙩

Physiotherapy is essential in preventing complications, restoring function, and promoting recovery.

1. Acute Phase (ICU/bedridden)

-Positioning to prevent pressure sores

-Passive range of motion (PROM) exercises to prevent contractures

-Chest physiotherapy (if respiratory involvement)

-Splinting to prevent foot drop

-Monitoring fatigue

2. Subacute Phase

-Begin assisted active movements

-Gradual strengthening (starting with isometrics)

-Balance and proprioception training

-Stretching of tight muscles

-Neuromuscular facilitation (PNF techniques)

3. Recovery Phase

-Gait training with or without assistive devices

-Functional training (sit-to-stand, transfers)

-Endurance building with low-resistance exercises

-Task-specific training for ADLs

-Psychological support for coping

> ⚠️ Avoid over-fatigue—Overexertion may worsen symptoms or delay recovery.

---

👉 𝙋𝙧𝙤𝙜𝙣𝙤𝙨𝙞𝙨

-Most patients recover partially or fully within 6 months to 1 year.

-15-20% may have residual weakness.

-5% may have a fatal outcome due to complications.

-Early treatment and rehabilitation improve outcomes.

---

👉 𝙆𝙚𝙮 𝙍𝙚𝙙 𝙁𝙡𝙖𝙜𝙨 𝙛𝙤𝙧 𝙋𝙝𝙮𝙨𝙞𝙤𝙩𝙝𝙚𝙧𝙖𝙥𝙞𝙨𝙩𝙨

-Sudden respiratory distress

-Autonomic instability (sweating, tachycardia, BP spikes)

-Excessive fatigue after minimal exertion

-Rapid changes in motor/sensory status

---

👉 𝘾𝙤𝙣𝙘𝙡𝙪𝙨𝙞𝙤𝙣

Guillain-Barré Syndrome is a neurological emergency requiring prompt intervention. A structured, phase-wise physiotherapy rehabilitation can significantly enhance functional recovery, minimize complications, and restore quality of life.
S.D Physiotherapy and rehabilitation center.
Physio Syed Didar.

08/08/2025

Biceps Brachii muscles also help in supination.
S.D Physiotherapy and rehabilitation center.
Physio Syed Didar.

24/07/2025

Physical anatomy :---
S.D Physiotherapy and rehabilitation center.
Physio Syed Didar.

24/07/2025

مخطط الوزن حسب ظروف المنزل باستخدام الهاتف المحمول.
Weighing chart according to home conditions using mobile.

মোবাইল ব্যাবহারের মাধ্যমে ঘারের অবস্থা অনুযায়ী ওজনের চাপ।

23/07/2025

TYPES OF PAINS
Pains can be categorized into various types, including:

Nociceptive pain (sharp, stabbing pain from tissue damage)
Inflammatory pain (aching, throbbing pain from inflammation)
Neuropathic pain (burning, shooting pain from nerve damage)
Visceral pain (cramping, colicky pain from internal organs)
Somatic pain (aching, soreness from muscles and bones)
Referred pain (pain felt in a different location from the source)
Phantom pain (pain felt in a missing or non-existent body part)
Breakthrough pain (sudden, severe pain despite ongoing pain management)
Chronic pain (persistent, long-term pain)
Acute pain (short-term, severe pain).

.
.
.
.
.
.
.
.

Physio Syed Didar.
S.D Physiotherapy and rehabilitation center.

20/07/2025

Pressure Measurement With A Sphygmomanometer
1. Cuff Inflated – Artery Closed
The cuff is pumped up to stop blood flow in the arm. You hear nothing through the stethoscope.
2. Cuff Pressure Drops – Artery Opens Slightly
Air is slowly released. When blood starts to squeeze through, it makes a tapping sound (called Korotkoff sounds).
→ First sound = Systolic pressure (top number)
3. Cuff Pressure Drops More – Artery Fully Open
Blood flows smoothly again and the sound disappears.
→ Last sound = Diastolic pressure (bottom number)

Tools:
• Sphygmomanometer (blood pressure device) includes:
• Gauge: Shows the pressure in mmHg.
• Bulb: Pumped by hand to inflate the cuff.
• Valve: Releases air slowly to lower the pressure.
• Cuff: Wrapped around the upper arm and inflated to squeeze the artery.
• Stethoscope: Used to listen to blood sounds in the arm.

Body Parts Involved:
• Heart: Pumps blood through the body.
• Brachial artery: Main artery used for measuring blood pressure.
• Radial & Ulnar arteries: Branch from the brachial artery but not directly used during this measurement.

🥼Physio Syed Didar.
S.D Physiotherapy and rehabilitation center.
.

S.D Physiotherapy and rehabilitation center

26/09/2025

09/09/2025

31/08/2025

31/08/2025

26/08/2025

08/08/2025

08/08/2025

24/07/2025

24/07/2025

23/07/2025

20/07/2025

Address

Opening Hours

Telephone

Website

Alerts

Contact The Practice

Shortcuts

Share

Category

Monday	09:00 - 23:00
Tuesday	09:00 - 23:00
Wednesday	09:00 - 23:00
Thursday	09:00 - 23:00
Friday	09:00 - 23:00
Saturday	09:00 - 23:00
Sunday	09:00 - 23:00