What are the opening hours?

Monday 8am - 9:30pm Tuesday 8am - 9:30pm Wednesday 8am - 9:30pm Thursday 8am - 9:30pm Friday 8am - 9:30pm Saturday 8am - 9:30pm Sunday 8am - 9:30pm

Physio360chennai, 1, Abdul kalam salai, Lakshmi Nagar, Gerugambakkam, Chennai (2026)

Q: What is the address?

1, Abdul Kalam Salai, Lakshmi Nagar, Gerugambakkam

08/12/2025

FINKELSTEIN’S MANEUVER

(Special Test for De Quervain’s Tenosynovitis)

Purpose

To assess inflammation of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) tendons.

Procedure

Ask the patient to make a fist with the thumb tucked inside.

Hold the patient’s forearm and gently ulnar-deviate the wrist.

Compare both sides for pain response.

Muscles Involved

Abductor Pollicis Longus (APL)

Extensor Pollicis Brevis (EPB)

Positive Interpretation

Sharp, localized pain over the radial styloid indicates De Quervain’s tenosynovitis.

Pain reproduced during ulnar deviation suggests tendon sheath irritation.

Causes

Repetitive thumb movements

Overuse (lifting infants, texting, typing)

Wrist strain

Inflammation of the first dorsal compartment

Physiotherapy Interventions

Rest & activity modification

Wrist and thumb splinting

Ice therapy to reduce inflammation

Soft tissue mobilization

Eccentric strengthening for APL & EPB

Stretching of wrist extensors

Ergonomic corrections

07/12/2025

Scapulohumeral rhythm (SHR) is the coordinated, synchronized movement between the glenohumeral (GH) joint and the scapulothoracic (ST) articulation during arm elevation (flexion or abduction).
It ensures that the shoulder moves smoothly, powerfully, and safely through its full range.

Why is this important?

The shoulder complex is not a single joint—it is a multi-joint system. The GH joint alone cannot elevate the arm to 180° without help from the scapula.
SHR allows:
✔ Full overhead reach
✔ Optimal muscle activation
✔ Stability during movement
✔ Distribution of mechanical load
✔ Prevention of impingement

🔶 The Classic 2:1 Ratio Explained

During arm elevation:

Every 3° of movement = 2° from GH + 1° from ST

This gives a ratio of 2:1

Example for 180° arm elevation:

120°: Pure GH joint elevation

60°: Scapular upward rotation

Is the ratio constant?

🔥 No. It actually changes through the range:

Initial 0–30° abduction and 0–60° flexion → Mostly GH movement (scapula is setting/stabilizing)

Beyond 30–60° → Scapula joins actively

After 90° → More scapular contribution due to clavicular rotation + AC joint elevation

🔶 Joint & Bone Movements in SHR
1️⃣ Glenohumeral Joint Movements

Humeral head rolls superiorly and glides inferiorly

External rotation occurs naturally to clear the greater tubercle from the acromion

Rotator cuff stabilizes the humeral head in the glenoid

2️⃣ Scapular Movements

Scapula performs:

Upward rotation (primary)

Elevation

Posterior tilt

External rotation (to avoid winging)

3️⃣ Clavicular Movements

To support scapular rotation:

Clavicle elevates at the sternoclavicular joint

Clavicle retracts

Clavicle rotates posteriorly

These movements allow the scapula to glide smoothly over the thoracic cage.

🔶 Muscular Control of Scapulohumeral Rhythm
A. Scapular Upward Rotation Force Couple

These 3 muscles act together to rotate the scapula upward:

1️⃣ Upper Trapezius

Elevates and upwardly rotates scapula

Stabilizes clavicle

2️⃣ Lower Trapezius

Depresses and upwardly rotates scapula

Controls end-range overhead movement

3️⃣ Serratus Anterior

Prime upward rotator

Prevents scapular winging

Controls protraction + posterior

06/12/2025

Pump-Handle Movement (Anterior–Posterior Expansion)

📌 What it is:
A movement of the upper ribs (1–6) where the rib cage moves forward and upward, similar to how a pump handle is lifted.

📌 Happens during:
✔ Inhalation — especially deep breathing.

📌 Biomechanics:

The sternum lifts up and out.

The anterior–posterior (AP) diameter of the rib cage increases.

Upper ribs rotate around a transverse axis through the costovertebral and costotransverse joints.

📌 Why it matters in physio:

Helpful in understanding thoracic mobility, posture, and respiratory mechanics.

Restricted in conditions like costochondritis, upper-rib dysfunction, upper thoracic stiffness.

Bucket-Handle Movement (Lateral Expansion)

📌 What it is:
A movement of the lower ribs (7–10) where the ribs move upward and outward, resembling the movement of a bucket handle.

📌 Happens during:
✔ Inhalation — increases side-to-side expansion.

📌 Biomechanics:

Ribs lift upward while moving laterally.

Increases the transverse diameter (left–right expansion) of the chest.

Occurs due to rotation around an anteroposterior axis.

📌 Why it matters in physio:

Important for diaphragmatic breathing, lower-rib mobility, and core activation training.

Often affected in postural restrictions, diaphragm tightness, obesity, and sedentary habits.

05/12/2025

Spondylolisthesis என்பது முதுகுத் தண்டு (spine) பகுதியில் ஒரு எலும்பு (vertebra) கீழே இருக்கும் எலும்பின் மீது முன்னோக்கி அல்லது பின்னோக்கி நகர்ந்து செல்லும் நிலை.
இந்த நகர்ச்சி காரணமாக நரம்புகள் அழுத்தம், வலி, கீழ் முதுகு சுணக்கம், மற்றும் கால்வலி ஏற்படலாம்.

🔹 காரணங்கள்

⚡ நார்த்திசு பலவீனம்

⚡ வெடிப்பு / Stress fracture (Pars defect)

⚡ வயது சார்ந்த disc & joint wear

⚡ Athletes (gymnastics, weight lifting)

⚡ பிறவிக்குரிய (congenital) அமைப்பு மாற்றம்

🔹 அறிகுறிகள் (Symptoms)

⬇️ கீழ் முதுகு வலி

⚡ காலில் பரவும் வலி (sciatica)

😣 நீண்ட நேரம் நிற்கும்/நடக்கும் போது வலி

🦵 காலில் சில நேரம் பலவீனம்

⛔ வளைந்து எடைகளை தூக்கும் போது வலி அதிகரிப்பு

🔹 நிலைகள் (Grades)

Grade 1: 25% வரை நகர்வு

Grade 2: 50% வரை

Grade 3: 75% வரை

Grade 4: 100% வரை நகர்வு

🔹 செய்ய வேண்டியது (Do’s)

✔ முதுகு எலும்பு நிலைபடுத்தும் பயிற்சி

✔ Core strengthening

✔ Hamstring & hip flexibility exercises

✔ நீண்ட நேரம் அமர்வதை தவிர்த்து இடைவேளையில் எழுந்து நடப்பது

✔ வலி இருந்தால் அறுவை சிகிச்சை பற்றி நிபுணர் ஆலோசனை

❌ தவிர்க்க வேண்டியது (Avoid in Tamil)

❌ வழிகாட்டுதல் இன்றி எடைகளை தூக்கும் பயிற்சி

❌ தொடர்ந்து forward bending

❌ நீண்ட நேரம் ஒரே நிலையில் அமர்ந்து இருப்பது

❌ sudden twisting movements

🔹 சிகிச்சை (Treatment)

📌 Physiotherapy – முதுகு தசை வலிமை, posture பயிற்சி

📌 Core strengthening

📌 Manual therapy / mobilisation

📌 Pain relief modalities

📌 கடினமான நிலைகளில் – Spinal surgery (fusion)

04/12/2025

தோள்ச் சுருள் (Shoulder capsule) தடிப்பாகி, இறுக்கமாகி, அழற்சி ஏற்பட்டு தோளில் வலி, இறுக்கம், இயக்கம் குறைவு ஏற்படும் நிலைதான் Adhesive Capsulitis.

இதற்கு பொதுவாக 40–60 வயதுக்குள் உள்ள பெண்கள் அதிகமாக பாதிக்கப்படுகிறார்கள்.
மேலும் சர்க்கரை நோய், தைராய்டு பிரச்சனை, காய்ச்சல்/சிகிச்சைக்குப் பிறகு நீண்ட நேரம் அசைவில்லாமல் இருப்பது காரணமாகவும் ஏற்படும்.

🔶 காரணங்கள் / ஆபத்து காரணிகள்

காயம் அல்லது அறுவை சிகிச்சைக்குப் பிறகு தோளை அசையாமல் வைப்பது

Diabetes

Thyroid பிரச்சனைகள்

Cervical spine பிரச்சனைகள்

Autoimmune / inflammatory conditions

சிறிய காயம் தாக்கத்திற்குப் பிறகு கவனிக்காதது

🔶 நிலைகள் (Stages)
1️⃣ Freezing Stage (Painful Phase – 2 to 9 மாதங்கள்)

மெதுவாக தொடங்கும் வலி

இரவில் வலி அதிகம்

Active & passive movement-களில் வலி

இயக்கம் تدريجமாக குறைதல்

2️⃣ Frozen Stage (Stiff Phase – 4 to 12 மாதங்கள்)

வலி குறையலாம்

இறுக்கம் மிக அதிகம்

Abduction, External Rotation, Flexion மிகவும் குறைவு

3️⃣ Thawing Stage (Recovery Phase – 6 to 24 மாதங்கள்)

மெதுவாக இயக்கம் அதிகரிக்கும்

வலி குறையும்

வழக்கமான நாள் உலக செயல்பாடுகள் திரும்பும்

🔶 அறிகுறிகள் (Clinical Features)

Deltoid பகுதியில் வலி

கைதூக்க கஷ்டம்

பின்புறம் கை எடுத்துச் செல்ல முடியாத நிலை

ER > ABD > FLEX ஆகியவற்றில் அதிக கட்டுபாடு

குளியல், சேலை/சட்டை அணிதல், தலைமுடி ஒத்தடித்தல் போன்ற செயல்களில் சிரமம்

🔶 Diagnosis

பொதுவாக clinical assessment மூலமாகவே கண்டறியப்படுகிறது.
MRI மற்ற பிரச்சனைகளை தவிர்க்க உதவும் (Rotator cuff tear, arthritis போன்றவை).

03/12/2025

assess PCL integrity by checking for posterior displacement of the tibia.

🧪 Procedure:

Patient is positioned supine.

Lift both legs so that the hips and knees are flexed to 90°.

Support the patient’s heels so the legs are relaxed.

Observe the tibial tuberosity from the side.

🔍 Positive Sign:

The tibia sags posteriorly (drops back) on the affected side compared to the other leg.

Indicates a PCL tear or significant PCL laxity.

🩺 Clinical Notes:

Also called the "Sag Test" or "Drop-back Sign".

Very sensitive for isolated PCL injuries.

Best observed from the side of the patient for clearer comparison.

01/12/2025

To assess ACL integrity—specifically anterolateral rotary instability of the knee.

✅ Indications

Suspected ACL tear

History of knee “giving way”

Rotational instability

Post-ACL reconstruction follow-up

🧪 Procedure (Step-by-Step)

Position:

Patient lies supine.

Relax the quadriceps (very important).

Therapist position:

Stand on the side of the affected knee.

One hand holds the heel or distal tibia.

Other hand holds the lateral joint line.

Movement sequence:

Start with knee in full extension.

Apply valgus stress to the knee.

Apply internal rotation to the tibia.

Slowly flex the knee from 0° to 30–40°.

🔍 Positive Test

A “clunk,” “shift,” or “Jerk” felt around 20–40° of flexion

Tibia reduces from an anteriorly subluxed position.

This indicates:

ACL tear (usually complete)

Anterolateral instability due to ACL + anterolateral capsule involvement.

🧠 Clinical Insight

Most specific test for functional ACL instability.

Hard to perform if patient guarding due to pain.

Useful in chronic ACL tears because quadriceps inhibition allows shift.

🎯 Biomechanical Concept

With ACL rupture → lateral tibial plateau subluxes anteriorly.

During test → valgus + internal rotation loads the lateral tibial plateau.

Flexion → iliotibial band shifts from an extensor to a flexor → reduces tibia, creating the classic clunk.

30/11/2025

Lever Sign (Lelli’s Test)

(For ACL Tear – Highly Sensitive & Specific)

⭐ Purpose

To detect anterior cruciate ligament (ACL) rupture by evaluating the tibia’s ability to remain stable when the femur is forced down.

⭐ How to Perform the Test

Ask the patient to lie supine on the treatment table.

The examiner places their fist under the proximal third of the patient’s calf (just below the tibial tuberosity).

With the other hand, apply a downward force on the distal femur (just above the knee).

Observe the movement of the heel during the pressure.

⭐ Positive Test (Indicates ACL Tear)

When pressure is applied on the femur,
➡ the heel does NOT lift off the table.

This means the tibia is not being pulled forward, suggesting a torn ACL cannot stabilize the joint.

✔ Positive = ACL injury likely
✔ Seen in complete ACL rupture.

⭐ Negative Test

With pressure on the femur,
➡ the heel LIFTS off the table.

This indicates the ACL is intact and stabilizing the tibia.

27/11/2025

A Patellar Sleeve Fracture is a rare but serious knee injury that occurs mostly in children and adolescents (8–12 years), when the patella has not fully ossified.
It involves the separation of the cartilage “sleeve” from the patella, often pulling a small piece of bone along with it.
This makes it more severe than a typical patellar fracture, because a large part of the cartilage is damaged.

📌 Mechanism of Injury

Most commonly caused by:

Forceful quadriceps contraction during jumping or landing

Sudden knee flexion with quadriceps tension

Sports like football, basketball, athletics, martial arts

A direct fall on a bent knee (less common)

🧒 Why it Occurs Mostly in Children

Children have a partially cartilaginous patella

The cartilage sleeve is vulnerable to avulsion

Strong quadriceps + weak ossification = perfect setup for injury

🚨 Symptoms & Clinical Features

Sudden acute knee pain after activity

Swelling around the knee joint

Inability to straighten the knee

Difficulty bearing weight

High-riding patella (patella alta) may be visible

Extensor lag during straight leg raise

Tenderness along the inferior pole of patella

🧪 Diagnostic Tests
🔎 Clinical Examination

Inability to perform Straight Leg Raise

Painful resisted knee extension

Palpable gap near inferior pole of patella

Observed patella alta

🖼 Imaging

X-Ray (may miss pure cartilaginous avulsion)

MRI – best to identify:

Cartilage separation

Bone fragment size

Tendon involvement

🦵 Treatment Options
1️⃣ Conservative Management (Rare – Only for MINIMAL displacement)

Immobilization in full extension for 4–6 weeks

Close follow-up with serial imaging

Gradual physiotherapy

2️⃣ Surgical Management (Most cases)

Open Reduction & Internal Fixation (ORIF)

Reattachment of cartilage sleeve

Repair of patellar tendon if involved

Early surgery gives the best functional outcomes.

26/11/2025

Osteoarthritis (OA) is a degenerative joint disorder characterized by:

Progressive loss of articular cartilage

Osteophyte (bone spur) formation

Joint space narrowing

Synovial inflammation

Subchondral bone sclerosis

It is the most common form of arthritis, often affecting weight-bearing joints like the knee, hip, spine, and also small joints of the hand.

🔹 Causes / Risk Factors
1. Ageing

Most common factor

Cartilage loses water + becomes weak

2. Mechanical Stress

Prolonged standing

Squatting/kneeling activities

Heavy weight lifting

Occupational stress (drivers, farmers, teachers)

3. Obesity

Increases compressive loads

Adipokines cause low-grade inflammation

4. Previous Injury

Meniscal tears

ACL injury

Fractures near the joint

5. Weak Muscles

Poor quadriceps strength increases knee OA risk

6. Genetics

Familial history

Joint morphology (varus/valgus)

7. Other Factors

Diabetes

Hormonal changes

Joint hypermobility

Poor footwear or biomechanics

🔹 Pathophysiology (Simple Explanation)

Cartilage degenerates due to overuse or aging.

Joint loses smooth gliding surface → friction increases.

Inflammation develops in the synovium.

Osteophytes form as the body attempts to stabilize the joint.

Joint space narrows → limited movement

Pain, stiffness, swelling, mobility loss follow.

🔹 Symptoms

Dull aching pain (worse in activity, better in rest)

Morning stiffness (< 30 min)

Crepitus (crackling sounds)

Joint swelling

Reduced range of motion

Difficulty in:

Walking long distances

Climbing stairs

Sitting-to-standing

Squatting

Varus/valgus deformity in chronic cases

25/11/2025

An incentive spirometer is a handheld breathing device used to help patients improve lung expansion, strengthen respiratory muscles, and prevent post-operative or chronic respiratory complications.
It provides visual feedback, motivating patients (“incentive”) to take slow, deep breaths.

🔬 Why Is It Important? (Role of the Respiratory Centre)

Normal breathing is controlled by the respiratory center located in the medulla and pons of the brainstem.
It regulates breathing based on:

CO₂ levels

O₂ levels

Stretch receptors in the lungs

Chemoreceptor feedback

When patients undergo surgery, prolonged bed rest, lung disease, or painful breathing, the respiratory centre becomes less active, leading to:

Shallow breathing

Reduced lung expansion

Collapse of alveoli (atelectasis)

Reduced oxygenation

👉 Incentive spirometry stimulates the respiratory centre by encouraging controlled, deep inhalation and lung re-inflation.

🫁 Benefits of Incentive Spirometry (Physio360 Insight)
✔️ Prevents postoperative lung collapse (Atelectasis)
✔️ Improves lung expansion and oxygenation
✔️ Reduces risk of pneumonia
✔️ Strengthens inspiratory muscles
✔️ Enhances recovery after cardiac and thoracic surgeries
✔️ Improves breathing efficiency in COPD, asthma, and post-COVID patients
✔️ Helps maintain lung hygiene by promoting airflow and clearance
🏥 Indications (Physio360 Chennai)

Use incentive spirometry for:

Post-cardiac surgery (CABG, valve repair, angioplasty recovery)

Post-abdominal surgery

Post-lung surgery

Chronic respiratory diseases

Immobilized/bedridden patients

Neuromuscular weakness affecting breathing

Cardiorespiratory wellness and fitness programs

🩺 How to Use an Incentive Spirometer (Step-by-Step)

Sit upright on a chair or bed.

Hold the spirometer at eye level.

Exhale normally.

Seal lips tightly around the mouthpiece.

Inhale slowly and deeply to raise the piston/ball.

Try to keep the marker within the “optimal” flow zone.

Hold your breath for 3–5 seconds.

Exhale and relax.

Repeat 10 times every hour, or as advised by the physiotherapist.

24/11/2025

Cardiac arrest is a sudden loss of heart function caused by an electrical malfunction in the heart.
This means the heart stops pumping blood, leading to immediate loss of consciousness and absence of breathing.

👉 It is a life-threatening emergency requiring immediate CPR and defibrillation.

🫀 Why Does Cardiac Arrest Happen?

Common causes include:

1️⃣ Abnormal Heart Rhythms (Arrhythmias)

Ventricular fibrillation (VF)

Ventricular tachycardia (VT)

These are the most common triggers.

2️⃣ Heart Attack (Myocardial Infarction)

Blocked arteries → damage to heart muscle → electrical failure.

3️⃣ Heart Failure
4️⃣ Severe electrolyte imbalance

Potassium, sodium, calcium abnormalities

5️⃣ Trauma / Electric shock
6️⃣ Respiratory arrest

Reduced oxygen → heart stops.

⚠️ Symptoms of Cardiac Arrest (Sudden Onset)

Sudden collapse

No pulse

No breathing or abnormal gasping

Unresponsive

Sometimes preceded by chest pain, dizziness, or palpitations

⏱ What to Do Immediately (First Aid)
1️⃣ Call for Emergency Help

Activate local emergency medical services.

2️⃣ Start CPR

Hard & fast chest compressions

Rate: 100–120/min

Depth: 5–6 cm

3️⃣ Use an AED (If Available)

AED shocks the heart to restore rhythm

Follow the device voice prompts

Early CPR + Early Defibrillation = Saves Lives

🧑‍⚕️ Medical Management

In-hospital treatment includes:

Advanced cardiac life support (ACLS)

Defibrillation

Medications (epinephrine, amiodarone)

Ventilation support

Post-cardiac arrest care

Cooling therapy (targeted temperature management)

🏥 Role of Rehabilitation After Cardiac Arrest

Once the patient is stabilized, cardiac rehab helps in:

✔ Improving heart function
✔ Increasing functional capacity
✔ Breathing training
✔ Aerobic conditioning
✔ Strengthening muscles
✔ Reducing recurrence risk
✔ Lifestyle guidance

Physio360chennai

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