Dr. Ayaz Physiotherapy & Multi Specialist Clinic

20/01/2020

🔈 TYPES OF MENISCUS TEARS
⠀
The meniscus is a C-shaped tissue between your femur (thigh bone) and your tibia (shin bone). Each knee has a medial (inner side) meniscus and a lateral (outer side) meniscus. The meniscus is composed of water, collagen, proteins and other cellular elements.
⠀
The meniscus is a shock absorber that helps optimize force transmission across the knee and protects the cartilage on the end of our femur and tibia. The medial meniscus is also a secondary stabilizer to the ACL as it can prevent anterior translation (forward shifting) of the tibia.
⠀
Tears in the outer 1/3 of the meniscus (red zone) have healing potential because there is blood flow to that area. However, tears in the inner 2/3 (white zone) generally do not heal well as a result of poor circulation.
⠀
All meniscus tears do not require surgery. Surgery is indicated if you have mechanical symptoms such as locking. Otherwise, you should try conservative management first. This includes NSAIDs (anti-inflammatories), physical therapy, and finally, injections. If you fail conservative therapy and do not have arthritis, you may then be a candidate for surgery.
⠀
The goal is always to save as much meniscus as possible, but that is not always possible. Generally, we try to repair the meniscus in younger patients (

🔈 TYPES OF MENISCUS TEARS ⠀ The meniscus is

20/01/2020

🔈 WHY DO YOU HAVE WEAK GLUTES?

ANATOMY

The three gluteal muscles are located in the buttock region, deep to the surronding adipose tissue. The large, superficial gluteus maximus is the most posterior of the group and has fibers that run diagonally across the buttock. The gluteus medius is located on the laterl side of the hip and is also superficial, except for the posterior portion which is deep to the maximus. Both the glutes maximus and medius are strong extensors and abductors of the hip. With its covergent fibers that pull the femur in multiple directions, the gluteus medius could be thought of as the 'deltoid' muscle of the coxal joit'. The gluteus minimus lies deep to the gluteus medius and is inaccessible, however its dense fibers can be felt beneath the medius. Because it attaches to the anterior surface of the greater trochanter, the gluteus mnimus flexes and medially rotates the hip, thus performing the opposite actions of the gluteus maximus.

WHEN DO YOU USE YOUR GLUTES?

You use glutes when you climb stairs, when you run, go cycling, swimming and skating. You use glutes when you dance – especially latin dancing (there are lots of latera rotation of the hip).

WHY ARE YOUR GLUTES WEAK?

Your glutes may be weak for a number of reasons since it's such a complicated goup of muscles responsible for doing so much. However, I would like to point out a few reasons:

1. ASYMMETRY

Weather though sports of habits, humans have a good and a bad side when it comes to certain muscle groups. If you play soccer and you prefere to kick with your right leg, which means you will be standing on your left leg, you are likely to have your left glute musculature stronger than the right, even if your dominant leg is your right leg. That means that your good side could accutally be the weaker side.

Another way an asymmetry can develop is through habits, including something as simple as standing. Stand long enough, and you will inevitably shift your weight to one side for relief, we usually do this to one side more than the other. Another example would be only crossing one leg over the other when you sit; these both have the potential to create asymmetries which may lead to more severe imbalances.

2. INACTIVITY

Unlike the other muscle groups that get used throughout normal life, for example, the quadriceps when you go from sitting to standing or the abdominals when you sit up in bed, the glutes typically get left behind. The problem is two-fold however because we are also sitting on them for hours on end. So not only are they not being used, but our brains are forgetting how to communicate with them as they atrophy in our office chairs.

3. INJURY

If you have ever suffered a lower-body injury that impacted how you walk or even stand, it most likely caused glute inhibition. Broken toe, torn groin, back injury? All of these will create compensatory movement patterns while the injury heals, but we never spend time undoing those patterns leading to problems down the road.

SYMPTOMS OF WEAK GLUTES

You may feel soreness or tightness in the buttocks, pain in the hips, tight hip flexors, low back pain, tight hamstrings, knee pain, or even pelvic instability. Basically, the glutes can present a number of problems because of their many roles!

We severely take our glutes for granted because of this. From walking and running, going up and down stairs, or anything having to do with rotation, weakness can manifest in many different areas. However, the biggest issue stemming from weak glute muscles is posture.

If your glutes are weak you are more likely to have less control over the positioning of your pelvis. If your hips are too tilted this will cause issues up and downstream, pain at the knee or ankles as well as the back, shoulder, and neck. Fix the glutes, align the pelvis and many problems go away on their own.

Best and latest treatment for back pain in nallasopara vasai virar

20/01/2020

🔈 MUSCLE ENERGY TECHNIQUE – SUBSCAPULARIS

ANATOMY

Origin: Subscapular fossa of the scapula
Insertion: Lesser tubercle of the humerus
Action: medial rotation of shoulder, stabilize the head of humerus in glenoid cavity

ASSESSMENT OF SUBSCAPULARIS

The therapist takes the patient's arm to 90 degrees of abduction and 90 degrees of elbow flexion – an assessment in this position in known as the 90/90 test. From this position, the therapist supports the patient's elbow with their right hand and the patient's forearm with their left hand. The therapist then takes the patient's arm into external rotation until a bind is felt. For normal range of motion of the subscapularis, the external rotation should achieve 90 degrees, i.e. the patient's forearm should be parallel to the couch. If there is shortness of the subscapularis, the range of motion will be less than 90 degrees.

MET TREATMENT OF SUBSCAPULARIS

PIR METHOD

The therapist takes the patient's shoulder into external rotation until a bind is felt. From the position of bind, the patient is asked to contract the subscapualris by internally rotating their shoulder. After 10 seconds and on the relaxation phase, the therapist applies traction to the shoulder joint (to prevent an impingement) and slowly encourages the shoulder into further external rotation.

RI METHOD

If the patient has discomfort activating the subscapularis, the antagonistic muscle of the infraspinatus can be activated instead. From the position of bind, the patient is asked to resist external rotation: this will contract the infraspinatus and allow the subscapularis to relax through RI. On the relaxation phase, a lengthening procedure of the subscapularis can then be performed.

🔑 The subscapularis is one of the rotator cuff muscles and is the main medial rotator of the glenohumeral joint. A subscapularis strain can result in referred pain to the area of the deltoid tuberosity.

Best Physiotherapy Clinic in nallasopara

18/01/2020

Club_foot
In clubfoot, the foot appears twisted and can even look as if it's upside down. Despite its appearance, clubfoot itself doesn't cause any discomfort or pain.
In clubfoot, feet are rotated inward and downward. The affected foot and leg may be smaller than the other. In about half of cases, clubfoot affects both feet.Most of the time clubfoot is not associated with other problems.

Without treatment, the foot remains deformed and people walk on the sides or tops of their feet. This can cause calluses, foot infections, trouble fitting into shoes, pain, difficulty walking, and disability.
Treatment is usually with some combination of the Ponseti method and French method.] The Ponseti method involves a combination of casting, Achilles tendon release, and bracing. It is widely used and highly effective under the age of two. The French method involves realignment, taping, and long-term home exercises and night splinting. It is also effective but outcomes vary and rely on heavy involvement of caregivers. Generally, the Ponseti method is preferred.Another technique, the Kite method, does not appear to be as effective. In about 20% of cases, additional surgery is required after initial treatment.

Bracing
Stretching
Exercises are mandatory

18/01/2020

A Fever Is A Good Thing, Don’t Suppress It

A low fever can actually benefit a sick child, and researchers have attributed parental tendencies to over-treat by “fever phobia”–a fear that fever is harmful–which they say originated after the introduction of anti-fever drugs like Tylenol. In addressing this important concern of parents, it’s vital to understand that a fever serves to protect your body against infection and trauma in three major ways.

1. A fever stimulates your immune system into producing more white blood cells, antibodies, and a protein called interferon, all of which work to protect your body against harmful microorganisms.

2. By raising your body’s temperature a few degrees, a fever makes it harder for invading bacteria and viruses to survive and flourish. The higher your core body temperature is, the harder it is for harmful microorganisms to survive in your body.

3. A fever helps to shuttle iron to your liver so that it is not readily available to fuel the growth of invading bacteria.

Longstanding belief, and even parental instinct, may compel you to fight your child’s fever to ease the persistent crying and discomfort. But most experts say not to worry so much about treating your child’s fever. In fact, they say, for children older than six months old, having a fever may be a good thing.

“Fever is often a good sign of a robust immune system, ” said Dr. Kathi Kemper, professor of pediatrics at Wake Forest University Baptist Medical Center. “A fever in and of itself is not dangerous.”

A Fever Is A Good Thing, Don’t Suppress It A

16/01/2020

, commonly called "knock-knee", is a condition in which the knees angle in and touch each other when the legs are straightened. Individuals with severe valgus deformities are typically unable to touch their feet together while simultaneously straightening the legs.
Causes: poor nutrition , genetic causes , obesity.

Treatment
People with genu valgum often have collapsed inner arches of their feet, and their inner ankle bones are generally lower than their outer ankle bones. Adults with uncorrected genu valgum are typically prone to injury and chronic knee problems such as chondromalacia and osteoarthritis. These in turn can cause severe pain and problems in walking.

It is normal for children to have genu valgum between the ages of two and five years of age, and almost all of them resolve as the child grows older. If symptoms are prolonged and pronounced or hereditary, doctors often use orthotic shoes or leg braces at night to gently move a child's leg back into position. If the condition persists and worsens later in life, surgery may be required to relieve pain and complications resulting from severe or hereditary genu valgum. Available surgical procedures include adjustments to the lower femur and total knee replacement (TKR).

Weight loss and substitution of high-impact for low-impact exercise can help slow progression of the condition. With every step, the patient's weight places a distortion on the knee toward a knocked knee position, and the effect is increased with increased angle or increased weight. Even in the normal knee position, the femurs function at an angle because they connect to the hip girdle at points much further apart than they connect at the knees.

Working with a physical medicine specialist such as a physiatrist, or a physiotherapist may assist a patient learning how to improve outcomes and use the leg muscles properly to support the bone structures. Alternative or complementary treatments may include certain procedures from Iyengar Yoga or the Feldenkrais Method.

Rarely, the bone malformation underlying genu valgum can be traced to a lack of nutrition necessary for bone growth, which can cause conditions such as rickets (lack of bone nutrients, especially dietary vitamin D and calcium), or scurvy (lack of vitamin C). The correction of the underlying vitamin deficiency may restore a more normal progression of bone growth.

Physiotherapy
For most people with genu valgum, exercise can help realign and stabilize their knees. Your doctor or physical therapist can evaluate your gait and suggest exercises designed to strengthen your leg, hip, and thigh muscles. Specific stretches may also be useful in relieving symptoms.

15/01/2020

Did you know that exercise is anti-inflammatory?

1. Regular physical activity activates anti-inflammatory pathway and may reduce pro-inflammatory cytokines (Petersen & Pedersen, 2005).

2. Certain aspects of physical activity might further enhance its anti-inflammatory profile:

-Moderate intensity
-Whole body exercise
-Longer durations of physical activity
-Concentric versus eccentric contractions
(Runhaar & Bierma-Zeinstra, 2016)

3. Regular physical activity enhances inhibitory mechanisms that might be important in reduce pain in people with persistent pain (Sluka et al. 2018)

MOTION IS LOTION!

Did you know that exercise is anti-inflammato

14/01/2020

PATELLAR TENDINOPATHY
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📌What is Patellar Tendinopathy?
It is a clinical diagnosis given to individuals who are experiencing pinpoint pain at their patellar tendon that is associated with changes in load. This can be affected by the magnitude of the load (weight) or the rate at which it is applied (speed). Let’s look at an example.
For someone who truly has patellar tendinopathy, we would expect a single leg squat to bother their knee more than a double leg squat because the amount of load it is experiencing is higher. We can take this one step further. We would expect a single leg landing to bother their knee more than a single leg squat because the magnitude and the rate at which it is applied are higher.
📌Treatment
With patellar tendinopathy, the dose makes the poison. A certain degree of load is currently making your symptoms worse, but a certain degree of load is going to make the symptoms better. We call this load management. There are absolutely no alternative treatments for this condition. You have to restore full neuromuscular function through an appropriate plan of care.
📌Exercises
Exercise selection exists on a continuum with the middle and end consisting of jumping, landing, and return to sport. The early aspect of that continuum is targeted strengthening exercises. We used to think that isometrics were a right of passage, but we now know that they are just another form of loading that can applied in a very controlled manner. Read through each exercise carefully and then we’ll have a discussion.
📌Exercise Prescription
Based on our previous discussion, which exercises will be most demanding? Well, you don’t have to control for the rate of application here that eliminates one part of the equation. We are just looking at the magnitude of the load. A weighted, heel elevated, or single leg variation will be harder than a double leg variation. All three combined make it even harder.
📌Goal
The early goal of rehab is to build strength and tolerance of the knee extensor complex (quads and patellar tendon). The most important thing is that you try to keep the difficulty at a 7/10 to truly load the patellar tendon. Then find the appropriate sets and frequency per week that work for you. An example would be 3-5 sets of 30-45 seconds 3-4x week for one of these movements.

14/01/2020

Foot is the basic foundation of human body.

Its a complex but unfortunately most ignored structure.

If the structure of Foot is abnormal (Studies shows it's as high as 50% in affluent classes), it can lead to problems at various levels of the body starting from Knees, Hip, Spine, neck etc.

In cases of Knee replacements one of the Major reasons observed is FOOT MISALIGNMENT. it may not affect you immediately but is really bad and non reversible in long terms.

There are good chances of getting the alignment corrected if this can be early diagnosed and treated.
Its possible even without medicine and surgery.

13/01/2020

Diagnostic Criteria for Pudendal Neuralgia by Pudendal Nerve Entrapment

Essential criteria (must all be present)

1. Pain in the territory of the pudendal nerve: from the
a**s to the p***s or cl****is

2. Pain is predominantly experienced while sitting
▪ The pain does not wake the patient at night
▪ Pain with no objective sensory impairment
▪ Pain relieved by diagnostic pudendal nerve block

3. Complementary diagnostic criteria
▪ Burning, shooting, stabbing pain, numbness
▪ Allodynia or hyperpathia
▪ Re**al or vaginal foreign body sensation (sympathalgia)
▪ Worsening of pain during the day
▪ Predominantly unilateral pain
▪ Pain triggered by defecation
▪ Presence of exquisite tenderness on palpation of the
ischial spine
▪ Clinical neurophysiology findings in men or nulliparous
women

4. Exclusion criteria
▪ Exclusively coccygeal, gluteal, p***c or hypogastric pain ▪ Pruritus
▪ Exclusively paroxysmal pain
▪ Imaging abnormalities able to account for the pain

5. Associated signs not excluding the diagnosis
▪ Buttock pain on sitting
▪ Referred sciatic pain
▪ Pain referred to the medial aspect of the thigh
▪ Suprap***c pain
▪ Urinary frequency and/or pain on a full bladder
▪ Pain occurring after ej*******on
▪ Dyspareunia and/or pain after sexual in*******se
▪ Erectile dysfunction
▪ Normal clinical neurophysiology

Diagnostic Criteria for Pudendal Neuralgia by

12/01/2020

Post nasal drip.
=============
Every day, glands in the linings of your nose, throat, airways, stomach, and intestinal tract produce mucus. ... When the mucus runs down the back of your nose to your throat, it's called postnasal drip. ... Sinus infection or sinusitis , which is an inflammation of the sinuses.
How do you get rid of post nasal drip?

Causes Postnasal Drip.
===================
Colds.
Flu.
Allergies , also called allergic postnasal drip.
Sinus infection or sinusitis , which is an inflammation of the sinuses.
Object stuck in the nose (most common in children)
Pregnancy.
Can post nasal drip cause eye problems?
If sinus infection is also present, headache and facial tenderness can occur. Severe infections can be associated with fever and chills. Watery eyes, fatigue, poor sense of smell, and puffiness under the eyes can be other symptoms seen with postnasal drip.
Post-nasal drip can be caused by allergies, among other things. There are many causes of post nasal drip, or phlegm in the throat, which causes many people to frequently clear their throats. While the symptoms are similar, causes may include: Allergic rhinitis (hayfever)
Certain medications , including some for birth control and blood pressure.
Shortness of breath and wheezing are byproducts of asthma. These breathing difficulties can result in a chronic cough. ... Sinusitis and post nasal drip: Frequent sinus infections can cause post-nasal drip, (sometimes called “a tickle in the back of the throat”), and drainage can trigger chronic cough.

Symptoms.
=========
How do you get rid of post nasal drip?
A simple way to thin it out is to drink more water. Other methods you can try include: Take a medication such as guaifenesin (Mucinex). Use saline nasal sprays or irrigation, like a neti pot, to flush mucus, bacteria, allergens, and other irritating things out of the sinuses.

Is post nasal drip a sign of cancer?
Although many sinus or nasal cancers exhibit no symptoms, certain prolonged symptoms may indicate cancer, including: Persistent nasal congestion, especially on one side. Pain in the forehead, cheek, nose or around the eyes or ear. Post-nasal drip at the back of the throat.

Treatment.(home remedies).
=======================
A simple way to thin it out is to drink more water. Other methods you can try include: Take a medication such as guaifenesin (Mucinex). Use saline nasal sprays or irrigation, like a neti pot, to flush mucus, bacteria, allergens, and other irritating things out of the sinuses.
Newer, nondrowsy antihistamines like loratadine-pseudoephedrine (Claritin) can work to get rid of postnasal drip. However, these are more effective after you take them for several days. Saline nasal sprays can help moisten your nasal passages and reduce symptoms of postnasal drip.
Avoid fatty and fried foods
Symptoms of GERD, including post-nasal drip and sore throat, can be drastically reduced by avoiding reflux-aggravating foods. That means anything fried and anything high in fat, as well as chocolate, coffee, alcohol, carbonated drinks, citrus fruits, and peppermint.

Surgery.
======
Functional endoscopic sinus surgery (FESS) – This surgery is performed using camera-guided imagery. It may be recommended for patients with structural issues such as a deviated septum or problematic sinus structure that makes them more likely to develop sinusitis and post-nasal drip.
You may notice some dark brown nasal discharge for several weeks after your surgery. This is old blood and mucus being cleared from the sinuses and is normal. Also, thick yellow or white drainage is common. This does not mean you have a sinus infection.Will septoplasty stop post nasal drip?
The primary goal of septoplasty surgery is to improve breathing through nose. This may however also reduce other symptoms such as nasal discharge, post-nasal drip, sinus pressure, recurrent sinus infections, or impaired sense of smell. Septoplasty surgery is usually performed under general anesthesia.

Post nasal drip. ============= Every day, gla

12/01/2020

Trigger finger.
+++++++++++
is a condition that causes pain, stiffness, and a sensation of locking or catching when you bend and straighten your finger. The condition is also known as “stenosing tenosynovitis.” The ring finger and thumb are most often affected by trigger finger, but it can occur in the other fingers, as well.

Test.
+++
Trigger finger is diagnosed with a physical exam of the hand and fingers. In some cases, the finger may be swollen and there may be a bump over the joint in the palm of the hand. The finger also may be locked in bent position, or it may be stiff and painful. No X-rays or lab tests are used to diagnose trigger finger.

Symptoms
++++++++
Signs and symptoms of trigger finger may progress from mild to severe and include:

Finger stiffness, particularly in the morning
A popping or clicking sensation as you move your finger
Tenderness or a bump (nodule) in the palm at the base of the affected finger
Finger catching or locking in a bent position, which suddenly pops straight
Finger locked in a bent position, which you are unable to straighten
Trigger finger can affect any finger, including the thumb. More than one finger may be affected at a time, and both hands might be involved. Triggering is usually more pronounced in the morning, while firmly grasping an object or when straightening your finger.

When to see a doctor
Seek immediate medical care if your finger joint is hot and inflamed, as these signs may indicate an infection.

If you have any stiffness, catching, numbness or pain in a finger joint, or if you can't straighten or bend a finger, make an appointment with your doctor.

Causes
+++++
What causes trigger finger? Local swelling from inflammation or scarring of the tendon sheath (tenosynovium) around the flexor tendons causes trigger finger. These tendons normally pull the affected digit inward toward the palm (flexion).

How exercise can help.
++++++++++++++++++
The inflammation that causes trigger finger can lead to pain, tenderness, and limited mobility.

Other symptoms include:
++++++++++++++++++++
heat, stiffness, or persistent pain at the base of your affected thumb or finger
a bump or lump at the base of your finger
a clicking, popping, or snapping noise or sensation when you move your finger
inability to straighten your finger after bending it
These symptoms may affect more than one finger at a time and on both hands. Symptoms may also be more pronounced or noticeable in the morning, when picking up an object, or when straightening your finger.

Performing targeted exercises and stretches can help to alleviate your symptoms and increase flexibility. It’s important that you do the exercises consistently in order to get the best results.

Surgical procedure.
+++++++++++++++
The surgical procedure for trigger finger is called “tenolysis” or “trigger finger release.” The goal of the procedure is to release the A1 pulley that is blocking tendon movement so the flexor tendon can glide more easily through the tendon sheath.

Trigger finger splint.
++++++++++++++++
Trigger Finger Splint, Built-in Aluminium Support Trigger, Mallet Finger Brace Relieve Pain, Adjustable Velcro: Finger Splints -

Trigger finger. +++++++++++ is a condition th