Dr.M Mursleen-PT

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Dr.M Mursleen-PT

The secret weapon against injuries: Explore physiotherapy and proactive wellness.🥼🩺

13/12/2025

Psoriatic Arthritis

Definition:
Chronic autoimmune arthritis associated with psoriasis, causing joint inflammation and skin lesions.

The Problem (Symptoms):
Joint pain
stiffness (especially in mornings)
swelling
dactylitis (sausage fingers)
nail changes
fatigue.

The Assessment:
Clinical examination
patient history
blood tests (ESR, CRP)
imaging (X-ray, MRI, ultrasound)
psoriasis evaluation.

The Treatment:

Medicine:
NSAIDs (ibuprofen, naproxen)
DMARDs (methotrexate, sulfasalazine)
biologics (etanercept, adalimumab).

Physiotherapy:
Joint mobilization
strengthening exercises
range-of-motion exercises
hydrotherapy
posture correction
activity modification.

12/12/2025

Systemic Lupus Erythematosus (SLE)

Definition:
A chronic autoimmune disease where the immune system attacks healthy tissues, causing inflammation and damage in multiple organs.

The Problem (Symptoms):
Fatigue, fever
Joint pain & swelling
Skin rashes (especially butterfly rash)
Photosensitivity
Kidney issues (proteinuria)
Chest pain, hair loss, mouth ulcers

The Assessment:
Blood tests: ANA, anti-dsDNA, anti-Sm antibodies
Urine tests: Proteinuria, hematuria
Organ function tests: Kidney, liver, heart
Clinical examination: Skin, joints, systemic signs

The Treatment:

Medicine:
NSAIDs (for pain & inflammation)
Hydroxychloroquine (antimalarial, disease control)
Corticosteroids (reduce flare-ups)
Immunosuppressants (azathioprine, mycophenolate, cyclophosphamide)
Biologics (belimumab in refractory cases)

Physiotherapy:
Joint mobility exercises
Low-impact aerobic training
Muscle strengthening & posture correction
Fatigue management strategies

11/12/2025

Fibromyalgia

Definition:

A chronic disorder causing widespread musculoskeletal pain, fatigue, and tenderness.

The Problem (Symptoms):

Widespread pain

Fatigue and sleep disturbances

Cognitive difficulties (“fibro fog”)

Stiffness, headaches, and mood issues

The Assessment:

Clinical evaluation of pain in ≥11 of 18 tender points

Patient history of chronic fatigue and sleep problems

Rule out other conditions via lab tests

The Treatment:

Medicine:

Pain relievers: Acetaminophen, NSAIDs

Antidepressants: Duloxetine, Amitriptyline

Anti-seizure drugs: Pregabalin, Gabapentin

Physiotherapy:

Aerobic exercise (walking, swimming)

Stretching and strengthening exercises

Pain-relief modalities: TENS, heat therapy

Education on pacing and energy conservation

10/12/2025

Gouty Arthritis

Definition:

A metabolic inflammatory arthritis caused by deposition of monosodium urate crystals in joints due to elevated serum uric acid levels.

The Problem (Symptoms):

Acute onset of severe joint pain, redness, warmth, swelling (commonly at the first MTP joint), tenderness, limited ROM, and possible fever during attacks.

The Assessment:

Clinical history, physical examination of affected joints, serum uric acid levels, joint aspiration showing urate crystals, ultrasound for crystal deposits, and X-ray for chronic changes.

The Treatment (Medicine + Physiotherapy):

Medicine:

NSAIDs (e.g., indomethacin), colchicine, corticosteroids for acute attacks; allopurinol or febuxostat for long-term urate lowering.

Physiotherapy:

Pain-relief modalities (cryotherapy during acute phase), gentle ROM exercises, joint protection strategies, strengthening after inflammation reduces, weight-management guidance, and education on lifestyle modification (low-purine diet, hydration).

09/12/2025

OSTEOPOROSIS

Definition:

A systemic skeletal disorder characterized by reduced bone mass and deterioration of bone micro-architecture, leading to increased bone fragility and risk of fractures.

The Problem (Symptoms):

Often asymptomatic until a fracture occurs. Common signs include back pain, loss of height, stooped posture, vertebral compression fractures, and fragility fractures of the hip, wrist, or spine.

The Assessment:

Bone Mineral Density (BMD) testing via DXA scan, FRAX fracture-risk assessment, spinal X-ray for vertebral fractures, lab tests to rule out secondary causes (calcium, vitamin D, thyroid, renal profile).

The Treatment:

Medicine:

Calcium + Vitamin D supplementation

Bisphosphonates (alendronate, risedronate)

Denosumab

Selective Estrogen Receptor Modulators (SERMs)

Teriparatide in severe cases.

Physiotherapy:

Weight-bearing exercises

resistance training

postural correction

balance training to reduce fall risk

spinal extension exercises

education on ergonomics and fracture prevention.

08/12/2025

Osteoarthritis (OA)

Definition

Chronic degenerative joint disease.

Characterized by cartilage breakdown, osteophyte formation, and reduced joint function.

The Problem (Symptoms)

Activity-related joint pain.

Morning stiffness < 30 minutes.

Crepitus on movement.

Reduced ROM.

Mild swelling and tenderness.

Joint deformity in advanced cases (e.g., varus/valgus).

Common sites: knee, hip, hands, spine.

The Assessment

Subjective

Pain pattern, functional limitations, onset.

Aggravating/relieving factors.

History of trauma, obesity, repetitive load.

Objective

Inspection: swelling, deformity, alignment.

Palpation: joint line tenderness.

ROM: reduced.

Functional tests: gait, sit-to-stand.

Investigations

X-ray: joint space narrowing, osteophytes, sclerosis.

MRI if needed.

Blood tests to exclude inflammatory arthritis.

Treatment

Medical

Analgesics (Paracetamol).

NSAIDs (oral/topical).

Intra-articular steroid injections.

Weight reduction if overweight.

Physiotherapy

Pain management: heat/cold, TENS.

ROM exercises.

Strengthening: quadriceps, hip muscles, core.

Low-impact aerobic training (cycling, walking).

Manual therapy: joint mobilization.

Gait and balance training.

Patient education: joint protection, activity pacing.

07/12/2025

Definition

A chronic, systemic autoimmune disease characterized by persistent synovial inflammation leading to joint pain, swelling, stiffness, and progressive joint destruction.

The Problem (Symptoms)

Symmetrical joint pain and swelling (especially small joints of hands/feet)

Morning stiffness lasting more than 1 hour

Warm, tender joints

Fatigue, low-grade fever, weight loss

Progressive deformities (ulnar deviation, swan-neck, boutonnière)

The Assessment

Clinical history and physical examination of affected joints

Laboratory tests: RF, Anti-CCP, ESR, CRP

Imaging: X-ray, ultrasound, or MRI to detect synovitis and erosion

Functional assessment: grip strength, ROM, ADL limitations

Disease activity scoring: DAS28 or similar scales

The Treatment

Medical Management

DMARDs (first-line): Methotrexate, Leflunomide, Sulfasalazine

Biologic agents: TNF inhibitors (Etanercept, Adalimumab), IL-6 inhibitors, others

JAK inhibitors: Tofacitinib, Baricitinib

NSAIDs: For pain and inflammation control

Corticosteroids: Low-dose for short-term flare management

Physiotherapy Management

Joint protection techniques and activity modification

ROM and stretching exercises to maintain mobility

Strengthening exercises (isometric → isotonic) for muscle support

Aerobic conditioning (walking, cycling, swimming)

Splinting for joint alignment during flares

Heat therapy for stiffness; cold therapy for acute inflammation

Patient education on pacing, posture, and energy conservation

15/11/2025

Physiotherapy Rehabilitation in ICU

• Physiotherapy is an important intervention that prevents and mitigates adverse effects of prolonged bed rest and mechanical ventilation.
• It incorporates any active and passive therapy that promotes movement and includes mobilisation.
• Early progressive physiotherapy, with a focus on mobility and walking whilst ventilated, is essential in minimising functional decline.
🔘Adverse effects of ICU stay:
• Physical Inactivity leading to muscular atrophy and generalized weakness
• Diaphragmatic weakness due to prolonged mechanical ventilation
• Pressure Ulcers
• Compromised cardiac and respiratory function
• Deep vein thrombosis
• Infections
Physiotherapist works to maintain and improve respiration and cardiac functions and later on aid in rehabilitation.
🔘Short term Goals:
• Early activity – Both passive and active to maintain integrity of musculoskeletal syste
• Positioning patients: To allow gravity to help sputum drain from the lungs.
• Manual techniques such as shaking and vibrations: These are applied to the ribs to try to loosen and clear the sputum.
• Suction: By placing a small tube into the lungs to suck out the excess sputum.
• They play a vital role in weaning a patient off ventilation.
🔘Long term Goals:
• Physical therapist plan an extensive rehabilitation program to integrate and re-initiate the patient into society.

14/11/2025

🧬 The Body's "Second Heart"

Your calf muscles are often called the "second heart."

They play a crucial role in your circulatory system. When you walk or move your legs, your calf muscles contract and squeeze the deep veins, pumping deoxygenated blood from your lower legs back up to your heart against gravity.
This "calf muscle pump" is essential for healthy blood flow and helps prevent swelling (edema), varicose veins, and dangerous blood clots (DVT).

13/11/2025

What is a muscle spasm? 🤔

It's a sudden, brief muscle contraction that often feels like a twitch. This diagram shows the nerve signal pathway from the spinal cord to the muscle fibres.
Common causes include stress, nerve irritation, or simple overuse.

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