Be Well Home Physio Care

22/02/2026

💥 What is an Adductor Strain?
An adductor strain is an injury to one or more of the adductor muscles on the inner thigh. These muscles pull the legs together and stabilize the pelvis during movement.

🦵 Common Causes
Sudden direction changes (common in soccer, hockey, football)

Overuse or poor flexibility

Inadequate warm-up

Previous groin injuries

⚠️ Symptoms
Sudden, sharp pain in the inner thigh or groin

Swelling or bruising

Difficulty bringing legs together or lifting the leg

Tenderness or weakness in the inner thigh

🔍 Grades of Strain
Grade I (Mild): Minor tear, slight pain, no loss of strength

Grade II (Moderate): Partial tear, noticeable pain, weakness, limited movement

Grade III (Severe): Complete tear, severe pain, significant loss of function

🦵 Muscles Involved in an Adductor Strain
1. Adductor Longus
Most commonly strained of the group

Long, superficial muscle

Originates from the p***c bone and inserts on the middle third of the femur

2. Adductor Brevis
Lies beneath the adductor longus

Assists in hip adduction and flexion

3. Adductor Magnus
Largest and deepest adductor

Functions in hip adduction, extension, and flexion

Has both adductor and hamstring portions

4. Gracilis
Most medial muscle of the thigh

Also assists in knee flexion and medial rotation

Crosses both the hip and knee joints

5. Pectineus
Short, flat muscle near the top of the inner thigh

Assists in hip adduction and flexion

🧠 Bonus: Supporting Muscles Sometimes Involved
Iliopsoas (hip flexor)

Obturator externus (hip stabilizer)

Quadriceps and Hamstrings may also be involved due to compensation or overuse

⏳ Recovery Time
Grade I: 1–2 weeks

Grade II: 3–6 weeks

Grade III: 2–3 months or more

✅ Prevention
Proper warm-up before activity

Strengthen core and hip muscles

Regular stretching (especially hip adductors and flexors)

Gradual increase in activity intensity

20/10/2025

Why Physiotherapy is important because it helps people restore, maintain, and improve their physical health and movement. It plays a vital role in recovery, prevention, and overall well-being. Here are the main reasons why physiotherapy is important:

🦵 1. Pain Relief
• Physiotherapy reduces or eliminates pain through exercises, manual therapy, and modalities such as heat, ultrasound, or electrical stimulation.
• It helps patients avoid long-term medication use or unnecessary surgeries.

🏃 2. Improves Mobility and Flexibility
• Whether due to injury, surgery, or aging, physiotherapy helps restore joint mobility and muscle strength.
• Regular sessions improve balance, posture, and overall flexibility.

🏥 3. Aids in Recovery After Surgery or Injury
• Physiotherapy is crucial for rehabilitation after fractures, ligament injuries, or surgeries (e.g., joint replacement).
• It speeds up healing and ensures a safe return to normal activities.

❤️ 4. Prevents Future Injuries
• Physiotherapists identify weak areas and correct movement patterns.
• This helps prevent re-injury and improves performance, especially for athletes.

👵 5. Supports Aging and Chronic Conditions
• Physiotherapy helps older adults stay active and independent.
• It manages conditions like arthritis, osteoporosis, stroke, and Parkinson’s disease.

💪 6. Improves Posture and Ergonomics
• It corrects posture-related issues caused by long hours of sitting, poor workspace setup, or repetitive strain.
• This reduces back, neck, and shoulder pain.

🧠 7. Enhances Mental and Emotional Well-being
• Physical recovery boosts confidence and reduces stress, anxiety, and depression.
• Exercise therapy releases endorphins that improve mood and energy levels.

03/11/2022

20/10/2022

🔈CERVICOGENIC HEADACHE (CGH) Syndrome

• Chronic hemicranial pain that is referred to the head from either bony structures or myofascial soft tissues of the upper CSP, - OA, C1-3 segments.

• The C1-C3 nerves relay pain signals to the nociceptive nucleus of the head and neck, the trigeminocervical nucleus. This connection
is thought to be the cause for referred pain to the occiput and/or eyes.
• The trigeminocervical nucleus is a region of the upper cervical spinal cord where sensory nerve fibres in the descending tract of the trigeminal nerve (trigeminal nucleus caudalis) are believed to
interact with sensory fibres from the upper cervical roots. This functional convergence of upper cervical and trigeminal sensory pathways allows the bidirectional referral of painful sensations
between the neck and trigeminal sensory receptive fields of the face and head.
• A functional convergence of sensorimotor fibres in the spinal accessory nerve (CN XI) and upper cervical nerve roots ultimately converge with the descending tract of the trigeminal nerve and
might also be responsible for the referral of cervical pain to the head.

Important to differentiate between: Migraine without aura, Tension-type, and Cervicogenic
headache.

• In Cervicogenic Headache, patient may present with combination of:
- movement dysfunction in whole of Csp
- muscle function impairment
- upper cervical individual joint dysfunction
• Pain and tenderness in sensitive structures in the upper neck, fascia in the head, TMJ,
mandible.
• History is important, look for activities involving some repetitive movement
static posture, maybe previous injury.
• Usually Ipsilateral pain but it can be bi-lateral!
• Patient can report unsteadiness and light-headedness, but fainting is a red flag!
static posture, and maybe previous injury of Cspraine without aura, Tension-type, and Cervicogenict.

12/09/2022

CAUSE:
Finger flexion (bending) and extension (straightening) is a complex process dependent on tendons that are located on the tops and sides of the fingers. These tendons, which are attached to the finger bones, stretch and contract to allow the fingers to straighten and bend.

Tendons in the finger include:

Flexor tendons: Located on the palm side of each finger and pull the finger down to bend
Extensor tendons: Attached to the bone in several places on the back side of each finger and pull the finger into a straightened position
Each finger is made up of three bones called phalanges (phalanx singularly). The fingertip is the distal phalanx, the middle phalanx is in the center, and the proximal phalanx is located next to the hand. Extensor tendons attach to the middle and distal phalanges. The area where the extensor tendon attaches to the middle phalanx is called the central slip. Damage to the central slip is what causes Boutonnière (French for buttonhole due to the nature of the tear) deformity. When the central slip is injured, the extensor tendon can no longer pull the finger into the extended position, therefore it remains bent. Similarly, when the extensor tendon attached to the distal phalanx is damaged, the result is a mallet finger.

The second aspect of Boutonnière deformity involves the distal phalanx. Because the first knuckle (also called the PIP joint) is unable to straighten, the ligaments on the sides of the finger shift and begin to hyperextend the end knuckle (DIP joint), adding to the crooked appearance of the finger.
TREATMENT:
Splinting: Most acute cases diagnosed promptly can be treated with splinting the PIP joint into the straight position, typically for 3-6 weeks. After this rehabilitation period, finger splinting at night may still be necessary for a time.
Hand therapy: Stretching and other flexibility exercises can improve range of motion and finger strength. Rehabilitative therapy will likely be recommended in conjunction with both surgical and non-surgical treatment options. The Fort Worth Hand Therapy Center at OSMI provides comprehensive hand rehabilitation services with a Certified Hand Therapist.
Hand surgery: Surgery may be required for the injured tendon if a penetrating laceration or additional finger damage is involved. For prolonged, untreated Boutonnière deformity, rheumatoid arthritis, or conditions that are unresponsive to splinting, surgery to reconstruct the ligament and repair the tendon may be recommended.

25/08/2022

🔈 SERRATUS POSTERIOR INFERIOR - OVERLOOKED CAUSE OF LOWER BACK PAIN

You have a client who tells you this:

'I reached for something and suddenly I felt a sharp spasm in the lower part of my back, slightly to the side of the spine, at the bottom of the ribs, and when I breathe in really deep I can feel it'.

Based on the above description you should suspect that you might be dealing with the Serratus Posterior Inferior muscle.

💡 Where is the Serratus Posterior Inferior muscle?

The Serratus Posterior Inferior muscle connects the lower 4 ribs to four vertebrae (T11, T12, L1, L2) in the low back.

💡 What movements does the Serratus Posterior Inferior muscle control?

✔️ Forced expiration (breathing out when breathing hard)
✔️ Assists with twisting at the waist
✔️ Assists with straightening the trunk (standing up straight)

💡 Activities that cause Serratus Posterior Inferior pain and symptoms:

✔️ Twisting the body when lifting
✔️ Overreaching overhead or to the side of the body
✔️ Lifting something heavy using the back muscles instead of leg muscles
✔️ Sleeping on a sagging or too soft mattress

ℹ️ Trigger Points

Trigger points in the Serratus Posterior Inferior may cause an uncommon local ache radiating over and around the muscle.

This may extend across the back and over the lower ribs, even continuing through the chest to the front of the body.

This discomfort is typically described by clients as a nagging ache.

In many cases this pain remains after other trigger points have been inactivated. This should be a good indicator for the therapist to recheck the Serratus Posterior Inferior for undiscovered trigger points.

👩‍🔬 Stretching for self-release of the Serratus Posterior Inferior

Cross your forearms just above the wrist, at about chest height. Inhale deeply as you slowly raise them up until the area where the arms cross is level with your forehead. Now lower the arms as you exhale.

Do this once or twice, allowing for a brief rest (a few breaths) before repeating. Do this exercise set several times a day.
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15/05/2022

A ‘Charley horse’ is a common referral for a muscle spasm.

In Traditional Chinese Medicine (TCM) the body is looked at as a whole to find reasoning.
According to TCM, the Liver stores blood & rules the tendons, the Spleen dominates limbs & rules muscles & the Kidney rules bones.
If a combination of those organs has been weakened or strained, they fail to nourish the muscles & tendons accordingly.
This will result in spasms or abnormal movements in the limbs.
These are internal factors that could contribute to muscle spasms.

External factors leading to spasm can be injuries, cold, wind and dampness that disrupt the flow of blood & QI in vital channels that then cause cramps and spasms in the muscles because circulation is poor & restricted.

21/04/2022

KNEE PAIN :
knee pain due to underlying disease, strain,stress,overloaded physical activity, setting on knee prolonged time.pain is due to may be OA or RA .exercise for knee pain is isometric quads,hamstring and stretching of hamstring ,Ta and vmo exercise essential for knee pain.

15/04/2022

ROTATOR CUFF INJURY

Rotator cuff injury is one of the common causes of shoulder pain in individuals. To ensure that your shoulder pain is only because of torn rotator cuff, it is important to study the causes of pain, symptoms and also the reason of such condition. It is important to know what it feels like to have a torn rotator cuff and how long does rotator cuff injury take to heal. This information can give you an insight into understanding the possibility of rotator cuff in your case and prompt you to seek timely medical opinion.

Torn rotator cuff can be defined as a tear in one or more of the tendons of the four rotator cuff muscles of the shoulder. This rotator cuff tear can be chronic or acute due to pathological reason or traumatic injury.

What Does A Torn Rotator Cuff Feel Like?
When you wonder what it feels like to have a torn rotator cuff, you need to know the signs and symptoms of torn rotator cuff. Some of the commonest signs of what rotator cuff looks like include:

Pain
The pain occurring from rotator cuff injury occurs at the outer side of shoulder and the upper arm. Such pain also occurs while performing overhead activities or usually happens in the night. If in case the torn rotator cuff is serious, then the pain might awaken the patients from sleep and make them feel stressed.

Decreased Strength
Strength of each rotator cuff tendons can be tested separately by the doctor. They can isolate each tendon and work to find out the extent of tear on each one of them. If in case, significant tears have occurred, the patient will find it difficult to raise their arms over head. Individuals might also find it difficult to hold arm directly out from the body and this is one of the prominent signs of rotator cuff tear.

Inability To Do Normal Tasks
Individuals suffering from rotator cuff tear find it difficult to perform their day to day activities, which include combing their hair, sleeping on the affected shoulder, hooking or unhooking their bra buttons etc. While approaching the doctor patient should ensure to specify activities which have got limited due to shoulder pain.

On average, with appropriate treatment for a torn rotator cuff, it may take around four to six months to heal. However, it depends on the severity of the injury, type of treatment and the rehabilitation.

EXERCISE TO PREVENT SHOULDER PAIN

Pendulum exercise
Stand with your good hand resting on a chair. Let your other
arm hang down and try to swing it gently backwards and forwards and in a circular motion.
Repeat about 5 times. Try this 2–3 times a day.

Shoulder stretch
Stand and raise your shoulders. Hold for 5 seconds. Squeeze your shoulder blades back and together and hold for 5 seconds. Pull your shoulder blades downward and hold
for 5 seconds. Relax and repeat 10 times.

Door lean
Stand in a doorway with both arms on the wall slightly above your head. Slowly lean forward until you feel a stretch in the
front of your shoulders. Hold for 15–30 seconds.
Repeat 3 times. This exercise isn’t suitable if you have a shoulder impingement.

06/04/2022

THORACIC OUTLET SYNDROME (TOS)

TOS are a group of syndromes involving pressure on the brachial plexus.
Each syndrome is named according the structure that is causing the compression.

1️⃣ ANTERIOR SCALENE SYNDROME:
The fibres of the brachial plexus must pass through a narrow aperture between scalenes anterior and medius. Any increased tone in one of these muscles (usually anterior), will provide enough compression to produce symptoms. Scarring and adhesions from injuries can be causes of compression, particularly if found at the attachments of the scalenes. Dysfunction or misalignent of the cervical/thoracic spine may also be a contributing factor to this syndrome.

2️⃣ COSTOCLAVICULAR SYNDROME:
Symptoms result in this case when the neurovascular bundle is tractioned between the clavicle and the first rib. This is often bilateral, indicating a symmetrical postural cause.

3️⃣ PECTORALIS MINOR SYNDROME: In this case, the compression occurs where the neurovascular bundle passes between the tendon of pectoralis minor and the coracoid process of the scapula. Tractioning is greatest with the arm in abduction, but even with the arm dependent, enough pressure from postural problems or tight pectoralis muscles can cause symptoms.

TOS can also compress the subclavian/axillary artery and/or vein.

CAUSES:
Crutch use, joint subluxation, adhesions and scarring, muscular hypertonicity from postural dysfunction, trigger points, occupational stresses, emotion stresses, all of which lead to shallow breathing and poor sleeping posture.

SIGNS AND SYMPTOMS:
All thoracic outlet syndromes feature paraesthesia in the arm, forearm, hand, and fingers. Symptoms are usually unilateral, but can be bilateral, particularly if postural dysfunction is a main cause.
Anterior scalene syndrome is also noted for edema in the hands and fingers.

The cadaver videos demonstrate nicely the brachial plexus of nerves with relationship to TOS.
TOS can cause compression of any of these nerves.

04/04/2022

➡️Foot drop, is a general term for difficulty lifting the front part of the foot. If you have foot drop, the front of your foot might drag on the ground when you walk.Foot drop isn't a disease. Rather, foot drop is a sign of an underlying neurological, muscular or anatomical problem.
➡️Foot drop is caused by weakness or paralysis of the muscles involved in lifting the front part of the foot , Nerve injury , or compression of a nerve in your leg that controls the muscles involved in lifting the foot (peroneal nerve).
➡️Some of its symptoms include inability to hold footwear. A feeling of loosening of the footwear may cause discomfort and dragging of the affected foot while walking,Tripping,Falls,High steppage gait , Circumduction gait , Limp foot , Numbness ,Often unilateral,etc....
➡️Specific exercises that strengthen the muscles in the foot, ankle and lower leg can help improve the symptoms of foot drop in some cases. Exercises are important for improving range of motion, preventing injury, improving balance and gait, and preventing muscle stiffness.Marble Pickup,Ankle Dorsiflexion,Plantar Flexion,Ball Lift.