The Physio Clinic Sadiqabad

02/01/2026

Piriformis syndrome can occur in both shortened (overactive/spasmed) and lengthened (inhibited/stretched) states, irritating the sciatic nerve via compression or altered tension—aggravated by valgus collapse or anterior pelvic tilt in squats/running.
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Shortened piriformis (most common)
Tight/spasmed from sitting/overuse; limits internal rotation, hurts palpation/sitting, eases with stretch/smashing but flares with strengthening.
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Compresses sciatic (deep, piercing in 15–16%, split above/below in others), causing gluteal pain radiating to thigh/calf, worse prolonged sitting.
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Lengthened piriformis
Sloppy mechanics (knee valgus, APT) stretch/inhibit it, causing opposite symptoms: pain with hip extension/abduction, limited external rotation, improves with strengthening but flares stretching.
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Lax muscle allows sciatic glide issues or secondary glute med weakness, mimicking deep glute pain.

Symptoms (one-sided posterior hip)
Buttock tenderness + radiation (glutes → leg/calf); numbness/tingling.

Short: FAIR test+, sitting aggravates. Long: stance/running hurts.

Anatomic variants (sciatic piercing piriformis 15%) raise risk—treat cause (glute activation for valgus) over symptoms for lasting fix.

02/01/2026

✅ Frozen shoulder, or adhesive capsulitis, is a condition causing significant pain and stiffness in the shoulder joint, where the connective tissue capsule thickens and tightens, restricting arm movement.

✅ It typically progresses through stages: painful (freezing), stiff (frozen), and gradual improvement (thawing), often resolving on its own but taking months to years.

❄️Key Characteristics❄️

✔️Pain & Stiffness: Gradual onset, often worse at night or with movement, making daily activities difficult.
✔️Cause: Inflammation and thickening of the shoulder joint capsule, leading to scar tissue.

❄️Stages❄️

✔️Freezing: Pain increases as motion becomes limited.
✔️Frozen: Pain may lessen, but stiffness is severe.
Thawing: Pain decreases, and movement slowly improves.
✔️Risk Factors: More common in women, usually between 40-70, and can follow shoulder injury or immobilization. Diabetes and thyroid issues increase risk.

❄️Treatment & Recovery❄️

➡️ Physiotherapy: Focuses on regaining motion and strength.
➡️ Pain Management: Cortisone injections may help.
Self-Limiting: Often resolves over time (1-3 years), but treatment helps speed recovery and reduce long-term disability.
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02/01/2026

Spondylolisthesis is a spine condition where one vertebra slips forward over the one below it. Most often, this happens in the lower back.

is actually slipping?

Your spine is a stack of bones called vertebrae. In spondylolisthesis, one bone moves out of its normal position and shifts forward. This can narrow the space for nerves and change how forces move through the spine.

types you should know

Understanding the type helps explain the cause and treatment.

1. Isthmic Caused by a defect or small fracture in a part of the vertebra called the pars interarticularis. Very common in adolescents and young adults, especially athletes.

2. Degenerative Happens due to wear and tear of discs and facet joints. Most common in people over 40.

3. Congenital Present from birth due to abnormal bone formation.

4. Traumatic Caused by a sudden injury to the spine.

5. Pathological Due to diseases like tumors or infections that weaken the bone.

severe is it?

Severity is graded by how much the vertebra has slipped.

Grade I: 0 to 25%

Grade II: 26 to 50%

Grade III: 51 to 75%

Grade IV: 76 to 100%

Grade V: Complete slip (rare)



√Some people have no symptoms at all. When symptoms appear, they may include:
√Low back pain, worse with standing or extension
√Pain radiating to the buttocks or legs
√Tight hamstrings
√Numbness or tingling if nerves are compressed
√Difficulty walking or standing for long periods

it is diagnosed

√X-ray to confirm the slip
√MRI if nerve involvement is suspected
√CT scan for detailed bone anatomy

approach

Most cases are treated without surgery.

treatment

√Activity modification
√Pain relief measures
√Core strengthening and stabilization exercises
√Hamstring stretching
√Postural correction

treatment Considered if there is:

√Severe or progressive slip
√Persistent pain despite conservative care
√Neurological deficits

physiotherapy focus

√Improve core stability
√Control lumbar movement
√Reduce excessive lumbar extension
√Improve hip and hamstring flexibility
√Gradual return to activity

02/01/2026

Non-Surgical Treatments (Most Common)
▪️Physical Therapy: Core strengthening, posture correction, stretching, and spinal alignment exercises are key.

▪️Medications: Over-the-counter or prescription pain relievers, NSAIDs, and muscle relaxants to manage symptoms.

▪️Pain Management: Heat/cold therapy, TENS (nerve stimulation).

▪️Activity Modification: Short-term rest followed by gradual return to activity, avoiding aggravating movements.

▪️Spinal Decompression: Non-invasive stretching to relieve nerve pressure and promote healing.

▪️Spinal Injections: Steroid injections (epidural) to reduce inflammation.

▪️Lifestyle Changes: Weight management, proper lifting, ergonomic adjustments.

01/01/2026

Spinal stenosis is the narrowing of the spinal canal where the spinal cord and nerve roots travel, often due to age-related arthritis (spondylosis) causing bone spurs, thickened ligaments, or disc bulging that irritate neural structures.

What causes it
Lumbar stenosis—the most common site—develops from degenerative changes like facet hypertrophy and ligamentum flavum thickening, reducing canal diameter and compressing cauda equina nerves.

Symptoms mimicking sciatica
Neurogenic claudication: leg pain, numbness, tingling, or weakness worse with standing/walking and relieved by sitting/flexion (unlike vascular claudication).

Bilateral buttock/leg symptoms without back pain dominance, sometimes with bladder/bowel changes in severe cases.

Diagnosis and surgery
Laminectomy removes the lamina (vertebral roof) and hypertrophied ligaments to decompress the canal, often with foraminotomy for exiting roots; success rates 70–80% for leg pain relief but variable for walking distance.

Conservative options (epidurals, PT) tried first unless red flags like cauda equina.

Differentiate from piriformis via exam/imaging—stenosis shows multilevel narrowing on MRI, while muscular causes localize to buttock without cord signal changes.

31/12/2025

Physiotherapy terms - Basics

31/12/2025

Best exercise for osteochondral defect ankle
🔲Non-operative treatment

✔️Ice: Apply for 20 minutes every 2–3 hours
✔️Elevation: Raise the ankle to reduce swelling
✔️Compression: Use an Ace bandage or ankle wrap

🔹NSAIDs: Medications such as ibuprofen or naproxen to ease pain
🔹Bracing or casting: To stabilize the ankle and prevent further injury

🔹Physical therapy:

•To restore strength, balance, to improve flexibility and range of motion

》 Gradually returning to weight-bearing activities
》 Stretching and strengthening exercises
》 Balance and stability training
》 Soft tissue massage
》 Electrotherapy (e.g. ultrasound)
》 Joint mobilisation
》 Ankle taping



》 Activity modification advice

》 Protecting the ankle with crutches or a boot

》 Use of a protective boot

》 Bio mechanical correction

30/12/2025

Lower back pain is a common issue, often caused by muscle strain, poor posture, or prolonged sitting. While most cases improve with rest, stretching, and movement, there are times when back pain requires attention.

Seek immediate medical care if you experience:
✔️Constant or intense pain not relieved by rest
✔️Weakness, numbness, or tingling in legs
✔️Pain radiating down legs, affecting walking or standing
✔️Pain after a fall, accident, or injury
✔️Fever, unexplained weight loss, or loss of bladder/bowel control

These symptoms may indicate nerve compression, disc injury, or other serious spinal conditions. Listen to your body. Early diagnosis and treatment can significantly impact your recovery and quality of life. Don't just live with the pain. Consult a professional if it feels different, severe, or persistent.

30/12/2025

29/12/2025

Shoulder Disorders