HEALTHY BONES – A FAMILY AFFAIR

Lifestyle for maintaining healthy bones should be adopted by the whole family as osteoporosis is an intergenerational disease that concerns the whole family.

Osteoporosis, literally means porous bone in which the density and quality of bone are reduced. It causes bones to become weak and fragile and break easily – even with a bump, a minor fall, a sneeze, or a sudden movement.

Osteoporosis can cause fractures which become major cause of pain and long-term disability and hence dependency on others for one’s own care. It also has emotional impact on the individual suffering from osteoporosis and also the caregiver.

Besides, fractures due to osteoporosis have devastating impact on millions of people worldwide raising socioeconomic costs to healthcare systems and society enormously.

Can we prevent osteoporosis and fractures?

Yes, if early action is taken!

So on this occasion of World Osteoporosis Day (October 20 each year), which aims to raise global awareness for prevention, diagnosis and treatment of osteoporosis and related musculoskeletal diseases, I would like to put up 5 steps to tackle this SILENT DISEASE (osteoporosis) and to call for change..

Here we go..

  1. REGULAR EXERCISE – must do!

Weight bearing, strength training, and balance training exercises are very effective to keep your bones strong.

While resorting to these exercises, an appropriate guidance is very essential as individual health status is different.

Physiotherapists are trained and qualified to examine you and prescribe you a customised exercise plan precisely for

-prevention of osteoporosis

-recovering from fracture due to osteoporosis

-prevention of another fracture due to osteoporosis

  1. BONE-HEALTHY NUTRITION

Calcium, vitamin D and protein are very important for bone health. Don’t forget to have enough vitamin D through adequate exposure to sunshine (10 minutes daily with part of your body exposed to sunlight).

Vegan and/lactose intolerant individuals should consider alternatives to dairy products which are source of calcium (E.g. green leafy vegetables, tofu, dried apricots, etc.)

  1. MAINTAIN A HEALTHY LIFESTYLE
  • Maintain a healthy body weight.
  • Avoid smoking and excessive alcohol as these contribute to reduced bone mineral density.
  • Reduce caffeine intake as it reduces calcium absorption.
  1. BE AWARE OF RISK FACTORS

A risk factor is anything that increases your chance of getting a disease.

Even if you have a risk factor, or even several, it does not mean that you will have osteoporosis. However, more risk factors increase your chance of developing a disease.

Risk factors are – fixed and modifiable.

Individuals can take action to reduce modifiable risks and, though there is no way to control fixed risk factors, there are strategies that can lessen their effect.

Do not forget to discuss these with your doctor and ask for an assessment of your bone health status.

  1. GET YOURSELF TREATED

Lifestyle changes, appropriate exercise program and medication (for those at high risk) may be prescribed for optimal protection against fractures.

If recovering from a fracture already, contact your physiotherapist to help you recover faster and better, and reduce your dependency due to disability.

Also you will be prescribed an exercise plan to reduce the chances and fear of subsequent fractures.

According to statistics by International Osteoporosis Foundation, osteoporosis accounts for more days in the hospital than breast cancer, heart attack, diabetes & other diseases and hence we should be aware about this SILENT DISEASE! And do not forget to implement these 5 steps for healthy bones and fracture free life!!

Authored by-
Dr Rajashree Lad (MPT, CAFST, CFMP, COMT)
Consultant Orthopedic Physiotherapist

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BACK ON TRACK!

Practically everyone on this planet at least once might have experienced back pain. Our spine undergoes a lot of wear and tear throughout life. So 16th October each year focuses on educating people about spine and its conditions and motivate them to restore their spinal health and wellbeing, especially after being indoors for a long time in this pandemic.

“You are only as young as your spine is flexible.”– Joseph Pilates

This proverb rightly entails the importance of spine health in population.

In India, occurrence of low back pain is alarming having prevalence of 60%. It affects day-to-day activities and also the performance at work-place. So, identifying poor posture and improper lifting techniques is paramount. For this, your physiotherapist is trained to find the source of your problems and work with you to correct them.

How physiotherapy intervention helps to maintain your spine healthy?

  1. Lifestyle Modification :

Awareness about importance of spine health in all age groups is paramount.

Appropriate nutrition, hydration, regular exercise, good sleep and smoking cessation on a regular basis is an important part of management of spine health.

In a recent study, high prevalence of vitamin D deficiency was found in patients with degenerative diseases of the spine. It was also observed that Vitamin D deficiency increased pain in patient with back pain. Hence taking proper calcium rich food and vitamin D supplements are essential to maintain spine healthy.

2. Ergonomics : It is defined as scientific study of people and their working conditions, especially done in order to improve their efficiency and health.

As ‘work from home’  convenience has encouraged more poor sitting posture, long hour static work, no in-between breaks. This causes abnormal loading of spine. Over time, poor posture may lead to muscle imbalance, and problems of spinal joints and discs. All of these can be major contributors for neck and back pain.

So here are some ergonomic measures to maintain healthy spine:

  • Identifying Good posture.
  • Sitting with appropriate support.

Back support: maintains the normal curve of spine, helping to reduce fatigue and stiffness. A small towel roll or lumbar roll/lumbar support of chair can be used to support the small of the back while sitting.

Seat cushion: reduces back pain, relieves stress on spine and improves sitting posture.

  • Proper lifting techniques
  • Frequent breaks in-between and change of position.

Rest periods should be used to relax when muscles are tired, to move around when muscles are stiff, to walk when work restricts an individual’s ability to change postures or positions, and so on.

  • Proper sleeping position and mattresses.

Medium firm density mattress can be used to reduce strain on your spine, improve your posture and prevent you from feeling stiff and sore when you wake up.

  • For students, backpack loads have been suggested to range from 10% to as high as 25% of their body weight which may have a negative impact on their body. With the growing spine vulnerable to physical stresses predisposes adolescents to back pain. Carrying double strap backpack with 10% of their body weight is relatively good for spine.

3. Maintenance of flexibility:

Yoga and stretching helps improve flexibility of muscles in order to improve spinal health and performance but should be performed under the guidance of experts.

4. Core Exercises :

Why is the Core so Important?

Let’s get to know its important functions:

  • Multilevel segmental support to spine
  • Distribution of weight
  • Produce force and dynamically stabilize spine against abnormal forces
  • Also protects abdominal organs

Which are my core muscles?

For appropriate activation of core muscles, cues and imagery are used to increase the connection of your core muscles with your breath. This gives awareness of the right muscle contractions which is very important. Your physiotherapist will help you achieve it precisely.

 What does your MRI scan says?

Coming to MRI and x-rays, I would like to bring to your attention that age-related changes are commonly found in spine imaging but often occur in pain-free individuals as well as those with back pain. Research studies have revealed that when an abnormality is identified on MRI or x-ray, it should be properly correlated and its clinical significance ascertained before being labeled as the source of back pain. Hence, any such abnormality should not bother you until you do not have symptoms associated with it or until your healthcare professional finds clinical correlation.

So on this occasion of World Spine Day, let us be aware of our spinal health to prevent aches and pains associated with it and seek appropriate health at the right time to prevent worsening of the symptoms.

Wishing you all Happy World Spine Day!!

Authored by-
Dr Prathamesh Turai (PT)
Masters in Musculoskeletal Physiotherapy

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THE “JOINT” EFFORT!

Centers for Disease Control and Prevention (CDC) describes “Arthritis” as inflammation (-itis) of one or more joints (arthros). There could be various conditions affecting the joints and eventually the tissues around it, causing an array of symptoms from pain, swelling to stiffness, amongst others.

There are more than 200 diseases identified, which affect the joints. According to the statistics provided by an Indian Rheumatologist, the prevalence of arthritis is around 15% (approximately 180 million people in India), much higher than diabetes or cancer. Ministry of health and family welfare quotes Osteoarthritis as the most frequent joint disease, with a prevalence of 22-39% in India.

Types of arthritis:

Risk factors:

These risk factors may eventually cause arthritis if not managed at the right time.

Symptoms:

Diagnosis:

Management:

1. Lifestyle modification:

  • Diet, nutrition, hydration, regular exercise and good sleep on a regular basis is an important part of management of arthritis.
  1. Medical Management
  • Painkillers, anti-inflammatory medications, drugs used to modify immune response, topical ointments, creams, gels and steroids form a major part of the medical management. Only over the counter drugs can be consumed as needed. Other medications should be consumed only as when prescribed by a doctor.
  1. Physical therapy and exercise:
  • This is one of the most important part of management at all stages, especially the early stage, where prevention of progression is of utmost importance. Physical therapy helps in pain control, improvement of range of motion, strengthening and eventually better function. This applies to all types, except infectious arthritis, where physiotherapy for the concerned joint is directly avoided or done in consultation with the orthopedic.

Physiotherapy management can be broadly classified into:

Patient education: explanation about the disease, its nature, course and prognosis is very important for the patient to have acceptance and understanding of the disease and treatment given.

Manual therapy: various techniques/equipments, like cupping, dry needling, myofascial release, neural mobilization, joint mobilization, taping and others, may be used to work on the joints or muscles to eventually decrease pain and aid function.

Manual therapy

-Electrotherapy: various electrical modalities like TENS, Ultrasound, IFT, LASER and others, are used to majorly manage pain during the flare phase of the inflammation. Dependency on these modalities should be avoided as exercise is eventually the only means of rehabilitation.

Electrotherapy

Exercise: Graded strengthening, range of motion exercises, stretching exercises forms the basis of management. Aquatic exercises are also quite helpful, especially when weight bearing joints are inflamed and painful. These are often well tolerated and beneficial according to a lot of researches.

– Bracing and splinting: From various splints and belts used for joint protection to dynamic splints which aid in function, there are a wide variety of orthoses prescribed only as and when required.

Relaxation: various different forms of relaxation techniques, breathing exercises, energy conservation techniques, positions and activity pacing is taught to the patient to give a more holistic approach to the management while focusing on the overall health, psychological state of mind and fatigue levels.

Relaxation technique

4. Surgical management:

Joint repair: where surfaces are smoothened or realigned. Often done arthroscopically.

Joint replacement: damaged joint replaced with an artificial one.

Joint fusion: generally used for smaller joints of hands and feet or even spine, where both the ends of the joints are fused into one unit.

Thus arthritis forms a major part of the economic burden in every country. On this World Arthritis Day (12th October), let’s all make it a “joint” effort to work towards being aware of our bodies and report early, so as to prevent worsening of symptoms. Early diagnosis and treatment helps to reduce symptoms, improve chances of remission and prevent disability! Kindly always consult an expert and not self-diagnose or self-treat, for better outcomes. Wishing you all happy and healthy joints!!

Authored by-
Dr Kinjal Atul Mehta
Masters in Musculoskeletal Physiotherapy

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You can’t defeat a healthy heart!

Heart health is more important than ever during this global pandemic, especially the reason your heart being one of the vital organs keeping you alive and active.

World Heart Day is celebrated worldwide on the 29th of September, every year. It created by the World Heart Federation, is the perfect platform for the CVD community to unite in the fight against CVD & to reduce the global disease burden. It aims to drive action to educate people and spread awareness about taking care of your heart by controlling risk factors (such as tobacco, alcohol consumption), unhealthy diet and physical inactivity which can prevent at least 80% of premature deaths from heart disease and stroke

Heart disease, also called as Cardiovascular Disease (CVD) is a spectrum of conditions which involves defect in structure and/or function of your heart. Naming below some common CVD:

Impact of CVD on life:

There are people who live with CVD and not know about it. But our body is sensitive and smart, it keeps on alerting us. But we should be smart enough not to ignore them. Check out the following warning signs:

  • difficulty in breathing or sudden onset breathlessness and fatigue
  • Discomfort in the center of the chest for more than a few minutes or that goes away or comes back.
  • Type: ‘squeezing, uncomfortable pressure, fullness’
  • Discomfort in other areas like one / both arms, back, neck, jaw or and stomach.
  • confusion or disorientation or light headedness
  • Bluish lips or face
  • Palpitations and profuse sweating
  • Puffy legs and feet.

Here are few easy ways to ensure your heart stays healthy and you stay strong:

  • Healthy diet [having green leafy veggies, whole grains, protein rich food, avoiding processed food and alcohol consumption.]
  • Stress management [talk to your loved ones, visit a counselor, indulge in your favorite activities etc.]
  • Physical activity
  • Adequate sleep
  • Regular screening i.e.
  • Check your blood pressure- High blood pressure is the no. one risk factor for CVD. It is called the ‘silent killer’, because it has no warning signs/symptoms and people usually don’t realize they have it.
  • Check your blood glucose levels- CVD accounts for 60% of total deaths in people with Diabetes.
  • Check your numbers- Get your cholesterol levels, weight, BMI, BP, blood glucose levels, etc. checked by a health care professional.

Physiotherapy and Cardiovascular Rehabilitation for Heart health:

Physiotherapy (PT) for Heart health not only helps in managing the ones who have developed CVD (including people undergone heart surgeries) but also the ones at the risk of having heart disease. Physiotherapist along with the cardiovascular specialist team works with your body to improve the heart’s function.

Enlisting the role played by physiotherapist to improve your heart performance:

In this Covid-19 pandemic, does this occasion of ‘World Heart Day’ bring into light any different perspective?

By the beginning of 2020, a new coronavirus emerged as a threat to the human population. Since then, Severe Acute Respiratory Syndrome- Coronavirus 2 (SARS-CoV 2) at the root of the coronavirus disease or Covid-19 has been claiming lives in diverse ways. The heart has been found to be one of the most affected organs.

Autopsies of patients with Covid-19 infection revealed infiltration of the myocardium (heart muscle) by interstitial inflammatory cells. Covid-19 infections are associated with increased cardiac biomarker levels due to myocardial injury.

It’s not about being afraid but about being aware of the risk factors and symptoms which will guide us to seek medical attention at the appropriate time without delay  and also to prevent potential problems related to heart health.

Photo by Daria Shevtsova on Pexels.com

Wishing you all HAPPY WORLD HEART DAY!!

Authored by-
Dr Chaitali Deshpande
Consultant Cardiopulmonary Physiotherapist

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Do you follow exercises on internet to relieve your pain?

Ouch!! That hurts.. what can I do..? Let me Google it!

I guess everyone has been there!! Saw few videos, read something online or merely just followed with some exercises told to us by our near ones who experience the same..

But guess what.. it didn’t improve! Or worst.. your pain increased!

Do you know why it happens?

It is because each one of us differ from each other in every way and hence the treatment/exercise regimen will vary for each one of us. Therefore, the treatment has to be personalized..

Let’s talk a bit more about what Personalized Physiotherapy is, and is not. 

As we know everybody’s body is different and everybody’s reasons/mechanism of injury for the same condition may be different. Every person reacts differently to the same exercise and so the assessment, interpretation, diagnosis and treatment is different, including people who don’t have pain/injury and just simply have goals to improve fitness. So physiotherapy is centered around the needs of patients and not around the work of therapist.

To understand better lets put it this way.. that physiotherapy is not…like going to McDonald..the menu is always the same, the experience is limited, the food is questionable, and the post-meal outcome is less than desirable. But you will have no trouble locating a McDonalds when you are hungry!!! 

Being physiotherapists, we believe, in our practice we have so much to offer as experts in manual and movement-based therapies.

Hence it’s important to contact your physiotherapist for advice/treatment plan before doing any sort of exercise for pain/injury or even fitness to harness the benefits/attain your goals at the same time being aware of the possibility of mistakes/injury.

Authored by-
Dr Charmi Parmar
Consultant Physiotherapist

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All you need to know about PCOS!

September is Poly Cystic Ovarian Syndrome (PCOS) Awareness month. It is a federally designed event which came into effect from 2017. A global event emphasizing the need for awareness around PCOS.

While there is ample information around available, it’s important to know all the aspects of PCOS.

PCOS is a hormonal disorder causing enlarged ovaries with small cysts on the outer edges. Three main features of PCOS are:

  • Presence of cysts in ovaries
  • Abnormally high level of male hormone – Androgen
  • Irregularity in menstrual periods

PCOS prevalence in India in women of reproductive age (18-44 years) ranges between is 9.13% to 36%, roughly estimating to 1 in 5 Indian women.

With this prevalence, it’s important to educate ourselves about PCOS.

CAUSES:

The cause for PCOS is relatively unknown. However following factors have been found to play a role:

Contributing factors: Early age of menarche, unhealthy lifestyle (inappropriate nutrition and lack of exercise) and pollution.

SIGNS AND SYMPTOMS:

Menstrual cycle: Heavy bleeding with irregular periods is often one of the main symptoms.

PCOS- signs and symptoms

DIAGNOSIS: 

The doctor (Gynaecologist) performs the following examinations:

  1. Pelvic Exam: A physical examination to look for any problems with your ovaries or other parts of your reproductive tract.
  2. Diagnostic imaging: Ultrasound examination (pelvic and transvaginal), MRI to look for abnormal follicles and other problems with your ovaries and uterus.
  3. Blood tests: To check for higher-than-normal levels of male hormones. Lab tests will measure the levels of: Follicle stimulating hormone(FSH), Leutinizing hormone, Testosterone, Oestrogen etc.

WHEN TO SEE A DOCTOR?

Consult a doctor if:

  • Absence of periods and you are not pregnant.
  • Signs of PCOS are visible on your body such as hair growth on your face, headache, pelvic pain etc.
  • Failure to become pregnant for more than 12 months.
  • Symptoms of diabetes are present.

COMPLICATIONS:

TREATMENT:

Treatment is symptomatic and a multidisciplinary approach is required to tackle it.

  1. MEDICAL TREATMENT:

It usually revolves around tackling the individual signs and symptoms.

Main concern includes:

  • Lowering of blood glucose levels.
  • Treatment of fertility.
  • Dissolving issues like acne, hirsutism.
  • Restoration of regular menstruation, and prevention of endometrial hyperplasia and endometrial cancer.

Common medical treatments include birth control, fertility drugs and metformin (to improve insulin levels).

  1. DIETARY CHANGES:

The best way to control and manage PCOS is through proper weight management.

American Association of Clinical Endocrinologists guidelines recommend a goal of achieving 5 to 15% weight loss or more, which improves insulin resistance and all hormonal disorders.

Diet should include:  

  • High protein intake
  • High fibre intake                       
  • Low on sugar
  • Low carbohydrates
  1. ROLE OF PHYSIOTHERAPY:

The most annoying complication of PCOS is obesity. Women with PCOS may also experience low back pain, sacral pain and lower quadrant abdominal pain.

High insulin resistance often leads to diabetes – a potential complication of PCOS. Exercise can effectively help in decreasing this resistance to insulin and thus reducing blood sugar levels.

Exercise also helps in weight reduction-

A physiotherapist will devise a customized exercise regimen for you according to your specific needs.

From personal experience, I have found women with PCOS benefitted a lot from a tailor-made exercise program for them, showing visible benefits like –

  • Increased strength in muscles
  • Weight loss
  • Increased Endurance (stamina)
  • Reduction in fatigue 

Two forms of exercises: Strength training and aerobic exercises.

A) Strength Training:

  • Builds muscle
  • Raises the BMR
  • Reduces insulin resistance and inflammation

Strength training can be incorporated using body weight, external weights such as dumb bells, therabands, weight cuffs, etc.

B) AEROBIC EXERCISES:

  • Increases stamina.
  • Helps in weight loss due to increased calorie consumption.
  • Reduces risk of cardiovascular disease.

Cycling, swimming and walking are some forms of aerobic exercises.

Yoga and Pilates has also shown to be beneficial in PCOS.

PCOS is an endocrine disorder affecting a lot of women. Women often have a severe impact of PCOS on their mental health. Change in body image – acne, weight problems, excess hair. All this causes them to develop anxiety and depression.

All this can be avoided with a right approach to PCOS.

If you are dealing with PCOS – the good news is that it is possible to live a comfortable life and manage it with a holistic approach.

Authored by-
Dr. Mansi Babrekar
Masters in Community Physiotherapy
(Women's health & Geriatrics)
Certified ANC PNC fitness trainer & K-taping therapist.

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What is Physiotherapy?

Today, that is, 8th of September of every year signifies World Physiotherapy Day. It is a global event recognizing the importance and trusted role physiotherapists play to improve health and quality of life of their patients.

So let’s get into the details..

WHAT IS PHYSIOTHERAPY (PHYSICAL THERAPY) ?

According to World Confederation for Physiotherapy-

Physiotherapy is a health care profession which is concerned with identifying and maximizing the quality of life and movement potential within spheres of promotion, prevention, treatment, habilitation and rehabilitation.

WHO IS A PHYSIOTHERAPIST?

Physiotherapist is a licensed health-care professional having Bachelor’s and/Master’s degree and/PhD degree .

Physiotherapists examine, assess, interpret, diagnose, plan treatment. They also provide advice for preventing, correcting, alleviating and limiting dysfunction.

PHYSIOTHERAPY SPECIALITIES:

  • Musculoskeletal (Orthopaedic) Physiotherapy
  • Neuro Physiotherapy
  • Cardio-respiratory Physiotherapy
  • Sports Physiotherapy
  • Community Based Rehabilitation
  • Pediatric Physiotherapy
  • Women’s Health
  • Geriatric Physiotherapy

WHERE PHYSIOTHERAPISTS WORK?

  • Government / Private hospitals
  • Clinics
  • Rehabilitation centers
  • Sports field

HOW DOES A PHYSIOTHERAPIST EXTEND SUPPORT TO AN INDIVIDUAL AND POPULATION WELLNESS?

  • By promoting physical activity and overall health.
  • By providing education to prevent disease, injury, and disability.
  • By managing acute and chronic conditions, activity limitations (certain activities which become more difficult for a person with a condition/disease), and participation restrictions (interactions with the world around becomes difficult for an individual).
  • By improving and maintaining optimal functional independence and physical performance of an individual.
  • By rehabilitating post-injury, post-surgery and the effects of disease or disability with graded therapeutic exercise programs and other interventions.
  • By educating and planning maintenance and support programs to prevent reocurrence, reinjury or functional decline of an individual.

WHEN TO VISIT A PHYSIOTHERAPIST?

If you are suffering from the following conditions visit physiotherapist at earliest:

  • Musculoskeletal (orthopaedic) conditions: Back pain, joint pain, arthritis, post orthopaedic surgery, scoliosis, etc.
  • Neurological conditions: stroke/paralysis, GBS, nerve palsies, vertigo, post neuro surgery, and for neuro rehabilitation, etc.
  • Cardiovascular and respiratory conditions: Asthama, COVID-19 and other respiratory infections, post cardiac/lung surgery, varicose veins, etc.
  • Pediatric conditions: Cerebral palsy, downs syndrome, delayed milestones, etc.
  • Sports: Prevention and rehabilitation of sports injuries, on field injury management, etc.
  • Women’s health: Before and after pregnancy, pelvic floor rehabilitation, urinary incontinence, post gynaecological surgeries, osteoporosis, etc.

HOW TO IDENTIFY QUALIFIED PHYSIOTHERAPIST?

Check for degree and & registration certificate (or license). Take Physiotherapy treatment from registered physiotherapy practitioner.

WHAT TO DO IF PHYSIOTHERAPIST IS NOT QUALIFIED?

  • Do not take Physiotherapy treatment from such persons.
  • Report it to Physiotherapy regulating body at your place.

Kindly note while taking Physiotherapy treatment, not just in Maharashtra but wherever you are! Take Physiotherapy treatment from a registered (licensed) Physiotherapist.

Thank you!

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Sports- to play or not to play is the question…

Greetings to one and all!!

National sports day in India is celebrated on the 29th of August every year, which marks the birth anniversary of Hockey legend Major Dhyan Chand. This day is observed considering the need to stay fit and healthy. So let’s accomplish the motive of this day…….

Though sports is one of the most popular topics in every country, many of us don’t take it seriously. So today, I would like to discuss about sports and its importance with you.

During this unexpected pandemic we all missed many occasions, family gatherings, job routine, but with this, most of us missed watching new sport tournaments on television or in stadium or sometimes checking match scores in college in the middle of lectures, at coffee shops or just standing outside that electronic shop to watch that single shot again…….

If you really like that sport, have you ever thought to incorporate that sport in your daily routine? Have you started playing that sport?

If YES, congratulations!!!!! and I must say you have made correct choice in your life.

If NO, no worries it’s never too late to make a new choice.

Many of us are not able to play a sport due to time constraints or busy schedules, fear of injuries and of being defeated in a sport or due to less awareness about sports itself, self-doubt or due to finding it economically demoralising. But I think this lockdown has already showed us the disadvantages of being physically inactive. So keeping ourselves active through sports will not only help us maintain our physical fitness but also keep up our healthy lifestyle.

Other benefits of sports are:

  1. Entertainment
  1. A sports person can do better in their academics/work.
  1. Constructive use of time.
  1. Develop sense of discipline
  1. Improves self-confidence, self-perception and body image.
  1. Builds team spirit and leadership qualities.
  1. Builds strong relationship with self and society

There’s a saying that

“Your life is a result of your choices, choose wisely.”

I assure you that implementing physical activity through sports will never let you down.

SO MY FRIENDS, WHICH ONE WOULD YOU LIKE TO PICK??

Which sport would you like to play?

Recreational v/s Competitive

If you are playing any sport with a goal of physical fitness and social interaction then you can start with RECREATIONAL SPORTS and if you are playing any sport for passion and are willing to opt for different levels of competition and ready to travel then COMPETITIVE SPORTS are appropriate.

High v/s low impact

High impact sports- As the name suggests, high-impact activities put more stress on your joints. These are good for conditioning as well as calorie burning. Avoid this kind of sport at old age or if you have some bone or joint issue like arthritis.

Eg: Running, Racquet sports, Ball sports.

Low impact sports- At the other end we have low-impact sports. It applies less force to your joints. A good option for people who are new to exercise.

Eg: Swimming, Cycling

Has your brain already started working on what to start with ????

If yes..so here are some quick tips for you to begin with..

  • Educate yourself about that particular sport.
  • Use suitable equipments and surfaces according to sport to prevent injury.
  • Use appropriate clothing and shoes.
  • Perform appropriate sport specific training.
  • Perform RAMP warm up for 15-20 minutes (include joint mobility, general warm up and  sport specific warm up).

    Why RAMP ? What does it do ?

  • Perform GUARDed cool down for 15-20 mins (include stretching, breathing exercises)

Why GUARDed ? what does it do ?

  • Keep yourself hydrated.
  • Take proper nutrition.
  • Be patient. No one becomes a pro at a new sport overnight.
  • Progress gradually.
  • Consult your doctor or/and physiotherapist if you have any injury.

So friends, don’t just think but start incorporating sports in your everyday life.

Stay healthy, stay fit!

Authored by-
Dr Aishwarya Ranbhor (MPT)
Consultant Orthpaedic and Sports Physiotherapist

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Happy Aging!

A very happy World Senior Citizen’s Day!! If you are 60 or 60 plus, Congratulations you are officially a senior citizen! I once heard an elderly say, I am not 60, I am sweet 16 with 44 years of experience.  As Shakespeare said, “Age is just a number,” but we tend to take this number very seriously.

So, today I would like to share with you some age-defying secrets. As this lock down has come upon us so unexpectedly, a lot of elderly miss their favorite morning or evening walks in the park. It was multi-purpose – Sehat bhi aur Social interaction bhi. As a result of the lack of physical activity and exercise, we all are on the road to become couch potatoes. I cannot agree less with the saying “Sitting is the new smoking”.  If you are sitting for more than 3 hours a day, if you have household help available for all your daily chores and if you travel by ola/uber or a car whenever you leave the house, consider yourself on the road to poor fitness. So it is extremely important to get yourself moving, though indoors.

There are four pillars of fitness-

1.Nutrition/Diet.

2. Sleep.

3. Exercise and

4. Physical activity.

 One is incomplete without the other. Exercise and physical activity are not always synonymous to each other. You need to exercise to keep your muscles and bones strong and also, keep your physical activity high throughout the day to maintain good stamina and general fitness.

Focus on 4 S’s of exercise-

  1. Strengthening- Makes your muscles strong.
  2.  Stamina- Sustains high energy levels during all the activities of the day.
  3. Stability- The ability to not lose balance.
  4. Stretching- How far can you reach shows your flexibility.

This chart gives you a few simple exercises to do at home. Perform each exercise 10-15 times as per your capacity.

Also, another great way for overall health is our age-old, time-tested favourite exercise – The Sun Salutation Or Surya Namaskar. It can be done in a modified way by sitting on a chair as shown below.

Also , for every 30 minutes of sitting, make it a rule to get up and walk or stretch for atleast 3 minutes. Make it a rule!

The most common excuse we all use for not exercising is – “ Time nahi milta Hai.” This lockdown has brought upon us a silver lining by taking away this excuse. So inculcate the habit of exercising daily. Slowly and steadily you will transform your body and defy ageing.

The whole world’s economy is shut down because everyone fears for their health. Job, money, career, success are all secondary accomplishments. The first and foremost is Good Health. This pandemic is here to stay in our lives for long. It is up to you that when you finally come out of your houses for a get together, do you want people to look at you and say, “Oh! You look so old and frail” or do you want them to look at you and say, “What have you been doing? You look so fit and energetic.” The choice is yours!!

Authored by-
Dr Pratha Mehta, Physiotherapist specialized in Orthopaedic conditions. She has completed her Masters in Physiotherapy from the prestigious KEM Hospital. She is a fitness expert with a passionate desire to bring about a fitness revolution in the elderly.

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FALL PREVENTION IN ELDERLY!

“Old age is not a disease- it is strength and survivorship, triumph over all kinds of vicissitudes and disappointments, trials and illness.”- Maggie Kuhn

The above mentioned quote is a reminder to all of us, not just the elderly but even for their loved ones that aging or rather “Active aging” as World Health Organization (WHO) states it as, is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age.

Falls and Elderly Population:

Individuals aged 60 years and above define the elderly population. With aging, they are at an increased risk of having a fall(s).

Falls can be risky especially among the elderly population. But don’t you worry, a little bit of information can keep you and your loved ones to be more cautious and help in preventing any sort of unforeseen hazards.

Leading cause of falls in elderly:

Various reasons can lead to falls in elderly, but most common ones are due to any pre-existing medical condition, imbalance or poor vision or side effects of their medications.

Factors increasing the risk of falls in elderly:

There are many factors that predispose our elderly population at a risk of falls.

Due to the process of progressive decline in internal physiological (bodily) functioning as well as external (environmental) factors, they can be at risk.

The severity of the risk can be determined by undergoing a thorough examination for Fall Risk assessment. You can contact your consultant physiotherapist for evaluating and guiding you through this process.

If utmost care is not taken, falls can cause:

  • morbidities/injuries like: bruise, cut, fracture, head injury.
  • reduced functioning.
  • hospitalization.

Especially in times of this pandemic, we all would want to prevent any such instance that put them at a greater risk of exposure due to difficult access to emergency facilities.

How do we reduce this risk?

No better measure than prevention, which can help us to keep our elderly at a lesser risk of falling.

FEATURE: One should seek help of a physiotherapist for a detailed assessment of the elderly prior to prescription of exercise regimen and customized program for fall prevention under complete guidance.

  1. Strength (Resistance) Training:
  1. Aerobic Training:
  • Cycle Ergometry:
  • Chair Aerobics:
  • Brisk Walking- Walk and talk:

Some of our senior citizens are often seen together in the parks, gardens or walking tracks, cracking jokes, communicating and enjoying their fitness routine while in company of others. Due to current situations, considering outdoor gatherings to be risky, many of them displayed reduced physical fitness.

It’s time to use the benefit of technologies! A Virtual Buddy Fitness session!

Organizing an online video calling fitness workout will not only keep them fit but also hold up their interest as they get an opportunity to reconnect with their buddies while doing so!

  1. Balance Training:
  • Standing on unstable surface:
  • Walking on line: i) With eyes open ii) With eyes closed
  1. Modifications at home and in different environments:
  • Balance out light levels:

i) Use of contrast and glare filters for very bright lighting

ii) Use of good lighting in dark spaces of the house.

  • Bathroom modification: High number of falls may occur in the bathroom due to poor grip and slippery surfaces. Hence, modifications are a must.

i) Nonslip bath mats                        

ii) Grab bar around toilet seat and bathtub

  • Staircase modification: Poor judgement for depth of step may result in high risk for falls.

i) Marking with paint                                                  

ii) Installing railings  

  1. Use of assistive device: A supportive device as per the prescription of a consultant can be of help as well.

i) Quadripod cane                                                       

ii) Walker

  • Emotional Support:

Our senior citizens display anxiety and fear when it comes to any previous incidents of falls.

Being emotionally supportive and motivating not just helps them feel comfortable but provides them with a boost of confidence that is required for their mobility in their daily life.

If we all come together and keep a positive mindset about ageing, this will be accepted, processed and adapted by our elderly with greater optimism.

“Aging is NOT lost youth, but a NEW stage of opportunity and strength” –Betty Friedan

Authored by-
Dr Kaushani Jhaveri
Masters of Physiotherapy in Neurosciences
Consultant Neurophysiotherapist 

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Child’s eye health and it’s influence on development

Ever wondered how are we able to see things…???

The visual ability is a complex interaction between light, eyes, and brain. Light reflected from the objects enters the eye through the cornea, which resembles a window at front of the eye. Pupil controls the amount of light entering the eye which is surrounded by colored part of the eye – Iris. The retina converts this light into signals and sends it to the information processing center – Brain. Also, retina which is made up of rods and cones (light sensors) is the one that perceives different frequencies of light which is responsible for our color vision… Isn’t it amazing..!!! Only if RETINA was an individual I would tell that person how thankful I’m for letting me experience such wonderful colors of nature…!!!

So everything we witness “out there” is merely the mental image of outside reality.

Infants are born with a complete visual system, but they must learn how to see just like how they learn to walk or talk. Most of the child’s visual ability develops throughout the first year of life and continues to develop in childhood. Healthy eyes and good vision is vital in how children learn to see.

Some of the important visual milestones are:

* Ability to focus

* Object and face recognition

* Eye coordination and tracking

* Depth (3D) perception

* Color vision.

How does a child’s vision influence learning?

Vision is more than just seeing clearly or having a 20/20 eyesight. It is also the ability to understand and respond to what is seen. 80% of our learning happens through vision. Processing visual information and various tasks require the activation of each part of the brain.

Eye impairments (problems)

Eye and vision impairments (problems) in infants/children can cause :

* Developmental delays

* Poor hand-eye coordination

* Poor social interaction

* Hinder academic performance

* Affect recreational activities etc.

Kids and adults both need a comprehensive eye examination. It is often recommended that infants should get their first eye exam done at 6 months, additional checkups should be done at 3 and at around 5-6 years. School-age children should get eye exams done every 2 years even if no corrective visual measures are required.

Visiting your eye doctor can help diagnose potential eye condition or disease and make the best decision about how to correct or manage it.

Common refractive errors include:

* Nearsightedness

* Farsightedness

* Astigmatism

Some serious eye impairments include:

* Strabismus (misalignment of eyes)

* Amblyopia (lazy eye)

* Ptosis (drooping of the eyelid)

* Colorblindness

* Poor depth (3D) perception

* Double vision

Having experience in treating kids with neurological affection who also have vision problems; correction of their vision problems did significantly improve their development and interaction with surrounding. Hence, regular eye check-ups should be done to notice changes in your child’s vision.

However if your child is exhibiting any of the following behaviors it’s best to schedule an appointment with an eye specialist:

* Struggling to concentrate and pay attention

* Complaining of eyes hurting, headaches or double vision

* Frequently rubbing eyes or uncontrollable blinking

* Tilting or turning head to look at objects

* Holding objects or reading material too close to face.

* Disinterest in reading or looking at objects from a distance

* Wandering eyes

* Closing one eye to watch TV or read

* Excessive eye discomfort while using any digital device.

Is your child spending more time on mobile devices and computer screens more than ever before…? The amount of screen time per day has been associated with developmental outcomes, obesity, poor sleep quality, and digital eye strain. The best possible way to deal with the effects of screens is to set some good habits not only for children but also for adults.

* Alternate reading an e-book with a real book

* Following the 20-20-20 rule i.e. every 20 minutes, look at least 20 feet away for 20 seconds.

* Adjust the brightness and contrast of the screen.

* Use good posture when using a screen. Poor posture can contribute to muscle tightness and headaches associated with eye strain.

* Encourage your child to hold digital media at an ideal distance of 18 to 24 inches.

* Remind them to blink when watching a screen.

* Establish media-free times each day.

* Reduce blue light (from digital devices) exposure by wearing blue light filtering lenses. Blue light may also affect your body’s sleep/wake cycle so avoid using screens one to two hours before bedtime or use nighttime settings.

Some activities to sharpen your child’s visual skills:

* Painting/drawing

* Pegboards, puzzles, building blocks, and similar games for eye-hand coordination.

* Making jewelry/stringing beads

* Playing outdoors preferably playgrounds

* Playing catch and throw with the ball.

Also adding a few tips on taking measures to protect eyes:

* Wearing protective eye gear while participating in recreational activities/sports.

* Ensure toys are age-appropriate, making sure for sharp/protruding parts.

* Wearing sunglasses that have 99-100% UVA and UVB protection when outside.

* Promoting good eye health through an appropriate diet.

Children’s eye health plays an important role in overall health and development. Hence taking an eye exam may be the key to unlocking your child’s full potential.

Authored by-
Dr Charmi Parmar
Consultant Neurophysiotherapist

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Are you recovering from COVID-19?

Your body has been through an ordeal and it’s bound to take time to get back to what you were!

But do not worry. There is always a hope, in this process, to facilitate your recovery!

And this is what exactly I am going to share with you today…that how will you recover faster and better post COVID-19?

So, here we go…

COVID-19 is a disease caused by corona virus as you all know it.

So how does it spread/transmit?

What happens once virus enters inside the body?

Also, the virus when enters the body causes sore throat, fever as a result of infection process.

Do you know how does your body fight against it?

Immune system of the body fights against this virus and with a weak immune system the body is taxed and there is a build of fluid and protein cells leading to pneumonia and respiratory distress (ARDS). This is when the need of ventilator arises.

Depending on the severity of symptoms COVID-19 patients are grouped as:

Patients recovered from COVID-19 may present with problems in different body systems as below:

  1. Respiratory system:
    • Dysfunctional breathing pattern.
    • Weakness of respiratory muscles.
  1. Cardiac system:
    • Reduced exercise capacity and endurance (stamina)
  1. Musculoskeletal system:
    • Restriction of joint mobility.
    • Reduced muscle flexibility and strength.
    • Fatigue and loss of lean body mass.

Also there affection of psychological system leading to stress and anxiety.

And let me tell you that recovery time varies from person to person and is dependent on the other associated diseases as well.

Here is what we, as physiotherapists plan for early recovery post COVID-19..

Goals for recovery and rehabilitation:

Note: An individual should be assessed for exercise capacity and oxygenation response during regular physical activity and then trained accordingly by a physiotherapist.

HOW TO START BACK?

  • During your hospitalization, you will likely be moving around less than normal. This may leave you feeling weak and more unsteady on your feet. This is normal due to loss of muscle that occurs with prolonged bed rest or sitting.
  • It is important to start to rebuild those muscles as soon as possible and become more active as this will help you recover both physically and mentally.
  • Comply with the exercise program prescribed by your physiotherapist which may begin with exercises at bed level, in sitting, and gradually progressed to variety of exercises in standing targeting balance, mobility and endurance.
  • Your physiotherapist will also prescribe breathing exercises that will assist with improving your lung capacity after this type of respiratory illness.
  • Use rate of perceived exertion (RPE) scale to monitor your exertion levels during different activities throughout the the day including your exercise sessions. You should keep your (RPE) in the range of 1 to 3 during your recovery. If you are rating the activity in the higher ranges, it means your body is not ready for that activity. Take planned rests throughout the activity and day.
Rate of Perceived Exertion (RPE) scale
  • Conserve energy. Energy conservation means finding the easiest way to do an everyday task, so you have some energy left over to do the other things you would like to do. Follow 4 P’s.
4 P’s of energy conservation
  • Start with light activity – examples include getting up to go to the bathroom versus a bedside commode, walking to make a cup of tea/coffee or even just standing up from a seated position.
  • Keep a walking log or activity diary to track the number or times and estimated distance you are able to walk each day.

WALKING LOG – track your progress

Points to remember during recovery from COVID-19:

  1. Recovering from a diagnosis of COVID-19 and/or acute respiratory distress will be slow and your ability to return to everyday tasks will be gradual.
  2. Take frequent rest breaks even if you do not feel short of breath.
  3. Positions to relieve breathlessness such as sitting and leaning forward, resting your hands on your knees, standing and leaning forward on a counter top or a sturdy piece of furniture can be used.
  1. Lying on your stomach (prone) may allow you to breathe more easily/expand your lungs. Also, this position helps with decreasing the efforts needed to breathe and help with air entry in lungs (Note: attempt this position taking into account your comfort and if not sure, consult your physiotherapist).
  1. Do follow energy conservation techniques mentioned above.
  2. Maintain good nutrition and hydration during your illness and recovery. Your body is requiring more calories to breathe and do the physical work of recovery, so make sure you are eating and drinking regularly, even if you have a low appetite.
  1. Gradually increase daily conditioning exercises and a walking program.
    • Use the Rate of Exertion (RPE) scale to help guide how hard you are working. Initial goal is to work in the 0-3 range. Keep taking short rest breaks.

 So, after retraining and rehabilitating, my patients have reported:-

  1. Increment in time and distance of walking as daily activity.
  2. Increased range of movements of limbs.
  3. Increased muscle strength.
  4. Reduction in symptoms i.e. breathlessness and cough.

– all with the varying recovering time.

So, based on my experience in treating COVID-19 recovering patients, I would like to tell you all – don’t feel worried or discouraged if it takes a while to get your energy and fitness back. It is important to understand that recovery time is different for each patient. And if you need any help in your recovery we are here for you!

Authored by-
Dr Krina Chheda 
Masters in Cardiopulmonary Physiotherapy
Consultant Cardiopulmonary Physiotherapist

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Living with diabetes!

Diabetes mellitus, also called simply diabetes, is a disease characterized by high glucose levels resulting from:

  • either an inadequate production of insulin by pancreas (type 1 – accounts for 5-10% of cases)
  • an inability of insulin to facilitate transport of glucose into the body cell (type 2- accounts for 90-95% of  cases
  • or both

Another type of diabetes is gestational diabetes developing in pregnant women and their babies, and usually disappears in both after delivery.

 And do you know diabetes is one of the most prevalent diseases in the world?

India is known as Capital of Diabetes where about 50.9 million people suffer from diabetes.

So, considering these numbers and people living with diabetes and people on borderline of this disease, it is high time we need to increase awareness about it. Living with diabetes implies:

The aim is to raise awareness of this disease which affects them in many ways right from heart, blood vessels, kidney, liver to the nerves and skin and eyes and which make you go weak sometimes as the body cells are deficient of glucose which remains in blood!

This is not to instill fear or anxiety about the disease but to increase your awareness about it so that you get empowered to seek early and appropriate help. Thus, save yourself from adverse situation due to delayed treatment or prevention of the problem in first place.

It has long been recommended that the 3 cornerstones of diabetic therapy are medication, diet, and exercise (ADA 2008). Medications and diet are usually followed but what tends to get overlooked is..EXERCISE which plays important role in blood glucose management, improving metabolism and overall well-being.

Being a diabetes fitness instructor along with a rehabilitation professional (and having treated people suffering due to diabetes complications), I would like to bring to your notice that exercise is beneficial..not just to diabetics but prediabetics too!

Exercise benefits

For type 1 diabetics, major benefits of exercise are

-reduced risk of diseases related to heart (which is very important in type 1)

-weight maintenance

-increases insulin sensitivity (increases the effectiveness of whatever amount of insulin present in blood)

 -lowering of fat levels.

For type 2 diabetics, exercise helps

-gain similar benefits as in type 1 along with control over blood glucose levels (ADA 2016).

How does exercise help?

In type 1 diabetes- exercise helps improve blood glucose control where there is lack of insulin to do so.

In type 2 diabetes-

Research reveals progressive resistance exercises (PRE) leads to reduction in glycosylated haemoglobin (HbA1c), especially for people with type 2 diabetes, thus help improve blood glucose control. A 1% decrease in HbA1c is associated with a 37% decrease in the risk of microvascular complications and a 21% decrease in the risk of death associated with diabetes.

Important!

Oral hypoglycemic (diabetes) medications can reduce HbA1c but they are accompanied with relatively high cost and side effects such as flatulence, nausea, diarrohea, abdominal pain and weight gain (IrvineC, TaylorNF 2009). Though these medications are essential, exercise (a much feasible part of the diabetes management plan) is emphasized to bring down the dosage of medications over the time.

Exercise not only helps with the problems associated with diabetes state but also helps improve mental health and immunity too (especially in these current circumstances of covid19), thus improving overall well-being which may also improve your social life.

Note:

The challenges related to blood glucose management vary with diabetes type, activity type, and presence of complications associated with diabetes. Therefore, exercise recommendations and precautions need to be tailored to meet the specific needs of each individual. Supervised training is recommended in order to gain maximum benefits.   

What’s coming up?

Stay tuned to know about exercise recommendations, tackling diabetic complications, self management strategies and much more information..

To stay on this journey ..sign up to receive monthly newsletter updating you and empowering you with exclusive information about diabetes! 

PS: You may email your queries to us at cognizancephysio@gmail.com  

Authored by-
Dr Rajashree Lad (MPT, CAFST, CFMP, COMT)
Consultant Orthopaedic Physiotherapist
Certified Diabetes Fitness Instructor

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Are you taking pills to relieve your pain?

With countless over-the-counter pills for treatment of pain, it can seem simple to turn to medicines for pain relief. Likewise pain relievers such as the opioids and steroids are also prescribed. While the long term effects of these medicines may be harmful, a relatively safer option can be thought of, that is, PHYSIOTHERAPY. With physiotherapy treatments, you can sweep all of those risks, worries, and unpleasant side effects aside. Physiotherapy can help numerous patients incredibly lessen their dependence on painkiller medications though some cases of severe pain might still require some medicines to be taken along with physiotherapy.

Many people bump physiotherapy into the same category as “alternative treatments” and it’s frequently confused with massage or chiropractic therapy. In any case, physiotherapy is different. Will it work for you? Let’s find out…

Physiotherapy is a health care profession which assists people to restore, maintain and make the most of a patient’s mobility, function and well-being as well as providing pain relief which is the main focus in the treatment for lot of injuries and conditions.

There is a multitude of different physiotherapy treatment approaches. After initial examination and testing physiotherapist will come to a diagnosis of what is the cause of pain. Depending on the cause/condition, treatment can involve a number of treatment and preventive approaches. Have a glance…

One or combination of any of these therapies depending on the tissue healing state may alleviate pain by:

  • Pain gate mechanism
  • Improving blood flow and fluid drainage
  • Production of the body’s natural pain-relieving chemicals.
  • Promote relaxation
  • Relieve pain and stiffness
  • Increased awareness of body and movements.

Physiotherapy not only helps to manage pain, but also helps in avoiding/delaying surgeries, getting back to function post-surgery, other health issues like diabetes, stroke, heart attack, obesity etc.

Like other complicated things in life, pain may not be limited to one specific cause. We often speak of pain as multifactorial, but we still tend to assume one specific cause of it. Let’s put light on other potential causes contributing to the already existing pain one experiences which directly affects duration, intensity and perception of pain.

  • Lifestyle and behavior [smoking, alcohol, physical activity, nutritional status.]
  • Clinical aspects like mental health [anxiety, depression], surgical interventions, co-morbidities, sleep disorders, genetics etc.
  • Socio-economic background [research suggests low levels of education about pain and injury, neighborhood deprivations and perceived income inequalities are associated with pain thus interfering with daily activities].
  • Employment status and occupational factors [poor job control, expectations to return to work, fear of re-injury, lack of ability to modify work, unemployment, employer and co-worker reactions to pain etc.]
  • Influence of ethnicity and cultural background.
  • Attitudes and beliefs about pain.
  • History of violent injury, abuse or interpersonal violence.

Being a Neurophysiotherapist I would say treating pain requires a multi-dimensional approach considering all the above information. Physiotherapy combined with efforts from general practitioners, pain management consultants, psychologists, orthopedic specialists and rheumatologists to give greater benefits from treatment.

What is your role in physiotherapy?

For physiotherapy to take effect and alleviate pain, it takes your active participation. The responsibility of reducing pain is not just on the physiotherapist, you have to do your part too. Only then those exercises/treatment will have an impact. Here are some tips for the therapy to work better and faster:

  • All the exercises prescribed should be done regularly.
  • The advice given by your therapist should be followed accurately.
  • Follow up should be maintained to evaluate the progression and if there is any modification in treatment.

It is important to know that physiotherapy and pain relief is a complex subject, and that every individual may respond differently to the therapy due to different body structures, different movement patterns and different habits.

You’re probably wondering whether you should bother visiting a physiotherapist or why not just wait it out? Unfortunately, waiting it out will probably reduce symptoms temporarily but may also aggravate them in long term and may not actually fix the reason you got that pain in the first place. I hope now you’re in a position to acknowledge your pain and get it treated.

Let us know how much this article has helped you and as always we’re here to answer all those questions popping in your mind…

Till then take good care of yourselves and the ones around you…!!!

Authored by-
Dr Charmi Parmar
Masters in Neurophysiotherapy
Specialised in Neurodynamics and Dry needling techniques
Consultant Neurophysiotherapist

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Let’s get to know your pain!

Whether you jammed your pinky toe against the table leg or touched a hot pan, you know that pain will usually follow. And what’s the first thing we do when we feel pain? Well, first there is some sort of emotional response or maybe we just complain. Then we try to get rid of it.

But did you ever wonder why you feel pain?

Pain, is a message, a sort of public service announcement from your brain about a potential danger. That’s how pain arising from tissues (nociceptive pain) is to supposedly work anyway. Pain has continually displayed a bit of an issue for evolutionary biology. In a chapter on “design” flaws, Richard Dawkins states this in his book, The Greatest Show on Earth:

Pain, like everything else about life, we presume, is a Darwinian device, which functions to improve the sufferer’s survival. Brains are built with a rule of thumb such as, ‘If you experience the sensation of pain, stop whatever you are doing and don’t do it again.’ 

 In various painful circumstances, a little pain would actually be impeccably capable to serve the basic evolutionary goal of warning us away from threats.

Pain is a motivator.

It exists to get us to act. The brain effectively and imperfectly controls how we experience pain/potentially harmful stimuli, but I have to report to you that you do not control your brain. It’s not your opinion of sensory signals that counts, it’s what your brain makes of them that counts — which happens quite independently of consciousness and self-awareness. 

So is there anything that one must do when they experience pain?

Well, first familiarize yourself with the discomfort rather than taking a pill and avoiding it. To begin, use your pain as a guide by simply being willing to lean into it. Taking help of the appropriate medical advisor in understanding the nature, source, severity of pain and figuring out what is causing it.

Pain changes everything…it affects our..

  • Mood and energy levels
  • Sleep
  • Physical activity and functions
  • Work and finances
  • Family and relationships            

Knowing your pain

Acute pain which can be described as pain that is experienced for a few days, weeks or months. Usually, it is experienced together with an injury or potential tissue damage.

Chronic pain which can be described as pain that is experienced for 3 months or more, or longer than expected healing time for an illness/trauma.

What’s causing that pain..?

Pain types do differ and are often classified by the kind of damage that causes it. Have a look…

Certain types of pain are referred to as syndromes. For instance, myofascial pain syndrome refers to pain that is set of trigger points located in the body’s muscles…exactly why you book those massage appointments!

When the primary complaint is pain, the treatment of pain should be primary.

Response to pain is individual, and what may be painful to one person can be only slightly uncomfortable to another. Since pain messages pass through the emotional and thinking regions of your brain, your experience of pain is molded not just by the physical damage or sensation, but by psychological, emotional and social factors as well. Your memories of past painful experiences, genetics, long-term health problems, coping strategies, and attitude towards pain, diet and lifestyle can all contribute to how you feel pain. Thus a physician who addresses a patient suffering from pain using a holistic approach provides him with the knowledge that is necessary to treat all factors contributing to pain.

Pain neurology has been shouting it from the rooftops for a couple of years now: pain begets pain. The more and longer we hurt, the more likely we are to become dysfunctionally oversensitive. Fortunately, neurology is also our friend. Now that you know how nasty pain can be, but still the brain is the king of pain. There is no pain without brain. The better you understand your own pain, the less you will fear it, and the more you will see what your body is able to do. You need not be in pain. We are here to help you…!!! If you or anyone you know are struggling with pain, get in touch with us…Your path to health and wellness may be a bit different from those around you, but it does not make the journey any less vital. 

Authored by-

Dr Charmi Parmar

Masters in Neurophysiotherapy

Certified in Neurodynamics and Dry needling techniques

Consultant Neurophysiotherapist

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Arthritis in kids- are you aware of this type?

Arthritis is often thought of as a disease that only affects grownups, but in fact, about 100 in 1 lakh kids have it (Medscape 2019).

Aches and pains are normal part of childhood which can make this condition difficult to diagnose and hence people may lack its awareness. Juvenile Idiopathic Arthritis (JIA) is a form of arthritis which affects children! As children with JIA reach their adulthood, they may face many problems such as – continuation of disease activity, medications related side effects, lifelong disability, emotional burden and social dysfunction. Hence, early recognition by parents is a matter of utmost importance. Because it is under-diagnosed, it is very crucial to make people aware of seriousness of JIA.

Photo by Polina Tankilevitch on Pexels.com

July being Juvenile Arthritis Awareness month, which is a campaign initiated by the Arthritis Foundation and having experience in treating JIA kids, today, I aim to spread awareness about JIA in order to improve quality of life of all JIA kids in long term!

What is it?

Juvenile- it affects children younger than 16 years of age

Idiopathic- it has no known cause

Arthritis- causes redness, warmth and swelling in and around joints

  • It lasts for more than 6 weeks with an unpredictable clinical course.
  • JIA is the most common form of juvenile arthritis (juvenile arthritis is an umbrella term which includes all inflammatory and rheumatic diseases).
  • It can also have impact on various body systems, causing limitations and restrictions in daily activities in a growing kid.
Photo by cottonbro on Pexels.com

What are the symptoms?

  • Symptoms are variable in each child with flare-ups (symptoms worsen) and remissions (symptoms improve or disappear).

Most common symptoms include:

  1. Joint pain, stiffness
  2. Swollen, warm and red joints
  3. Fatigue
  4. Fever
  5. Blurry vision
  6. Appetite loss
  7. Growth problems
  8. Rash
  9. Swollen lymph nodes

What’s next?

You should see your family physician if you experience above symptoms who may refer you to pediatric rheumatologist (doctor specialized in managing arthritis and related conditions). Diagnosis will be confirmed with detailed medical history, International League of Association for Rheumatology (ILAR) diagnostic criteria along with various diagnostic tests: C reactive protein test, Rh factor test, HLA B27 test, ESR and imaging studies: MRI scans, x-rays.

Photo by Pixabay on Pexels.com

There is no definite cure for JIA but controlling flare-ups/achieving remissions is possible. The long term outcomes have improved in last decades due to advanced diagnostic techniques and extensive research in treatment options. Ultimate goal is to improve quality of life which is achieved by holistic approach adopted by a multidisciplinary team that includes pediatric rheumatologist, physiotherapist, occupational therapist, dietician, social worker, psychologist etc.

What about its treatment?

  1. Your rheumatologist is the right person to prescribe medicines to relieve your symptoms.
  2. Surgery of any kind is rarely required for it.
  3. Exercise/physical therapy to improve quality of life of the child.

How does physiotherapy help?

 Since there is no definite cure for JIA, the focus should be on improving the quality of life of the child to let the child live life to the best possible level in long term. Staying active is the key! And Physical therapy (PT) exactly does it all, along with the medications.

PT helps in-

  • Pain reduction
  • Improving mobility (to reduce stiffness), muscular strength and stamina by prescribing appropriate exercises.
  • Aerobic conditioning
  • Trains and supports the child in participation of age appropriate activities considering child’s clinical condition.
  • Educating family members to support them in taking care of child with JIA.

Feat!!!

Lastly, I would like to introduce you to an American golf champion, Kristy McPherson who was confined to bed at the age of 11 due to Juvenile arthritis, now is an inspiration to 3,00,000 kids with Juvenile arthritis in America. She fought against all odds, worked with medicines and physical therapy eventually to achieve remarkable success as pro golfer. She wants other kids and adults with arthritis to have a chance of productive and painfree life.

Take away..

So..for all those parents/caregivers taking care of their beloved ones or having someone who is suffering from JIA..the message is

Active lifestyle with appropriate guidance is important!

Stay active!

Stay strong with strong will power and hope!

Appreciate yourself for going against all odds with JIA!

So let all of us extend support to all those in need by sharing this post to spread awareness and empower them to live life to the maximum!

Thank you.

Authored by-

Dr. Bhakti Dhanu (MPT)

Consultant Orthopaedic Physiotherapist

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Worried about your child care amidst Covid-19?

Hello! Welcome back! Well I need to state we are living through historically unprecedented times. Government bodies are taking a gander at opening up the economy and yet the corona virus is in full swing.

Around this time, many are hoping to create healthier habits, make new goals, set objectives, and think beyond practical boundaries. The thing is, habits influence our own lives and of the ones around us; the present post is about child care in COVID times.

There are so many things out of control right now, but one thing you can control is communication with your child. Kids are already asking so many questions, so let them! Here’s how I recommend initiating a conversation about COVID-19:

  • Start by asking what they know. This allows you to start where they are and not give information than they can handle.
  • Correct any misinformation they have and you can help them figure out what is real and not.
  • Keep it simple and developmentally appropriate.
  • It’s OK to not know. You won’t always have all the answers, so it’s more than OK to tell them you’re not sure and you will get back to them.

Sleep, exercise and balanced nutrition are always important for overall health and wellness. In addition, here are some things you can do to model and practice healthy habits with your entire family during this time:

  • Limit screen time. We are flooded with information and constant alerts on phones which creates anxiety. Try and aim to be informed and take proper precautions without being obsessive and excessive.
  • Maintain routines as much as possible (regular meal times and bedtimes). Consistent routines allow children to know what to expect, which creates a sense of safety and security.
  • Keep communication open.
  • Do things you enjoy.

Also emergence of COVID-19 has led to widespread concern and to some extent panic among parents, having queries regarding the ramifications of this disease in children and what they will do to stay kids healthy. I will be addressing some of the questions and guidance to parents in this matter.

What are the General Precautions to be taken?

  • Clean hands often using soap and water or alcohol-based hand sanitizer.
  • Children should wear a cloth face-covering over their nose and mouth when in public settings. If kids despise the use of masks, then relate it to their favorite superhero character (your mask is as cool as Batman’s).
  • Educate your child to cover the mouth and nose with a tissue or flexed elbow while coughing and sneezing. Dispose the tissues immediately and wash hands.
  • Clean and disinfect high-touch surfaces daily in household common areas (like tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, and sinks).
  • Routinely clean, sanitize, and disinfect surfaces and objects that are frequently touched, especially toys and games.
  • Do not share toys with other groups of infants or toddlers, unless they are washed and sanitized.
  • Child care providers should wash their hands before and after washing, feeding, or holding young children.
  • To help children maintain social connections while social distancing, help your children have supervised phone calls or video chats with their friends.

Watch your child for any symptoms of COVID illness like..

  • Shortness of breath
  • Nasal congestion
  • Fever
  • Running nose
  • Vomiting
  • Rash

If any such symptoms are present, stay calm. Talk to a healthcare provider. The doctor will take a detailed history and make an assessment of the severity of the condition. Only if there is a history of close contact with a COVID-19 patient, then testing may be recommended. Follow the instructions and the advice of your pediatrician.

How to keep children active and healthy?

  1. Breathing exercises not only help to relax but also reduces stress and anxiety. Fun activities in form of games can be incorporated to encourage deep breathing. Activities that require children to exhale, for example blowing bubbles, blowing off crepe paper, inflating balloon, blowing ping pong balls on the floor, blowing through the straw to spread the paint etc.
  1. Having experience in treating pediatric patients, I have noticed that more and more kids tend to have difficulty in maintaining functional posture at home during various activities. This may be due to poor core muscle strength which could be due to a number of reasons including-
  • Kids becoming more interested in video games and television.
  • The rising trend of children being less physically active due to intense academic demands.
  • An increase in the number of children with developmental delays.

Enlisting few exercises that not only improves core muscle strength but also motor control, motor planning/co-ordination and overall strength-

  • Bridging
  • Planks
  • Superman position
  • Walking wheelbarrow

Plank exercise

Bridging exercise

Superman pose

Walking wheelbarrow

  1. Cerebellum also known as the “little brain” is only 10% of our brain volume, has its role in developing fine motor skills that require coordination of small muscle with the eyes like playing piano, drawing, play-dough etc. And it also coordinates our motor output with visual input like finger painting, working a jigsaw puzzle, arranging blocks, kicking a ball rolled to you etc.
  1. In case your child is in an on-going academic schedule during the current lockdown, then you can enable your children to continue with their education by getting in touch with the class teacher and through e-learning methods.
  1. Its 6 o’clock in evening and your kid wants to watch cartoon, but you want your kid to do something more productive and fun. Well you can try to do activities that boosts brain and thus improve cognition like scavenger hunt, building fort of blocks, Rubik’s cube, scrabble, playing memory games etc.

So, the next time your child says they’re bored— just play a game!

Hope this blog has given you some ideas and guidance on taking care for your children.

Do let us know what you liked the most about it and share it with your loved ones.

Till then Stay Safe! Stay healthy!

Authored by-

Dr Charmi Parmar

MPT, NDS, CDN

Consultant Neurophysiotherapist

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Can exercise help improve your immunity too?

Hello everyone!

Hope you all are doing well and following all measures in the context of Covid as gradually we have begun moving out of our homes after long!

It’s just the beginning and there is no access to gyms and sports clubs but this does not mean people should stop exercising!

Photo by Andrea Piacquadio on Pexels.com

And did you know regular exercise actually benefits our immune system?

A recent study at the University of Bath revealed regular, daily exercise at a time plays an important role in helping to maintain a healthy immune system which is much needed especially in these crucial times of Covid.

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Benefits

Exercise:

-if performed in short term, causes natural killer cells and neutrophils (our body’s first immune cells) to respond to infections profoundly.

-if performed in long term, has profound effect on adaptive (or memory) immunity in identifying and responding to pathogens and cancer as we age.

Myths

It has been thought since last few decades that strenuous and prolonged exercise such as running marathon or ultra-marathon temporarily suppresses immune function but there is limited evidence to support it.

Also, these effects have been seen in athletes and linked to psychological stress, intensified training and inadequate food intake during training, insufficient sleep, inadequate dietary intake of micro and macro nutrients along with hydration.

Exercise, in itself, does not seem to supress immunity. Generally, the greatest risk factor for a bacterial or viral infection is exposure at mass gatherings, probably via exposure to crowds or by touching surfaces that may have become contaminated.

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So, these findings emphasizes upon the present norms of social distancing, minimising gatherings and travelling and exercising at home or in isolation if exercising outdoors. Make sure you maintain a good personal hygiene, follow all measures to prevent infection during and after exercise especially considering the present Covid circumstances.

How much.. to get the benefits?

-Moderate intensity aerobic exercise such as brisk walking, jogging or cycling with the aim of achieving about 150 minutes of exercise per week is recommended.

-Longer, more vigorous exercise would not be harmful but should be avoided if the capacity of an individual to exercise with vigorous intensity is restricted due to health condition or disability. ‘Something is better than nothing’ is the message!

-Strengthening exercise also has shown benefits for maintaining muscles which also helps movement.

Photo by Dom Gould on Pexels.com

Important!

Emphasis upon maintaining regularity in exercise routine is given to get tremendously positive effect on our health and well-being, both today and for future.

So, are you ready to give your body its best chance at fighting-off infections by exercising regularly?

Also, do not forget to get a good amount of sleep and maintain a healthy diet to maintain energy balance that is used during exercise.

Happy exercising!

Don’t forget to share it with your loved ones to encourage them to begin with or resume an exercise routine.

Thank you!!

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Authored by-

Dr Rajashree Lad

MPT, CAFST, CFMP, COMT Consultant Orthopedic Physiotherapist

Unlock secrets to mental health with unlock 1.0

Hello everyone!

Hope you all are keeping well and safe.

We know that all of us are going back to our before-lockdown routine gradually after being in lockdown for long time now. But is the routine going to be same again?!

Whether it is going to be same or not..we do not know but we can keep ourselves abreast with the changing scenarios while we get back to our work or routine, especially our mental health which is overlooked often!

We need to be in good state of mind and overall well-being to handle whatever comes our way.

Considering this perspective, not just for these currently changing scenarios but also for life henceforth, we are here to introduce you to the secret to boost up your mental health.

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The secret to uplift and sustain your mood, feel enthusiastic, increase attention and memory and all of which can help you increase your efficiency almost in everything you do and help you stay happy.  

Wouldn’t it be interesting to know that there is one thing which if included in your daily routine can give you all those benefits?!

And what’s that?

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EXERCISE!!! Yes, you read it correct.. Exercise can give you all those benefits!

So here is the beauty and benefits of exercise-

  1. Exercise increases secretion of certain hormones-
  • Serotonin: enhances mood.
  • Dopamine: improves focus, learning and motivation.
  • Norepinephrine: improves attention, perception and motivation.
  • Endorphins: reduces pain sensation.
Photo by Andrea Piacquadio on Pexels.com
  1. Improves memory-

A recent research review from Journal of Brain Plasticity has revealed that a wonderful part of our brain called hippocampus which plays role in memory, has its activity increased with exercise and gifts us with improved memory and learning ability (so popping supplement pills to increase memory can be avoided by owning this amazing hack of exercising!!).

Repetition (bringing to mind often) and association (linking and connecting what we know and what we learn) are the processes through which exercise helps increase our memory.

  1. Exercise protects and repair brain cells called neurons. Hence, it protects brain from deterioration as we age.
  1. Besides mood regulation, it also helps us achieve and maintain mental clarity.

So, to conclude, if you stay motivated, have a good mood, with improved focus and memory then you will get through your work efficiently which will make you happy and you remain in good mood and this cycle goes on and on and on…!

Isn’t that an amazing gift to yourself..?!!

So go ahead and get an exercise routine as all these benefits will last long only if you exercise regularly. Be consistent to not skip dose of all those hormones to keep up your mental health and efficiency while facing challenges.

In case you do feel like skipping it, turn to these benefits here to pep up your determination to get back to exercising!!!

Stay motivated and happy!

Don’t forget to share it with your loved ones especially in these times.

Thank you!

Authored by-

Dr Rajashree Lad

MPT, CAFST, CFMP, COMT

Consultant Orthopedic Physiotherapist

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Do you want quick exercise tips while working from home? (S2)

Series 2

Hello everyone! Hope you all are doing well and following all the exercise tips from my previous blog to keep up the good mood and energy while staying fit working from home!

We all know that working from home is no more as enthusiastic as it used to be earlier but exercising for few minutes by taking quick work breaks help increase focus and efficiency when we get back to work again. Remember, increased efficiency will help complete work faster and you will have more time to enjoy with your family or it will help you find a creative way to manage both.. work and family fun time.

So, here we go-

  • Relaxation: While taking break from work, sit relaxed on your chair. Take your eyes off that screen and close. Get settled and begin observing your breathing pattern. Just observe it without any thought.. and relax your body and mind!
  • Foot tapping: While sitting straight on your chair with your feet flat on the floor, tap feet alternately but gently (do not bang it) on the floor. The control in feet movement and rhythm is very important to follow. Increase the speed of tapping as tolerated. Perform it for 30 seconds. This exercise will help increase your focus.
  • Heel raises: While standing straight behind your chair, raise your both heels off the floor and back to the floor. You may take support of the chair. Repeat 10 times.
  • Chair squats: Sit towards the edge of your chair with your back straight. You may clasp your hands in front, lean forward a little while not slouching your back and try lifting your buttocks off the chair about an inch. Hold this position for 3-5 seconds and sit back slowly. Repeat 10 times. Make sure you don’t hold your breath during this exercise.
  • Single leg standing: Stand behind your chair. Lift one foot off the floor by bending at knee and try to maintain balance on other foot for 5-10 seconds. Repeat 3 times on each foot.
  • Chest opener: Sit straight on a chair. Place hands behind your head with elbows bent. Pull the elbows out to the side while taking a deep breath in, squeezing shoulder blades, holding your head high and straightening the slouched back. Feel a good stretch to the muscles of the front of your shoulders and chest.  Breathe out and bring the elbows in and chin down. Repeat it 10 times.

Note: Listen to your body and go gently or skip any part of exercise series if it is hurting. Mild discomfort and stretch may be expected during these exercises but will make you feel better in some time.

Hope these exercises help you stay fit while working from home. Share it with your loved ones to help them as well.

Thank you.

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