Lybrate.com has a number of highly qualified Orthopedists in India. You will find Orthopedists with more than 26 years of experience on Lybrate.com. You can find Orthopedists online in Bangalore and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment with Dr. Balakrishna
Knee Pain Treatment
Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Knee replacement
Treatment of Joint And Muscle Problems
Treatment of Nerve And Muscle Disorders
Acl Reconstruction Procedure
Hip Replacement Surgery
Joint Dislocation Treatment
Knee Care Procedures
Joint Replacement Surgery
Ankle Pain Treatment
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Treatment of Joint Dislocation
Treatment Of Disk Slip
Treatment Of Herniated Disc
Submit a review for Dr. BalakrishnaYour feedback matters!
I am 24 age male and my left toe pains more I had pain near about 1and half year ago So what should I do.
Dear sir Every evening I have pain in my head (headache) and also pain in legs in night and I cant sleep properly over night.
Hello doctors my wife 28 weeks pregnant now she is feeling more leg pains n little stomach pain too other than this she is fine please suggest.
My mother aged 65 years has severe arthritis of both knees, should she get both knees replaced in one sitting?
You should do both knees in one sitting if the severity is same in both the knees and the patient is unable to differentiate the painful knee. In case the patient says one knee is more painful than address one knee at a lime. Your own knee is always the best till it lasts.
What are the advantages of doing both the knees in one sitting?
- Exposure to the risk of anaesthesia reduced to only once
- Aids simultaneous rehabilitation especially in severely deformed knees
- Bilateralprocedure reduces cost
- Earlier return to baseline function and convenience for the patient and relatives
- Shorter cumulative hospital stays
What are the risks associated with bilateral Total Knee Replacement (TKR) and are there any studies to support the same?
The risks of cardiac and infection related complications for bilateral TKR are lower than the combined risk of two unilateral TKRs. A population-based comparison of the incidence of adverse outcomes after simultaneous-bilateral and staged-Bilateral Total Knee Arthroplasty published in The Journal of Bone And Joint Surgery.
Result: Records were available for 11.445 simultaneous-bilateral arthroplasty Procedures and 23.715 staged-bilateral procedures.
Conclusions: Simultaneous-bilateral total knee arthroplasty was associated with clinically important reduction in the incidence of infection and malfunction within one year after arthroplasty.
What is the latest Technology available which could help improve surgical outcomes?
Custom Fit Knee Resurfacing: A knee with your name on it i.e. customized specifically based on your dimensions.
Understanding Custom Fit Knee Resurfacing: You are unique and so is your individual anatomy and thus lack of accuracy leads to discomfort and even further corrective surgeries That is why Custom Fit Knee replacement surgery, which utilizes MRI (Magnetic Resonance Imaging) technology to create personalized positioning guides for total Knee replacement is recommended.
Practical Benefits Of Custom Fit Knee Replacement
- MRI of the affected knee is done based on which we can make a customized jig for better fitting of the implant for the patients
- No intra medullary instruments so minimal chances of fat embolism
- Minimally Invasive (just a 4-5 inch incision)
- Improves the speed of the operation theater time (40% reduced surgical time)
- Increases implant inventory efficiency (know sizing)
- Faster recovery of the patient
- Perfect patient alignment thus better mobilization
What is the role of body exhaust 'space' suits in Bilateral TKR?
- 'Space' suits maintain a more sterile environment and offer more mobility to the surgeons.
- Space suits are used to help reduce contamination from the operating teams from entering the wounds.
- The impure air exhaled by the operating team is pushed down by the rotating fan in the helmet of space suits and absorbed by the laminar air flow in the 0.T.
In case you have a concern or query you can always consult an expert & get answers to your questions!
i had black spots below my knea which does not look good but no aching or pain people say rupture vaines
The soreness is felt most strongly 24 to 72 hours after the exercise. It is thought to be caused by eccentric (lengthening) exercise, which causes microtrauma to the muscle fibers. After such exercise, the muscle adapts rapidly to prevent muscle damage, and thereby soreness, if the exercise is repeated.
Delayed onset muscle soreness is one symptom of exercise-induced muscle damage. The other is acute muscle soreness, which appears during and immediately after exercise.
The soreness is perceived as a dull, aching pain in the affected muscle, often combined with tenderness and stiffness. The pain is typically felt only when the muscle is stretched, contracted or put under pressure, not when it is at rest. This tenderness, a characteristic symptom of doms, is also referred to as" muscular mechanical hyperalgesia.
Although there is variance among exercises and individuals, the soreness usually increases in intensity in the first 24 hours after exercise. It peaks from 24 to 72 hours, then subsides and disappears up to seven days after exercise.
The soreness is caused by eccentric exercise, that is, exercise consisting of eccentric (lengthening) contractions of the muscle. Isometric (static) exercise causes much less soreness, and concentric (shortening) exercise causes none.
The mechanism of delayed onset muscle soreness is not completely understood, but the pain is ultimately thought to be a result of microtrauma mechanical damage at a very small scale to the muscles being exercised.
Doms was first described in 1902 by theodore hough, who concluded that this kind of soreness is" fundamentally the result of ruptures within the muscle. According to this" muscle damage" theory of doms, these ruptures are microscopic lesions at the z-line of the muscle sarcomere. The soreness has been attributed to the increased tension force and muscle lengthening from eccentric exercise. This may cause the actin and myosin cross-bridges to separate prior to relaxation, ultimately causing greater tension on the remaining active motor units. this increases the risk of broadening, smearing, and damage to the sarcomere. When micro-trauma occurs to these structures, nociceptors (pain receptors) within muscle connective tissues are stimulated and cause the sensation of pain.
Another explanation for the pain associated with doms is the" enzyme efflux" theory. Following microtrauma, calcium that is normally stored in the sarcoplasmic reticulum accumulates in the damaged muscles. Cellular respiration is inhibited and atp needed to actively transport calcium back into the sarcoplasmic reticulum is also slowed. This accumulation of calcium may activate proteases and phospholipases which in turn break down and degenerate muscle protein. This causes inflammation, and in turn pain due to the accumulation of histamines, prostaglandins, and potassium.
An earlier theory posited that doms is connected to the build-up of lactic acid in the blood, which was thought to continue being produced following exercise. This build-up of lactic acid was thought to be a toxic metabolic waste product that caused the perception of pain at a delayed stage. This theory has been largely rejected, as concentric contractions which also produce lactic acid have been unable to cause doms. Additionally, lactic acid is known from multiple studies to return to normal levels within one hour of exercise, and therefore cannot cause the pain that occurs much later
Relation to other effects
Although delayed onset muscle soreness is a symptom associated with muscle damage, its magnitude does not necessarily reflect the magnitude of muscle damage.
Soreness is one of the temporary changes caused in muscles by unaccustomed eccentric exercise. Other such changes include decreased muscle strength, reduced range of motion, and muscle swelling. It has been shown, however, that these changes develop independently in time from one another and that the soreness is therefore not the cause of the reduction in muscle function.
Possible function as a warning sign
Soreness might conceivably serve as a warning to reduce muscle activity so as to prevent further injury. However, further activity temporarily alleviates the soreness, even though it causes more pain initially. Continued use of the sore muscle also has no adverse effect on recovery from soreness and does not exacerbate muscle damage. It is therefore unlikely that soreness is in fact a warning sign not to use the affected muscle.
After performing an unaccustomed eccentric exercise and exhibiting severe soreness, the muscle rapidly adapts to reduce further damage from the same exercise. This is called the" repeated-bout effect.
As a result of this effect, not only is the soreness reduced, but other indicators of muscle damage, such as swelling, reduced strength and reduced range of motion, are also more quickly recovered from. The effect is mostly, but not wholly, specific to the exercised muscle: experiments have shown that some of the protective effect is also conferred on other muscles.
The magnitude of the effect is subject to many variations, depending for instance on the time between bouts, the number and length of eccentric contractions and the exercise mode. It also varies between people and between indicators of muscle damage. Generally, though, the protective effect lasts for at least several weeks. It seems to gradually decrease as time between bouts increases, and is undetectable after about one year.
The first bout does not need to be as intense as the subsequent bouts in order to confer at least some protection against soreness. For instance, eccentric exercise performed at 40% of maximal strength has been shown to confer a protection of 20 to 60% from muscle damage incurred by a 100% strength exercise two to three weeks later. Also, the repeated-bout effect appears even after a relatively small number of contractions, possibly as few as two. In one study, a first bout of 10, 20 or 50 contractions provided equal protection for a second bout of 50 contractions three weeks later.
The reason for the protective effect is not yet understood. A number of possible mechanisms, which may complement one another, have been proposed. These include neural adaptations (improved use and control of the muscle by the nervous system), mechanical adaptations (increased muscle stiffness or muscle support tissue), and cellular adaptations (adaptation to inflammatory response and increased protein synthesis, among others).
Delayed onset muscle soreness can be reduced or prevented by gradually increasing the intensity of a new exercise program, thereby taking advantage of the repeated-bout effect.
Soreness can theoretically be avoided by limiting exercise to concentric and isometric contractions. But eccentric contractions in some muscles are normally unavoidable during exercise, especially when muscles are fatigued. Limiting the length of eccentric muscle extensions during exercise may afford some protection against soreness, but this may also not be practical depending on the mode of exercise. A study comparing arm muscle training at different starting lengths found that training at the short length reduced muscle damage indicators by about 50% compared to the long length, but this effect was not found in leg muscles.
Static stretching or warming up the muscles does not prevent soreness.[needs update] overstretching can by itself cause soreness.
The use of correctly fitted, medical-grade, graduated compression garments such as socks and calf sleeves during the workout can reduce muscle oscillation and thus some of the micro-tears that contribute to doms, proper nutrition to manage electrolytes and glycogen before and after exertion has also been proposed as a way to ease soreness. consuming more vitamin c may not prevent soreness, but oral curcumin (2.5 gram, twice daily) likely reduces it.
The soreness usually disappears within about 72 hours after appearing. If treatment is desired, any measure that increases blood flow to the muscle, such as low-intensity activity, massage, hot baths, or a sauna visit may help somewhat.
Immersion in cool or icy water, an occasionally recommended remedy, was found to be ineffective in alleviating doms in one 2011 study, but effective in another. There is also insufficient evidence to determine whether whole-body cryotherapy compared with passive rest or no whole-body cryotherapy reduces doms, or improves subjective recovery, after exercise.
Counterintuitively, continued exercise may temporarily suppress the soreness. Exercise increases pain thresholds and pain tolerance. This effect, called exercise-induced analgesia, is known to occur in endurance training (running, cycling, swimming), but little is known about whether it also occurs in resistance training. There are claims in the literature that exercising sore muscles appears to be the best way to reduce or eliminate the soreness, but this has not yet been systematically investigated.