Lybrate.com has an excellent community of Orthopedists in India. You will find Orthopedists with more than 40 years of experience on Lybrate.com. You can find Orthopedists online in Chennai and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment
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. SampathYour feedback matters!
Hii, I have been not able to sleep since 2 days, I have a severe headache and also a back ache what to do?
I am Dr. Ankit Bhartia. I am an orthopedician and i am specialized in orthoscopy and orthoplasty of the knee hip and shoulder. I practice at Sparsh orthopedics and sports injury center on the Sohna Road Gurgaon. Today I will be talking about the ligament injuries.
Ligaments are tough band of tissues which connects to bone. In the knee joint there are four ligaments which stabilize the knee. These are the cruciate ligament and the posterior cruciate ligament which are inside the joint and middle collateral ligament and lateral collateral ligament which are outside the joint. These ligaments can stress or can get torn or in this case or whenever there is injury to the knee. The injury can occur in lot of circumstances. These are landing or jumping in a flexion knee, stopping suddenly during running, twisting the knee over on of slanted foot and direct blow to the knee can cause injury to any of four ligaments of the knee. These injuries are more common in sports persons. Those playing basketball, football, gymnast are all prone to fast injuries. During injury, patient may feel sudden pop or snap sound during the injury and immediately after that patient may feel pain which may be severe to mild and varieties of swelling which can again severe to mild. Patient will not be able to completely select reasoning or extend the knee. He will always have a walkway and it will always be painful and patient will have the feeling of looseness of the joint in the sense that he will be instable during walking or enduring pain climbing stairs from walking on uneven surfaces. Ligament injuries once happens in a patient we will have to consult an orthopedician. The orthopedician will examine the knee thoroughly and guide him for about the diagnosis and treatment.
Partial knee ligament injuries can be treated by conservative ways and the treatment which you will be advised for are rest to the knee joint, ice pack to the compression apparel dressings in the form of the kneecap or say bandage elevation of the knee joint and external bracing or knee support in the form of knee brace to support the knee joint till the ligaments are healed and medications which will be prescribed.
Our analysis and anti-inflammatory medications to reduce the swelling will be prescribed to you and physiotherapy to strengthen knee joint are very important to help in healing of the ligaments and recover to the full extent. Once the knee is completely torn, the completely torn ligament like ACL and PCL does not leave by itself nor it cannot connect be repaired. It can only be reconstructed nowadays.
In the past what has happened is lot of athletes had to leave this post because of this ligament injuries and no successful treatment is available but now a specifically these ligaments can be reconstructed and very small instruction are given and it is all done as quickly where a ligament is taken from one part of the body and is implanted into the injured part and and recovery is possible and return to the activity is guided by physiotherapy. Doctor has some patients recover very fast, some take time to recover so it is a guided process. Within first week you will start and your increase in activity will depend upon your recovery process as such.
How to prevent ligaments of your knee to get injured?
- Very important is to warm up before all activity especially evasive activities, gym and the morning walks etc.
- Another thing is to strengthen your thigh muscles, strengthen your knee muscles is very important apart from strengthening, stretching of the muscles is also equally important.
How to prevent the injuries to the knee?
- Most important thing is to strengthen your knee muscles and to maintain the flexibility apart from extension you need to do stretching of your knee muscle as well.
- Second most important thing is to always warm up before starting any kind of exercise, running, gyming or sports.
- Apart from this you need to take care that you should not start to any of the activity of the knee and you should not even increase the limit of your activity abruptly.
Thank you. To contact me and to consult me, you can contact Lybrate or you can call up at Sarah Orthopedic and Sports Injury Center, Sohna road, Gurgaon.
Now a days I am preparing for my exams and I am studying like 10 to 12 hours a day. The problem which I have started facing is. Due to continuous sitting my bottom, thigh, calf pains allot and there is a pain in the joints of my body shoulder elbow knees ankle wrist even sometimes fingers joints too. Is it because of weather?
Hi Doctor, I am having pain in shoulder joint this is because of throwing the ball contiounsly(speed movement) and playing shuttle with full hand. I am playing contiuosly even though I have Pain. Please advice how to cure the pain it would be really helpful for your advice Thanks Ravikumar
I am a 41 yr old housewife with 3 cesarean born kids. I have straightening of spine which i'm told is due to stress. Also I have severe acidity which makes me giddy most of time. I have jammed & ringing in my ears. Also I have very horrible travelling sickness.
My friend has pain on her legs, she is telling me that when she was running, pain started from knee to toe & this pain is not mussels pain it is from beside the leg bone & its so painfully. She aslo informed that when she stop running pain become more but if she take rest for few days this pain become vanished. She went to doctors but result become zero. She is around 20th. Place give me some suggestions for her. Thanking you in advanced.
Hi I am having pain in body. It started from lower neck the to the shoulder. Now it is all joints. Some times in chest bones fingers also. Pls suggest.
Delayed onset muscle soreness (doms), also called muscle fever, is the pain and stiffness felt in muscles several hours to days after unaccustomed or strenuous exercise.
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.