Clubfoot is a deformity of the foot in infants. The condition is usually present from birth. This happens when the tissues linking the muscles to the tendons are shorter than usual, as a result of which the infant s foot appears twisted and out of shape. The condition can be mild or severe, depending on the symptoms. Often times, babies who are born with clubfoot have it in both the legs.

How to identify if your child has clubfoot?

Since the condition is present from birth, the symptoms are also easily observable. Identifying the following signs can help detect if your child is born with clubfoot-

  A foot that turns downward and inward and toes that point towards the opposite foot
  The affected foot may appear half an inch shorter than the normal foot size
  The heel of the affected foot may be smaller in size than it normally should be
  The calf muscle on the affected leg will be underdeveloped (appear slightly smaller)
  If the condition is severe, the foot may be twisted upside down

Despite its unusual shape, clubfoot does not cause pain or discomfort. The doctor will most likely notice the symptoms after the infant s birth. He/she will recommend appropriate treatment of the condition, or refer to an orthopaedic who specializes in muscle and bone ailments.

What is the treatment of clubfoot?

Clubfoot is curable so parents need not worry about their child living with a lifelong deformity.

Depending on the severity of the condition, the orthopaedic will either use devices, resort to stretching methods, or will recommend surgery.

  Ponseti Method (stretching and casting) - It is the standard treatment worldover. It starts at birth or anytime within two weeks of age and has best results in younger kids. It involves stretching the clubfoot and casting it in correct position several times over the months to restore the foot shape.
  French Functional Method (stretching and taping) - The doctor will stretch the affected foot and tape it in position several times over a couple of months to realign the shape. It, however, has very limites following.
  Surgery - Surgeries may be needed in older neglected kids or adults. The surgeon performs a surgical procedure (Achilles tenotomy) to lengthen the tendon of the clubfoot and realigns the joints and bones. Following the surgery, the child will need to be in a cast for about 2 months. Further, to prevent the recurrence of the condition, the child will be advised to wear braces for a year at least.
  Devices - They are adjunctive maintenance devices which are used by doctors in treatment of clubfoot. They are applied to the body to stabilize and limit or protect the movement of the damaged joint.

Parents should seek medical intervention if their baby is born with clubfoot. If the condition is not treated early, the child may face difficulty walking, or may even develop other disorders affecting the joints, like arthritis.

Clubfoot - Ways To Identify & Treat It Well!

Pregnancy places a lot of demand on the expectant mother. While the emotional demands are not very evident, the physical ones are. The mother has to ensure that the developing baby gets all the required nutrients through her. Some of them are very critical, and not getting adequate amounts of these manifest as problems, which cannot be rectified later. Calcium supply and associated problems that may arise is one such example.
If there is a reduced supply of calcium and the bones and teeth are not formed properly, taking any amount of calcium is not going to correct the situation later, after delivery.

The bones which are forming in the developing baby are dependent on the mother for adequate supply of calcium. It is common knowledge that calcium is an integral component of bones, teeth, and skeleton. Hypocalcemia, which is a condition where there is reduced amounts of calcium in the body, can be quite severe during pregnancy.
In addition to the growing baby s needs, calcium also plays a vital role in the pregnant mother for muscular contractions, nerve conduction, hormone secretion, and blood clotting. So adequate intake of calcium during pregnancy is essential.
Now, the question arises as to how much calcium is good enough. For a normal female, about 1000 mg of calcium is required on a daily basis. This goes up by another 200 to 300 mg for a pregnant woman, especially during the third trimester when the bone and teeth formation is in full speed. This extra amount of calcium should be continued even after pregnancy, as calcium continues to be provided to the baby during the lactation phase.

Some of the symptoms of reduced calcium intake during pregnancy are aching muscles, brittle nails, weakened bones, severe cramping, and dry skin. If there is suspected hypocalcemia, it is best to seek medical advice. It is not advisable to take supplements without medical supervision. Increased amounts of calcium can produce a different set of symptoms.

While these are evident symptoms, there are other detrimental effects on the baby too. Calcium deficiency affects development of heart and associated structures and puts the newborn at a higher risk of developing hypertension. The baby s fat percentage and triglycerides are also increased. The bone mineral density is reduced. The delivery period could be prolonged, as muscular contractions and nerve conduction are severely impacted when there is less calcium in the system. Recovery from labor is also delayed.

It is possible that you are taking adequate amounts of calcium, but its absorption is affected. Reducing caffeine intake helps in better absorption of calcium. Iron, which is often given during pregnancy, prevents calcium absorption and so needs to be spaced out.

Calcium & Bone Disorders - How to Know If Your Are Suffering From Them?

Spondylolisthesis refers to the condition which affects your spinal bones or lower vertebrae. Due to this condition one of the lower vertebrae overlaps the bone directly beneath it. Although a painful condition, it can certainly be treated with both surgical and therapeutic methods.

People with spondylolisthesis often find it difficult to perform routine activities. They usually encounter symptoms such as- persistent pain in the pelvic region, lower back; stiffness in the legs, hamstrings and hip muscles.

What causes spondylolisthesis?
The causes of spondylolisthesis can vary with lifestyle, heredity and age. Children may develop this condition due to an injury or birth defect. Nevertheless, people belonging to all age groups are susceptible to spondylolisthesis if the condition is genetic.

Over exercise or strenuous physical activities can cause spondylolisthesis because over stretching and carrying heavy weight or strain puts too much stress on the lower back.

Participating in sports like football, gymnastics, weightlifting are likely to trigger spondylolisthesis.

Spondylolisthesis can also be triggered due to sondylolysis. The vertebrae safeguard the spinal cord and work with tendons, ligaments, joints and muscles to provide flexibility, structure and support to the neck. Any sort of damage or wear and tear in the protective cartilage and bones in the neck can lead to cervical spondylosis, which in turn leads to spondylolisthesis.

What is the treatment for spondylolisthesis?
Treatment of spondylolisthesis depends on the severity of the pain. While non-surgical methods help ease the pain, a surgery is recommended when the bone has slipped to such an extent that your spine doesn t respond to medications.

Non-surgical treatment includes the following-

Taking anti-inflammatory drugs like ibuprofen to ease pain.
Practicing a few physiotherapy exercises to reduce lower back pain.
Use of minimally invasive Epidural Steroid Injections (EPIs) to get relief from lower back pain and pelvic pain caused by inflamed spinal nerves. When over-the-counter medications fail to treat tSpondylolysthesishe condition or ease the symptoms, then a surgery is inevitable.
Discectomy- It is a surgical procedure that makes small incisions to remove a part of the damaged disc to relieve pressure from the surrounding spinal cord or nerve root.
Laminotomy- This refers to a minimally invasive procedure that removes a part of the lamina which is the upper surface of the vertebra. This process is used to create more space within the spinal canal.
Foraminotomy- With this method excess bone tissues are removed so that they don t make the foramen narrow and compress the nerve root. Removing these extra tissues reduce back pain and ease symptoms triggered by nerve compression.
Medical attention is crucial for countering symptoms of spondylolisthesis. Although this condition may not seem life-threatening, if left untreated, it can lead to chronic, persistent pain and permanent nerve damage.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Spondylolysthesis - A Condition Which Affects Your Spinal Bones!

Sports injuries are a common problem, where various types of musculoskeletal injuries can occur during the physical activities. These injuries can either be acute or chronic in nature. In athletes, such injuries can pose as a risk to their careers, which makes it essential for the physicians to provide the most appropriate treatment. It is mandatory to provide a prompt, safe and quick treatment that can restore the athlete s preinjury level of participation in sports.

Various treatment approaches are present for treating sports injuries. The use of intra-lesion blood injection is being made for addressing the musculoskeletal injuries. An easy and minimally invasive method of using concentrated autologous growth factors in treating sports injuries is the use of platelet rich plasma (PRP). It is a fraction of the blood plasma that contains a higher concentration of platelets than normal plasma, along with growth factors.

PRP is used in the treatment of both soft tissue and bone injuries. Growth factors have a positively influencing effect on the healing process of connective tissue components.
There is a huge difference between the anatomy and functions of tendons, ligaments, muscles and joint capsules. Hence, the site of injection of PRP also varies.
The cellular tension in the tissue and the collagen structure is affected after the administration of PRP.
Use of PRP is popular in the treatment of an Achilles tendon. For injecting PRP, an ultrasound scan is done, the site of injection is accurately identified and then PRP is administered.
Proper location of the site of injury and deciding the accurate injection zone prior to the injection of PRP makes it easier to facilitate treatment and eliminate discomfort.
Administration of PRP should be considered secondary to physical therapy and other conservative means of treatment.
Enthesopathy is a discomfort in the area where the attachment of tendons, ligaments and the articular capsule is present. The use of PRP is increasing in the treatment of this condition. It has an inflammatory nature and presents as epicondylitis or capsulitis.
Studies have proved that PRP is an effective alternative to injection of steroids for an anti-inflammatory effect. Steroids majorly provide only symptomatic relief, whereas PRP is more definitive.
PRP has also found an increased use in the area of surgical procedures of knees. It is used to increase the efficiency of the healing grafts placed in the knee during reconstructive surgeries.
For treatment of bone injuries, use of PRP has shown an improved quality and rate of bone healing. Even in cases of an infected injury, PRP aids in healing efficiently.
No known side effects or complications after use of PRP have been observed, which makes it a sought after option in management of sports injuries.


Platelet Rich Plasma In Sports Injuries

 Movement disorders    the term refers to a class of neurological conditions, which lead to either an increased/abnormal movement or a scarcity of involuntary and voluntary movements.

Types of Movement Disorders- 
The most common types of movement disorders are  
  Myalgia   More commonly known as muscle pain, myalgia originates in any part of the body. A person with myalgia will experience achiness and soreness in the muscles, which may range from severe to mild.

Myalgia does not occur from an underlying disease. Rather, the pain develops over time, mostly due to prolonged sitting, lying down, a strenuous physical activity, strains or sprains.

  Muscular dystrophy   This refers to a group of genetic disorders that lead to weakness and loss of muscle mass. The abnormal genes cause muscle degeneration and usually begins in early childhood. Myotonic, Facioscapulohumeral (FSHD), and Limb-girdle are a few forms of muscular dystrophy.

Muscular dystrophy is characterized by symptoms like   difficulty jumping and running, muscle stiffness and pain, walking on toes, waddling gait, trouble swallowing and breathing etc.

  Dystonia   The condition involves continuous involuntary muscle contractions with repetitive, twisting movements. Dystonia may affect either a specific body part (known as focal dystonia) or the full body (known as generalized dystonia).

  Huntington s Disease   This is an inherited, neurodegenerative condition, where the brain s nerve cells break down over time. Huntington s disease usually kicks in, in the 30s or 40s. The disease results in psychiatric and cognitive symptoms   amnesia, confusion, slowness in activity etc.

  Multiple System Atrophy   This is a rare neurological disorder, which affects both the autonomic nervous system   the part of the nervous system that controls involuntary actions like digestion and blood pressure   and movement. Multiple System Atrophy leads to movement disorders like Parkinsonism or ataxia.

Symptoms of this disorder include   double or blurred vision, visual disturbances, unsteady gait, loss of balance etc.

  Tourette Syndrome   This is a disorder of the nervous system, which occurs usually between one s childhood and teenage years. The disorder is associated with vocal sounds (vocal tics) and repetitive movements (motor tics).

Physiotherapy for Movement Disorders-
In most cases, movement disorders cannot be completely cured. However, with physiotherapy, you may be able to manage the symptoms and live a better life.

Physiotherapy is based on a few physical activities or mild exercises that help improve your joint movement and builds muscle strength. This particular treatment approach centres on  

  Exercises based on daily tasks that improve muscle strength
  Activities that improve your balance and reduce the chances of falling
  Exercises to gain control over the uncontrolled movement of legs, arms, and head
  Correct posture while standing or sitting to reduce pain and increase comfort
  Cueing, repetition and movement strategies to reduce the effects of freezing
  Participating in certain functional activities that make it easier for you to move around
  The repetitive movement to trigger pathways to the brain and improve movement accuracy
  Exercise to reduce fatigue and increase stamina
  Hydrotherapy and relaxation therapy to ease muscle stiffness

Neurological disorders affect people in different ways. Physiotherapy for movement disorders is tailored according to the patient s goal and needs so that they are able to achieve maximum physical potential.

Movement Disorders - Its Types, Symptoms & Physiotherapy Treatment!

If you are the on the wrong side of your fifties, then you will know the importance of regular checkups to the orthopedist. Aging related physical changes such as greying hair and wrinkles are a few things that you can cope with easily, however, when it comes to the health of your bones and muscles, you need to be very careful. You need to be particular about being active, as it can help reverse or reduce the risks of most of the bone disorders that you may suffer from. Ageing affects both the muscles and bones, but not always in the same manner. So, it is important that you understand how each is affected by ageing.

Changes in your muscles due to aging
As you age, your muscles tend to lose strength and size. This can make you prone to fatigue, weakness and a decrease in your tolerance levels to exercise. The various factors that play a role in this are:

Modifications in your nervous system can impair the ability of the muscle to contract.
The muscle fibers in the body reduce both in size and number.
The replacement rate of the muscle tissue in the body falls.
Changes in your bones due to aging
Ageing impacts the structure of the bone and leads to a loss of the bone tissue. Aging causes low bone mass, thus rendering them weak. This means a simple fall can have a serious effect on your bones.
The various causes that can bring about these changes are:

Loss of vital minerals such as calcium
Being physically inactive
Undergoing hormonal changes in the body such as menopause, wherein the body loses minerals from the bone tissues. In case of men, progressive decline of sex hormones can lead to changes in the bone structure.
Common conditions that affect your musculoskeletal system in your old age:

Osteoporosis: This disorder results from a loss of bone density resulting in fragile bones. This makes the bones highly susceptible to fractures and breakage.
Rheumatoid arthritis: An autoimmune disorder that usually develops after the age of 40; here, the immune system of the body attacks the body tissues, thus leading to inflammation in your joints.
Osteoarthritis: It is a disorder of the joints which is caused by deterioration of the cartilage that cushions the joints.

Old Age - How It Impacts Your Muscles & Bones?

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