 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!

Knee is a complex structure of your body made up of bones, ligaments, tendons, articular cartilage, muscles and meniscus. Knee is a very important joint as it plays a crucial role in human movement and is also very much prone to injuries. Your shoulder like your knee is also composed of bones, ligaments, tendons and muscles. It is the most flexible joint of your body and because of its frequent movement is also vulnerable to injuries. Knee and shoulder injuries can happen due to various reasons such as while playing sports, carelessly falling down or accidents. Your knee is made up of many important structures, any of which can be injured.

Pain and swelling are the most common signs of knee injury. In addition, your knee may catch or lock up. Many knee injuries cause instability, the feeling that your knee is giving way.

The most common knee injuries are as follows-

Fracture- In case of a fracture usually the patella gets affected. But sometimes the ends of femur or tibia can also get fractured.
Sprains and Strains- This is the most common injury that can happen while playing sports. Sprains and strains refer to the injury of the ACL or MCL.
Dislocation- Sometimes bones like femur or tibia gets displaced from their usual alignment.
Ligament Injuries- Your ligaments may get injured if the position of your knee is in a bent condition during the injury. Ligament injuries are common to sportspersons and can also happen if you encounter an accident.
Meniscal Tear and Tendon Tear- These are very common knee injuries which can happen while playing sports or falling down carelessly.
Treatment of Knee Injuries- 

When you are first injured, the RICE method   rest, ice, gentle compression and elevation   can help speed your recovery. The type of treatment your doctor recommends will depend on several factors, such as the severity of your injury, your age, general health, and activity level.

Nonsurgical Treatment-

Many knee injuries can be treated with simple measures, such as:

Immobilization: Your doctor may recommend a brace to prevent your knee from moving.
Physical Therapy: Specific exercises will restore function to your knee and strengthen the leg muscles that support it.
Non-steroidal anti-inflammatory medicines: Drugs like aspirin and ibuprofen reduce pain and swelling.
Surgical Treatment-

Many fractures and injuries around the knee require surgery to fully restore function to your leg. In some cases   such as ACL, PCL, Meniscal tears, surgery can be done arthroscopically using small incisions and minimally Invasive techniques.

The most common shoulder injuries are stated below-

Dislocation- Sometimes joints may get dislocated from their usual alignment
Fractures- Fractures of the collar bone, humerus and scapular fracture
Frozen Shoulder- It occurs due to the stiffness of the shoulder joint
AC Joint Injury- The ligaments may get injured in this type of an injury. It is common in sportsperson or may also happen due to falling down
Shoulder Impingement- In this case the muscles gets injured
Rotator Cuff Disease (Tendinitis and Bursitis)- In tendinitis of the shoulder, tendons become inflamed (red, sore, and swollen) from being pinched by parts around the shoulder. However, Bursitis occurs when the bursa, a small fluid-filled sac that helps protect the shoulder joint is inflamed.
Rotator Cuff Tear- Rotator cuff tendons can become inflamed from frequent use or aging. Sometimes they are injured from a fall on an outstretched hand.
Treatment of Shoulder Injuries-

Early detection is the key to preventing serious shoulder injuries.
Shoulder Exercises
Anti-inflammatory medication also may be prescribed to reduce pain and swelling.
Shoulder injuries can be treated by exercises and physiotherapy
Shoulder arthroscopy surgery is a small key hole, Day care surgery done for various problems like Periarthritis, Recurrent Shoulder Dislocation, Rotator Cuff Tear

Sports Injury - Its Surgical And Non-Surgical Treatment!

Most bone fractures mend very easily with proper medical treatment and rest. However, in rare cases, a fracture caused by trauma may not mend even after adequate treatment. When a broken bone fails to heal, it is known as non-union. There are two major reasons for non-union:

  Bone lacks adequate stability

All broken bones require stability to heal. In case of a fracture, doctors place the dislocated bone in its original place and use an external device to hold the broken part in place. Usually, this stability is provided by a splint or cast, but can also be offered by frames and rods as well. However, if the broken bone lacks the required support, it may not set or heal properly, leading to the non-union.

  Fracture lacks proper blood supply

Even with proper stability, a broken bone requires a proper blood supply to start the healing process. The blood carries oxygen and other chemicals that aid in the repair of the bone and makes it crucial during the recovery stage. However, if the blood supply is disrupted, the bone cannot heal and leads to non-union.



Risk factors of non-union:

You are more likely to suffer from non-union if one or more of the following is true in your case-

  People who engage in cigarette smoking and any other form of nicotine addiction have a higher risk of non-unions after a fracture
  Older people can often face non-union, which is why fractures may take longer to heal in these people
  Severe anaemia can often restrict proper blood flow to the broken bone, thus inhibiting the healing procedure
  Similarly, people suffering from diabetes face a greater risk of non-unions
  Lack of proper nutrition may also be blamed for the non-union
  Non-union risks may increase because of side effects from certain medication, such as prednisone, ibuprofen, and aspirin. Consult your doctor in such a case, so that proper precautions can be taken accordingly.

Non-surgical treatment can be used for treating the non-union. Electromagnetic and ultrasound waves are passed through the skin and into the affected bone, in order to treat the non-union. In most cases, this treatment is very effective in curing the fracture. However, if the non-surgical treatment proves ineffective, surgical procedures, such as bone grafts and allograft can be utilized.

Trauma And Nonunion - The Various Risks Involved With It!

There are 27 bones in the human hand. An injury to any one of them or a disease that affects the bones, tendons, muscles or blood vessels in the hand, are the most likely causes for pain in the hand and tenderness.

Some of the most common conditions that cause hand pain are:

De Quervain's Tendinitis: Pain on and around the thumb is the characteristic sign of this condition. This pain may develop gradually or come on suddenly and can travel the length of the thumb and forearm. De Quervain's tendinitis is caused by the swelling of wrist tendons at the base of the thumb. Repetitive actions and overuse are the most common triggers for this condition.

Carpal Tunnel Syndrome: The symptoms of carpal tunnel syndrome are felt mainly in the thumb, index finger and middle finger. This pain is often worse at night and is caused by the swelling of inflamed tendons at the base of the hand that puts pressure on the median nerve. This syndrome can make it very difficult for a person to grip objects.

Fractures: The fracture can cause extreme pain along with stiffness, swelling and loss of movement. A fracture refers to the breaking of a bone and can be of many types including simple fractures, complex fractures, comminuted fractures and compound fractures. The type of fracture dictates the type of treatment required. Spraining a muscle in the hand is another leading cause of pain in the hands.

Arthritis: This is one of the most common causes of pain in the hand that is related to ageing. Arthritis causes loss of cartilage that makes the movement of one bone against the other extremely painful. It may or may not also be accompanied by swelling. When it comes to the hand, arthritis affects the base of the thumb and middle or top joints of the fingers. Osteoarthritis may also cause bony nodules to be formed on the fingers.

Trigger Finger: This condition is also known as stenosing tenosynovitis. This condition locks the fingers or thumb in a bent position. This condition is triggered by the flexor tendons getting irritated. These tendons control the movements of the thumb and fingers. As the tendon is inflamed, the sheath that surrounds the tendons may also thicken and nodules may form of the affected tendons. People suffering from rheumatoid arthritis, gout and diabetes are at a high risk of suffering from this condition.

Pain And Tenderness In Bones Of The Hand - Factors That May Cause it!

The shoulder is one of the most intricate joints in the body and given that it is subjected to a lot of lifting and movements, there are chances for it to tear or dislocate. The shoulder is a ball-and-socket joint with the socket in the shoulder, and the ball in the upper arm. The joint space between the two bones is surrounded by cartilage, and the space between the two is filled with fluid. Especially in athletes, due to forceful movement, this joint could get dislocated or the cartilage could tear.

The Bankart lesion is when there is a tear of the cartilage in the central anterior shoulder. This causes the cartilage to be damaged, allowing the humeral head to slip down from the socket. When the arm is extended down or to the side, it is commonly dislocated. This can happen posteriorly also, but this movement and so the injury is less likely than an anterior dislocation. If there is also a fracture of the shoulder bone with this dislocation, then it is known as bony or osseous Bankart lesion.

Causes: Bankart lesions can be acute or chronic. Acute is when there is sudden dislocation due to sports activity or accidents. Repetitive use of the shoulder can also lead to chronic Bankart lesions. This is usually seen in sportspersons like swimmers, tennis players, and weightlifters.

Signs and Symptoms:

Pain: The most common symptom with Bankart is shoulder pain that restricts any kind of movement. One may find it difficult pick up things or lifting your hands and in some cases, it is difficult to even sit straight.
Weakness: The shoulder feels weak and one is unable to perform normal activities
Instability: One may lose the grip and strength.
Limited movement: The range of motion of the shoulder may be reduced compared to before the injury.
Crackling: The damage to the fibrous cartilage produces a crackling sound, which can be heard during the movement of the shoulder.
Diagnosis: A combination of symptoms, physical examination, X-ray, and MRI can help in confirming the diagnosis.

The course of treatment depends on the cause and condition of the patient. An exercise regimen is prescribed as the first step in the treatment process. If there is inadequate progress, or if the pain seems to be recurrent, open or closed shoulder surgery may be recommended to include the following:

Arthroscopy (closed surgery) to repair the cartilage damage
Ligament re-attachment
Bone reshaping
Cartilage build up and reshaping
Ligament repair to improve stability
Any of these shoulder surgeries would be followed up with measures to reduce further injury. It is therefore advised to visit a doctor in case of any such discomfort as he/she will be able to find out the severity of the situation and devise a treatment plan accordingly.

Bankart's Lesion - What Exactly Is It?

The human body allows for movement through the complex system of bones, muscles and joints. A break in the bone is medically known as a fracture and can be caused by constant stress, pressure or impact. It is common knowledge that with age, the bone strength decreases and incidence of fractures (osteoporotic fracture) increases. Based on the affected bone and impact, different types of fractures are commonly identified as:

Complete: When the breakage of the bone is complete, producing two or more pieces, it is referred to as a complete fracture.
Incomplete: When the breakage is incomplete, where the bone has cracked, but does not break into pieces, it is known as an incomplete fracture.
Another type would be the open or closed fracture:
Open fracture: When the skin is exposed and the bone breaks through this exposed skin, it is known as compound or open fracture.
Simple or closed fracture: The bone breaks, but the skin continuity is maintained. Again, here are different types including hairline, greenstick, oblique, etc.
What is the reason behind a fracture?
A bone will fracture when force is applied to it that is stronger than the bone itself. A key factor in a bone s susceptibility to fracturing is age. Both children and older people are prone to bone fractures. Children s bones are constantly growing and have not reached their full strength. Elderly people have brittle bones with old age and are prone to develop bone diseases, making them susceptible to fractures.

How they are treated?
Splint and pain medications are commonly used. Closed reduction where the fracture is reduced without opening up the tissues and open reduction, where the tissues are opened up are common approaches to managing fractures.

Can they be prevented?
Especially with children and in the elderly, extra precaution should be taken to avoid any kind of injury and fracture.

Develop an exercise routine to strengthen the muscles
Manage weight
Use the right footwear and exercise gear
Watch your medications (avoid sleep inducing ones)
Increase lighting in the room/home to improve clarity of vision for elderly
Make the home/living area fall-proof by reducing clutter, using railing in the bathroom and bedroom, using rubber mat, etc.
While a fall may seem inevitable, taking the above steps can help reduce the incidence and severity of a fall, thereby minimizing damage.

Bone Fracture - Common Types and How They Can be Prevented?

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