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!

 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!

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?

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

Bone loss is a silent condition that occurs over the years as you age. It is a condition when the bones become weak and fragile. Many people may not even know that that they are suffering bone loss until it leads to serious conditions such as Osteoporosis. Bone loss resulting in osteoporosis is more in women than men. It is estimated that one of every three women above 50 years suffers from osteoporosis related fracture.

What causes bone loss?
Bones are made of minerals, calcium, and phosphate. Bones are being constantly destroyed and refoemed within the body. As long as your body balances the process, your bones stay strong and healthy. However when the bone decay out grows the bone formation process, bone loss and a host of other problems occur. Some of the common causes bone loss are:

With growing age, the body starts to reabsorb phosphate and calcium instead of keeping it in the bones. This makes the bones weak. When the process continues for a long time, it leads to osteoporosis.
If your diet doesnot contain high calcium foods, then your bones donot get enough calcium.
Smoking and drinking can make your bones weak.
Medical conditions like rheumatoid arthritis, chronic kidney disease can cause bone loss.
Sometimes medicines can also result in bone loss.
What are the symptoms of bone loss?

Receding gums: Our teeth are connected to the jaw bone and if the jaw starts losing bone then it causes receding of gums. Loss of jaw bone is linked to lower bone mineral density.
Decreased grip strength: Hand grips strength decreases due to low bone density.
Weak and brittle fingernails: You may find your fingernails have become weak and brittle.
Cramps,muscle pain, and joint ache: Pain in muscles and joints are an important indicator of vitamin D deficiency, which is a vital component for healthy bones. Cramps in legs and foot at night are an indicator of deficiency of potassium and calcium in the bones.
Height loss: This is a common problem that comes with age. But there are other factors that lead to height loss such as poor posture and fractured vertebra. Poor posture can cause bone loss.
Overall low fitness: If you notice that your overall fitness has declined which includes your balance, muscle strength then you may be suffering from bone loss.
Can homeopathy treat osteoporosis?
Homeopathy has the most effective and holistic approach to treat osteoporosis. Homeopathy doesn t intend to cure bone loss, instead, it tries to treat the underlying health condition that leads to osteoporosis. Some of the important homeopathy remedies are:

Calcaria Phos: It is a very effective remedy for osteoporosis It helps in increasing the absorption of calcium from the food. It is a bone builder and creates new cells.
Calcaria Iod: This is a great remedy to treat loss of bones as well as loss of muscles and fat.
Alendronate: Alendronate is given to patients suffering from osteoporosis which is caused by steroid treatment. It reduces the release of calcium from the bones to the blood.
Calcitonin - Salmon: Calcitonin-Salmon is a man-made hormone used to treat osteoporosis.

Bone Loss - Can Homeopathy Help Treating it

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