The shoulder is a complex joint consisting of a number of bones, ball, socket, and cartilage. For people suffering from arthritis of the shoulder joint, a total replacement of the shoulder joint is often a successful procedure. It significantly improves pain and range of motion. However, in case the patient is suffering from a special type of arthritis of the joint known as  cuff tear arthropathy , a total shoulder replacement often does not produce the desired result. These people suffer from large rotator cuff tear as well as arthritis. For such patients, a reverse shoulder arthroplasty often show better results. 

Reverse Shoulder Arthroplasty 

In traditional total shoulder replacement, the device put into the joint consists of a plastic cup fitted into the glenoid bone, also known as the socket, and a metal ball attached to the top of the humerus, the upper arm bone. In a way, it mimics the configuration of the original shoulder joint. However, in case of reverse shoulder arthroplasty, the positions of the metal ball and the socket are interchanged. The plastic cup is attached to the humeral head whereas the metal ball is attached to the glenoid bone. 

Benefits of the Procedure 

A reverse shoulder arthroplasty works better for patients who have a large rotator cuff tear along with arthritis. There are a number of rotator cuff muscles in the shoulder and they help to hold the arm in position as well as provide power to the arm during extreme movements. In case of people with large rotator cuff tear and arthropathy, the upper arm has to rely on different muscles for movement because the rotator cuff muscles don t function. Hence, the arm has to depend on other muscles such as the deltoid muscles, to position and power the arm. This is why a reverse arthroplasty is carried out.

Who Can Undergo This Surgery?

Every patient with cuff tear arthropathy is not a candidate for reverse shoulder arthroplasty. Surgeons recommend this surgery when the patient is suffering from: 

  A total tear of the rotator cuff which cannot be repaired 

  A special type of shoulder arthritis known as cuff tear arthropathy 

  An unsuccessful shoulder replacement surgery 

  Extreme shoulder pain along with difficulty in lifting the arm over the head or away from the body 

  A complex type of fracture in shoulder joint 

  A chronic dislocation of the shoulder 

  A tumor in shoulder joint 

Doctors can also suggest this procedure if the patient had previously tried other remedial measures such as medications, rest, physical therapy, injections, etc., but was not successful in alleviating the pain and improving the range of motion of the shoulder. 

Conclusion 

There are some medications that you need to stop before the surgery since they may cause excessive bleeding after the surgery. Some of these medicines are blood-thinning medicines and Non-steroidal anti-inflammatory medicines.

Revision Replacement - What Should You Know?

Ayurveda is a very old system of medicine, which originated in India. Using herbs found in nature to cure various illnesses, knee pain can also be permanently cured with this method indigenous to India. It reduces knee pain caused by various illnesses including arthritis, inflammation of the cartilage and wearing of the patella among others. Here are some common Ayurvedic remedies, which help reduce knee pain:

1. Alfalfa: Alfalfa is medically known as Medicago Sativa. Alfalfa is excellent for making sure that your joint pain reduces, when taken in liquid form four times a day.

2. Ashwagandha: Ashwagandha is medically known as Withania Somnifera. In the West, Ashwagandha is popularly known as Winter Cherry. Also, it has a lot of therapeutic properties, which include reducing joint pains. 

3. Banyan: The Banyan tree's medical name is Ficus Benghalensis. It has a sap very similar to the form of rubber known as latex is derived from the Banyan tree. The Banyan tree's sap is externally applied over the joints and the pain usually disappears after a few regular applications. 

4. Bishop's weed: The medical name for Bishop's weed is Trachyspermum Ammi. The oil extracted from this herb is usually applied to the knees to reduce the intensity of such knee pains.

5. Celery: The medical name for celery is Apium Graveolens. Celery is not only an effective treatment for rheumatoid arthritis and associated pains in the knees, but it is also helpful in treating gout. It is usually agreed upon that this particular treatment is usually long lasting because of its alkaline nature.

6. Dandelion: Dandelion's biological name is Taraxacum Officinale. It is rich in magnesium and is crucial for the correct mineralization of the bones. This mineralization allows the bones to become stronger and also prevents knee pain.

7.  Garlic: The medical name for garlic is allium sativum. Five to six cloves eaten everyday has proved to reduce knee pains.

8. Ginger: Ginger is biologically called Zingiber Officinale. These can be easily included in your diet and go a long way in curbing knee pain.

Ayurveda and Knee Pain

 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!

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

Myths about Total Knee Replacement

Myth#1 - Knee replacement is a surgery for old people. “I’m too young for a knee replacement.”
Fact - Candidacy for a knee replacement is not based on age, but on the person’s level of pain and immobility. Living with a painful joint that prohibits you from working or participating in normal life activities is an outdated way of thinking. Age is not necessarily a limiting factor. Often times, a patient is actually fearful about the uncertainty of surgery. Once they are able to resume many of the activities they enjoyed before the surgery, with increased mobility and with less pain, they are very happy they had the surgery. The quality of life one achieves by living without knee pain is priceless.

Myth#2 - “I should wait as long as possible to undergo knee replacement surgery” 
Fact - You don't need to suffer by waiting until the pain is intolerable. The longer life of joint replacements enables people to consider surgery earlier and at a younger age. Osteoarthritis is a degenerative disease that continues to damage the joint and delaying surgery makes both surgery and return to activity more difficult. Delaying surgery lowers a patients’ quality of life not only before the operation, but even for up to two years following surgery.

Myth#3 - “I should continue with medications as long as possible”
Fact - Medicines including painkillers just give symptomatic relief for a temporary duration and prolonged usage is riddled with serious side effects such as renal failure, peptic ulceration  etc. All these medicines are NOT curable.

Myth#4 - Alternative therapies such as acupressure, ozone treatment, massage beds, oils, laser therapy, magnetic therapy; braces will cure my advanced arthritis and knee pain.
Fact - Till date there is NO cure for advanced knee arthritis and these alternate therapies are not backed by established scientific data. All these modalities give temporary pain relief in early to moderate arthritis for some duration only and are NOT curative. Often times, a patient who is actually fearful about the uncertainty of surgery lands up trying these in order to avoid surgery. 

Myth#5 - After a knee replacement, it takes months to recover.
Fact - Depending on the activity, most patients who undergo knee replacement are able to perform routine tasks within a few weeks. A return to rigorous activity takes only a few months. One becomes independent for himself before discharge from hospital. There’s no prolonged best rest required after the surgery.


Myth#6 - After knee replacement, I’ll have to give up some activities and sports.
Fact - You have a high probability of getting back to activities like brisk walking or cycling in 6 to 12 weeks. It will take a bit longer to return to more rigorous activities and contact sports. Squatting and sitting cross legged though possible but at best should be kept to minimal.

Myth#7 - Knee replacement surgery leaves a large scar that is noticeable.
Fact - Scarring is minimal compared to traditional surgery. In fact, the scar is typically only 3 to 5 inches long. As time passes, the scar will fade and become less noticeable.

Myth#8 - Knee replacement is a very painful surgery. There is lots of pain in post operative period.
Fact - With modern day pain management such as in a multimodal approach, ensures that the patient does not feel any pain in post op period and has a smooth recovery.

Myth#9 - Knee replacement is done one at a time.
Fact - Both the knees can be operated at the same time if the patient does not have significant co morbidities and is deemed fit to undergo the procedure by the doctor.

Myth#10 - The new knee lasts for 5-6 yrs. only.
Fact - With modern day precision including computer assisted knee replacement and advancement in biomaterials, the survivorship has increased considerably. Today's joint replacements last 25 years or longer and, for most people, will last a lifetime.

Myth#11 - Knee replacement cannot be done a second time.
Fact - Knee replacement can be done multiple times what is called as a revision joint replacement surgery with good survivorship.

Myth#12 - “I am obese, I cannot undergo Knee replacement surgery.”
Fact - Knee replacement can be successfully done in an obese patient though the recovery is somewhat prolonged and might require additional implants. However, patients who are morbidly obese and have restricted mobility primarily due to obesity are better off after a bariatric procedure.

Myth#13 “I have diabetes or hypertension or heart ailment, so  I cannot undergo Knee replacement surgery.”
Fact  - diabetes hypertension or heart.



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 13 Myths About Total Knee Replacement (TKR), Busted!

Three Ways to Protect Your Knees

The knee is known as the largest and one of the most complex joints in the human body, and also one of the most vulnerable, as it supports the weight of the entire body. The knee joint is made up of several elements including the knee cap, meniscus, connective tissue, tendons, ligaments, cartilage, and muscles. Damage to any part of the knee can cause chronic pain. So how can you protect your knee from damage and injury? Take a look at these three points!

Dealing with Load: Weight is a big one. Carrying around extra pounds and kilograms can be detrimental for your knees in the long run. Your knee is not equipped to handle the excessive weight. It already supports three to five times your weight when you get up and walk around or indulge in some mild jogging. One must be careful of those extra pounds to take the load off the knee and keep it from falling prey to damage.

Exercise: Moderate to intense exercise is prescribed for one and all. This, of course, depends on one's overall health and age. If you are already suffering from joint pain, then you may want to go easy on the exercise with a focus on building muscle strength and foundation. If you are healthy, then some amount of daily exercise as a routine will keep those knees in prime working condition and well lubricated as well. Inactivity and a sedentary lifestyle can affect the knees very badly.

Do not Ignore: Warning signals such as chronic or acute knee pain should not be ignored. Remember to see a doctor or an orthopaedic specialist to find out if you have contracted an infection or if you may have suffered a fracture due to an injury. Also, it is important to take a bone density test regularly, especially after the age of 40 or for women going through menopause, as this will point to any deficiencies and even warn you in case there is any trace of osteoporosis.

Rest, exercise, and food should be kept in fine balance for a healthy body. These are a few measures that one can take to keep knee pain at bay. Yet, it is also advisable to speak with a doctor at length regarding measures to protect your knees.

Remember to ask us for a private consultation today!

Three Ways to Protect Your Knees

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