Knee is a hinge joint where the lower leg bone tibia meets the thigh bone femur. During osteoarthritis, cartilage or ligament defects and degenerative arthritis, knee replacement surgery is recommended world-wide to get relief from extreme pain. Knee replacement surgery, also known as knee arthroscopy, is a surgical procedure, in which the affected knee joint is replaced with synthetic material. The most likely candidates for total knee replacement are the patients with severe destruction of the knee joint coupled with progressive pain and impaired function.

Modern technological advances have made computer assisted knee replacement surgery extremely popular around the globe. In this surgery, the surgeon is assisted by a computer to remove the optimum amount and angle of the bone, which otherwise is done by inspecting manually. This is an excellent example of surgery through small incision and it eliminates the chances of human error. A perfect alignment and balance is achieved and hence longevity is also increased to 20 - 30 years. Knee replacement surgery is also specific to gender as the anatomy of male and female patients is different.

There are many types of knee replacements, most common being the total knee replacement or Total Knee Arthroplasty. In addition, there is partial knee replacement, bilateral knee replacement, revision knee replacement and knee arthroscopy.

In knee replacement surgery, the worn out surfaces of joints of knee are replaced with artificial implant of plastic and metal. The lower end of the femur bone is removed and replaced with a metal shell. The upper end of the lower leg bone (tibia) is also removed and replaced with a channelled plastic implant with a metal stem. A plastic ball is also added under the kneecap depending on its condition. These artificial components are commonly referred as prosthesis. The design of these highly flexible implants replicate knee, with the rotating knee replacement implants assist in backward and forward swing of the legs.

Patients whose knee joints have been damaged by either trauma or progressive arthritis should consider total knee replacement surgery. Post-surgical hospital stay after knee joint replacement is usually three to five days. The surgery has a very high success rate and shows dramatic improvement after a month. This improvement is most notable one month or more after surgery. The pain caused by the damaged joint is reduced significantly when the new gliding surface is constructed during surgery. Initially, patient will walk with the help of a walking aid until the knee is able to support full body weight. After six weeks, patient can walk comfortably with minimal assistance. Patients with artificial joints are prescribed to take antibiotics during the course of any elective invasive procedures including dental work. Physiotherapy is an essential part of rehabilitation and it will increase the muscle strength and patient can enjoy most activities, except running and jumping.

Knee Replacement

Tennis elbow is a condition which is characterized by a sharp pain on the outer portion of the elbow. This condition is also called  lateral epicondylitis  and it occurs when the muscles of the elbow are overused. The symptoms of pain tend to occur near the forearm when you bend your elbow or try to grip an object.

Causes
The elbow joint comprises of muscles which facilitate movement of the wrist, elbows and the fingers. There are tendons present in the elbow which join the muscles and bones, thus regulating the forearm muscles. When the muscles of the elbow are overused, then it can lead to inflammation and tears in the muscles.

This condition is so called as it is usually caused by playing certain sports, primarily tennis. It may also be caused by activities that put repetitive stress on the elbow. If the same pain occurs around the inner portion of the elbow, it is called a  golfer s elbow .

Prevention
The best treatment method to prevent tennis elbow is to strengthen your elbow muscles. You need to follow a regulated strength and stretching program directed at strengthening the muscles of the body, including the elbows.

Here are some tips to prevent tennis elbow:

Try to stay in good shape physically.
Use proper technique when you are carrying out any activity that involves the elbow.
Avoid overstressing the elbow joint with repetitive movements as it can cause injury to the tendon.
The muscles of the shoulder, arm and the upper back should be strengthened to prevent tennis elbow.
For movements that require you to twist your arm or grasp things, you can use a counter force brace to protect your elbow. This brace is worn on the forearm which redistributes pressure on the muscle. A counter force brace is recommended for people who are at an increased risk of tennis elbow.

Tennis Elbow - Tips To Help You Prevent It!

Your shoulders are one of the most important parts of your body, but sadly it is also one of the most neglected parts. People use their shoulders for day to day activities. Without shoulders it would be very difficult to even do a simple activity like lifting a fallen paper from the ground. Like your other body-parts, shoulders also need proper attention and care.

Why is shoulder mobility so important?
Whether it is about moving a growing child, lifting a barbeque table or about moving heavy luggage, actions require shoulder mobility. If you find it difficult to do these activities it is highly probable that you have shoulder impingement syndrome. This syndrome occurs when the rotator cuff muscles become inflamed and irritated and result in severe pain and difficulty while moving one s shoulder. Weak shoulders also make your posture look bad, it can cause grave strains in your neck and back and make you look hunched which is not at all attractive for your appearance.

Different kinds of shoulder injuries and causes of shoulder immobility:

Rotator cuff injury

Frozen shoulder

Onset of arthritis

Shoulder instability

Injury to the tendons and ligaments

Shoulder dislocation

Torn rotator cuff

Impingement   It refers to the excessive friction of the shoulder muscles against the top part of the shoulder blade.

How can you improve shoulder mobility?

You can improve your shoulder mobility with the help of some exercises. For example, stand straight with your hip and feet apart. Move your hands behind your back and try to interlock your fingers, if you face difficulty in doing so, use a towel instead. Hold this position for a minute or so.
Sit and keep your feet and knees straight pointing towards the direction of your eyes. Touch your shoulder blade by bringing your hands backward, touch your elbow with your other hand and bring it upwards. Sit straight, hold your head up and breathe slowly. Hold this position for a minute and then repeat again.
You can also improve your shoulder mobility with the help of yoga. Yoga is all about relieving your tension and stress, hence it is very beneficial to loosen up tight shoulders and it makes you much healthier by improving shoulder mobility. Stand straight with your feet at least four feet apart and then bend your left foot slightly towards to the right. Make your right foot bend 90 degrees. Raise your right arm towards the left and bend your body. Inhale and exhale. Switch sides after taking five breaths.
Physiotherapy For Shoulder Mobility-

Physical Therapy is not just scientific; it is also very thorough and very methodical in its way of healing and remedying clients with many aches and pains. A therapist is well trained and very careful in massaging and handling delicate parts of the body such as the vertebrae, extremities and in cases of temporomandibular joint neuromusculoskeletal dysfunction. Physical Therapy is a distinct specialization in the practice of physiotherapy.

Before patients are treated with the therapy, it is very important that they undergo a preliminary assessment of what ails them. Their dysfunctions are determined and their biochemical systems are assessed as well. The body's posture as well as the placement is analyzed and almost all areas of the entire body in terms of the position and functioning of the musculoskeletal system is considered just to make sure that the root cause of the problem is discovered and treated. 

The aim of the therapy is to alleviate pain, strengthen the body, and improve movement and usability of the limbs as well as the other areas of the body through the use of the hands. The therapy also utilizes various work-out regimens as well as a home carry over system to make sure that the intervention plan will work as expected. More than just treatment, physical therapy is a means of assisting a patient to recover body movement, strength and function, therefore the need to have a strong determination to improve from the patient is definitely required. Here are some physical exercises to improve shoulder mobility-

First step is to provide adequate rest to the shoulder. Avoid using the affected arm too much. Keep it in a comfortable position. Do not strain the arm.

Cold compressions can help to ease pain and swelling. Alternate applications of hot and cold compressions help to reduce inflammation and provide quicker relief.

Keeping the arm elevated in a swing is recommended. It helps to drain the fluid or oedema and reduce pain.

Other exercises recommended are basic shoulder strengthening exercises. Example of one such exercise is gently pulling an elastic tubing attached to a door knob, towards your body. These can be performed twice daily, starting five times with each arm.

Wall push exercises are those that strengthen shoulders, forearms, biceps and triceps. You must stand at least a feet away from the wall and push against the wall, for a count of 5 to 10.

Shoulder press ups are exercises that can be comfortably done while sitting on a chair. Keep your arms on the armrest of the chair. Instead of putting the weight on your feet, rise up slowly by putting the weight on your hands. Repeat this 5 times twice or thrice daily.

There are isometric shoulder mobility exercises that involve muscle contraction and movement of limbs. It involves strengthening the muscles through extension, contraction, rotation and flexion of shoulder joint.

There are lateral rotation abduction exercises, lateral shoulder raises, lateral shoulder pull down.

There s a range of scapula squeeze exercises that involve strengthening and stabilising the shoulder blades.

Medicine balls and lightweight dumbbells can be used as props to exercise the shoulders.

A bad shoulder not only results in a bad posture but also prevents you from doing day to day activities. Hence it is necessary to take care of your shoulders and exercise daily to improve the mobility.

Shoulder Mobility - How You Can Improve it?

Hip replacement surgery is a method wherein a defective hip joint is removed and replaced with an artificial hip joint. This procedure is only opted for after all the other treatments have failed to yield the desired effects. Hip replacement surgery removes damaged or diseased parts of a hip joint and replaces them with new, man-made parts. The goals of this surgery are to:

Relieve pain

Help the hip joint work better

Improve walking and other movements.

Who Should Have Hip Replacement Surgery?

The most common reason for hip replacement is osteoarthritis in the hip joint. Your doctor might also suggest this surgery if you have:

Rheumatoid arthritis (a disease that causes joint pain, stiffness, and swelling)

Osteonecrosis (a disease that causes the bone in joints to die)

Injury of the hip joint

Bone tumors that break down the hip joint.

Your doctor will likely suggest other treatments first, including:

Walking aids, such as a cane

An exercise program

Physical therapy

Medications.

These treatments may decrease hip pain and improve function. Sometimes the pain remains and makes daily activities hard to do. In this case, your doctor may order an x ray to look at the damage to the joint. If the x ray shows damage and your hip joint hurts, you may need a hip replacement.

The Procedure-

Hip replacement surgery is a procedure that can either be performed by traditional means or a minimally invasive procedure. The primary difference between the two procedures is the size of the incision. The procedure begins with the doctor administering local anesthesia, though in certain cases, general anesthesia is also administered.

An incision is then made along the hip and the muscles that are connected to the thigh bone are shifted, so that the hip joint is exposed.

An equipment is then used to remove the ball socket of the joint by cutting the thighbone.

The artificial joint is then fixed to the thighbone and it is allowed to adhere properly.

Once the joint is fixed, the ball of the thighbone is then put in the hip socket.

The fluids from the incision area are then allowed to drain.

The hip muscles are then put in place and the incision is closed.

Post -surgery-

After the surgery, the recovery stage begins. The period of hospital stay post-surgery usually lasts for 4-6 days. A drainage tube is attached to the bladder to get rid of waste products from the body. Physical therapy begins immediately after the surgery and you will be able to walk after a few days with walking aids. The physical therapy continues for a few months after the surgery.

After care-

It is advised to avoid activities that involve twisting your leg for at least half a year. You should also avoid crossing the leg along the mid portion of your body. Your physiotherapist will provide you with exercises that aid to help you recover. Avoid climbing stairs and sit on chairs that have strong back support.

Know Everything About Hip Replacement Surgery

Physiotherapy can greatly help a patient of paralysis by making him/her independent to the maximum extent. Physiotherapy also plays an important role in negating potential complications after a paralysis. Although the process of rehabilitation can take time, it produces significantly encouraging result for a patient to continue with it until full recovery. The recovery depends on the type of paralysis a person has undergone. Notably, there are four types of paralysis:

Hemiplegia

Quadriplegia

Paraplegia

Monoplegia

Role of Physiotherapy-

The process of physiotherapy should resume as soon as the patient is stabilized. It not only helps in relaxing muscles, but also helps in smooth blood circulation. Long-term therapy can ensure muscle tone and overall well-being of an individual.

In the case of an external injury related to the brain, physiotherapy can speed up the recovery and reduce swelling to a significant extent. Some of the benefits are-

Physiotherapy can help a person regain the highest possible mobility.

Physiotherapy can increase the respiratory function of a person.

It helps the person in bringing down blood pressure and contracture.

A physiotherapist also focuses on unaffected area and works on them to ensure that the unaffected part of the body, in no way, loses mobility and retains the natural strength.

Physiotherapy also helps to manage a paralyzed bladder.

A physiotherapist suggests proper wheelchair, splint, braces, orthosis etc. These help a person to reintegrate quickly after the paralysis.

Physiotherapy lifts the morale and motivation of a patient by addressing post-traumatic experiences such as denial, anxiety, hostility, depression and anger.

It also serves as a perfect guide for the family of the patient.

Exercises that a Physiotherapist Suggests-

Aerobic Exercise: This is a set of physical exercises that lets the muscle tissues exchange oxygen at a rapid rate. The goal is to enhance the function of the motor neuron and the aerobic capacity of a patient. Support straps and gain belts might be required for a patient to stand on feet. A handrail helps to walk during this phase.

Physical Conditioning: Balance, stability, and coordination is the motive of any physical program for a paralyzed individual. Passive or active motion exercises help an individual to regain function of the limbs. Passive exercise also helps to regain strength. A physiotherapist rotates the thumb of a patient in such a way that the back of his hand faces forward.

Leg Rotations: One common exercise that is tried by a physiotherapist is to make the patient lie down on a mat with his/her legs straightened. Supporting the knee joint and the ankle, the right leg is moved outward and pulled backward. This is again repeated with the other leg.

Physiotherapy For Paralysis

Exercises to cure long hours of sitting
Most of us are used to sitting throughout the day, willingly or unwillingly due to work or otherwise. We spend more hours sitting, and most of our work is done in this position. The downsides of this are many, one of them being a stiff back which not only causes a lot of pain but also initiates many other health problems.
Train yourselves on these highly effective exercises which minimise the pain and keep your muscles active.

1. Back press: put towel on your back and press the towel with the back. Hold that position for 10 sec. Repeat 10 times. Do not hold your breath while applying pressure at the back.
2. Bridges: lie on the floor, bend your knees and secure your feet on the ground. Raise your hips upwards so that your body forms a straight line from your shoulders to your knees. Release and go back to previous position.
3. Knee to chest exercise: just lie down on an exercise mat, bend your one knee while lying and try to touch that knee to the stomach. Hold it for 10 seconds. Repeat this with the other leg. Alternate the legs each time.
4. Bilateral knee to chest: bend both the knees while lying on bed. With support of your hands try bringing both bent knees to touch the stomach. Hold that position for 10 seconds. Repeat 5 times.
5. Static abdominal exercise: lying on your back, try to contract your stomach without holding your breath. Hold it for 10 seconds. Repeat the exercise for 7 or 10 times.
6. Knee to opposite chest: lying on your back, bend your knees. Try bringing one knee to opposite side of the chest and hold that position for 7 sec. Do this for 7 times and repeat the same for the other leg too.
7: leg swings: these are easy and fun. Stand by the wall, hold on to a rod or something similar to keep balance. Now with the leg that is not towards the wall, swing. Swing your leg from front to back, left to right. Do not be too quick, do this at a mediocre pace. Repeat with the other leg.
8: static glutei: lying on the stomach, squeeze your buttock and hold it for 10 seconds. Repeat 10 times.

General precautions:
1. Avoid bending instantly after or during the exercises. Incase you have to bend, first bend your knee then bend your back to pick up anything from ground.
2. While getting up from bed first turn to one side while lying, sideways then get up from bed slowly.
3. Apply hot pack in back whenever there is pain.
4. Try to sleep in hard part of mattress not in soft mattress.



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