Physiotherapy plays a pivotal role in helping a person recover after a hip replacement surgery. It brings back the old flexibility and prevents blood clots in the area where the procedure has taken place. After the surgery team gives its green signal, a physiotherapist starts working with a patient for a full recovery. 

Here is a list of some common exercises that a physiotherapist suggests after a hip replacement surgery:

Walking: It is important to use the crutches for a time period of 4-5 weeks post the procedure. Until the surgeon or the physiotherapist advises against using the crutches, it makes sense to use it while walking. It makes sense to retain the normal walking posture by using the crutches rather than limping without it. A physiotherapist reviews the pressure exerted by the arm while holding a crutch, before advising the patient to get rid of the crutches.
Increasing hip flexibility: This is a basic form of exercise where an individual lies on one side of the body with knees and hips bent. A pillow is placed in between the knees. While doing this, it should be ensured that both the feet is kept together and the back muscle is not twisted. The top knee should be slowly raised like an opening of the calm shell. This position should be maintained for 4-5 seconds.
Strengthening the hips: The body should rest on the stomach. The buttocks should be tightened and one leg should be slowly lifted. This position should be maintained for a stretch of 3-5 seconds. The same should be repeated for both the legs.
Strengthening the hip and the stomach muscle: The body should rest on the back with a leg bent. The stomach muscle should be tightened and the bent leg should be lifted carefully while ensuring that the bend does not supersede more than 90 degrees. While keeping the stomach muscle tight, the lifted leg should slowly come down to touch the surface. This act should be repeated for 5-6 times.
Strengthening the thigh muscle: While sitting in a steady chair, an elastic loop should be wrapped around the ankles. The elastic loop should be stretched with one leg while keeping the other foot firmly rooted to the ground. The lifted foot should slowly come down to the normal position. The same act should be repeated for 4-5 times.
Improving balance: An elastic loop should be tied to one leg of a table and the other end of the loop should be tied to one ankle. The table should be held on for maintaining balance. Maintaining an erect position, the tied up ankle should be stretched sideways. The position should be maintained for 3-5 seconds to return back to normal standing position.

How Physiotherapy Can Improve Recovery After Hip Replacement Surgery?

The joints and bones of the body are connected by fibrous band of tissue called as a ligament. When these ligaments are over stretched or are subjected to any injury that could cause tearing of the ligament and a sprain of the ligament happens. Sprains usually occur at the ankle joint, knee joint or the shoulder, since these areas have a connection of bones at a joint. 

During movement, the ligament functions to stretch or expand and move back to its original position. However, sometimes due to an over-stretch of the ligament, it gets pushed or expands beyond its usual position. A sudden twisting movement of the ligament can also cause a sprain. 

While walking, any abnormal movement of the leg can cause a sprain, hence, the ankle joint is the most common location affected by a sprain. Sports injuries are a common causative factor of sprains. In accordance to the body part involved frequently in playing sports, a wrist sprain or an ankle sprain is a common finding. 

Dancers are also prone to frequently sprain their ligaments. If a sprain occurs at the wrist joint, it can also lead to cause the Carpal tunnel syndrome, which leads to the numbness of the wrist joint. Moderate to severe pain around the affected joint, presence of bruising in cases of an injury, swelling around the affected joint and difficulty in movement are the common symptoms of a sprain.



There can be a popping sound heard during an injury to the joint, which indicates a sprain. Sprain of the joint can cause other complications too. If there is an involvement of the nerve in the injury, there can be an associated numbness and tingling sensation at the affected area. A physician performs physical inspection of the area while looking for the symptoms of sprain. If the injury involves a larger surface area and is causing severe pain, an MRI or X-ray can be ordered to detect for the ligament or bone involvement, respectively. 

Classification of sprain can be enlisted as follows: 

Grade 1 sprain (mild): Slight stretching and little damage to the fibers of the ligament. 
Grade 2 sprain (moderate): Includes partial tearing of the ligament.  
Grade 3 sprain (severe): Includes complete tearing of the ligament.  Prevention of a sprain can be achieved with certain measures. Specific exercises that can be targeted for sprain prevention can be learnt from the physical therapist.
Stretching exercises and muscle training are important in prevention of a sprain. Sprain preventing measures are as follows: 

1. Before beginning an exercise routine, it is essential to do warm up exercises. Slight jogging can be done to activate muscle movement. 

2. Stretching before and after an exercise routine is necessary. It ensures that the muscles around the joint are in a relaxed position. It helps in minimizing the risk of an injury. 

3. Some specific exercises that help to strengthen the muscles around ankles should be done. Heel raise exercise is beneficial in strengthening the ankle muscles. 

4. Exercises that target the improvement of overall body s balance should be done on a regular basis. These exercises help in preventing twisting of ankles during walking or moving down the stairs. 

5. In case of a previous ankle injury, it is recommended to wear an ankle brace to prevent any twisting caused by a dis-balance. 

Treatment of the sprain is done by following the RICE procedure. This procedure includes the protocol of rest, ice, compression and elevation. Analgesics can be taken for pain relief. Ice pack application helps in reducing the swelling. Using a compression bandage helps in immobilizing the injury.

Sprain - Effective Tips To Prevent It!

The causes and symptoms of chronic lower back pain

Lower back pain is characterized by a feeling of pain around the lumbar region (curve of the back connecting the upper back and glutes- muscles in the buttock that are responsible for thigh movement) caused by muscle or ligament injury. The spinal area is most likely to be affected by lower pain as it may impair routine activities like walking and standing. Any lower back pain that lasts for more than ninety days can be considered as chronic.

Causes of lower back pain

There are plenty of causes for lower back pain. Anything that exposes the lumbar area of the spine to a level of stress beyond its capacity can cause lower back pain. These causes are-

1. Disorders of the discs

The spinal area in the lower back comprises of small bones called the vertebra, which are connected to each other by pieces of cartilage known as discs. These discs act as shock absorbers, and when exposed to excessive shock can cause the disc to bulge, resulting in herniated discs. Wear and tear of the discs can also occur.

2. Spinal stenosis

Spinal stenosis occurs when the area around the spine becomes narrow. It may affect the nerves surrounding the lower back, resulting in pain.

3. Wear and tear of the joints and ligaments

Normal wear and tear of the joints and ligaments cause difficulties in holding the spine in its proper position and this progresses with age. This may cause a vertebra to slide over another and affect the nerve endings, giving rise to pain.

Symptoms of lower back pain

The symptoms of lower back pain are usually a dull or excruciating pain in the lower back. It can also affect other parts of the body such as the hips and the legs. In case of severe pain, simple activities like walking, bending and sitting will be impaired.



The Causes and Symptoms of Chronic Lower Back Pain

Plantar fasciitis is the inflammation of a tissue underneath the ankle bone, which causes intermittent pain and discomfort. It affects a whopping 10 million people in India every year. Those aged 40 and above are at a higher risk of being affected by the condition.

Causes Of Plantar Fasciitis-
Plantar fascia is the soft tissue under the ankle bone, which connects the ankle bone to the toes and facilitates movement. If the fascia gets inflamed, the condition is known as Plantar fasciitis. If the tissue undergoes too much pressure, small tears are likely to take place. With repeated stretching and tearing of the tissue, inflammation and pain may develop.

However, in most cases, the exact cause of the condition is not well understood. Although, it is possible that sprinters or sportsmen are more likely to develop the Plantar fasciitis. Furthermore, obese people have a tendency to develop the condition, as do pregnant women during the later stages of pregnancy.

Symptoms
Here are some common symptoms associated with the Plantar fasciitis-

Pain is the most common symptom related to the condition, although the exact location may vary. Some people experience discomfort on the heels, while others may experience pain at the bottom mid-foot area.
The intensity of the pain also differs, as some may experience a dull pain, while others undergo a sharp pain while moving.
The pain is common when you take your first steps in the morning after getting out of bed. It is also common for the pain to return when you get up after spending a prolonged period of time sitting down.
Treatment For The Condition
Treatment is broadly divided into home remedies and conventional medication. Home remedies involve the usage of ice packs on the heels, at least three to four times a day. Ample rest for your legs may also be enough to cure the condition. Additionally, the use of comfortable shoes along with stretching exercises may also cure the condition.

However, if none of the home remedies seems to work, over the counter nonsteroidal anti-inflammatory medications may be used. The doctor may even inject a steroidal medication into the affected region. In such cases, the medical treatments must be used in conjunction with physical therapy.

Plantar Fasciitis - What Are The Causes, Symptoms, And Treatment?

A meniscus tear is a common injury associated with the knee. The meniscus acts a defensive shield, providing a much-needed cushion to the knees, keeping it stable and injury free. Each knee joints contain two menisci located between the tibia and the femur. In this article, we will discuss important details related to meniscus tear to help you understand the injury better.

Facts related to a Meniscus Tear

A meniscus tear can affect all and sundry. However, sports persons (especially those associated with soccer, tennis, football, and basketball) and aged people are more susceptible to the condition.
As per Boston Children's Hospital, of late there has been a steady rise among children suffering from the meniscus tear.
Osteoarthritis may act as a catalyst, accelerating the chances of a meniscus tear.
In most of the times, a meniscus tear occurs when you exert immense pressure on the knee joints such as lifting a heavy object or suddenly standing up from a squatting position. With age, the meniscus is known to suffer from a natural wear and tear resulting in the injury.
As already mentioned, there are two menisci present in each knee joints. The one present inside the knee joint is called Medial Meniscus. Lateral Meniscus is the one present on the outer part of the joint.
Depending on the extent and severity of the injury, a meniscus tear may be
A minor tear: This is a small injury accompanied by mild pain and swelling which may last for not more than 2-3 weeks.
A moderate tear: The injury results in pain that are concentrated mainly around the center or the sides of the knee. The swelling goes from bad to worse over the next 2-3 days, with the person facing discomfort while bending their knee. The knee also stiffens. You may be relieved of the symptoms within a week or two but overusing the knee or twisting it may cause a relapse.
A severe tear: True to its name, your knee is the worst affected in this case. The cartilage tear may be such that the torn pieces get lodged in between the joint spaces causing the knee to lock, pop or even catch. A person experiences unbearable pain and discomfort along with stiffness and swelling (can be immediately following the injury or within 2-3 days). In the case of a severe meniscus tear, a person may not be able to straighten the knee at all (without treatment and medical intervention)
Treatment for a meniscus tear may be surgical or nonsurgical.
The nonsurgical treatment involves the application of cold compress on the affected area. The person needs to take ample rest exerting minimum pressure on the affected knee. Physiotherapy and strengthening exercise can go a long way in improving the condition. To reduce the pain and swelling, the doctor may prescribe painkillers and NSAIDs (Nonsteroidal Anti-Inflammatory Drugs). Keep the knee elevated. The use of elastic wraps may be helpful.

In extreme cases, surgery may help to treat the injury and the associated symptoms.

Facts About a Meniscus Tear!

The term Sciatica is used to describe leg pain, tingling, numbness or weakness that travels down the low back via the sciatic nerve to the back of leg. Sciatic nerve arises from each side of lower spine and passes deep in the buttock along the back of thigh and legs. The pain of Sciatica may be irregular/ infrequent or persistent causing severe agony to the patients. The pain of Sciatica may be confined to low back or hips or may extend up to toes. The pain of Sciatica can be excruciating and "not relieved by painkillers".

What causes Sciatica?

Pain in Sciatica is due to irritation or pinching of Sciatic nerve within the spine. This occurs most commonly due to prolapsed intervertebral disc (slip disc) causing nerve compression resulting in pain.

Is surgery the only treatment for Sciatica?

Most patients can be managed with medication/exercises. So surgery is not the only way out. Patients who have severe pain can also benefit from "Epidural Steroid Injection". This treatment has proven to be effective in avoiding spine surgery in such patients.

What is Epidural Steroid Injection?

Epidural Steroid Injection is a procedure done by a Specialist (Interventional Pain) in an Operation Theatre using X-Ray (Image Intensifier) to locate exact level of injection. A drug mixture consisting of Steroid with Local Anaesthetic is injected at the epidural space of affected nerve root. The steroid washes away inflammatory mediators from the epidural space which decreases the pain. Steroid also decreases the inflammatory response of body to the prolapsed disc. As a result the pain arising from nerve inflammation is decreased. This is a day care procedure i.e. the patients are discharged the same day.

How is the possibility of surgery ruled out?

Epidural Steroid Injection is a proven, safe and an effective treatment that works on the concept of Interventional pain management - to provide relief from persistent and chronic pain of Sciatica. Generally, a single injection is sufficient to relieve patients of the pain. The procedure can be repeated for a maximum 3 times in a year, depending on the patient's response. With effective pain relief, surgery is negated.

Non-Surgical Treatment For Sciatica

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