You must have often heard about sports person, especially those associated with tennis or baseball (that involves continuous arm movement) suffer from rotator cuff injury. But what exactly is this injury? To understand the condition better, you need to know what is a rotator cuff. A rotator cuff is a group of tendons and muscles that keep the shoulder joints stable enabling a person to rotate or lift their shoulders freely.

With time, certain activities may cause a wear and tear of the rotator cuff injuring them. The injury sustained can result from a partial or a complete tear.
A partial tear of the rotator cuff may damage the tendons, but it will remain attached to the bones. However, in the case of a complete tear, the injury is more severe that penetrates deep within detaching the tendons off the bone (humerus).

Who can suffer from a Rotator Cuff Injury?
While the condition can affect anyone, people under the following situations stand a greater chance of injuring their rotator cuff.

People in their old age may suffer from the Rotator Cuff injury as with age the tendons and muscles may undergo a degeneration.
The injury may also be genetically linked.
The problem is found to be common among tennis and baseball players.
Painters, as well as carpenters who need to move their arms and shoulders continuously in a particular direction, stand at a risk of injuring the rotator cuff.
Symptoms associated with a Rotator Cuff Injury
People with a Rotator Cuff Injury may exhibit the following symptoms and associated discomfort.

The rotator cuff ensures the free and comfortable rotation of the arm and the shoulder. An injury will limit this rotation. As a result, a person may experience great difficulty and pain in lifting and moving the arm.
Lying on the affected shoulder can be a painful experience.
There is instability of the shoulder joints followed by weakness.
A person finds it difficult to carry out the basic activities such as bringing a glass of water close to the mouth or combing the hair.
Treatment

Anti-inflammatory drugs and painkillers (Acetaminophen) may be used to reduce the pain and swelling associated with the injury.
Physiotherapy and various strengthening exercise can go a long way to deal with shoulder weakness, stiffness, and restricted movement. However, one needs to have patience as the treatment may take time to produce the desired results.
In extreme cases, the doctor may opt for a surgery.
Arthroscopic surgery: The procedure is simple and involves a small incision on the affected shoulder to place an arthroscope (that comes fitted with a camera and the surgical instruments) to treat the condition.
The doctor may also carry out an open surgery or a mini-open surgery (an amalgamation of open and arthroscopic surgery) to fix the tear.

Rotator Cuff Injury - Symptoms Associated With It!

Causes and symptoms of Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease, which is characterized by the inflammation of the joint lining and gives rise to pain, stiffness, warmth and redness in the joints. The inflammation occurs in the tissue that normally produces lubricating fluids for the joint. This condition is progressive in nature, and can cause the destruction of joints, leading to functional and locomotive disability.

Though rheumatoid arthritis is a disease that can last for years, patients may not experience any symptoms for a long time. In some cases, the disease may affect other parts of the body like the eyes, lungs, and the heart.

The severity and duration of the symptoms are unpredictable, and the symptoms experienced are:

- At times, people experience increased disease conditions called flare-ups.

- They may also experience alternating periods when the symptoms fade or diminish, which is referred to as remission.

- Some of the common symptoms of the disease include lasting pain and stiffness for more than an hour in the morning, inflammation, fatigue, fever, and a general sense of discomfort.

- Inflammation in the joints close to the hands like wrists and fingers and other parts like neck, shoulders, elbows, knees and hips can also be affected.

- In some cases, both sides of the body are affected at the same time, which is known as inflammation in a symmetric pattern.

Rheumatoid arthritis is usually caused by the body's weakened immune system, which produces antigens to attack itself. The trigger to this reaction is not yet clearly deciphered.

It is diagnosed by clinical examination (American association of Rheumatology criterion) supported by relevant Investigations.

Management

Management for Arthritis includes the following aspects:

1) To control disease activity and control of symptoms of pain, stiffness.

2) Medical treatment to prevent system effects of the disease.

3) Nonmedical treatments comprise of dietary therapy, physiotherapy, immunomodulation therapy.

4) Minimal surgical therapy like arthroscopic synovectomy to confirm the diagnosis as well as reduce disease activity. At times, with the advanced decline of joints, a major surgery like replacement therapy may be required for specific cases.

What's more important is to know that at any stage of the disease patient can adopt and live an active life with appropriate treatment.



What Really Causes Rheumatoid Arthritis?

Injuries are very common, especially head injuries are one of the leading causes of death and disability in adults. As per surveys conducted, 1.7 million people suffer from head injuries every year and this estimation is increasing day by day.

Head Injury is any trauma to head other than superficial injuries to face. It results in high morbidity & mortality. Head injuries are an important cause of loss of young people at their productive age.

Causes of Head Injury-

A head injury can occur due to many reasons. Some common causes of these head injuries are:

Vehicle accidents

Street fights

Fall from height

Child abuse

Symptoms of Head Injury-

A head injury is followed by various symptoms depending upon the intensity of the injury. Here is a list of the possible symptoms of brain injuries:  

Nausea and vomiting, fatigue or sleepiness, severe headache, confusion, amnesia,  loss of consciousness, seizures, loss of muscle control or paralysis in the part of the body controlled by the part of the brain that is affected, coma, dilation of the pupils and disturbance of vision, Cerebrospinal fluids might come out of the ears and nose, sometimes accompanied by blood, difficulty in breathing, low pulse rate, increase in blood pressure, difficulty in swallowing, loss of hearing, problems in cognitive functions.

Brain damage is a process, not an event. 80% are minor head injuries, 10% are moderate head injuries and 10% are major head injuries.

Management of Head Injury-

Diagnosis of a brain injury has to be detailed and very quick at the same time. It always comes under emergency cases. Some of the steps involved are:

Glasgow Coma Scale

Pupillary reaction to light

Brain stem reflex tests

Head to toe examination

CT scan of head is the initial study of choice. MRI Brain is helpful in cases of non-haemorrhagic contusions, diffuse axonal injury and deep lesions.

Surgical Indications

Head injuries with intracranial hematomas causing significant mass effect

Massive cerebral edema

Hydrocephalus

Infection

Precautions for Head Injury

Use Helmets- both riders

Use Seat Belts

Keep vehicle speed under control

Follow traffic rules

Take adequate precautions during trekking, diving

Take Away-

No head injury is minor enough to be neglected nor severe enough to be given up.

Head injuries take time to heal, but medical treatment along with neurosurgery can aid the process of recovery and also help a person to lead a healthy life in the future. Most young patients recover fully, while some older patients or patients with preexisting neurological conditions live with a degree of disability.



Head Injuries - All You Must Know!

At some point in life most people experience acute pain in their lower back which is extremely painful. Pain in the spine causes a lot of discomfort and disruption in the life of an individual and hence, it is always better to get it checked on time. There are patients who even wonder when they should consult a neurosurgeon or a spine surgeon for their back pain. It is advisable that a physical examination is done by a primary care physician for low back pain before consulting a spine surgeon.

Why consult a Physical care Physician First?
The main reason to consult a primary care physician at first is that he would prescribe medications for severe lower back pain. The medications could include non-narcotic pain medications such as Ultram or non-steroidal anti-inflammatory drugs such as Motrin. The physician can even refer you to a chiropractor or for physical therapy to get relief from the back pain. Mechanical means are made use of by a chiropractor mainly to alleviate the back pain of the patient.

If the patient feels better with the physical therapy or the medications prescribed by the family doctor and is able to resume normal activities, then there is no need to see a spine surgeon. It is often recommended to take good care of the back and to exercise. A combination of ergonomics, regular stretching and improved everyday posture is beneficial as it reduces the chance of causing pain in the lower back. Exercise plays a very important role and it provides the possibility of reducing the pain.

Conservative Care for Treating Lower back Pain
It is best for patients to consult a conservative care specialist if after consulting a chiropractor they do not find any reduction in their pain and they do not want to undergo spine surgery. The conservative care specialists are well-trained in rehabilitation of musculoskeletal disorders and specialize in spine care. The role of the conservative care specialist is similar to a cardiologist who specializes in treating neurological disorders.

The specialist for spine care works along with the surgeon in a spine center to treat the lower back pain. The specialist is trained in diagnostic techniques and is capable of making use of a combination of diagnostic tests as well as injection techniques such as epidural steroid injections to diagnose the source of the lower back pain in a patient. They can even advise patients whether it is appropriate to consult a spine surgeon for surgery. Surgery is done to correct the anatomical conditions and it is performed only when non-surgical treatments are not successful in alleviating the pain of the patient.

When Is The Right Time To See A Spine Surgeon?

Did you know that in addition to your diet, exercise is one of the best ways to make sure that you never lie on a hospital bed with a surgeon treating you for a bone disorder? Medical expertise has constantly pointed out to the fact that regular exercise makes your bones less likely to suffer from wear and tear during old age.

As you exercise, your muscles become stronger, your bone density increases and your balance improves. Of course, it goes without saying that you need to follow certain precautions before you exercise to avoid certain injuries.

Before starting any exercise program, make sure that you prepare your body for exercise. A brief warm up helps you to get your muscles ready for exercise. It also makes sure that your chances of injury are drastically reduced.

Here are some tips to keep your bones healthy:

Weight lifting: Weight lifting is a type of exercise that, if done correctly, will be extremely beneficial for your bones. You can opt for simple bodyweight exercises such as pushups and squats, which build muscle as well as strength. Avoid using very heavy weights as it causes back-related problems such as slipped disk.

Yoga: Yoga is another method of exercise which is very beneficial for bones and joints. The premise of yoga is static strength building wherein you hold a pose or an exercise for a certain period of time; this helps in strengthening your muscles. Along with your muscles, your bones also become stronger as you get fitter. Yoga is repetitive stress which is good for flexibility and hence keeps your joints supple and muscles in good shape. There are certain asanas which are weight bearing and anti-gravity postures can strengthen your bones. 

Swimming: Swimming again is a good aerobic exercise and is good for back and over all fitness but doesn't strengthen bone per se. It is a way to keep you healthy. Swimming is a cardiovascular exercise, which is also known for its calorie burning capabilities. It is also very effective is incinerating fat and keeping your skeletal system healthy. Whereas walking and jogging and running certainly build your bones as they are weight bearing exercises.

Pilates: Pilates is a new form of exercise that has been gaining a lot of steam lately. It does not require much equipment, as you can get started with just a mat. It is very effective in working your spine and the hips, thus keeping your lower back strong. A weak lower back increases the chances of bone disorders drastically.

How Exercise Can Help In Keeping Your Bones Healthy?

Knee pain or injuries are very common and have numerous causes. Knee pain can emerge from delicate tissue wounds like ligament sprains and muscle strains. Bone conditions like knee joint pain, Osgood Schlatters, and biomechanical dysfunction can also cause knee pain. Treatment can include basic knee mobilization techniques, taping, massages or knee strengthening exercises completely through a careful recovery method after knee replacement or reconstruction.

Physiotherapy can help you overcome the pain and increase your strength and flexibility. A physiotherapist can suggest you a number of treatments and also help you understand your issue and get you back to your everyday routine. Physiotherapists are said to be successful in getting rid of the source of the knee pain by diagnosing a cause. This includes tightness around the knee and treating it with stretching and exercises.

Following are some of the exercises a physiotherapist might generally recommend for knee pain:

Hamstring stretch: Stretching keeps you flexible and increases your scope of movement, or how far you can move your joints in different directions. It additionally helps you reduce your chances of injuries and pain. Continuously warm up with a five minute walk first. Lie down when you are prepared to stretch your hamstring. Circle a bed sheet around your right foot, use the sheet to pull the leg up and hold for twenty seconds and then lower the leg. Repeat twice and switch legs.
Calf stretch: Use a chair for balance. Bend your left leg. Step back with your right leg and gradually straighten it behind you. Press your left heel toward the floor. You should feel the stretch in the calf of your back leg. Hold for 20 seconds. Repeat twice and then switch legs.
Straight leg raise: It helps build muscle strength to give support to the weak joints. Lie on the floor. Twist your left knee, foot on the floor. Keep the right leg straight, toes pointed up. Tighten your thigh muscles and raise your right leg.
Quad set: With these, you don't raise your leg. Just tighten the thigh muscles, also called the quadriceps, of one leg at once. Begin by lying on the floor. Keep both legs on the ground, loose. Flex and hold the left leg tense for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Cushion squeeze: This move strengthens your legs from the inside so that they can support the knees. Lie on your back, both knees facing inwards. Place a cushion or a pillow between the knees. Press your knees together, squishing the cushion between them. Hold for five seconds and then relax. Do three sets of ten repetitions. Switch legs after every set.
Heel raise: Stand tall and hold the back of a seat for support. Lift your heels off the ground and rise on the toes of both feet. Hold for three seconds. Gradually lower both heels to the ground. Do three sets of ten repetitions. 

Knee Pain - How Physiotherapy Can Heal Knee Pain?

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