What is Developmental Dysplasia of the Hip?

Developmental dysplasia of the hip or DDH, is a condition that affects the hip joint in newborns and young children. The hip is like a ball-and-cup, formed by the round top of the thigh bone - called the femur - and a cup-shaped socket in the pelvis. The hip joint is stable in spite of its large range of motion and is kept in place by ligaments and other soft tissue structures. The normal infant hip is not mature at birth but develops into a strong and stable joint as the child grows.

What happens in hip dysplasia?

In DDH, the hip does not develop normally as the cup and ball are either partially or completely out of alignment. DDH can vary from mild to severe depending on whether the cup is shallow, soft tissue structures are lax or a combination of all. These problems may cause the hip to become unstable, and even come out of the joint. This is known as a dislocated hip and is believed to occur in around one in 1000 infants. One or both hips can be affected. DDH isn't painful in babies and young children. Untreated DDH can result in limping in young children. This can progress to hip pain and arthritis at a later date.

How common is it?

DDH is more common in girls and first-born children. It's more likely to occur if there's a family history or if the baby was breech. Swaddling or wrapping a baby's legs too tightly can also lead to DDH. Certain traditional practices like wrapping the children, etc. are known to increase the risk, while carrying them with limbs separated apart is known to decrease the risk of dysplasia. All newborns should have both hips carefully examined by a health professional. 

Treatment options

Treatment depends on the child's age and the severity of the condition. Young babies with confirmed DDH are usually treated in a brace or harness that holds the legs apart. This helps the hip socket to deepen and the hip to become stable with growth. Regular monitoring of the hip position is necessary to ensure good outcomes. Surgery may be necessary if brace treatment is unsuccessful, or if a hip dislocation is first noticed when the child is older.

What is the long-term outlook?

Most infants who are diagnosed and treated early do not have any hip problems in later life. Earlier the diagnosis and treatment, the better the outcome, as late diagnosis often requires surgical treatment and can mean a higher likelihood of ongoing hip problems.

Developmental Dysplasia Of Hip - How Common It Is?

Most of us suffer from lower back pain at some point in our lives; be it from a sedentary lifestyle, spending hours at the office desk or from strenuous physical exercises. In most cases, a little bit of rest does the trick. However, if the lower back pain persists for 3-6 weeks, physiotherapy is recommended.

How does physiotherapy help?

The main purpose behind physiotherapy is reducing lower back pain and increasing muscle and bone function, so that such instances are avoided in the future. Physiotherapy is the first line of defence against lower back pain. More drastic measures such as surgery are undertaken once physiotherapy fails to do is job.

Physiotherapy is often recommended when the back pain is caused due to lifestyle factors, a minor injury like a fall or other moderate factors. For more severe back injuries, doctors recommend surgery straight away when there is no scope of performing physiotherapy.

Low-intensity back pain can be cured using a combination of heat packs, ultrasound wave therapy and Iontophoresis (using a localized current source to introduce medical ionic compounds to the body).

A physical therapy program for back pain usually has two components:

Passive physical therapy to help reduce the patient's pain to a more manageable level

Active exercises

Passive Physical Therapy - Modalities

The physical therapist may focus on decreasing pain with passive physical therapy (modalities). These therapies are considered passive because they are done to the patient. Examples include:

Heat/ice packs

TENS units

Iontophoresis

Ultrasound

Active Physical Therapy - Back Pain Exercises

In addition to passive therapies, active physical therapy (exercise) is also necessary to rehabilitate the spine. Here are some of the common exercises for back pain:

Back Stretch: Put your hands underneath your head while lying back. Bend your knees but put your feet on the ground. Roll your legs to one side and hold them there for 10 seconds. Repeat three times for each side.

Deep Lunge: For this, you need to kneel on one knee with the other foot pointed towards the front. Lift the back knee up and hold it there for five seconds and then bring it down. Repeat this exercise three times for each side.

One Leg Stand: This is the simplest of exercises. Hold on to a wall for support while standing and face towards it. Then slowly hold one leg and bend it behind you. Hold in the same position for five seconds before bringing it down. Repeat the process three times for each leg in five second gaps.

Physiotherapy for Back Pain

Why Does Your Back Hurt?

Most of us, experience back pain due to incorrect posture or longer duration of sitting.

Sometimes you may experience back pain because of exertion - you spent the entire day doing the same kind of job or maybe you bent in a wrong manner while picking up your child. However, the actual cause of your spinal agony may not be very clear, but it pays to be aware of the possible reasons that can cause backache. It is good to consult a doctor if your back pain is consistent and recurrent.

Here are few of the causes:

1. The position of your pelvis

The pelvis consists of three bones that can shift depending on which muscles become weak or stiff. This brings about a pull in the muscle of the lower back, resulting in severe strain to this area. You should consult a physiotherapist for suggestions regarding the best exercises for strengthening your pelvic area.

2. Weak abdominal muscles

A cause of your back pain can be weak stomach muscles. Abdominal muscles play an important role in balancing out the constant bending that your back muscles perform. When you've weak abdominal muscles, your spine is not able to maintain proper balance, resulting in severe stress on the spinal column.

3. Disc injuries

Located between the bones of your spine, discs perform the function of a shock absorber. Physical injury to these padded cushions can cause them to break open, leading to a condition known as herniated disc. This can then bring about pain in the back area.

Few precautions that can be taken for a hurting back. Despite the causes, there are certain precautions that you can take, which are:

- Avoid sitting in a bad posture, that is, keep your back straight as much as you can. Pull and stretch your body in continual intervals to keep it relaxed.

- Consult the right physician instead of doing exercise that can aggravate your pain.

- Take a break from work and go for short walks, every couple of hours.

If you would like to consult with me privately, please click on 'consult'.

Why Does Your Back Hurt? + What To Do About It

A bone may break due to several reasons starting from a fall or an injury or a condition like osteoporosis that makes the bones brittle and leaves them susceptible to fractures. The fracture usually takes a few weeks to get fixed as the broken bones grow back together with the help of various forms of treatment including a plaster and sling applied by the orthopaedic specialist or general physician. Find out more about how bones heal with this article.

Types of fracture: Before we get to the subject of how bones heal, it is important to understand the various kinds of fractures recognised by doctors. The first kind is the complete fracture where the bone breaks into two distinct parts. The next kind is the greenstick fracture or hairline fracture where there is simply a crack on one side of the bone due to pressure. Further, there is the single fracture which occurs where there is breakage of the bone only in one place. A bowing fracture may occur when the bones bend instead of breaking completely. This kind of fracture is pretty common for children. The comminuted fracture happens when the bone is crushed or broken in many places. And finally, the open fracture is one where the bone ends up protruding from the skin.

Treatment: Once you have broken a bone, the doctor will conduct an X ray which will help in understanding the type of fracture and the extent of the damage caused. The doctor will then apply a cast and plaster that will help in bringing the bone back to its normal position so that it grows back with the main bone. In case the bone has broken into various parts or there is a complete fracture, then the doctor may even insert metal pins.

Natural healers: Bones are known as natural healers that can heal with the process of new cells and vessel production which rebuilds the bone by covering the broken ends and closing the gap caused due to the damage or the crack.
Clot: Once a bone has broken, a blood clot or a callus forms in the surrounding region, which kind of acts towards sealing the area.
Threads: Once these clots have formed, the new threads of the bone cells begin to grow slowly from the ends of the broken bones. This will grow on both sides of the affected and fractured bones, almost as if drawing a line from one broken end to another.
Absorption: Finally, the callus will be absorbed by the new cell and the gap will close.
See a doctor is you are experiencing any noticeable symptoms that may point towards bone fractures.

Broken Bones - How Do They Heal?

A fall or an injury is among the most common causes of a fracture. For a fracture to heal; the bones must be set in the correct position and a cast may need to be worn so as to hold them in place. This allows the bones to grow new tissue and bridge the break. The food you eat can help you speed up this process. Some of the best foods to build strong bones and help a fracture heal are:

Milk: Milk is one of the richest sources of calcium and vitamin D. It is also rich in proteins. These three elements are crucial to building strong bones. Proteins help the body release amino acids which in turn come together and create new tissue for the bones. Calcium is, of course, the building block of our bones. However, it is vitamin D that enables the body to absorb this calcium and utilize it. If you do not like the taste of milk, you could substitute it with yogurt. This dairy product is considered equally rich in proteins, calcium and vitamin D. In addition, it also contains amino acids such as glutamine and lysine that helps the bones absorb calcium.
Kale: Kale is known as a superfood. One of the reasons for this is the amount of calcium it contains. Kale is one of the few vegetables that are rich in this mineral. Thus, lactose intolerant people can get their required calcium from this vegetable. Kale can be eaten raw or cooked. Kale can also be juiced. However, to benefit fully from the vitamins and minerals in this vegetable, it is best to eat it raw.
Spinach: Spinach is another green leafy vegetable that is rich in calcium. It also contains zinc. Zinc helps stimulate the chemical reactions needed to bind calcium and other minerals together to create new bones. In addition, spinach is also a rich source of vitamin K. While this vitamin does not play a direct role in healing bones, it helps speed up the healing process.
Broccoli: Broccoli is a cruciferous vegetable that is rich in vitamin K1. This is very beneficial to your overall health and bone health. Vitamin K1 aids in the mineralization process of fusing broken bones together and building new bone tissue. Thus, it helps the bones set correctly.
Citrus Fruits: Fruits such as oranges are chock-full of vitamin C. This nutrient helps build a strong immune system and aids in the fracture healing process. Vitamin C also helps the body create collagen that surrounds the broken bones and allows it to heal faster.

Food Items That Help You Recover From Fractures!

One of the most common complaints of men and women is that of a back ache with lower back aches being the most common. Apart from an improper posture, this may be caused by old age, lifting heavy weights or an injury to the back. A consistent back ache can affect your daily life and make performing regular tasks uncomfortable. Luckily, it can be managed quite well with simple ayurvedic remedies.
According to Ayurveda, backaches are triggered by an excess of Vata dosha. Thus, the Ayurvedic remedies for a back ache aim at reducing the Vata dosha. Ayurvedic remedies are natural and have negligible side effects. 

For this reason, they can be prescribed to both children and adults. Some such remedies are:

Cut down on spices: One of the main characteristics of the Vata dosha is dryness. This can be caused by pungent spices such as wasabi and green or red chillies. The internal dryness caused by these spices can lead to constipation which in turn can be one of the causes of low back aches. Hence, if you suffer from a chronic backache that may or may not be accompanied by constipation, cut back on the spices and try eating food that is slightly blander.
Eat food before it gets cold: Eating cold food or cold drinks can also increase the Vata dosha levels in our body. Coldness creates congestion and constricts the internal organs while warm food allows the digestive and stool carrying channels to stay open. This allows for the easy expulsion of waste and reduces toxins in the body. Hence, opt for warm drinks like tea or coffee instead of soft drinks and juices and try to eat your food while it is hot.
Padahastasana or the standing forward fold pose: This yoga asana is very effective when it comes to treating back pain as it allows the Vata dosha to flow easily through the body. In doing this it opens up the digestive channels that may have been causing constipation and back pain. It also relieves problems associated with sciatica. To practise this asana begin by standing upright with your feet beside each other. While inhaling, lift your arms over your head till they touch your ears. Bend forward from your hips while exhaling and try to keep the back and your legs straight. Touch the floor or wrap your hands around your calves. Bring your head as close to the knees as possible and hold for 5   10 seconds. Inhale and the slowly roll your body upright again.

Back Pain - Ayurvedic Remedies for Managing it!

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