Runner s knee is a very common problem with athletes. It is definitely not something one needs to worry about. In fact, with certain exercises, it can be prevented and if you do develop a runner s knee, it can be treated with some exercises as well. There are special sports medical practitioners who prescribe not only regular physiotherapy, but also specific exercises to deal with specific sports injuries. To fight with runner s knee pain, there are a few exercises. 

But the four most important ones are described in detail below.

Quads: For performing proper quads, all you need is a back wall for additional support. You need to hold yourself against the wall and keep your legs apart from each other. The legs should be folded in the knees. In this position, you have to move up till the knee position with a minimum of one minute hold time in the knee position. You can repeat this exercise 10 times at a stretch before moving on to the next exercise.
Hamstring: This is a fairly easier exercise than the previous one. You have to stand straight with your legs apart. Bend downwards from your hips. Relax your neck and back. Ease your head downwards as well. Keep your hands behind. Join both your hands and give it a stretch. If you think that this position is straining your neck or back a little too much, then you can simply stretch your hands without joining them.
Calves: Calves is a standard exercise that is prescribed by medical practitioners and physiotherapists for easing out the pain caused by runner s knee. You have to stand with your hand against the wall. Put your left leg forward and bend it at the knees. Stand on your right heel. Hold yourself in this position for 20 to 30 seconds before changing the legs and doing the same.
Lateral: Lateral is also one of the easiest and common forms of exercises. You have to stand with your legs directly below your hips. Then stretch your right leg apart. Without bending your knees, try to touch the toes of your right leg with the fingers of your left hand. Hold this position for 20 to 30 seconds before changing the position and performing the lateral with your left leg.
Thus, these are some of the very fundamental exercises that one should follow in order to get quick relief from the pains of a runner s knee. These exercises are very easy and help in reducing pain.

Runner's Knee - 4 Most Important Exercises for it

From marathon runners to footballers, amongst athletes, 'pulling a hamstring' is the most common type of injury. The hamstring is a group of four muscles at the back of your thigh. When one of these muscles gets overloaded or begins to tear, it is known as a hamstring injury. While a hamstring injury is painful, it does not indicate the end of an athlete's career.

Minor hamstring injuries may heal by themselves. In cases where one of the muscles is torn, surgery is required to repair and reattach the muscles. Recovery time depends on the severity of the injury. Stretching and exercising the muscles of the leg are the most important parts of rehabilitation. The healing of a hamstring injury can be divided into four stages.

1. Acute phase: The first five days after a hamstring injury is known as the acute phase of rehabilitation. The aim of treatment at this phase is to reduce inflammation and keep the other muscles from atrophy. For minor hamstring injuries resting the leg, using ice packs and keeping the leg elevated can accelerate the healing process. Once the pain and swelling has decreased, patients can use a cane or crutch to exercise the leg.

2. Subacute phase: From the fifth day to the 3rd week after the injury, the focus of the treatment shifts from minimizing swelling to strengthening the leg and increasing the range of possible motions. At this time, an athlete can resume cardiovascular training. Swimming and other forms of aquatic training are said to be especially beneficial to the treatment of hamstring injuries.

3. Remodeling phase: The remodeling phase continues upto 6 weeks after the injury. Strengthening the leg is the focus of this stage of treatment. Using ankle weights can be beneficial towards strengthening the leg muscles. It is important to be careful about the weight being used and to gradually increase this weight to avoid an added injury.

4. Functional stage: This stage can last upto 6 months until the athlete can regain full function of his or her leg. As the athlete's gait gets back to normal, they may start jogging and short sprints. Gradually, more sport specific exercises may be added to the workout.

There is no fixed time when an athlete can return to active sports after a hamstring injury. While players with minor injuries may return to the field after 3 weeks, athletes with muscles tears may take upto 6 months to recover completely. Hamstring injuries tend to reoccur and hence before they can get back to active sports, an athlete must pass an isometric strength test and flexibility test. This ensures that there are no subtle after effects of the injury that can increase the risk of a repeat injury.

Hamstring Injury Recovery and Return to Sports

Gridhrasi is what Sciatica is known as in Ayurveda. It is the disorder that causes mild to agonizing pain in the sciatic nerve or neuralgia. These nerves, emerging from the pelvis, run along the hamstring and may cause intense pain in one or both the legs when a person suffers from Sciatica. Sciatic pains fill your life with misery as the simplest of daily activities cause sudden and excruciating pain. There are two types of sciatica i.e. true sciatica and pseudo sciatica. Sciatica may be caused due to bulging disc or herniated disc, degenerative disc disease, piriformis syndrome, pregnancy or trauma etc. 

According to Ayurveda, Sciatica is caused due to impairment in Vata i.e. the dosha responsible for the functional ability and movement of the body and also in some cases due to impairment in the Kapha i.e. the dosha that is responsible for body fluids and lubrication. Ayurvedic herbs that improve the symptoms of Sciatica are:

1. Babunah is also known as Bitter Chamomile. Not only is it used to relieve and reduce the pain faced by a sciatica patient, but it is also used for treating problems such as rheumatism due to the advancement of age. Compressed bitter chamomile flowers are prescribed for sciatica.
2. Guggul is also known as Indian Bdellium. Since guggulu is well known for its anti-inflammatory properties, it relaxes the sciatic nerves.
3. Rasna is also known as Vanda Orchid. Intense or agonizing pain due to the sciatic nerve issues can be reduced by this ayurvedic herb due to its anti-inflammatory properties. 
4. Juniper oil is extremely helpful when massaged onto the thigh muscles with firm strokes or pressure. It is used extensively in massage therapy for treating sciatica since the extent of reduction in sciatic nerve pain is tremendous. 
5. Jaiphal is also known as Nutmeg. After being mixed with sesame seeds oil, nutmeg is coarsely powdered and then fried till it turns brown. This is then applied to those areas where the sciatic pain is intense for instant relief.
6. Kumari is also known as Indian Aloe. Properties of Indian Aloe are extremely helpful in treating lower back ailments such as sciatica and lumbago.
7. Shallaki is also known as Boswellia or Frankincense. Containing anti-inflammatory properties, shallaki is applied externally to get relief from sciatic nerve pain. 

Ayurvedic preparations such as yogaraja guggulu, Vataganjakusha, Saindhavadi taila are also very useful in treating Sciatica.

Ayurvedic Treatment of Sciatica

Spinal fractures are extremely painful and usually happen when an external force applied to the spine exceeds the vertebral column s ability to bear the load. Many times, the bone fragments pinch and damage the spinal cord, which leads to an injury or dislocation of the bony vertebra. Although spinal fractures can develop anywhere along the spine, the most common site is the lower back.

What causes spinal fractures?

Spinal fractures can occur due to both minor trauma/falls and major accidents. The following are the probable causes of such fractures-

  Injuries sustained while playing a sport
  A traumatic injury
  Spinal instability
  Injuries sustained after falling from a height
  A whiplash
  Injuries sustained in an accident
  An underlying condition such as Osteoporosis, which causes the spinal bones to weaken

Symptoms observed:

Spinal fractures are characterized by the following symptoms-

  Muscle spasm and swelling
  Numbness
  Acute pain that worsens when you walk or stand for a long time
  A tingling sensation
  Restricted mobility of the spinal column
  Spinal deformity/disability
  Sudden onset of pain in the lower back region

What are the various types of spinal fractures?

Spinal fractures primarily fall into four categories, namely the following-

  Compression - Compression fractures are quite common in people with osteoporosis or bone cancer. The bones become fragile and brittle. If sudden force is applied with extreme pressure, the vertebra may not be able to support the load and that may result in a fracture.

  Burst - Severe trauma, such as a car accident can cause burst fractures. The external pressure is so much that the vertebra gets crushed. As a result, the bony fragments spread out and cause spinal cord injury. Unlike a compression fracture, where only a part of the vertebra is damaged, a burst fracture leads to multiple fractures in the vertebra.

  Flexion-distraction - This type of fracture is likely to happen if you are involved in a car accident. Normally, the spine is made to flex forward. However, a sudden jerk that pushes your body forward can put a lot of pressure on the spine and cause the vertebrae to break.

  Fracture-dislocation - This debilitating condition results from a torn ligament and broken bone.

What is the treatment for spinal fractures?

Treatment options for spinal fractures include both non-surgical and surgical methods.

  Non-surgical treatment - Most cases of spinal fractures can be treated with immobilization in a corset or brace for up to 10-12 weeks. Bracing will help prevent deformity and reduce pain.

  Surgical treatment - The doctor may recommend surgery in severe cases. The two standard surgical procedures are-

Vertebroplasty - The surgeon will insert a tube, known as a catheter, into the compressed vertebra. Through the catheter, he/she will inject bone cement into the fracture site. This will harden and stabilize the vertebral column. Vertebroplasty has proved to be an effective procedure to reduce pain. The surgery restores mobility and prevents loss of bone due to bed rest.

Kyphoplasty - During this procedure, the surgeon inserts a catheter into the spinal column under the guidance of an X-ray. Next, he/she makes small incisions along the back and inserts an inflatable bone stamp. The tamp, once inflated, bring back the vertebral body to its original height. It also creates a cavity to be filled with bone cement, which seals the cracks. The bone cement stops the vertebra from collapsing again. After the whole procedure, the surgeon will remove the catheter and stitch the incisions.

Following surgery, you will need to wear a brace for about 6-12 weeks. Physical therapy is strongly recommended initially to help you get back to your daily activities in a week or two.

Spinal Fractures - All You Should Know!

Rotator cuff is the name given to four muscles and their tendons, which keep your arms in your shoulder sockets, allowing you to lift your arms and do day-to-day stuff like combing your hair, cutting vegetables etc.

The shoulder joint is a very important joint of the body and this is why any tear that happens in the rotator cuff can be devastating.

Causes

Tears can happen in rotator cuff due to a number of factors like injury and degeneration due to age. Tears that happen due to an injury to the shoulder are called acute. Degenerative tears are tears that happen due to degeneration of the tendon over time.

Common causes of degeneration are lack of proper blood circulation, which impedes the rotator cuff s ability to repair itself. Repetitive stress is another cause where we stress the tendon by repeating the same shoulder motions again and again while playing games like tennis, cricket etc. and doing jobs that require us to extend our arms upwards a lot. Lifting heavy objects can also lead to tears.

Symptoms

Chronic shoulder and arm pain are good reasons for you to see your doctor. If you suffer from pain in your shoulder at rest, while sleeping on the affected shoulder or pain while lifting and lowering your arm, then there is no time to wait.

The doctor will do a physical examination by moving your arm in different directions. He may follow it up with X-rays and MRI to check how big the tear is in your rotator cuff.

Treatment

Once confirmed that you indeed have a rotator cuff tear, your doctor will start the treatment. The goal of any treatment is to reduce pain and make your shoulder joint work properly again.

Nonsurgical Treatments: 

Nonsurgical treatments include rest, using of a sling to protect the shoulder and modifying your daily activities. This means you may not be able to do activities that cause shoulder pain. Your doctor can also prescribe pain and anti-inflammatory medicines. Strengthening and physical therapy bring up the rear of this type of treatment.

What you must remember is that nonsurgical treatment relieves pain and improves function in the shoulder, but does not improve shoulder strength. The size of your tear may also increase over time.

Surgery: 

Surgery, which attaches the rotator cuff to your bone, is done if you suffer from continuous pain and symptoms over a year or so. If you have a large tear, conservative treatments will not work and surgery will have to be resorted to. 

If you have been suffering from chronic shoulder or arm pain, waiting and watching is definitely not an option. You must visit an orthopedic surgeon at the earliest. Remember, if treatment is not started soon enough, your rotator cuff tear will get larger and will require only surgery.

Rotator Cuff Tears: What Are My Options?

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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