Leg bypass surgery is needed when the patient suffers from peripheral artery disease. PAD is a very common condition in elderly people, where the rate of flow of blood to the limbs (in this case, the legs) is reduced due to narrowing of the blood vessels.

Causes and risk factors-

The narrowing of the blood vessels occurs due to excess calcium accumulation and fat deposits in the walls of the arteries. The following are the risk factors of PAD-

  Age (60 years and above)
  Smoking
  Diabetes

The condition may be life-long or can last for years.

Symptoms that indicate you might need a leg bypass surgery-

The following are the signs and symptoms of PAD, which suggest you should consider having a leg bypass surgery-

  Pain in the legs, especially when walking
  Pain in the buttocks
  A sore on a foot/leg that does not seem to heal
  Thinning of the skin on the legs
  Loss of hair on the legs
  Tingling, weakness, or numbness in the legs
  One or both the feet/legs may feel cold
  The feet or legs may appear bluish, pale, or dark reddish in colour

You should get yourself checked by a specialist in the initial stage, or else the condition may get worse and affect your day-to-day activities.

Vascular surgery for PAD in the legs:

Vascular surgery is a surgical sub-specialty, which manages vascular system disorders- disorders of the veins, arteries, and lymphatic circulation- by surgical reconstructions, minimally invasive procedures, and medical therapies.

The most commonly used surgical procedure is the leg bypass surgery. The surgery aims to reroute the supply of blood around an obstructed artery in one of the legs.

How is leg bypass surgery performed?

The surgeon performs leg bypass surgery using a graft (usually made of plastic tube) to bypass or replace the blocked portion of the artery. On some occasions, the graft may be a vein or blood vessel taken from the patient s body (usually, the other leg).

During the surgery, the surgeon will first administer anaesthesia so that you are not able to feel pain or discomfort. He/she will make an incision over the portion of the blocked artery. After carefully removing the skin tissues, the surgeon will place clamps on each side of the narrowed artery and sew the grafts in place. The surgeon will ensure that the flow of blood in your lower extremity (legs) is good. An arteriogram (an X-ray of the arteries/blood vessels) is recommended to make sure that the graft is working fine after the leg bypass surgery.

For most people, leg bypass surgery helps improve the flow of blood in the arteries. The prognosis is better if underlying medical conditions like diabetes are controlled.

Leg Bypass - Treating It Through Vascular Surgery!

A bone fracture is often abbreviated as FX or # and is a painful medical condition that causes damage in the continuity of the bone. A dictionary meaning of fracture is a separation of an object or a material into two or more pieces under the action of stress.


A bone fracture could be due to a high force impact or stress, an injury from trauma or sports or even certain medical conditions that weaken the bones, such as osteoporosis, bone cancer or osteogenesis imperfecta.


However, a significant number of fractures occur due to high force impact or stress. A fracture could be simple where the skin is not exposed or compound where skin gets exposed. A fracture could be complete where the bone breaks up in two pieces or could be incomplete with a crack in the bone.


Treatment of bone fracture depends on the type of fracture. In a large number of cases, the bone is aligned through a cast or splint. However, a very crucial part in the recovery of the treatment is physiotherapy. Physiotherapy is a comprehensive care plan designed for the patient for optimal and complete recovery. Yet most patients do not understand its effectiveness. In layman's terms physiotherapy is understood as few exercises or messages designed to aid the patient's treatment. However, Physiotherapy not only aids the recovery, it effectively promotes healing, reduces pain and stiffness and gradually helps the patient to return back to his/her normal daily activities of life.


Physiotherapy is a complete preventive and rehabilitative approach to treatment and must begin as early as possible and continue post fracture. Physiotherapy has been proven to be effective in preventing post fracture stiffness and weakness that occurs in adjacent joints and muscles generally during the first six weeks of the healing process. If the X-ray shows poor healing, physiotherapy is a medium used to help the patient regain muscle strength and speed up recovery.


Irregular movements can lead the bones to further damage the surrounding tissues and muscles. Damage may also lead to infection, especially in compound fractures where the skin is exposed. Thus, physiotherapy regulates the movements, supports healing and prevents further damage. Physiotherapy not only involves messages or exercises. It includes a range of interventions designed for prevention and rehabilitation of patients. These interventions include pain management, education and awareness on safety and prevention of injury, strength building and flexibility exercises and in some cases taping, bracing and electrotherapy.


To add to its benefits, physiotherapy procedures are also completely safe and are supported by medical science. These procedures also do not have any side effects. Always remember to consult your orthopedic doctor as he can guide you towards the best physiotherapy treatment.


Stay fit and healthy!"

Physiotherapy - Why it is Critical for Recovery from Fracture?

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 human spine has 33 vertebrae. However, some conditions can fuse these vertebrae. Ankylosing Spondylitis is one such condition. This disease may also be known as AS or Bechterew's disease. It is an inflammatory disease that can make the spine less flexible by fusing the vertebrae of the lower back together. In some cases, it can also affect the rib cage and make it difficult to breathe. This disease typically affects more men as compared to women. Most patients begin showing symptoms in early adulthood.

Ankylosing Spondylitis affects the sacroiliac joints. These joints are located just above the tailbone. It causes inflammation of the spinal bones that in turn cause pain and stiffness. With time, this inflammation spreads to the entire spine and the vertebrae begin fusing together. This can make movement difficult and painful. In severe cases, it can also lead to the development of a hunchback. This disease also affects the other tissues of the body. For example, it can affect other joints and aggravate arthritis or affect organs such as the kidney, heart, lungs, and eyes.

A specific cause has not yet been identified for Ankylosing Spondylitis. However, studies show that genetic factors can be a trigger. In particular, the presence of the HLA-B27 gene increases a person s risk of developing symptoms pertaining to this condition. However, it is important to note that merely the presence of this gene does not make Ankylosing Spondylitis inevitable. Other genes that are associated with this disease are ARTS1 and IL23R. These genes influence the functioning of the immune system. While it can affect people of all ages, adults are at a higher risk of suffering from this condition.

In many cases, the initial inflammation of the spine is due to a bacterial infection of microbial infection. Though the infection itself may be treated and cured, it may cause the immune system to react and trigger inflammation. Once activated, if the immune system cannot be turned off, this inflammation will continue and can trigger Ankylosing Spondylitis. In each case, the disease presents a unique pattern of progression.

There is presently no cure for this condition, but with an early diagnosis and treatment, the symptoms can be managed and progression can be slowed. This treatment usually takes the form of medication to relieve pain, inflammation and discomfort and physical therapy. Surgery cannot be used to treat Ankylosing Spondylitis but in cases where it has caused severe joint damage, surgery may be advised to replace the damaged joint.

Ankylosing Spondylitis - What Are The Causes?

A sprained thumb is a painful condition caused due to an injury on the ligament of a thumb. A ligament is a soft tissue, which connects bones to each other at a joint. The ligament might get partially or fully torn due to extreme backward bending of thumb causing the ligament connecting the thumb and index finger to suffer injury.

The problem is quite common among basketball, rugby and football players. For this reason, it is known as a sports injury. Skiing may also cause extreme pressure to the thumb, causing a ligament tear. Injury due to skiing is called skier s thumb.

The injury causes pain, bruising and tenderness. It can cause swelling on just the thumb or sometimes on the entire hand. In severe cases, weakness and instability in the region can be seen. A sprained thumb weakens the ability to pinch and grasp things. The patient will have trouble holding a glass, turning a knob or writing. An untreated injury may lead to joint stiffness, muscle weakness, scar tissue formation, instability of the thumb or even arthritis. It is strongly advised to visit a professional therapist for an early diagnosis and treatment.

Usually, an X-ray leads to an apt diagnosis of the injury. The doctor also ascertains damage to the bone and ligament and develops a treatment plan. Some ligament tears can be treated using a splint or cast. A chronic ligament tear might not heal and would require surgical intervention.

A partial or mild ligament tear can be managed through useful home remedies like putting an ice pack, bandage or splint. It is also advised to keep the thumb elevated and restrict its movement. A heat pack is beneficial as it can ease pain and relax the muscles. However, heat pack must be avoided during the first 48 hours of injury as it can lead to bleeding.

If there is a chronic injury and the ligament is completely torn, a surgery is needed. A surgery helps join a new ligament to the bone in case the torn ligament fails to heal. It also helps reconnect the injured ligament to the bone. Sometimes, there might be bone damage as bone fragments might get pulled away with the ligament. In such cases, bone fragments need to be put back in their position through surgery. After the surgery, a cast or splint is put till it heals completely.

An early visit to a physiotherapist has potential advantages. A therapist can fasten the healing process, help relieve pain and improve a person s ability to resume daily tasks. Massages and strengthening exercises are initiated to avoid re-injury and instill strength in the injured region. Physiotherapy also helps immensely after surgery through planned mobility exercises that regain movement and strength.  

Sprained Thumb- Causes and Treatment

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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