The Anterior cruciate ligament (ACL) is an important ligament that gives stability to the knees. An injury to this ligament can result in a host of complications and discomfort. Children or adults who are into sports such as gymnastics, volleyball, tennis, basketball, soccer, football, often injure this ligament. As per various studies and surveys, ACL injury is more likely to affect female athletes as compared to their male counterparts.

Depending on the severity and extent of the damage, an Anterior Cruciate Ligament Injury may be ranked on a grade of 3.

Grade 1 sprains indicate a mild injury or stretching of the ligament, seldom affecting the stability of the knees.
Grade 2 sprains are indicative of a partial ligament tear (the ligament loosen up). The damage is still under control.
Grade 3 sprains are extensive and severe, indicating a complete ligament tear (the ligament often breaks in two pieces). With a complete ligament tear, the stability of the knee is also affected (the knee becomes highly unstable).
What causes Anterior Cruciate Ligament (ACL) Injury?
While a host of sports activities mentioned above increases the risk of the injury, a person may also suffer a partial or a complete anterior cruciate ligament tear under the following situations.

A jump down a ladder, a tree, or a wall. An incorrect jump or a landing may be equally responsible for the ligament tear.
A collision or a hit, especially on the knee (while playing football).
Slowing down suddenly while still in running motion. A person suddenly stopping or missing a step can also injure the ligament.
Symptoms associated with ACL injury

An excruciating pain (especially in the back and outside of the knee) is often seen in people with a complete ligament tear (the movement is yet not affected). However, within a few hours, there may a swelling around the knee, indicating the severity of the injury with internal bleeding within the knee joints.
There may be restricted knee movement. The knee also feels unstable, further limiting the movement.
Sometimes a pop in the knee can be heard just at the time of the ACL injury.
Prolonged ACL injury left unattended can result in a painful complication such as knee osteoarthritis.
Diagnosis
To diagnose the extent of the damage, the doctor may suggest

Physical examination, including a quick brief about the case history.
Imaging tests such as X-rays and MRI can go a long way to analyze the ligament injury.
In the case of extensive swelling of the knees, the doctor may carry out an arthroscopy to have a closer look inside of the knee.
An accurate and timely diagnosis is important to avoid the aggravation of the injury. In the case of swelling and knee pain, consult a doctor, and get yourself thoroughly examined.

Anterior Cruciate Ligament Injury- Causes, Symptoms, and Diagnosis

Shoulder pain can be a persistent dull and nagging sensation in the upper arm or shoulder area. It can be easily differentiated from neck pain as it is related to the movement of shoulders i.e. it will increase and decrease with shoulder movements, especially overhead activities. The other signs to identify shoulder pain is if your shoulder movements are reduced.

If you find it difficult to scratch / wash your back, comb your hair or reach your back pocket, it clearly shows you are suffering from shoulder pain. Shoulder pain can happen due to various reasons, it varies from person to person depending on the activities he/she is involved in, for e.g. sports, manual job etc. It can be a single major injury or multiple small injuries due to repetitive usage patterns. Also, degenerative changes in various parts of the shoulder can lead to shoulder pain.

In case of middle to old age, injuries that can cause shoulder pain are:

    Biceps Tendonitis
    Acromio-clavicular Joint arthritis
    Scapular Dyskinesia
    Trapezitis
    Suprascapular nerve entrapment In young age, injury due to sports or gym activity can cause shoulder pain
    Superior labral anterior/posterior (SLAP tear)lesion

Also, traumatic or repeated dislocations of shoulder can cause shoulder pain due to:

    Bankart lesion

Diagnose Shoulder Pain

Shoulder pain can be diagnosed only after thorough history taking and clinical examination. However, some imaging studies can be very helpful like:

    X-rays: Through an x-ray one can view the shoulder in many different views.
    Ultrasound: With an ultrasound, you can also check the damaged caused to the tendons and muscles of the shoulder but the quality of reporting depends upon the expertise of the doctor.
    MRI: MRI gives a clear picture of the shoulder as it shows everything related to a shoulder joint that is joints, vessels, tendons and muscles that too from different angles.
    Diagnostic Arthroscopy: A surgical procedure often used by orthopaedic surgeons to diagnose and treat issues inside a joint. Arthroscopy has the big advantage that one can use it to diagnose as well as treat at the same time.

Treatment for Various Types of Shoulder Pain

    For Shoulder Impingement or Rotator Cuff tear: Give rest to the shoulder for a few days only Dedicated Physiotherapy Protocol Bursal injections If these fail then, (Surgery)Arthroscopic sub-acromial decompression If Cuff tear is found, then one can go for Arthroscopic/Mini-open repair
    Labral Lesions: For anterior Labral lesions (Bankart's) following anterior shoulder dislocation then surgery in the form of Arthroscopic Bankart's repair is the only option to reduce risk of recurrence and degeneration.

SLAP Lesions

    Pain relief and physiotherapy as first step If this fails then following surgical options are available
    Arthroscopic debridement or repair of labrum
    Biceps tenotomy or tenodesis

Arthritis

In this case, the joint is already destroyed and has to be resurfaced for pain relief and to maintain ROM. If Rotator cuff muscles are working, then Shoulder resurfacing hemiarthroplasty (preferred in young people), that has a life of 10 to 15 years, Total shoulder replacement (preferred in middle aged to old people) has a life of 10 to 15 years. But, if rotator cuff muscle are not working then Reverse Geometry Shoulder replacement is recommended, that has a life of 10 years.

It is always advisable to get yourself diagnosed properly in case of shoulder pain as management changes depending on clinical situations. Neglecting shoulder conditions can lead to bigger problems later on.

Always remember 'a stitch in time saves nine'

Shoulder Pain: Causes, Diagnoses & Treatment

Problems with the arteries and veins present in the hands or legs can lead to vascular disorders. The arteries carry blood from the heart to other parts of the body in order to deliver nutrients and oxygen. The veins carry the blood back to the heart, after the nutrients have been used up. If these blood vessels of the arteries or veins become blocked or narrowed, it can lead to a vascular blockage.

A vascular blockage that occurs in the hands or legs comes under the category of Peripheral Artery Disease or PAD. These type of disorders are less common in the upper extremities of the arms or hands than in the lower extremities of legs. Few of the signs for the same are:

Pain and difficulty in movement due to decreased blood flow
Numbness or weakness of leg or fingertips
Sores on the toes or feet
If the blockage is deep, symptoms of redness, swelling, extreme pain or cramping can be experienced
Abnormal color changes in the fingertips
Ulcers or wounds that don t heal
Skin sensitivity problems when in cold temperatures
How can it be diagnosed?
The blockage can be detected by various methods namely-

Physical Examination   Your doctor may find decreased pulse at armpit, wrist or fingers, full veins, masses, wounds or gangrene.
Doppler or Ultrasound examination to determine the blood flow in the arteries and veins
MRI Scan of the affected area to pay special attention to the blood vessels
Cold Stress Test
Arteriography to show clear blood vessel details
Angiography to map blockages and narrowing of the arteries
What are the Risk Factors for Peripheral Artery Disease?
An individual is at risk for developing vascular blockages in the hands or legs if one or more of the following factors are present:

Smoking
Diabetes
Heredity Factors   A personal or family history of blood vessel disease
High blood pressure
High cholesterol
Aging   People aged above 50 years and older are more prone to vascular blockage
Can it be treated?
Treatments for vascular blockage can vary depending on the age, cause of the blockage, intensity and overall well-being.

Treatments can include:

Self-care   Reducing risk factors and making lifestyle changes to quit smoking, sedentary life or diabetes, blood pressure and cholesterol management can reverse symptoms of vascular disease.
Medications   A variety of drugs can be prescribed to lower the risk and progression of narrowing blood vessels or prevent blood clotting.
Interventional Procedures   Minimally invasive surgery like saloon angioplasty, stenting or removal of artery plaque build-up.
Surgery   If the blockage is severe, surgery may be performed to lessen the vessel narrowing, reconstruct the artery or tie it off, depending on the circumstances.

Pain in the Hands or Legs!

Abdomen pain or abdominal pain is usually experienced in the area between the chest and the stomach. This kind of pain usually comes as a dull cramp that also produces shooting stabs of pains intermittently, or it may be a localised pain in one side of the stomach. This may also be accompanied by inflammation and other diseases related to organs like intestines, kidneys, pancreas, liver, spleen and stomach. So what are the causes of stomach or abdomen pain? Read on to find out:

Food Poisoning: Food poisoning can be caused due to dirty water or contaminated food. This can give rise to various infections as well as conditions like traveler's diarrhea or loose motions.

Gastro-Intestinal Conditions: GERD or gastroesophageal reflux disease and gastroenteritis, among various others, can also lead to abdomen pain as a symptom along with severe acidity and nausea. Irritable bowel syndrome is another major ailment which can leave you with persistent abdominal pain. 

Generalized Pain: This kind of pain occurs in the overall area all around the stomach and may point at the presence of conditions like Crohn's Disease, a traumatic injury, appendicitis, flu, or even a urinary tract infection. Further, when the gas settles and tightens the stomach due to the inability to pass a motion on a normal, regular basis, this may be termed as constipation. This also leads to abdomen pain. 

Localised Lower Abdomen Pain: Pain that is found specifically in the lower area of the abdomen can be caused due to appendicitis, obstruction or blockage in the intestine or colon, and other ailments. This pain can also be accompanied by nausea and vomiting. 

Localised Upper Abdomen Pain: This kind of pain may emanate due to the presence of gallstones, liver inflammation or hepatitis, pneumonia, or even in the middle of a heart attack.

Localised Centre Abdomen Pain: Pain in the centre part of the stomach or abdomen may be caused due to gastroenteritis, an injury or even the accumulation of waste products in the body, otherwise known as uremia.

Abdomen Pain and Women: For women, such localised pain may be caused due to pelvic inflammatory disease, urinary tract infection, endometriosis, ectopic pregnancy, menstrual cramps which are also called dysmenorrhoea, and fibroids. Miscarriages can also cause pain in this part of the abdomen, for women.

Renal Stones: Renal stones or stone in kidney is one of the most common causes of abdomen pain. The pain caused by kidney stone is such that it can make a patient roll in bed and this pain may radiate to toward the groin as well. Persistent pain and nausea that come with vomiting and finally give rise to blood in the vomit or stool should be checked by the doctor immediately, so as to rule out any serious ailment. Imaging tests, ultrasound and an X-Ray can help in diagnosis.

Abdomen Pain - Knowing The Common Causes Of It!

The appendix is a small, finger-shaped pouch attached to the large intestine in the right belly area. It is a vestigial organ as it has no specific role to play in humans, but the organ is still seen, though in a very small size compared to the earlier living beings in the evolutionary chain. Acutely inflamed appendix is the most common cause leading to it removal, often seen in the ages of 10 to 19.

Causes: the appendix gets infected by two main reasons - general infection in the abdomen that reaches the appendix or blockage of the appendix leading to inflammation and swelling within it. The appendix is a blind pouch, and there is a good chance for its blockage from food particles, lymphatic tissue, or even sometimes feces. Some of the potential risk factors for appendicitis include a diet low in fiber, high in sugar, gut flora, and family history.

Symptoms/diagnosis: in adults, the appendicitis has very characteristic symptoms including acute pain in the right upper part of the belly associated with fever and vomiting. However, in children, the pain may not be as tell-tale a sign but is still quite diagnostic of appendicitis. However, presence of the following symptoms together is surely indicative of appendicitis.
1. Right abdominal pain, especially rebound tenderness, where pressure placed in the right upper part of the belly and released leads to excruciating pain.
2. Fever, nausea, and vomiting
3. Abdominal fullness or bloating
4. Elevated white blood count (as with most infections)
Additionally, the younger the child, the symptoms are not very clear, but ultrasound will confirm the diagnosis. The inflamed, enlarged appendix will be visible on the images and could be surrounded by free fluid. Ct scan also can be considered if required to confirm the diagnosis.

Treatment: as noted above, children present with symptoms that do not pinpoint to appendicitis. Treatment usually takes two routes:

If diagnosed as appendicitis before rupture, then surgical removal is the best method to contain its symptoms. Other symptoms like fever and nausea and vomiting usually subside a couple of days after the surgery.
If the appendicitis goes unnoticed and ruptures, then the intestinal cavity can get infected, which is called peritonitis. Earlier, the preferred approach was to control the infection and then go for removal. However, lately, removing the appendix followed by antibiotics to control the infection is the preferred approach.
The prognosis and recovery from appendicitis is very good. Deaths have occurred only in very small infants, where they are not able to pinpoint the area and therefore it can go undiagnosed, leading to rupture and subsequent death.

Early identification is the key to proper identification, immediate treatment, and complete recovery from appendicitis.

Appendicitis in Children

Being fit is a matter of striking the right balance between one s diet as well as exercise. There are many kinds of problems that we all face when we do not strike a balance between the two. A flat stomach is a sought after feature in one s figure. One usually ends up losing a flat stomach when you have weight gain due to pregnancy and the onset of age. 

When one wants to get back a flat stomach, there are many measures that one can take because this is a very difficult thing to get back once you have put on weight because you will usually lose weight from the abdomen at the very end. Yet, one does not need to spend many hours in the gym for a flat stomach. You can also do exercises at home in order to get a flat stomach. Read on to know the secret!

Squats: One can do squats every morning as a part of a warm up before getting into the exercises. Ensure that you hold it for a while before you release and straighten up. You can also do squats while you are standing at the kitchen counter so that you get plenty of exercise with just a few moments of hard work through various times during the day.
Sit Ups: Sit ups are also a good form of exercise that one can do at home. Along with lunges and squats, you can also do sit ups so that you get a more toned torso with good exercise for your muscles in that area.
Pike and Stretch: This is another very well known exercise that can easily be done at home. The pike and stretch requires you to lie on a mat, facing upwards. Then, you will have to crunch up and try and touch your toes. The next step is to bring your arms behind your head and keep them straight while you crush up one leg at a time. This should be done at least ten times so that your abs and hips are well worked out.
The Standing Side Crunch: This crunch can be done with a chair. You need to stand on your left leg and then extend the left arm so that the right foot gets lifted off of the ground level by a few inches. Then, place the right hand behind your head with the elbow bent. After this, you will need to lift the left knee towards the right shoulder. Repeat this at least 15 times for it to show any results on your abs and abdomen area.
The Plank: This is a very well known move that many people take to. You will have to lie down on a mat and elevate yourself on your elbows. This position will have to be held for as long as possible for maximum effect on the abs, torso, hips and the thighs and legs as well. This exercise is recommended for a flat stomach, more than any other.

Want a Flat Stomach - 5 Must Do Exercises!

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