Dr. Samrat Jain

Any surgery that requires an incision will involve sutures or staples as the last step of the procedure. This helps close the incision and keep out infections. Taking care of your stitches can help limit scarring and discomfort and speed up the healing process. Here are a few things to keep in mind.

1. Keep it clean and dry: For the first few days, use a washed wet cloth to clean the incision site. After a few days, you may start washing the area with soap and water unless advised else wise by your doctor. Ensure that you dry the skin thoroughly after washing it. Avoid baths that involve soaking the area in water. Also, avoid swimming. Do not use any powders, lotions, creams, deodorants etc on the wound site.
2. Look out for signs of infections: Avoid activities that may involve exposing your wound to dirty water, chemicals, dust etc. This increases your risk of infections. Also look out for signs f infections such as redness, swelling, pus or bleeding, fever or increased pain from the wound. In case you notice such signs, consult your doctor at the earliest.
3. Do not scratch: As it heals, your skin is likely to turn itchy. However, refrain from scratching so as to reduce chances of infections. Do not try and pull away from the scab but let it fall off on its own. This will also help limit scarring.
4. Limit contact: Avoid wearing tight clothes or anything that sticks to the skin while your wound is healing. Instead have plenty of loose, comfortable clothes easily accessible. Also, do not take part in close contact sports such as football etc until the stitches have healed completely.
5. Change your dressing regularly: A dressing should be changed as soon as it gets wet or soaked with blood or other body fluids. Wear clean medical gloves while changing a dressing. When putting on a new dressing do not touch the inside of the dressing or apply any creams on the stitches unless advised so by your doctor. In the case of removable stitches, the doctor will usually remove the stitches after a few days. DO not attempt to pull the stitches out on your own.
6. Avoid exposing the wound to sunlight: New skin that forms as the incision heals is very sensitive to sunlight and gets sunburnt very easily. Limiting your exposure to sunlight can help reduce the effects of scarring.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Your shoulders are one of the most important parts of your body, but sadly it is also one of the most neglected parts. People use their shoulders for day to day activities. Without shoulders it would be very difficult to even do a simple activity like lifting a fallen paper from the ground. Like your other body-parts, shoulders also need proper attention and care.

Why is shoulder mobility so important?
Whether it is about moving a growing child, lifting a barbeque table or about moving heavy luggage, actions require shoulder mobility. If you find it difficult to do these activities it is highly probable that you have shoulder impingement syndrome. This syndrome occurs when the rotator cuff muscles become inflamed and irritated and result in severe pain and difficulty while moving one’s shoulder. Weak shoulders also make your posture look bad, it can cause grave strains in your neck and back and make you look hunched which is not at all attractive for your appearance.

Different kinds of shoulder injuries and causes of shoulder immobility:

1. Rotator cuff injury

2. Frozen shoulder

3. Onset of arthritis

4. Shoulder instability

5. Injury to the tendons and ligaments

6. Shoulder dislocation

7. Torn rotator cuff

8. Impingement – It refers to the excessive friction of the shoulder muscles against the top part of the shoulder blade.

How can you improve shoulder mobility?

1. You can improve your shoulder mobility with the help of some exercises. For example, stand straight with your hip and feet apart. Move your hands behind your back and try to interlock your fingers, if you face difficulty in doing so, use a towel instead. Hold this position for a minute or so.
2. Sit and keep your feet and knees straight pointing towards the direction of your eyes. Touch your shoulder blade by bringing your hands backward, touch your elbow with your other hand and bring it upwards. Sit straight, hold your head up and breathe slowly. Hold this position for a minute and then repeat again.
3. You can also improve your shoulder mobility with the help of yoga. Yoga is all about relieving your tension and stress, hence it is very beneficial to loosen up tight shoulders and it makes you much healthier by improving shoulder mobility. Stand straight with your feet at least four feet apart and then bend your left foot slightly towards to the right. Make your right foot bend 90 degrees. Raise your right arm towards the left and bend your body. Inhale and exhale. Switch sides after taking five breaths.

Physiotherapy For Shoulder Mobility-

Physical Therapy is not just scientific; it is also very thorough and very methodical in its way of healing and remedying clients with many aches and pains. A therapist is well trained and very careful in massaging and handling delicate parts of the body such as the vertebrae, extremities and in cases of temporomandibular joint neuromusculoskeletal dysfunction. Physical Therapy is a distinct specialization in the practice of physiotherapy.

Before patients are treated with the therapy, it is very important that they undergo a preliminary assessment of what ails them. Their dysfunctions are determined and their biochemical systems are assessed as well. The body's posture as well as the placement is analyzed and almost all areas of the entire body in terms of the position and functioning of the musculoskeletal system is considered just to make sure that the root cause of the problem is discovered and treated.

The aim of the therapy is to alleviate pain, strengthen the body, and improve movement and usability of the limbs as well as the other areas of the body through the use of the hands. The therapy also utilizes various work-out regimens as well as a home carry over system to make sure that the intervention plan will work as expected. More than just treatment, physical therapy is a means of assisting a patient to recover body movement, strength and function, therefore the need to have a strong determination to improve from the patient is definitely required. Here are some physical exercises to improve shoulder mobility-

1. First step is to provide adequate rest to the shoulder. Avoid using the affected arm too much. Keep it in a comfortable position. Do not strain the arm.

2. Cold compressions can help to ease pain and swelling. Alternate applications of hot and cold compressions help to reduce inflammation and provide quicker relief.

3. Keeping the arm elevated in a swing is recommended. It helps to drain the fluid or oedema and reduce pain.

4. Other exercises recommended are basic shoulder strengthening exercises. Example of one such exercise is gently pulling an elastic tubing attached to a door knob, towards your body. These can be performed twice daily, starting five times with each arm.

5. Wall push exercises are those that strengthen shoulders, forearms, biceps and triceps. You must stand at least a feet away from the wall and push against the wall, for a count of 5 to 10.

6. Shoulder press ups are exercises that can be comfortably done while sitting on a chair. Keep your arms on the armrest of the chair. Instead of putting the weight on your feet, rise up slowly by putting the weight on your hands. Repeat this 5 times twice or thrice daily.

7. There are isometric shoulder mobility exercises that involve muscle contraction and movement of limbs. It involves strengthening the muscles through extension, contraction, rotation and flexion of shoulder joint.

8. There are lateral rotation abduction exercises, lateral shoulder raises, lateral shoulder pull down.

9. There’s a range of scapula squeeze exercises that involve strengthening and stabilising the shoulder blades.

10. Medicine balls and lightweight dumbbells can be used as props to exercise the shoulders.

A bad shoulder not only results in a bad posture but also prevents you from doing day to day activities. Hence it is necessary to take care of your shoulders and exercise daily to improve the mobility. In case you have a concern or query you can always consult an expert & get answers to your questions!

A small piece of bone is known as a fragment and it is very common that an avulsion fracture also tends to damage the protrusions of bone to which the tendons attach. This basically means that the tendon or ligament will come away from the bone and it will take a small piece of bone with it. It is sometimes very hard to find out what type of injury you have and this is why knowing the causes and symptoms of an avulsion fracture are very helpful in determining exactly how severe the injury is. 

Here are the causes of an avulsion fracture:

1. Explosive landing: Athletes who tend to jump or land with great impact tend to get these most commonly. Therefore, it is crucial for your health that if you participate in such sports, you do follow the correct method of jumping.
2. Explosive extension: Similar to how an athlete landing ferociously can get an avulsion fracture, someone who is extending the legs very violently and explosively during an exercise can also get an avulsion fracture. This is because the bone getting extended could very well damage the protrusions to which the tendons are attached. 

Symptoms
These are the two main causes of an avulsion fracture. There are not many symptoms of an avulsion fracture. This is because an avulsion fracture can only be determined by an MRI or by an X-ray scan. Therefore it is nearly impossible to diagnose that you have an avulsion fracture without looking at the results of the tests performed on the part of your body. However, the way you got the fracture and especially the details of it are very good indications of whether you have an avulsion fracture or not.