Lybrate.com has a number of highly qualified Physiotherapists in India. You will find Physiotherapists with more than 33 years of experience on Lybrate.com. You can find Physiotherapists online in Gurgaon and from across India. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment with Dr. Nice Joseph
Spinal Surgery Disorders
Treatment of Neurological Problems
Treatment of Nerve And Muscle Disorders
Treatment of Hip Disorders
Neuro Physiotherapy Treatment
Treatment of Knee Injury
Pregnancy Exercise Therapy
Treatment of Sports Injuries
Treatment of Splinting
Treatment of Spondylosis
Arthritis And Pain Management Treatment
Heat Therapy Treatment
Post Pregnancy Classes
Orthopedic Physical Therapy
Treatment of Shin Splints
Submit a review for Dr. Nice JosephYour feedback matters!
Patient Review Highlights
Last month I did my full body health check .In my report my vitamin D count is 6.2 .I am feeling low nowadays and feeling pain in my legs .please help me out.
Hello Lybrate doctors Below I am mentioning my case please go through it I had a lateral malleolus fracture in my left feet. I had plaster for 4 weeks plus bed rest. After that also I had rested for 2 more weeks. The duration on plaster was 29 apr 17 to last date of may. After 6 weeks of rest I had started going to office. At first two months I felt very much problem in my knee muscle which unable me toh walk properly. I had visited doctor said the pain will come and go. But the whole recovery will take 3-4 months. I am 85 kgs. Now I am walking great but when my injured feet got tired it signal me through little tired pain. I can travel upstairs easily but unable toh walk down. What can I do to heel the pain? What exercises can I do without putting much stress in my that feet. Please help me.
Shoulder pain and injuries
The shoulder is a ball-and-socket joint that has three main bones: the humerus (long arm bone), the clavicle (collarbone), and the scapula (also known as the shoulder blade). These bones are cushioned by a layer of cartilage
The shoulder joint is a very mobile joint which makes it very susceptible to injury. It moves the shoulder forward and backward. It also allows the arm to move in a circular motion, and to move up and away from the body.
Shoulders get their range of motion from the rotator cuff. The rotator cuff is made up of four tendons. Tendons are the tissues that connect muscles to bone. It may be painful or difficult to lift your arm over your head if the tendons or bones around the rotator cuff are damaged or swollen.
You can injure your shoulder by performing manual labor, playing sports, or even by repetitive movement. Certain diseases can bring about pain that travels to the shoulder. These include diseases of the cervical spine of the neck, as well as liver, heart, or gallbladder disease.
You're more likely to have problems with your shoulder as you grow older. It is especially common after age 60. This is because the soft tissues surrounding the shoulder tend to degenerate with age.
Most shoulder pain problems are:
- tendonitis/bursitis, injury or instability of the joint, or arthritic disease.
- rotator cuff syndrome is a strain or sprain or tear of the tendons that make up the rotator cuff.
- rarely, tumors, infections, and nerve damage cause shoulder pain.
- much neck pain is caused by soft tissue damage due to injuries such as whiplash or wear and tear due to overuse.
- damage to spine joints and bones, such as cervical disk degeneration, arthritis, or traumatic injury can cause severe pain and disability.
- fibromyalgia (whole body pain syndrome) can contribute to neck and upper back pain. Poor posture while performing everyday activities can also cause significant neck pain. Rarely, infections or tumors will cause neck pain.
- pinching a nerve in the neck or shoulder, or breaking a shoulder or arm bone, are also causes of pain.
- a frozen shoulder is when tendons, ligaments, and muscles stiffen and become difficult or impossible to move.
- a dislocated shoulder is when the ball of the humerus pulls out of the shoulder socket. An injury due to overuse or repetitive use can cause injury
A work environment that's good for the body is very important. Most of us spend hours each day sitting in front of our computer.
The first step to creating an ergonomic workstation is to consider how you spend most of your time at the workstation.
How physiotherapy can help through pregnancy and after pregnancy:
Pregnancy and childbirth throw a woman's daily routine out for a toss. During and after pregnancy is the time when her body undergoes a number of hormonal and physical changes. Mundane tasks like sitting, standing, walking, and working become a challenge.
Research suggests that almost all pregnant women experience musculoskeletal discomfort but around 25% become temporarily disabled because of it. All these occur due to the incredible changes taking place in the body during a normal pregnancy.
Pregnancy discomfort has been accepted as a part of the normal process of pregnancy for years now. But just because you are pregnant does not necessarily mean that you have to accept problems like a backache and pelvic girdle pain as unmanageable. Doctors of today have realized that physiotherapy is the key to enhancing a woman's health during pregnancy. The main aim of physiotherapy is to reduce discomfort, to prepare the body for delivery and to speed-up recovery after childbirth.
Physiotherapy through pregnancy
The basic aim of physiotherapy during pregnancy is to help the body deal with issues related to mobility, musculature, circulation and respiration. Prior to starting an effective antenatal (before birth) program, a thorough evaluation is done to recognize which exercises would be best suited to the woman's needs. These exercises are aimed at strengthening muscles,
decreasing joint pain, correcting muscle imbalances, and increasing the overall range of motion of the body. Therapists may also advise you about correct sleeping positions as your normal sleeping routine may be disturbed during pregnancy.
Here's how physiotherapy deals with some common complaints experienced by women during pregnancy.
Lower back pain: almost all pregnant women experience low back pain, though it tends to become severe after third trimester begins because the woman's centre-of-gravity shifts due to the increase in the stomach size. Lower back pain is treated with manual and passive physiotherapy, back support, postural education, and some pilates exercises. Home exercises are also taught which the women are encouraged to continue at home.
Pain in the sacroiliac joints: sacroiliac joints are present in the lowest region of the lower back. This pain is usually concentrated in the buttock region. During pregnancy, due to excessive hormone release, the body's connective tissues tend to relax so that the muscles can stretch to aid in delivery. This may cause the sacroiliac muscles and ligaments to become excessively mobile, causing extreme joint movements. Due to this, the woman may experience difficulty in lifting the leg, swelling in the joints, pain in the hips, and difficulty while standing and sitting. Strengthening exercises are provided by the physiotherapist to stabilize the joints and hands-on therapy is given to reduce the pain by realigning the pelvis.
Urinary incontinence (due to pelvic floor weakness): progesterone, which is known as the pregnancy hormone, relaxes the muscles of the pelvic floor in order for it to be supple and ready for delivery. Therefore, these muscles can weaken and strain during pregnancy and childbirth, which leads to urinary incontinence (unable to contain or retain urine) and pelvic floor dysfunction. Physiotherapists will teach you strengthening exercises to strengthen the pelvic floor muscles. They may also provide you with a pilates based exercise program to help reduce the muscle weakness that may occur after childbirth.
Sciatica: sciatica is a problem that a lot of pregnant women experience. Continuous pressure or strain on the sciatic nerve can lead to backache, and weakness, numbness and tingling in the leg or associated areas. Physiotherapy uses stretching exercises and manual therapy to relieve you of these symptoms.
Carpal tunnel syndrome: this condition is caused due to build-up of excessive fluid resulting in swelling in the carpal tunnel in the wrist. You may experience symptoms like pain, numbness, tingling, and loss of coordination in your hands and fingers. Physiotherapy techniques such as mobilization, strengthening exercises, stretching, and soft tissue techniques help to reduce these symptoms. In severe cases, a wrist brace may be provided to put on during specific activities to minimize inflammation.
Physiotherapy after pregnancy
Physiotherapy does not stop once your baby is born. It is very much part of post-natal care too. Gentle physiotherapy exercises must be started two days after the baby's birth. However, this must only be done after consulting with your doctor. Most hospitals have physiotherapists who will offer their services before you are discharged. For the first six weeks after childbirth, your body is still in the recovery phase and walking is the best exercise for you. Start with short walks, and then slowly increase time, distance, and speed of your walks, according to your comfort. Swimming is another good exercise, but you can only start with this after you have recovered properly. If you experience any pain and discomfort, discontinue the activity immediately and consult your doctor. After six weeks, with the go-ahead from your doctor, you can start with sports and exercise classes.
Women also experience certain post-natal complications. Here is how physiotherapy helps you recover from them.
Low back pain: physiotherapy techniques such mobilization, stretching, strengthening, soft tissue techniques, and hydrotherapy are very beneficial in reliving post-natal backache. Certain pilates exercises are also helpful.
Weakness of pelvic floor muscles: immediately after childbirth, the pelvic floor muscles are weakened. These muscles can be strengthened by pilates based exercise program and other exercises specific to pelvic floor muscle strengthening, which the physiotherapist will teach you.
Sacroiliac joint pain: this pain can continue after pregnancy too. Strengthening exercises and hydrotherapy can help in regaining normal muscle tone.
Diastasis recti or abdominal separation: generally this condition occurs in women who have undergone multiple pregnancies. A physiotherapist will provide you strengthening exercises to strengthen the abdominal muscles.
A woman's body undergoes incredible strain during pregnancy, and physiotherapy is something that can make the entire process so much easier. It aims not only at your recovery but enhances your body's ability to have a smooth and easy delivery. Physiotherapy makes the experience of pregnancy positive and joyful, just as it should be.
For public interest - one who is suffering from prolapse intervertebral disc (pivd) either cervical or lumbar region not to go for any type of surgical procedure, it is not at all success, if doing surgery initially there will be little relief, after some time the chronic pain relapse, which is beyond the scope of any surgery. So I advise sufferers to go to a qualified physiotherapist and treated by the manual therapy procedure at any stage of pivd. For pivd no choice of surgery, it is a self-healing procedure with physical agents is the best choice.
Chondromalacia patella (patellofemoral syndrome)
Chondromalacia patella facts
chondromalacia patella is the most common cause of chronic knee pain.
chondromalacia patella has also been called patellofemoral syndrome.
the pain of chondromalacia patella is aggravated by activity or prolonged sitting with bent knees.
abnormal 'tracking' allows the kneecap (patella) to grate over the lower end of the thighbone (femur), causing chronic inflammation and pain.
treatment involves improving the alignment of the patella during contraction of the thigh muscle.
What is the chondromalacia patella?
Chondromalacia patella is abnormal softening of the cartilage of the underside the kneecap (patella). It is a cause of pain in the front of the knee (anterior knee pain). Chondromalacia patella is one of the most common causes of chronic knee pain. Chondromalacia patella results from degeneration of cartilage due to poor alignment of the kneecap (patella) as it slides over the lower end of the thighbone (femur). This process is sometimes referred to as a patellofemoral syndrome.
What causes chondromalacia patella?
The patella (kneecap) is normally pulled over the end of the femur in a straight line by the quadriceps (thigh) muscle. Patients with chondromalacia patella frequently have abnormal patellar' tracking' toward the lateral (outer) side of the femur. This slightly off-kilter pathway allows the undersurface of the patella to grate along the femur, causing chronic inflammation and pain. Certain individuals are predisposed to develop chondromalacia patella: females, knock-kneed or flat-footed runners, or those with an unusually shaped patella undersurface.
What are the symptoms and signs of chondromalacia patella?
The symptoms of chondromalacia patella are generally a vague discomfort of the inner front of the knee, aggravated by activity (running, jumping, climbing or descending stairs) or by prolonged sitting with knees in a moderately bent position (the so-called' theater sign' of pain upon arising from a desk or theater seat). Some patients may also have a vague sense of 'tightness' or 'fullness' in the knee area. Occasionally, if chronic symptoms are ignored, the associated loss of quadriceps (thigh) muscle strength may cause the leg to 'give out' besides an obvious reduction in quadriceps muscle mass, mild swelling of the knee area may occur.
How is chondromalacia patella diagnosed?
Chondromalacia patella is suspected in a person with anterior knee pain, especially in teenage females or young adults. With manual compression of the kneecap, while the quadriceps muscle is tightened, there can be pain. This is referred to as the positive 'shrug' sign. Generally, there is no associated swelling (knee joint effusion).
X-rays or MRIs may be done to confirm the inflammation on the posterior part of the patella.
7 days flat belly diet plan
For people who have lost their shape can get back into shape for which a perfect plan has to be cut out, it has to be planned in such a way that this plan will enable losing all the unnecessary fat. It has to be understood that this diet plan which is being etched will not include any harmful food which will promote the body in storing fat which usually means foods like sugar, processed foods and alcohol.
This plan which is being made up usually includes foods like lean meat, fish, chicken, turkey and some fresh vegetables, the main part of this plan is that it has been cut out thinking that the body is usually lean and fit nothing like a fat and lazy one. Processed foods are known to contaminate the body forcing additional fat to be stuck at the usually flat stomach, hips, thighs and bum but for the body to quickly lose all the unnecessary fat it is necessary to stop intake of these foods which pollute the body.
Though all the processed food is cut down it is also necessary to first believe that you can do it that have to be supported by some changes to the diet in order to get a flat belly at a faster rate.
Avoid junk food: Keep distance from four main foods which are known to the prime ones to force fat onto the body which are caffeine, refined sugar, alcohol and processed foods. Indulge in fat food weekly once. There is no harm done to the body if any fancy food can be eaten once a week as long as it is not too much and rest of the time only healthy food has to be chosen. Consume fish oil: this is known to burn excessive fat and provide with all the necessary fatty acids. Make breakfast compulsory: breakfast has to be eaten just after an hour from when you wake up and if there is not much time left for breakfast go with nuts and fresh fruits. Say no to heavy meals after 8 pm: do not entertain heavy meals in the evening especially if the body is having a feeling of being slow down.
Apart from the changes made to diet, it is also necessary to indulge in physical activity which also has to be done in a smarter way rather than getting it done in a harder way. For those who are going to exercises should see that they will get more out of less rather than going with exercise throughout the day, hence, here we give you moves to get flat belly which is known to work on the reduction of stress hormones in body which are known to mainly affect middle part of the body.
This is a type of physical activity which is known to have positive results for those trying to get rid of their belly fat, for which the steps are given below that will ensure proper procedure to do this exercise.
Slowly work this exercise which has to be repeated for about 10 minutes. Lower your bottom down as far as is possible by inhaling through the nose after waiting for some time exhale slowly then come back up while inhaling at the same time.
This is the exercise which is known to be great for those suffering from digestion which needs breathing to be done slowly and repeated for 20 times
Stand with feet shoulder-width apart and arms in front while the palms are facing down. Inhale while pulling the hands back towards the shoulder. Exhale while pushing the arms back into its starting position.
This physical exercise is known to work great for those who want to attain lower abs which have to be repeated 10 times.
Lie down on the back with feet on the floor while the knees are best to inhale and then bring knees into chest while exhaling at the same time. Inhale once again while returning the feet to floor.
Here is a 7-day plan which will help in losing weight and is suggested to begin on the weekend that also provides with sufficient time to get everything all set to go on a weight loss regime that can proceed for two weeks.
So here goes the plan:
Breakfast: prepare omelet with three egg whites and fill it with 75g of spinach and pepper mixture.
Mid-morning snack: sliced red pepper with 100g chicken
Lunch: salad made with grilled chicken breast, red pepper, mixed salad leaves, tbsp olive oil and green beans.
Mid-afternoon snack: Sliced cucumber with 100g turkey breast
Dinner: Steamed broccoli with 100g grilled chicken breast
Breakfast: stir-fried kale with baked chicken breast
Mid-morning snack: sliced green pepper with 100g turkey breast
Lunch: mixed green salad with tbsp olive oil with baked haddock fillet
Mid-afternoon snack: 75g steamed broccoli with 100g turkey breast
Dinner: salmon steak accompanied by steamed green beans and chopped dill
Breakfast: spinach with 100g smoked salmon
Mid-morning snack: sliced yellow pepper with 100g chicken breast
Lunch: garden salad with tbsp olive oil with one grilled chicken breast
Mid-afternoon snack: avocado with 100g turkey slices
Dinner: steamed spinach, broccoli with cutlets or grilled lamb steak
Breakfast: green beans, tomatoes and scrambled eggs made with one whole and two whites
Mid-morning snack: sliced cucumbers with 100g turkey slices
Lunch: salad, tbsp olive oil, spinach, baked cod fillet, tomato
Mid-afternoon snack: grilled courgette and 100g chicken breast
Dinner: tbsp oil with green veg and stir fried 100g chicken breast
Breakfast: sliced avocado with sliced cucumber and 200g turkey breast
Mid-morning snack: sliced red pepper with two boiled eggs
Lunch: mixed green salad with tbsp olive oil, tomatoes and 150g grilled prawns
Mid-afternoon snack: five almonds with 100g turkey breast
Dinner: steamed broccoli with 100g chicken breast
Breakfast: roasted courgettes and peppers with grilled haddock fillet
Mid-morning snack: sliced tomato with 100g chicken
Lunch: green salad with tbsp olive oil and steamed broccoli accompanied by 150g turkey
Mid-afternoon snack: 5 pecan nuts with 100g chicken
Dinner: steamed broccoli, green beans with 150g to 200g steak
Breakfast: steamed spinach, grilled tomatoes and omelette with three egg whites
Mid-morning snack: 5 brazil nuts with 100g turkey
Lunch: steamed asparagus, green salad with 150g chicken breast
Mid-afternoon snack: sliced cucumber with 100g turkey
Dinner: steamed broccoli or orientals with grilled duck breast.
Sprain vs. Strain
Sprains and strains are common injuries to the musculoskeletal system. Although these two words are often used interchangeably, they are different types of injuries.
What is a sprain?
A sprain is an injury involving the stretching or tearing of a ligament (tissue that connects bone to bone) or a joint capsule, which help provide joint stability. A severely damaged ligament or joint capsule can cause instability in a joint. Symptoms may include pain, inflammation, and in some cases, the inability to move a limb (arm, leg, foot). Sprains occur when a joint is forced beyond its normal range of motion, such as turning or rolling your ankle.
What is a strain?
Strains are injuries that involve the stretching or tearing of a musculo-tendinous (muscle and tendon) structure. An acute (instant or recent) strain of the musculo-tendinous structure occurs at the junction where the muscle is becoming a tendon. These strains take place when a muscle is stretched and suddenly contracts, as with running or jumping. This type of injury is frequently seen in runners who strain their hamstrings. Many times the injury will occur suddenly while the runner is in full stride.
Symptoms for an acute muscle strain may include:
- muscle spasm
- loss of strength
- limited range of motion
Chronic (long-lasting) strains are injuries that gradually build up from overuse or repetitive stress, resulting in tendinitis (inflammation of a tendon). For example, a tennis player may get tendinitis in his or her shoulder as the result of constant stress from repeated serves.
Severity of sprains and strains
A physician categorizes sprains and strains according to severity. A grade I (mild) sprain or strain involves some stretching or minor tearing of a ligament or muscle. A grade ii (moderate) sprain or strain is a ligament or muscle that is partially torn but still intact. A grade iii (severe) sprain or strain means that the ligament or muscle is completely torn, resulting in joint instability.
Grade I injuries usually heal quickly with rest, ice, compression, and elevation (rice). Therapeutic exercise can also help restore strength and flexibility. Grade ii injuries are treated similarly but may require immobilization of the injured area to permit healing. Grade iii sprains and strains usually require immobilization and possibly surgery to restore function.
The key to recovery is an early evaluation by a medical professional. Once the injury has been determined, a treatment plan can be developed. With proper care, most sprains and strains will heal without long-term side effects.