Child Learning Centre

Frozen shoulder (also known as adhesive capsulitis) is a condition in which the shoulder is stiff, painful, and has limited motion in all directions. A person suffering from a frozen shoulder can be pretty uncomfortable.

Frozen shoulder treatment should be done immediately once it has been detected. Stretching exercises are considered as the best-frozen shoulder treatment exercises. A proper warm up becomes very necessary before any exercise. Making the area warm by using a heating pad is one of the warm-up methods. However, a warm shower covers it all. Physiotherapy for frozen shoulder includes various exercises that should be first confirmed by a doctor. There are a number of exercises for frozen shoulder.

Some very important frozen shoulder exercises are listed below:

1. Pendulum Stretch: To start with, you can do the pendulum stretch. This dictates that the shoulders should be in a state of relaxation, initially, following which the arm which is affected should be allowed to hang down slightly. Once this is done, the arm is to be swung in a small circle i.e. about a foot in diameter. This is to be done consistently so that there can be a gradual improvement in the condition. As there is an improvement, the size of the circle can be increased and once the shoulder can take sufficient weight again, minor weights (up to five pounds) can be used.
2. Finger Walk: A simple exercise which can be done almost anywhere is the finger walk. What this exercise entails is that the person stands about three-fourths of an arm’s length away from a wall and then places his or her fingers on the wall itself, at around the level of the waist. The fingers are to crawl or walk up the wall till the point that it becomes a little uncomfortable. While this is just one repetition, after the fingers have been lowered, it is to be done again. In order to have the best results in combating frozen shoulder, the finger walk exercise is to be repeated about twenty times in a day.
3. Towel Stretches: Towels do not serve a greater role apart from drying up post a bath or over the course of a visit to the spa, right? Well, this is not really true due to the fact that they can be used to even help with frozen shoulder! Indeed, towel stretches done by holding the towel with each hand across one’s back. The arm which is normal should then pull the affected arm so it is stretched. As is the case with the finger walk, about 20 repetitions a day is ideal for good results.

If one goes a step forward and follows a regime of with all these exercises, the person suffering due to frozen shoulder will be back to normal in almost no time at all!

Rotator cuff constitutes the muscles and tendons that hold the shoulder in position. It is a crucial component of the shoulder as it helps in lifting the arm to complete any task. Repetitive actions, deterioration with age or an outstretched hand can lead to a sudden tear.

4 Important Things To Know About Rotator Cuff Repair
An injured rotator cuff can be repaired surgically. Arthroscopy and open surgery are among the techniques used to fix a tear of the rotator cuff surgically. An arthroscope is a tube-shaped apparatus made of a system of lenses, a light and a small video camera. The camera is linked with a monitoring system to view a joint via a tiny incision.

1. Before the surgery:

Blood tests and other diagnostic tests might be carried out by a healthcare provider to ensure that the patient is in good health prior to the procedure.

2. Things to inform the healthcare provider before the surgery-

The healthcare provider must be informed of a few things prior to the surgery:

• Details of allergy or reaction to latex, any medicines, tape or anaesthetic agents
• Information related to bleeding disorders or the intake of anticoagulant or blood-thinning medicines

3. Details of the procedure:
During the rotator cuff repair procedure, anaesthesia is administered as per the patient`s requirement. The details of the procedure are mentioned below:

• The patient is made to wear a gown.
• An intravenous (IV) line is started on the arm of one of the hands.
• The anaesthesiologist monitors various aspects such as the blood pressure, heart rate and blood oxygen level of the patient throughout the procedure.
• The skin above the surgical site is then cleansed, using an antiseptic solution.
• An incision is made in the shoulder area as per the kind of surgical procedure required such as open surgery or an arthroscopy.
• The arthroscope is then inserted via the incision.
• A graft tendon will be taken from another part of the patient’s body to repair the wounded tendons and muscles.
• Stitches or surgical staples are used to close the incisions after which a sterile bandage or dressing is applied.

4. After the procedure:

1. The sensation on the arm is monitored after the procedure. The patient can go home once his/her pulse, blood pressure and breathing are stable.
2. The surgical area must be kept dirt-free and dry after the procedure. A pain reliever is usually prescribed for soreness.
3. Arthroscopic rotator cuff repair is an effective treatment if a patient is not satisfied with alternative medical treatments, such as anti-inflammatory medicines and steroid injections. The procedure is usually done as part of the patient’s stay in a hospital or on an outpatient basis.

If you are about to undergo a knee replacement surgery, it is important to know the extent of pain that it involves, and the recovery period that follows. A knee replacement surgery is a major surgery, and a patient needs a lot of time to adjust to the replacement of his knee. The time of recovery depends on the patient and form of surgery that has been undertaken. The steps of recovery after a knee replacement surgery are as follows:

After surgery

• After the surgery, you will be given painkillers which you can self-administer using a switch. You may also require an oxygen mask or blood transfusion.
• You may require crutches and should walk within a frame. The ability to get back to walking without any help depends on the patient.
• You will be taught exercises for strengthening your knees in the hospital by a physiotherapist.
• It is likely for you to experience some initial discomfort during exercising and walking, as your legs may become swollen.
• Putting on a passive motion machine may be beneficial in restoring movement in your knees when you are lying in bed.
• It is likely for you to spend a period of three to five days in the hospital, based on your condition and its progress.
• An enhanced recovery program may be suggested by your surgeon in which you may start walking from the surgery day itself.

Recovery at home

• It is normal for you to feel tired and fatigued at home in the beginning. A knee replacement surgery is a major surgery, and the tissues and muscles around your knees require time to heal properly.
• You should arrange for a person who would help you while you go out for a few weeks after the surgery.
• It is very important for you to practice the exercises prescribed by your physiotherapist. This is a vital part of speedy recovery and you should not avoid them.
• You will be able to stop depending on crutches or walking frames and go back to your regular activities and schedule, six weeks after the surgery.
• The swelling and pain associated with the surgery may take around three months to depart.

The recovery process usually continues for two years after undergoing the surgery. During this period, scar tissue heals and your muscles get restored through exercises. It is recommended for you to avoid any kind of extreme sports or movements in which there is a risk of falling, such as mountain biking, or skiing.

If you are suffering from arthritis, it is important for you to know about how it affects your knee and other joints. Arthritis is a chronic, systematic inflammatory disease which damages your joints and connective tissues. Your knee is commonly affected by arthritis and there are three primary types of arthritis that occur in the knees. They include osteoarthritis, rheumatoid arthritis and post-traumatic arthritis.

Types of arthritis 
The different types of arthritis affecting the knees occur due to different reasons. Osteoarthritis is a progressive condition, which wears away the joint cartilage over time. Rheumatoid arthritis is an inflammatory condition, which may occur at any age. Post-traumatic arthritis occurs after an injury is inflicted to the knee and may occur several years after a ligament injury or knee fracture.

Major symptoms

1. Arthritis pain may occur all of a sudden but develops slowly. In the early stages, the pain is observed in the morning after you have been inactive over the night. Pain is likely when you want to move around. Pain may be experienced even when immobile.
2. Periodic inflammation is a common symptom of arthritis of the knee. This happens because of the formation of bone spurs or excess fluids in your knee. The swelling gets pronounced after being inactive for a long period. The skin on your knee may look red and feel warm while you touch it. This may lead to chronic inflammation, which is very difficult to manage.

Treatment
There are several ways of treating knee arthritis. The mode of treatment depends on the severity and cause of knee arthritis. NSAIDS or nonsteroidal anti-inflammatory drugs are commonly prescribed for dealing with arthritis pain temporarily. Other medicines used for knee arthritis treatment are as follows:

1. Analgesics, which help in pain reduction act as good alternatives to NSAIDS.
2. Corticosteroids are used for reducing inflammation.
3. Certain DMARDs or disease-modifying antirheumatic drugs are used.

Certain injections that are used for helping with knee arthritis. They include:

1. Hyaluronic acid supplements, which ease the pain and inflammation by lubricating your knee joints.
2. Corticosteroid injections also soothe inflammation and pain.

You may also require a surgery for dealing with knee arthritis when other modes of treatment fail. The most common surgeries are as follows:

1. Total joint replacement, where your knee is replaced with a prosthetic made of metal, plastic or ceramic.
2. Osteotomy, where the knee bones are modified for controlling pressure and damage in the knees.
3. Arthroscopy, where an incision is made in the knee for removing damaged parts.

It is recommended for you to consult a doctor, if you experience any symptom of knee arthritis. Early treatment will prevent the condition from worsening.

What is Articular Cartilage Injury? 
Cartilage is an important structural unit of the body. It is present in places like the joints, the spine, the end of ribs, in the bronchial tubes, and the ear and the nose. Cartilages are firm, but flexible tissues. There are many types of cartilages found in the body. Among them articular cartilages are the ones that are present on the surface of the bones. As the name suggests articular cartilages exist to render articulation to the bones and retain their lubrication. Complexities arise when these cartilages are damaged, behind which many causes can play an active role. For example, a sport injury can damage the cartilages around the knees. Other causes include the twisting of the Anterior cruciate ligament and a progressive knee injury. Articular Cartilage Injury can also be an isolated event. 

Since there are no blood vessels in the cartilages, it takes quite long for them to heal. Symptoms Pain and inflammation of the knee Locking of the knee Generation of noises when the knee is moved 

Treatment 
The best treatment option for damaged cartilages is RICE therapy if the injury is not too severe. rice can be broken down into Rest, Ice, Compression and Elevation. 

1. Rest: One needs to rest the affected area in order to prevent further injury. However, Rest does not indicate complete immobility. One needs to put as much strain as is within one’s capacity. 
2. Ice: Ice must be applied on the affected area every 15 minutes following injury for at least 48 hours. Ice works as a vasoconstrictor, as well as a pain reliever. 
3. Compression: The next step is wrapping a bandage around the affected area. But it is to be remembered that the compression must not be too tight. Compression reduces inflammation and it also safeguards the joint from injury. Professional help might be sought to properly bandage the area. 
4. Elevation: After the area has been bound well, the leg has to be raised to prevent the fluid from accumulating in the affected area. The leg must remain in that position for as long as the doctor recommends. 
5. Ibuprofen or pain killers might be prescribed to the patient. 

For severe cases, interventional methods like osteochondritis dissecans surgery might be attempted. The objective of this surgery is to attach the detached fragment. Another surgery that works to restore the damaged cartilage is marrow stem cell transplant whereby the stem cell is implanted in the cartilage defect. Multiple arthroscopic modalities of treatment are now available for cartilage repair which are customised according to the specific condition.

Have you suffered from a dislocated kneecap and are looking for effective treatment options? A dislocated kneecap is a very common form of injury that takes around six weeks time to heal. It is generally caused by a blow or a change in direction when your leg is planted on the ground. Such injuries are common during sports and dancing. The patella or knee cap, which sits at the front of the knee, glides over a groove in your joint, on straightening or bending your leg. Dislocations make it come out of the groove, leading to the tearing of the supporting tissues.

Symptoms

• When your kneecap gets dislocated, it is likely to look out of place, or the angle will seem odd.
• Other symptoms include severe knee pain, inability to walk, swelling of the knee, inability to straighten the knee, and a popping sensation in the knee.

Treatment

• A dislocated knee cap is not something very serious and it pops back in place on its own in many cases. However, it is recommended for you to get it diagnosed and treated by a health professional.
• In case your knee cap goes back into place on its own, you should visit a minor injuries unit or MIU, or an accident and emergency department.
• If your kneecap does not go back into place by itself, you need to call an ambulance and avoid trying to put it back in place by yourself.
• On the way to the hospital, or while you wait for the ambulance to arrive, you should sit, keeping your leg in a position that is most comfortable for you.
• If your kneecap does not correct itself by the time you reach a hospital, it has to be manipulated back in place by a doctor. This process is called reduction.
• You will be given medication to ensure that you keep relaxed and free from pain during the procedure.
• After the knee cap is put back in place, an X-ray has to be undertaken to check out if your bones are in the right position. Signs of other damages are also analysed.
• After the procedure, you will be prescribed painkillers. Your leg will be immobile and put in a removable splint for some time.
• For effective recovery, you should undergo physiotherapy for several weeks.

A surgery for a dislocated kneecap may only be required to be undertaken in case of a fracture or associated injuries like a ligament tear. A surgery may also be required in case you had experienced a knee cap dislocation in the past.