Dr. Aparna Pradhan

Chronic muscle pain, especially in the neck and spinal areas, is today quite prevalent in many patients. When every other treatment fails matrix works-

How does it work? when there is pain - patient runs for doctors,
 They examine and suggest for mri, degeneration of disc is seen or slip disc is seen, despite of good physiotherapy and pain killers some cases don't come up with results.

Those patient have multiple joint pain, we treat then for neck & patient complaints for lower back pain. These patient have myofacial syndrome -specially when they say' I have morning stiffness slowly as day goes I feel better.

Theses patients develop myofacial tightness due to wrong posture and sedentary lifestyle or nutritional deficiency.
Now how to work on in these cases we try to give these patients release technique with matrix therapy, first we mobilize fascia which is above muscle & free underlying structures. Once muscles are functioning better we give exercise to correct forces on bone. Patient feels better consecutive sittings.

Little about therapy does wonders for us-

Matrix is an innovative therapeutic approach it is based on the scientific fact that the all cells of biological systems vibrate rhythmically as long as they are alive

Recommended for:

– acute or chronic upper, medium or lower back pain
– headaches – migraines
– tennis elbow
– frozen shoulder syndrome
– sleeping disorders
– fibromyalgia
– swelling
– cellulitis
– sciatic syndrome
– carpal canal syndrome

 Neurological conditions

Matrix therapy is very helpful for the rehabilitation of patients with neurological conditions. For spasticity and tightness in cases of neurological disorders. Control the further deterioration of the condition and functions.

Neurological conditions

• Stroke-
• Brain tumor operation
• Craniocerebral trauma
• Incomplete spinal cord injury
• Cerebral palsy
• Multiple sclerosis
• Parkinson
• Motor neuron disease
• Acute and chronic pain episodes, e. G. Migraine.

The after effects of any surgery can be harsh on the body. Post knee replacement surgery, one will need to remain in a straight and relaxed position for a long time due to the bed rest prescribed by the orthopaedic specialist. Yet, it is important to carry out some kind of activity after the surgery so as to make the knee strong, firm and ready to be normal again.

Here are a few physiotherapy exercises that can help post knee replacement patients: 

1. Pumps and Circles: Ankle pumps and circles should be done in sets of ten per direction. This can help in ensuring that the blood circulation and nerve function normalise within no time after the surgery. This action is especially helpful because it affects the heels, calves and leg muscles before reaching the knee. Ensure that you rotate each foot clockwise and the counter clockwise. 
2. Thigh Squeeze: The thigh squeeze is an excellent want to ensure that you are working the muscles of the legs without putting undue pressure on the knees. This is especially helpful when you have been advised bed rest. This motion involves squeezing and releasing the thighs so that there is some amount of firmness that is being built along with strength and stamina. You can hold the squeeze for five to ten seconds before you relax and try again.
3. Heel Slide: The heel slide is a good option for those who are going through bed rest. This exercise ensures that you work your knee in a suitable way as the bending motion gets the knee to get used to being functional again. Due to the posture of the patient, this does not put pressure on the knee. Slowly bring your heel up, stop and then slide it down. Repeat at least ten times for each knee before increasing it to twenty times. 
4. Kicks: While you are lying down, you can render small kicks into the air. Repeat at least ten times for each leg before increasing it gradually to twenty kicks per leg. This should be done when you are lying flat on your back. This exercise can help in flexing and strengthening your quadriceps. Hold the kick for at least five to ten seconds before you relax and repeat with the other leg. 
5. Sitting Flex: You can also sit in a chair and flex your knee, holding the leg out in front of you for at least five to ten seconds, before slowly bringing it down and lifting again. This will help in strengthening the thigh and knee to a great extent.

You will need to exercise regularly in order to recover well after a knee replacement procedure.

Being flexible is not always about doing splits or doing some random bending. It is about achieving a level of mobility that will not hold you back from doing whatever you are able to do. Most people think that stretching or flexing your muscles and body as the first method to defend you from pain. But if stretching and flexing can be done correctly, it can lengthen one's muscles and give one relief from pains and aches. Stretching is also done to increase the functional range of one's joints and muscles. There are various ways by which one can stretch their muscles. However, the question which looms over here is which is the correct procedure and which is the wrong one.

The wrong vs the right Way: Before discussing about the correct way, let us talk about the various wrong ways in which stretching can be done. The first rule is that if stretching is causing you pain or if it is hurting you, then you are probably taking it too far. A muscle needs to relax as much as possible, if it needs to stretch. If one is stretching so hard that he or she cannot relax then the muscle will not lengthen. Stretching should never be painful.

One should also avoid stretching for an insufficient length of time. Only a few seconds of stretching will not hold the therapeutic effects of stretching.

The following methods are few of the correct ways to stretch:

1. Always start with the warm muscles. Warm your muscles by doing some aerobic movement or by applying heat with the help of a warm bath.
2. After warming your muscles, monitor your level of discomfort. Let it go once you feel pain.
3. Hold any stretch for at least 30 seconds.

Stretching the Correct Muscle: There are muscles, which need to be stretched and there are muscles, which should not be. So getting to know the correct muscles to be stretched is as important as knowing the correct procedure to stretch your muscles. Every muscle, which does not hurt should not be stretched. There are different types of muscles that cause pain like stiff, tight, short muscles and long muscles. Muscles that are tight should only be subjected to stretching. Stretching muscles that are too long is not a good idea.

Using Physiotherapists: Most people who cannot determine which muscle should be stretched and which should not be, should consult a physiotherapist. Physiotherapists can quickly and easily diagnose muscular issues. They will also show ways to stretch which are most effective for particular needs.

Stretching should be made a part of one's life. It is a way by which one can become their healthiest self and avoid muscular imbalances. In case you have a concern or query you can always consult an expert & get answers to your questions!

The spine is a foundational structure of the human body that supports both the head and the neck. The neck is especially vulnerable to the damaging effects of poor posture because it’s influenced by the position of the skull as well as the curvature of the spine. 

 When the neck leans forward and the head is in front of the shoulders, the forward weight of the head can place considerable pressure on the vertebrae of the neck. This position, if held repeatedly for long periods of time, has been found to contribute to disc deterioration and other degenerative conditions.

Prolonged malposition of the spine or the head can put a fair amount of strain on neck muscles, causing them to become tight and tense. 
This muscle tension often leads to pain and stiffness. There are also several other muscles that are particularly susceptible to damage caused by strain. 

These muscles are- 

1- scalene muscles
2-suboccipital muscles 
 3-levator scapulae muscles. 

A forward head position also places strain on the upper back and shoulder muscles. Excessive muscle strain is a common culprit for recurring back pain.

The results of poor posture-

If left uncorrected over time, poor posture can lead to numerous long-term problems. Improper posture can begin to irritate the ligaments, joints and soft tissues in and surrounding the neck. 

Irritation could contribute to the development of osteoarthritis, disc herniation or degenerative disc disease. It may also cause decreased range of motion and the development of painful trigger points (areas of muscle that are extremely sensitive to touch).

How physiotherapy can help?

Treatment of neck problems involves identifying and managing the underlying causes present.

 Physiotherapy treatment includes- mobilization and/or manipulation techniques, stretching and strengthening of the neck musculature, soft tissue therapy and trigger pointing, heat therapy, cryotherapy, postural correction, acupuncture, ultrasound and pilates.

 Manual therapy techniques are used to loosen joint and soft tissue restrictions, while posture correction and specific and how to prevent recurrences. 

The majority of neck pain sufferers tend to work at desks; therefore, optimising this environment through ergonomic assessment is often the key to successful management of this problem.

Repetitive strain injury is most commonly an occupational health hazard. The term repetitive strain injury (RSI) is used to describe a range of painful conditions of the muscles, tendons and other soft tissues. Repetitive strain injury (RSI) is a condition where pain and other symptoms occur in an area of the body which has done repetitive tasks (often the arms or hands). It is usually related to an occupation and is one of the most common work injuries, but leisure activities can also be a cause. Unlike a normal strain following a sudden injury, symptoms of RSI can persist well beyond the time it would take symptoms of normal strain injuries to ease.

What Causes Repetitive Strain Injury?

• Poor posture while performing repetitive movements

• Excessive force while performing repetitive movements

• Not having enough breaks 

  Symptoms in the affected area can include:

• Pain

• Tightness

• Dull ache

• Throbbing

• Numbness

• Tingling

• Weakness

• Cramping

• Stiffness

The symptoms tend to develop gradually. At first the symptoms may only occur whilst you do the repetitive task, and ease off when you rest. In time the symptoms can be present all the time – but tend to be madeworse by doing the repetitive task. Symptoms can range from mild to severe.

What Can Recovery Physio Do To Help You With RSI?

Early intervention is very important with RSI, and it is best to address these problems within 2 months of the first sign of symptoms.

• Muscle stretches

• Strengthening exercises

• Gentle joint manipulation to free the affected joints

• Electrotherapy and/or acupuncture to help relieve the pain

Physiotherapy heals gently and slowly.No medication / non surgical way of treating spine 

What causes a slip (herniated) disc?

Violent injury or the normal aging process or by everyday activities- lifting heavy objects the wrong way, stretching too hard during a sports activity, commonly happens in neck (cervical spine) or lower back (lumbar spine).

How can physiotherapy reduce pain and disc pressure? 

To know how does physiotherapy helps first we need know about the occurrence of events at spine after prolapsed disc.

Whenever disc herniation occurs muscles try to protect slip of the disc as a result there is sudden muscles spasm because of which there sudden onset of pain and slipped disc also causes lot of inflammation when it presses surrounding ligaments and vessels. Situation worsens when person tries to move with stiff back more pain results due to wrong movement of muscle.

If pain killers are taken then till an extent they help to reduce inflammation and spasm, but prolapsed disc is mechanical problem. Compression on ligaments and occlusion of blood vessel persists. Pain comes back on stopping pain killers.

Physiotherapy works on the disc compression by correcting the alignment (posture). With manual therapy (mobilization) and electrotherapy instruments compression and pain reduces.

For, exercises are prescribed in opposite direction of disc compression so further compression can be reduced and strong muscles can support the spine inefficient way. Physical therapy works on the cause of the pain, not just suppresses it.

Lateral epicondylitis (tennis elbow) is inflammation of the tendons that extend the hand backward and away from the palm.

Factors that increase having- 

1-weak shoulder and forearm muscles.

2-playing with a racket that is too tightly strung

3-too short, hitting the ball off center on the racket (out of the sweet spot)

4-hitting heavy, wet balls.
 
Hitting backhanded and allowing the wrist to bend increase the chance of developing lateral epicondylitis.

Treatment -

1-ice is applied to the outer elbow, and exercises that cause pain are avoided.

2- use of a tennis elbow brace (usually for a few weeks as per your physio's advice) can be beneficial. 

3 - ultrasound if swelling visible, tens is also very helpful in combination with ultra sound.

4- as pain decreases, elbow and wrist flexibility and strengthening exercises can be started.

In addition to this conventional treatment of physiotherapy our clinic also has shockwave therapy. One sitting treatment. 

Hormones such as oestrogen, testosterone, adrenaline and insulin are extremely important chemical messengers. The entire endocrine system works together to control the level of hormones circulating throughout body is slightly imbalanced it can cause widespread, major health problems.

Some specific problems associated with some of the most common hormonal imbalances include:

Estrogen dominance: Changes in sleep patterns, changes in weight and appetite, higher perceived stress, slowed metabolism polycystic 

Ovarian syndrome (pcos): Infertility, weight gain, higher risk for diabetes, acne, abnormal hair growth

Low estrogen: Low sex drive, reproductive problems, menstrual irregularity, changes in mood hypothyroidism: slowed metabolism, weight gain, fatigue, anxiety, irritability, digestive issues, irregular periods

Low testosterone: Erectile dysfunction, muscle loss, weight gain, fatigue, mood-related problems

Hyperthyroidism and grave’s disease: Anxiety, thinning hair, weight loss, ibs, trouble sleeping, irregular heartbeats

Diabetes: Weight gain, nerve damage (neuropathy), higher risk for vision loss, fatigue, trouble breathing, dry mouth, skin problems

Adrenal fatigue: Fatigue, muscle aches and pains, anxiety and depression, trouble sleeping, brain fog, reproductive problems here are three main tools to help achieve this enjoyable state of being: breathing exercises, quiet self-reflection, and exercise.

First, it should be understood that exercise is like medicine and is very specific for each person &most accessible tool for most people.

Effects of exercise on endocrine system - 

During exercise, the pituitary gland releases human growth hormone, which tells the body to increase bone, muscle and tissue production & thyroid gland sends out hormones that regulate the body's temperature, heart rate and blood pressure.

Exercises for the growth of hormone, bone, muscle tissue production and metabolic rate

Heavy weightlifting, stimulates the release of luteinizing hormone in brain which triggers testosterone production, also stimulates the release of thyroxine from thyroid gland. Testosterone and thyroxine speed up your metabolism so one can lose weight.

Exercise for luteinizing hormone, testosterone, thyroxine and weight reduction

Blood sugar insulin, a hormone transports blood sugar to muscles for energy. Excessive insulin reduces sensitivity to insulin & leads to diabetes. Exercise increases insulin sensitivity by its uptake by muscles. Blood insulin decreases after 10 minutes of aerobic exercise, and weight training increases sensitivity to insulin at rest.

Blood flow: Adrenal medulla releases epinephrine during exercise level increase at higher exercise intensities. This hormone controls amount of blood that heart pumps, also enhances ability to use muscles during exercise by widening blood vessels and muscles get more oxygen-rich blood.

Thyroxine hormone: Increases during exercise which increases amount of blood in body by about 30 %, and secretions might remain elevated for around five hours 

Psychological effects: Works as anti-depressant, exercise-induced testosterone might increase confidence and libido. Low testosterone levels might inhibit your motivation, self-confidence, concentration, memory.

Your pituitary gland produces endorphin (happy hormone) levels shortly after exercise begins. 

Activities for hormone health

Reduce sitting time: Most of us sit for far too long, but it just takes a few habit changes to make it less damaging to our health (and hormones)

Walk and talk: Instead of coffee shop meet up, arrange a walking meeting mobile walk with it set an alarm phone or computer to get up and take a quick break.

Find what kind of exercise and how much of it is best for maintaining a healthy hormone balance.

Free gym: Stairs, park, squats while you are watching tv walking out improves mood and feeling calmer.

HIIT: High intensity interval training (or ‘burst’ training) has been shown to burn fat more effectively than aerobic exercise. Good for strengthening lungs and heart, raises human growth hormone (hgh), the hormone, abundant when we are young, declines rapidly as we age. Improves insulin sensitivity, a great result for waistline and risk of serious disease.

Ask for metabolic aftershock programme to your physio :

Resistance and weights: Muscle mass declines with aging (at a rapid rate if no strength training done ever). The more muscle we have the more calories are burnt, day and night, reducing fat stores. High cortisol has a negative effect on muscle mass, so building muscle is really important if you’re over stressed. Not necessary to go to gym! weight training at home will helps. Fat / muscle ratio is what we are aiming to improve (note- you may not see weight loss if you are increasing muscle to fat).

Strength training also lowers risk of osteoporosis, especially at menopause.

Yoga and pilates- They improve flexibility, strength, posture, stress & mood. It’s the ultimate anti-ageing exercise! when one does yoga, focusing on the pose it is impossible to think about anything else, plus strengthening body at the same time is a great thing to do.

Relaxation technique- Stress, be it physical, emotional or environmental, can threaten a body's homeostasis. Certain endocrine glands secrete hormones that help the body respond to stress, but the function is meant to be short term. Extended secretion may weaken the body's defences, leaving room for infection, or even result in high blood pressure or a lack of cortisol and other steroid hormones. Long-term, this lack can lead to organ damage and even failure· 

Relaxation methods can include meditation activities such as walking, painting or knitting · anything calm and repetitive or focusing for a few minutes on breathing deeply or finding a quiet place to lie down and calm your heart beat. 

Sleep and hormone- Sleep is a good way to relax and calm down brain.

The amount of sleep you need to function best varies among individuals,

Adults -7 to 9 hr

Teens- 8.5 to 9.25 hr

Children- 5 to 10 - 10 to 11 hr

Preschoolchildren - 11 to 13 hr

Toddlersages 1 to 3 -12 to 14 hr

Infants- 14to 15 hrnew born -12 to 18 hr

Running is proven to be one of the most efficient forms of exercise as it has a ton of benefits attached to it. For instance, running helps you in maintaining your body weight by cutting down that unwanted or extra body fat, and helps in keeping you slim and trim. It also aids in improving your metabolism. Regular exercising will keep you energised, and increase your stamina.

Before starting with this physical activity, there are certain things you should know about. These are:

1. Be patient: Patience is key! Now, we all know that that nothing can change in a day. You won't notice any signs of improvement on the first day. So, the best thing to do is work out every single day with dedication, and you'll notice the results in a month or so.
2. Be Comfortable: It is very necessary to feel comfortable before you start your exercise. If you are going to run with your high heels or slippers on, it's never going to work out. So, it is very important to dress in your most comfortable attire before you start running.
3. Eat well: A healthy diet packed with all the essential nutrients is an absolute must if you plan to take up running as a regular exercise. Do not starve yourself at any cost or skip any meal. Running will take up a lot of your energy and a healthy diet is a must if you intend on being fit and strong.
4. Drink lots of water: It is very essential to drink lots of water and keep yourself hydrated throughout the day. Pro tip: Gulp down some water after your run, as we tend to lose water and minerals from our body in the form of sweat.
5. Run with music on: Recent studies have proven that running with music on is the better alternative. Music helps us focus more on our goal and also helps us stay calm.
6. Consistency: You have to be consistent in your workout and only then will you be able to notice a significant change in your health. Running at least once a day is recommended. Some people tend to run twice a day too, but that depends from person to person. Do not burden yourself too much. Running is an exhausting exercise and you should not force your body too much.
7. Calm your body and mind: Running or jogging in the morning can have a positive impact on you as it reduces stress and keeps you calm and sound throughout the day.

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