Low Stomach Acid Symptoms

Dr. Jyoti MongaBAMSAyurvedic Doctor

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"dear Lybrate user thanks for sending across your query. Pls get you ft3, ft4, tsh done to check weather levels are normal or you need to increase a decrease the dosage of medicine. 

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Dr. G.R. AgrawalDHMS (Hons.)Homeopathy Doctor

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Hi, lybrate user, •Go for meditation to reduce your stress to nourish your body including reproductive organs regulating blood  flow to penis to ease errectile disfunction. •Tk, Aloe Vera  juice,pomegranate juice , Banana ,water melon, apples, almonds, wallnuts and milk  inorder to improve testosterone level and to regulate blood flow towards penis increasing errection and libido. •Go for aerobics excercise, regulating blood circulation to your penile arteries to ease your distress. •Maintain, blood sugar and BP level in control. •Consult ,privetly for a faster recovery , till , then ,take,homoeopathic medicine ,underlying: @ Agnus cast Q-10 drops ,thrice with 2tsfl of normal water. •Avoid,junk food, alcohol and Nicotine. •Tk, care. 

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Dr. HariharanM.S.Ortho Post Graduation, Masters in Orthopaedic surgery , Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.), Medicine, P.G.D.M.C.H, DNB Orthopaedic SurgeryOrthopedic Doctor

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It is reversible 100 % with diet please contact mobile in what's app if you have gout, a form of arthritis characterized by the accumulation of uric acid crystals in the joints, it's important to follow a diet that helps manage your condition. The following are some dietary recommendations for individuals with gout, based on an indian diet: 1. Limit purine-rich foods: purines are compounds that break down into uric acid in the body. Foods high in purines can increase uric acid levels and trigger gout attacks. Limit or avoid purine-rich foods such as organ meats (liver, kidneys), red meat (beef, lamb), seafood (anchovies, sardines, shellfish), and certain legumes (lentils, chickpeas). 2. Increase low-fat dairy intake: low-fat dairy products, such as milk, yogurt, and cheese, have been associated with a lower risk of gout. They contain proteins that may help lower uric acid levels. Choose low-fat or skim varieties, and aim for 2-3 servings per day. 3. Consume plenty of fruits and vegetables: fruits and vegetables are generally low in purines and high in fiber and antioxidants, which can be beneficial for managing gout. Include a variety of colorful fruits and vegetables in your diet, such as berries, cherries, citrus fruits, leafy greens, tomatoes, and bell peppers. 4. Emphasize whole grains: whole grains like brown rice, whole wheat, oats, and quinoa are healthy carbohydrate sources that provide fiber and nutrients. They can be included in meals to replace refined grains. 5. Stay hydrated: drinking an adequate amount of water helps in flushing out uric acid from the body. Aim for at least 8-10 glasses of water per day, and include hydrating fluids like coconut water, herbal teas, and low-sugar fruit juices. 6. Limit alcohol and sugary beverages: alcohol, especially beer, can raise uric acid levels and trigger gout attacks. It's best to limit or avoid alcohol consumption. Additionally, sugary beverages like soft drinks and sweetened fruit juices should be minimized, as they may contribute to weight gain and worsen gout symptoms. 7. Moderate your intake of protein: while high-purine protein sources should be avoided, it's still important to consume moderate amounts of protein for overall health. Include lean sources of protein like skinless poultry, eggs, low-fat dairy, and plant-based proteins like legumes and tofu. 8. Control portion sizes and maintain a healthy weight: excess weight can increase the risk and severity of gout attacks. Watch your portion sizes, avoid overeating, and focus on achieving and maintaining a healthy weight through a balanced diet and regular physical activity. Remember, it's always a good idea to consult with a healthcare professional or registered dietitian who can provide personalized dietary advice and guidance based on your specific needs and medical condition. Dr. hariharan dhamodharan m.s.ortho d.n.b.ortho. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Back pain exercises; kindly do these exercises. Back pain is described as acute or chronic based on how long you’ve had it. Acute pain lasts days to weeks, subacute pain lasts six weeks to three months, and chronic pain lasts longer than three months. Things that make it better or worse back pain may get worse with movement or if you sit or stand for a long time. It may get better if you switch positions or walk around. Other symptoms you may experience with back pain include: •the painful spot looking swollen and feeling tender to the touch •a muscle spasm in the painful area •numbness or weakness in one or both of your legs (if the pain is due to a nerve issue) if you find you have back pain and can’t hold your urine or bowel movements, something is pressing on your spinal nerves, and you should be evaluated immediately. This condition, called cauda equina syndrome, can cause severe long-term damage to your spinal nerves if not treated right away. 6 imbalances that cause pain—and how to fix them "pain is a medical condition and a medical issue, says brett jones, owner of applied strength in pittsburgh who is certified for the functional movement screen, a system of tests and cor rective exercise strategies. "it's a warning sign. The pain is there to tell you something's wrong. And that warning sign could be more serious than "you're going too hard. Jones and the other coaches consulted for this piece all had a horror story to tell-when pain in a client meant a more serious condition such as a nerve issue, thyroid issue, or even cancer. The point: if you experience regular pain while exercising-or when you're not-go to the doctor. If you've been cleared by a doc and you're still feeling discomfort, try these simple tests to see what's truly causing the pain-it could be related to an imbalance in a completely different part of your body. The good news: with these drills, stretches, and corrective exercises, you may be able to fix them-no doctors necessary. 1. Standing extension how it helps – this standing extension helps reverse what you do on a daily basis (hunching)… since most bulging discs and herniated discs are caused by poor posture and repeated flexion of the spine (esp bending fwd in bad posture), this stretch helps push the disc back to neutral position. How to do it – begin this exercise by standing up with good posture. Now take both hands and place them on both sides of your lower back. Now with the help of your hands push your pelvis forward and extend your spine back. Follow the extension with your neck so that you end up facing the ceiling. – start with 10 repetitions and do 2-3 sets. – this one is particularly great to do when you need a break from sitting at your desk. ** this should not cause any pain. If you feel pain during it is not a good one for you. In that case, stop and try some of the other exercises below instead. 2. Half cobra pose (prone lumbar extension) how it helps – the half cobra stretch helps to push the disc material back towards the center of the inter-vertebral disc to allow for improved healing. The goal of repeated lower back extension is the “centralization of symptoms”, which basically means pain that travels down the affected leg to the foot should come back up closer to the low back – which will in turn alleviate the pain. How to do it – begin this exercise by lying on your stomach (prone position) and slowly prop yourself up on your elbows while keeping your hips in contact with the floor. – hold the prop-up position for 10-15 seconds before returning to the prone position (lying face down). – gradually increase to holding the end position for 30 seconds. Aim for 10 repetitions of this stretch. ** initially, you may not be able to tolerate this position very well, so make sure you start slowly and carefully. If there’s any pain, try a different exercise instead. 3. Full cobra pose (advanced extension) how it helps – this stretch is based on the same principle as the half cobra pose above. This advanced extension helps to push disc material back towards the center of the intervertebral disc, with the goal of alleviating pain symptoms. How to do it – once you’ve mastered the half cobra pose, you can increase the difficulty by moving to the advanced version of this stretch. Begin this exercise by lying on your stomach in the prone position (lying facing down) and slowly press up on your hands while keeping your pelvis in contact with the floor and lower back relaxed. – hold the prop-up position for 10 seconds. Aim for 10 repetitions of this stretch. – eventually try to hold this pose for longer if it feels good (20-30 seconds). ** if you feel pain during this exercise, it is not a good one for you. In that case, stop and try some of the other exercises instead. 4. Cat-cow how it helps – this is one of the most popular herniated disc exercises. By combining two yoga poses, the cat-cow stretch can help to relieve pressure on the herniated disc by opening the intervertebral disc space. It also improves mobility of the spine, which may help to relieve disc herniation pain and speed recovery. How to do it – begin this stretch on your hands and knees. Inhale and let your stomach “drop” towards the floor as you look up towards the ceiling. – follow this by exhaling and slowly rounding your spine while pressing into the floor with your hands and slightly curving your neck to look at your feet. – aim for 10 repetitions of this stretch and do 2-3 sets. How it helps – this exercise will help strengthen and stabilize your lower back and deep spine muscles. This will help you to maintain a good posture and avoid future episodes of herniated discs. How to do it: – begin on your hands and knees with your hands positioned under your shoulders and knees positioned under your hips. – raise your left arm and reach it forwards until it is aligned with your torso; at the same time, kick your right leg backwards until is it aligned with your torso. – hold this position for 2-3 seconds before slowly returning to the starting position. – repeat with your right arm and left leg. – alternate sides for 10 repetitions and do 2-3 sets. ** ensure that your head, neck, and back maintain a neutral alignment to minimize stress on your neck. 5.plank: how it helps – just like the bird dog, this “core” exercise will help bring your pelvis into right position by strengthening the deep spinal muscles and glutes (butt muscles). How to do it – begin lying on your stomach with your forearms against the mat. – engage your core and lift your body so that you are resting on your forearms and toes. – start with 10 second holds and work up to 30 second holds, do 2-3 sets. ** ensure to keep your back straight throughout the entire exercise – spine in neutral position. Thoracic expansion if you’re using a chair, sit facing forward and allow your upper body to fall over the back of the chair. Extend your arms above your head for a deeper stretch. Hold either position for 10 seconds. 1. Plank the world record for the longest plank is 8 hours. Luckily, you don’t need to hold it that long for the exercise to have an effect! in fact. You can hold it for 10-15 seconds. • the plank is similar to a push-up position, but instead of resting on your hands, you rest on your elbows and bring them directly underneath your chest. • after kneeling, lean forward and place your elbows on the ground directly below your shoulders. • lift your knees off of the floor and push your feet back. Ensure your back is straight and keep your neck aligned with the rest of your spine. • hold the position and tighten your core muscles for the desired time. 2. Side plank just like the original plank, but only balancing on one side. • lie on the floor on your side, facing sideways with your feet together. • lift up your body until you are supporting yourself with your elbow, directly below your shoulder. • raise your hips until your body is in a straight line and tighten your core muscles; your body should create a slant from your shoulders to your feet. • hold this position without dropping your hips. • repeat on the opposite side. 3. Pelvic tilt with exercise ball sit on a ball that allows your legs to be at a 90-degree angle with your feet flat on the floor. • keep your shoulders back and spine straight. • tilt your hips forward and flex your abdominals tight. • tilt your hips backward as you stick your tailbone out. • move back and forth slowly, keeping your shoulders back. • repeat 10 times for 3 sets. 4. Superman lie on your stomach, face down, with your arms out in front of you. • lift arms, legs, and chest off the floor simultaneously while keeping your hips grounded. • hold for a minimum of two seconds. • lower back down slowly. • repeat 10 times for 3 sets. 6. Crunches lie flat on your back, placing your feet flat on the floor with your legs bent. • fold your arms across your chest and lift your torso up until your head, neck, and torso are off the ground. • hold for a moment before lowering back down. • repeat. 6. Quadruped arm opposite leg raises • kneel on the floor, lean forward, and place your hands palm-down on the floor. • make sure your back is straight, your knees are below your hips, and that your palms are directly below your shoulders. • raise one arm as you raise the opposite leg until both are aligned straight out from your body, parallel to your spine. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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It may be due to venous insufficiency kindly do certain exercises that may help you to get rid of your pain. Strengthening exercises 5. Half squat to do this exercise: 1. Get into a standing squat position with your feet shoulder-width apart. Place your hands on your hips or out in front of you for balance. 2. Looking straight ahead, slowly squat down about 10 inches. This is the halfway point to a full squat. 3. Pause for a few seconds, then stand up by pushing through your heels. 4. Do 2 to 3 sets of 10 repetitions. 5. Calf raises to do this exercise: 1. Stand with your feet shoulder-width apart. Position yourself next to a wall or hold on to the back of a chair for support. 2. Lift both your heels off the ground so that you’re standing on the balls of your feet. 3. Slowly lower your heels to the starting position. Control is important with this exercise for strengthening your calf muscles. 4. Do 2 to 3 sets of 10 repetitions. 6. Hamstring curl 7. Leg extensions to do this exercise: 1. Sit up tall in a chair. 2. Put your feet flat on the floor, hip-width apart. 3. Look straight ahead, contract your thigh muscles, and extend one leg as high as possible without raising your buttocks off the chair. 4. Pause, then lower to the starting position. 5. Do 2 to 3 sets of 10 repetitions for each leg. 8. Straight leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning under your back. 2. Lie down on the floor with one leg bent and one leg straight out in front of you. 3. Contract the quadricep of your straight leg and slowly raise it up off the floor until it’s the same height as your bent knee. 4. Pause at the top for 5 seconds, then lower to the starting position 5. Do 2 to 3 sets of 10 repetitions for each leg. 9. Side leg raises to do this exercise: 1. Lie on your side with your legs stacked on top of each other. Cradle your head in your hand, and place your other hand on the floor in front of you. 2. Raise your top leg as high as you comfortably can. You should feel this on the side of your hips. 3. Pause briefly at the top, then lower your leg. 4. Do 2 to 3 sets of 10 repetitions for each leg. 10. Prone leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning beneath you. 2. Lie on your stomach with your legs straight out behind you. You can let your head rest on your arms. 3. Engage your glute and hamstring muscles in your left leg and lift your leg as high as you exercise. 4. Hold your leg in the lifted position for 5 seconds. 5. Lower your leg, rest for 2 seconds, then repeat. 6. Do 2 to 3 sets of 10 repetitions for each leg. Lifestyle and home remedies rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time. Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You also can use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don't use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin. Heat. You may experience temporary pain relief by applying a heat pack or hot-water bottle to the painful area on your knee. Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that's lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with cot oirculation. Elevation. To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner. Home remedies and prevention: •drinking plenty of water. Over-the-counter nsaids (nonsteroidal anti-inflammatory drugs), such as ibuprofen (advil, motrin). •home remedies may be very beneficial for the management of chronic gout, as well. The dietary modifications detailed above can be very effective in certain patients. Drinking plenty of water to remain well-hydrated can be beneficial in preventing gout attacks. •limit or avoid alcohol. Talk with your doctor about whether any amount or type of alcohol is safe for you. Recent evidence suggests that beer may be particularly likely to increase the risk of gout symptoms, especially in men. •get your protein from low-fat dairy products. Low-fat dairy products may actually have a protective effect against gout, so these are your best-bet protein sources. •limit your intake of meat, fish and poultry. A small amount may be tolerable, but pay close attention to what types — and how much — seem to cause problems for you. •maintain a desirable body weight. Choose portions that allow you to maintain a healthy weight. Losing weight may decrease uric acid levels in your body. But avoid fasting or rapid weight loss, since doing so may temporarily raise uric acid levels. Food to eat: •fresh fruits and vegetables such as berries, oranges, bell pepper and pineapple. •low-fat dairy products, such as yogurt and skimmed milk. •nuts including nut butter ••s such as almond butter and peanut butter. •whole grains. •potatoes, rice, whole-grain bread and pasta. •eggs (in moderation). •oils such as olive oil.•flax and other seeds. •plenty of water and other non-sugary and non-alcoholic drinks. •vitamin c. Supplements containing vitamin c may reduce the levels of uric acid in your blood. •cherries have been lower levels of uric acid, as well as reduce the number of gout attacks. •decaffeinated coffee and caffein will lower uric acid levels. Foods to be avoided: •alcohol is a major trigger for gout attacks. Beer is especially bad for gout since it is rich in purines. •certain fish, seafood and shellfish, including anchovies, trout, sardines, herring, codfish, mussels, codfish, scallops and haddock. •organ meats such as liver, kidney, sweetbreads and brain. People with gout, however, can have a moderate intake of lean meats such as chicken and turkey. •red meat including bacon, turkey, veal and venison.•dried beans and peas. Food products containing a high amount of fructose such as soda and some juices, cereal, ice cream, candy and junk food. 

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Dr. Piyush SaraswatPost Graduation, Masters in Orthopaedic surgery, Post doctoral fellowship in paediatric orthopaedicOrthopedic Doctor

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Try to offload joint which is less of using stairs, sitting on chair, avoid sitting cross leg. Along with quadriceps strength exercises. Thanks. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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This is a general knee pain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, it looks like you are is important to check that. Anaemia always leads to the symptoms of being tired and also having body pain though there may not be any pathological reasons for knee pain. With knee exercises you will definitely feel better and muscles must be strengthened. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap uuwhich would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone. Stiffness have developed due to weakness of the ligaments &inflammed cartilage. Specific knee exercises will also help ie. Keeping ball underneath the knee and keep pressing it. That's the simple exercise which will help you to strengthen the knee. • ultrasound- which heals the damaged tissues and heals • electric stimulation / ift- which reduces the pain • kinesiology taping • application of heat or ice • soft tissue massages or knee joint mobilization 5 do’s & don’ts to reduce your knee pain. 1. Don’t take too much rest- not only your body muscles may become weaker even your joint’s pain may become worse. Take consultation from your physiotherapist to guide you with knee pain exercises which are safe for your knees & keep doing it. 2. Do exercise– exercises help in strengthening the muscles, increase flexibility & also support your knee. You can also do swimming, walking, elliptical machines & bicycles, etc. 3. Don’t avoid your weight– excess weight may increase the stress on your knee and if you have inflammatory arthritis then it may become worse. You don’t need to have ideal weight, you just need to start working to reduce the weight. 4. Rice -this process is good for joint pain caused due to minor injury or an arthritis. • • r (rest) – give some rest to your knees. • I (ice) – massage your knees with ice to reduce swelling. • c (compression)- start wearing compression bandage. • e (elevation)- keep your knee elevated. 5. Don’t wear bad shoes- we actively wear shoes in our daily life for hours without noticing how it can affect your knees badly. So, if you are facing knee pain, then check your shoes first. Is it giving you good comfort? If not then change it urgently. The importance of buying braces and splints from us – orthopaedic support braces we suggest you to wear knee brace which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Resisted terminal knee extension: make a loop with a piece of elastic tubing by tying a knot in both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed. Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise. Standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep as arthritis is very common that you get generally bilaterally. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone 1. Heel and calf stretch to do this stretch: 1. Stand facing a wall. 2. Place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3. Lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4. Change legs and repeat. 5. Do this stretch twice for both legs. Short arc quad / isometeric quad exercise the short arc quad exercise is a great way to really focus in on properly contracting your quadriceps muscles. Here is how you do it: lie on your back and use a yoga block or basketball to prop your knee up. Slowly straighten your bent knee until it is all the way straight. Tighten your quad muscle with your toes pointed toward the ceiling and hold it tight for five seconds. Slowly lower your leg down. Repeat for 15 repetitions. Quadriceps, isometric (strength) this exercise is for an injured right knee. Switch sides if the injury is to your left knee. 1. Sit on the floor with your straight in front of you. Bend your left knee up and put your left foot flat on the floor. Right leg 2. Flex your right foot and tighten the thigh muscles of your right leg. Press the back of your right knee toward the floor. Don’t arch your back or hunch your shoulders. 3. Hold for 5 to 10 seconds. Then relax. 4. Repeat 10 times, or as instructed. 5. Do this exercise 3 times a day, or as instructed. 2. Quadriceps stretch to do this stretch: 1. Stand next to a wall or use a chair for support. Your feet should be shoulder-width apart. 2. Bend one knee so your foot goes up toward your glutes. 3. Grab your ankle and gently pull it toward your glutes as far as you can comfortably. 4. Hold for 30 seconds. 5. Return to the starting position and change legs. 6. Repeat 2 times on each side. Hamstring stretch • take a break from strenuous activities to allow the injury to heal. • use a cane or crutches to avoiding putting your full weight on your injured leg. • apply ice packs several times a day to relieve pain and reduce swelling. • wrap the injured area with a compression bandage or wear compression shorts to minimize swelling. • rest with your leg elevated above the level of your heart, if possible, to improve drainage and minimize swelling. To do this stretch: to do this stretch: 1. For this stretch, you can use a mat to add cushioning under your back. 2. Lie down on the floor or mat and straighten both legs. Or, if it’s more comfortable, you can bend both knees with your feet flat on the floor. 3. Lift one leg off the floor. 4. Place your hands behind your thigh, but below the knee, and gently pull your knee toward your chest until you feel a slight stretch. This shouldn’t be painful. 5. Hold for 30 seconds. 6. Lower and change legs. 7. Repeat 2 times on each side. Strengthening exercises 5. Half squat to do this exercise: 1. Get into a standing squat position with your feet shoulder-width apart. Place your hands on your hips or out in front of you for balance. 2. Looking straight ahead, slowly squat down about 10 inches. This is the halfway point to a full squat. 3. Pause for a few seconds, then stand up by pushing through your heels. 4. Do 2 to 3 sets of 10 repetitions. 5. Calf raises to do this exercise: 1. Stand with your feet shoulder-width apart. Position yourself next to a wall or hold on to the back of a chair for support. 2. Lift both your heels off the ground so that you’re standing on the balls of your feet. 3. Slowly lower your heels to the starting position. Control is important with this exercise for strengthening your calf muscles. 4. Do 2 to 3 sets of 10 repetitions. 6. Hamstring curl 7. Leg extensions to do this exercise: 1. Sit up tall in a chair. 2. Put your feet flat on the floor, hip-width apart. 3. Look straight ahead, contract your thigh muscles, and extend one leg as high as possible without raising your buttocks off the chair. 4. Pause, then lower to the starting position. 5. Do 2 to 3 sets of 10 repetitions for each leg. 8. Straight leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning under your back. 2. Lie down on the floor with one leg bent and one leg straight out in front of you. 3. Contract the quadricep of your straight leg and slowly raise it up off the floor until it’s the same height as your bent knee. 4. Pause at the top for 5 seconds, then lower to the starting position 5. Do 2 to 3 sets of 10 repetitions for each leg. 9. Side leg raises to do this exercise: 1. Lie on your side with your legs stacked on top of each other. Cradle your head in your hand, and place your other hand on the floor in front of you. 2. Raise your top leg as high as you comfortably can. You should feel this on the side of your hips. 3. Pause briefly at the top, then lower your leg. 4. Do 2 to 3 sets of 10 repetitions for each leg. 10. Prone leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning beneath you. 2. Lie on your stomach with your legs straight out behind you. You can let your head rest on your arms. 3. Engage your glute and hamstring muscles in your left leg and lift your leg as high as you exercise. 4. Hold your leg in the lifted position for 5 seconds. 5. Lower your leg, rest for 2 seconds, then repeat. 6. Do 2 to 3 sets of 10 repetitions for each leg. Lifestyle and home remedies rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time. Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You also can use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don't use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin. Heat. You may experience temporary pain relief by applying a heat pack or hot-water bottle to the painful area on your knee. Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that's lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with cot oirculation. Elevation. To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner. Home remedies and prevention: •drinking plenty of water. Over-the-counter nsaids (nonsteroidal anti-inflammatory drugs), such as ibuprofen (advil, motrin). •home remedies may be very beneficial for the management of chronic gout, as well. The dietary modifications detailed above can be very effective in certain patients. Drinking plenty of water to remain well-hydrated can be beneficial in preventing gout attacks. •limit or avoid alcohol. Talk with your doctor about whether any amount or type of alcohol is safe for you. Recent evidence suggests that beer may be particularly likely to increase the risk of gout symptoms, especially in men. •get your protein from low-fat dairy products. Low-fat dairy products may actually have a protective effect against gout, so these are your best-bet protein sources. •limit your intake of meat, fish and poultry. A small amount may be tolerable, but pay close attention to what types — and how much — seem to cause problems for you. •maintain a desirable body weight. Choose portions that allow you to maintain a healthy weight. Losing weight may decrease uric acid levels in your body. But avoid fasting or rapid weight loss, since doing so may temporarily raise uric acid levels. Food to eat: •fresh fruits and vegetables such as berries, oranges, bell pepper and pineapple. •low-fat dairy products, such as yogurt and skimmed milk. •nuts including nut butter ••s such as almond butter and peanut butter. •whole grains. •potatoes, rice, whole-grain bread and pasta. •eggs (in moderation). •oils such as olive oil.•flax and other seeds. •plenty of water and other non-sugary and non-alcoholic drinks. •vitamin c. Supplements containing vitamin c may reduce the levels of uric acid in your blood. •cherries have been lower levels of uric acid, as well as reduce the number of gout attacks. •decaffeinated coffee and caffein will lower uric acid levels. Foods to be avoided: •alcohol is a major trigger for gout attacks. Beer is especially bad for gout since it is rich in purines. •certain fish, seafood and shellfish, including anchovies, trout, sardines, herring, codfish, mussels, codfish, scallops and haddock. •organ meats such as liver, kidney, sweetbreads and brain. People with gout, however, can have a moderate intake of lean meats such as chicken and turkey. •red meat including bacon, turkey, veal and venison.•dried beans and peas. •food products containing a high amount of fructose such as soda and some juices, cereal, ice cream, candy and. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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•drinking plenty of water. Over-the-counter nsaids (nonsteroidal anti-inflammatory drugs), such as ibuprofen (advil, motrin). •home remedies may be very beneficial for the management of chronic gout, as well. The dietary modifications detailed above can be very effective in certain patients. Drinking plenty of water to remain well-hydrated can be beneficial in preventing gout attacks. •limit or avoid alcohol. Talk with your doctor about whether any amount or type of alcohol is safe for you. Recent evidence suggests that beer may be particularly likely to increase the risk of gout symptoms, especially in men. •get your protein from low-fat dairy products. Low-fat dairy products may actually have a protective effect against gout, so these are your best-bet protein sources. •limit your intake of meat, fish and poultry. A small amount may be tolerable, but pay close attention to what types — and how much — seem to cause problems for you. •maintain a desirable body weight. Choose portions that allow you to maintain a healthy weight. Losing weight may decrease uric acid levels in your body. But avoid fasting or rapid weight loss, since doing so may temporarily raise uric acid levels. Food to eat: •fresh fruits and vegetables such as berries, oranges, bell pepper and pineapple. •low-fat dairy products, such as yogurt and skimmed milk. •nuts including nut butter ••s such as almond butter and peanut butter. •whole grains. •potatoes, rice, whole-grain bread and pasta. •eggs (in moderation). •oils such as olive oil.•flax and other seeds. •plenty of water and other non-sugary and non-alcoholic drinks. •vitamin c. Supplements containing vitamin c may reduce the levels of uric acid in your blood. •cherries have been lower levels of uric acid, as well as reduce the number of gout attacks. •decaffeinated coffee and caffein will lower uric acid levels. Foods to be avoided: •alcohol is a major trigger for gout attacks. Beer is especially bad for gout since it is rich in purines. •certain fish, seafood and shellfish, including anchovies, trout, sardines, herring, codfish, mussels, codfish, scallops and haddock. •organ meats such as liver, kidney, sweetbreads and brain. People with gout, however, can have a moderate intake of lean meats such as chicken and turkey. •red meat including bacon, turkey, veal and venison.•dried beans and peas. •food products containing a high amount of fructose such as soda and some juices, cereal, ice cream, candy and junk food. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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You need to consume good protein and iron diet in your body which will help you to break the fatigue and general body pain. However non veg foods definitely makes you to get increased with the toxin levels in the body and it makes your knee to have less fluid content in the system. In general we suggest patients who has knee pain to eat more water content vegetables which will definitely help you to feel better. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone. Stiffness have developed due to weakness of the ligaments &inflammed cartilage. Specific knee exercises will also help ie. Keeping ball underneath the knee and keep pressing it. That's the simple exercise which will help you to strengthen the knee. • ultrasound- which heals the damaged tissues and heals • electric stimulation / ift- which reduces the pain • kinesiology taping • application of heat or ice • soft tissue massages or knee joint mobilization 5 do’s & don’ts to reduce your knee pain. 1. Don’t take too much rest- not only your body muscles may become weaker even your joint’s pain may become worse. Take consultation from your physiotherapist to guide you with knee pain exercises which are safe for your knees & keep doing it. 2. Do exercise– exercises help in strengthening the muscles, increase flexibility & also support your knee. You can also do swimming, walking, elliptical machines & bicycles, etc. 3. Don’t avoid your weight– excess weight may increase the stress on your knee and if you have inflammatory arthritis then it may become worse. You don’t need to have ideal weight, you just need to start working to reduce the weight. 4. Rice -this process is good for joint pain caused due to minor injury or an arthritis. • • r (rest) – give some rest to your knees. • I (ice) – massage your knees with ice to reduce swelling. • c (compression)- start wearing compression bandage. • e (elevation)- keep your knee elevated. 5. Don’t wear bad shoes- we actively wear shoes in our daily life for hours without noticing how it can affect your knees badly. So, if you are facing knee pain, then check your shoes first. Is it giving you good comfort? If not then change it urgently. The importance of buying braces and splints from us – orthopaedic support braces we suggest you to wear knee brace which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Resisted terminal knee extension: make a loop with a piece of elastic tubing by tying a knot in both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed. Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise. Standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep as arthritis is very common that you get generally bilaterally. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone 1. Heel and calf stretch to do this stretch: 1. Stand facing a wall. 2. Place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3. Lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4. Change legs and repeat. 5. Do this stretch twice for both legs. Short arc quad / isometeric quad exercise the short arc quad exercise is a great way to really focus in on properly contracting your quadriceps muscles. Here is how you do it: lie on your back and use a yoga block or basketball to prop your knee up. Slowly straighten your bent knee until it is all the way straight. Tighten your quad muscle with your toes pointed toward the ceiling and hold it tight for five seconds. Slowly lower your leg down. Repeat for 15 repetitions. Quadriceps, isometric (strength) this exercise is for an injured right knee. Switch sides if the injury is to your left knee. 1. Sit on the floor with your right leg straight in front of you. Bend your left knee up and put your left foot flat on the floor. 2. Flex your right foot and tighten the thigh muscles of your right leg. Press the back of your right knee toward the floor. Don’t arch your back or hunch your shoulders. 3. Hold for 5 to 10 seconds. Then relax. 4. Repeat 10 times, or as instructed. 5. Do this exercise 3 times a day, or as instructed. 2. Quadriceps stretch to do this stretch: 1. Stand next to a wall or use a chair for support. Your feet should be shoulder-width apart. 2. Bend one knee so your foot goes up toward your glutes. 3. Grab your ankle and gently pull it toward your glutes as far as you can comfortably. 4. Hold for 30 seconds. 5. Return to the starting position and change legs. 6. Repeat 2 times on each side. Hamstring stretch • take a break from strenuous activities to allow the injury to heal. • use a cane or crutches to avoiding putting your full weight on your injured leg. • apply ice packs several times a day to relieve pain and reduce swelling. • wrap the injured area with a compression bandage or wear compression shorts to minimize swelling. • rest with your leg elevated above the level of your heart, if possible, to improve drainage and minimize swelling. To do this stretch: to do this stretch: 1. For this stretch, you can use a mat to add cushioning under your back. 2. Lie down on the floor or mat and straighten both legs. Or, if it’s more comfortable, you can bend both knees with your feet flat on the floor. 3. Lift one leg off the floor. 4. Place your hands behind your thigh, but below the knee, and gently pull your knee toward your chest until you feel a slight stretch. This shouldn’t be painful. 5. Hold for 30 seconds. 6. Lower and change legs. 7. Repeat 2 times on each side. Strengthening exercises 5. Half squat to do this exercise: 1. Get into a standing squat position with your feet shoulder-width apart. Place your hands on your hips or out in front of you for balance. 2. Looking straight ahead, slowly squat down about 10 inches. This is the halfway point to a full squat. 3. Pause for a few seconds, then stand up by pushing through your heels. 4. Do 2 to 3 sets of 10 repetitions. 5. Calf raises to do this exercise: 1. Stand with your feet shoulder-width apart. Position yourself next to a wall or hold on to the back of a chair for support. 2. Lift both your heels off the ground so that you’re standing on the balls of your feet. 3. Slowly lower your heels to the starting position. Control is important with this exercise for strengthening your calf muscles. 4. Do 2 to 3 sets of 10 repetitions. 6. Hamstring curl 7. Leg extensions to do this exercise: 1. Sit up tall in a chair. 2. Put your feet flat on the floor, hip-width apart. 3. Look straight ahead, contract your thigh muscles, and extend one leg as high as possible without raising your buttocks off the chair. 4. Pause, then lower to the starting position. 5. Do 2 to 3 sets of 10 repetitions for each leg. 8. Straight leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning under your back. 2. Lie down on the floor with one leg bent and one leg straight out in front of you. 3. Contract the quadricep of your straight leg and slowly raise it up off the floor until it’s the same height as your bent knee. 4. Pause at the top for 5 seconds, then lower to the starting position 5. Do 2 to 3 sets of 10 repetitions for each leg. 9. Side leg raises to do this exercise: 1. Lie on your side with your legs stacked on top of each other. Cradle your head in your hand, and place your other hand on the floor in front of you. 2. Raise your top leg as high as you comfortably can. You should feel this on the side of your hips. 3. Pause briefly at the top, then lower your leg. 4. Do 2 to 3 sets of 10 repetitions for each leg. 10. Prone leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning beneath you. 2. Lie on your stomach with your legs straight out behind you. You can let your head rest on your arms. 3. Engage your glute and hamstring muscles in your left leg and lift your leg as high as you exercise. 4. Hold your leg in the lifted position for 5 seconds. 5. Lower your leg, rest for 2 seconds, then repeat. 6. Do 2 to 3 sets of 10 repetitions for each leg. Lifestyle and home remedies rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time. Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You also can use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don't use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin. Heat. You may experience temporary pain relief by applying a heat pack or hot-water bottle to the painful area on your knee. Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that's lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with circulation. Elevation. To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner. Home remedies and prevention: •drinking plenty of water. Over-the-counter nsaids (nonsteroidal anti-inflammatory drugs), such as ibuprofen (advil, motrin). •home remedies may be very beneficial for the management of chronic gout, as well. The dietary modifications detailed above can be very effective in certain patients. Drinking plenty of water to remain well-hydrated can be beneficial in preventing gout attacks. •limit or avoid alcohol. Talk with your doctor about whether any amount or type of alcohol is safe for you. Recent evidence suggests that beer may be particularly likely to increase the risk of gout symptoms, especially in men. •get your protein from low-fat dairy products. Low-fat dairy products may actually have a protective effect against gout, so these are your best-bet protein sources. •limit your intake of meat, fish and poultry. A small amount may be tolerable, but pay close attention to what types — and how much — seem to cause problems for you. •maintain a desirable body weight. Choose portions that allow you to maintain a healthy weight. Losing weight may decrease uric acid levels in your body. But avoid fasting or rapid weight loss, since doing so may temporarily raise uric acid levels. Food to eat: •fresh fruits and vegetables such as berries, oranges, bell pepper and pineapple. •low-fat dairy products, such as yogurt and skimmed milk. •nuts including nut butter ••s such as almond butter and peanut butter. •whole grains. •potatoes, rice, whole-grain bread and pasta. •eggs (in moderation). •oils such as olive oil.•flax and other seeds. •plenty of water and other non-sugary and non-alcoholic drinks. •vitamin c. Supplements containing vitamin c may reduce the levels of uric acid in your blood. •cherries have been lower levels of uric acid, as well as reduce the number of gout attacks. •decaffeinated coffee and caffein will lower uric acid levels. Foods to be avoided: •alcohol is a major trigger for gout attacks. Beer is especially bad for gout since it is rich in purines. •certain fish, seafood and shellfish, including anchovies, trout, sardines, herring, codfish, mussels, codfish, scallops and haddock. •organ meats such as liver, kidney, sweetbreads and brain. People with gout, however, can have a moderate intake of lean meats such as chicken and turkey. •red meat including bacon, turkey, veal and venison.•dried beans and peas. •food products containing a high amount of fructose such as soda and some juices, cereal, ice cream, candy and junk food. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Back pain can affect people of any age, for different reasonsas people get older, the chance of developing lower back pain increases, due to factors such as previous occupation and degenerative disk disease. Lower back pain may be linked to the bony lumbar spine, discs between the vertebrae, ligaments around the spine and discs, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, and the skin around the lumbar area. •acute pain starts suddenly and lasts for up to 6 weeks. •chronic or long-term pain develops over a longer period, lasts for over 3 months, and causes ongoing problems. Home advise: •resting from strenuous activity can help, but moving around will ease stiffness, reduce pain, and prevent muscles from weakening. •applying heat, ice, ultrasound, and electrical stimulation — as well as some muscle-release techniques to the back muscles and soft tissues — may help alleviate pain. •as the pain improves, the physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques for improving posture may also help. •the patient will be encouraged to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence. Regular exercise helps build strength and control body weight. Guided, low-impact aerobic activities can boost heart health without straining or jerking the back. Before starting any exercise program, talk to a health care professional. There are two main types of exercise that people can do to reduce the risk of back pain: •core-strengthening exercises work the abdominal and back muscles, helping to strengthen muscles that protect the back. •flexibility training aims at improving core flexibility, including the spine, hips, and upper legs. We suggest you to wear lumbosacral corset (belt) which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Uses of lumbosacral corset (belt) a lumbosacral corset adds pressure to the intra-abdominal area. This adds stability to the spine. It is prescribed to people suffering from moderate to severe pain. Other benefits of using a lumbar spine belt are: 1.helps in a certain degree of immobilization of facet joints. 2.reduces pain to allow continuation of normal activities. 3.speeds up the healing process. 4.the pressure exerted by a lumbar spine belt helps in stretching the erector spine muscles. 5.this belt can also be used to support the lower back while exercising. Ohelps prevent rolling oprovides stability to lumbar and sacral regions of the back ocan be used when performing actions like lifting and handling heavy items ocan also be used when playing sports orestricts back movement to aid treatment of back problems do’s and don’ts sitting do: • sit as little as possible and then only for short periods. • place a supportive towel roll at the belt line of the back especially when sitting in a car. • when getting up from sitting, keep the normal curves in your back. Move to the front of the seat and stand up by straightening your legs. Avoid bending forward at the waist. • try to keep the normal curves in your back at all times. Don’t: • do not sit on a low soft couch with a deep seat. It will force you to sit with your hips lower than your knees and will round your back. You will loose the normal curve in your back. • do not place your legs straight out in front of you while sitting (e.g. Sitting in the bath tub). Standing do: • if you must stand for a long period of time, keep one leg up on a foot stool. • adapt work heights. Don’t: • avoid half bent positions. Lifting avoid lifting if you can. Do: • use the correct lifting technique. Keep your back straight when lifting. Never stoop or bend forward. Stand close to the load, have a firm footing and wide stance. Kneel on one knee, keeping the back straight. Have a secure grip on the load and lift by straightening your knees. Do a steady lift. Shift your feet to turn and do not twist your back. Don’t: • do not jerk when you lift. • do not bend over the object you are lifting. Lying do: • sleep on a good firm surface. • if your bed sags, use slats or plywood supports between the mattress and base to firm it. You also can place the mattress on the floor, a simple but temporary solution. • you may be more comfortable at night when you use a pillow for support. Don’t: • do not sleep on your stomach unless advised to do so by your doctor or physical therapist. Bending forward do: • keep the natural curves of your back when doing these and other activities: making a bed, vacuuming, sweeping or mopping the floor, weeding the garden or raking leaves. Coughing and sneezing do: • bend backwards to increase the curve of your back while you cough or sneeze. Driving a car do: • drive the car as little as possible. It is better to be a passenger than to drive yourself. • move the seat forward to the steering wheel. Your seat must be close enough to the wheel to keep the natural curves of your back. If your hips are lower than your knees in this position, raise yourself by sitting on a pillow. Exercises for low back pain safety guidelines • an increase in your low back pain can be expected with these exercises. This is acceptable as long as your leg symptoms are not increasing. • if while doing these exercises, your pain worsens or you have new pain or symptoms, stop the exercises and discuss your symptoms with your doctor or physical therapist. • stop exercising and let your doctor or physical therapist know right away if you have any change in your bowel or bladder control or any increase in weakness in your leg or foot. Exercises ‰ •press-ups: keep your back and buttocks relaxed and use your arms to press up. Concentrate on keeping your hips down and push up your upper body as high as possible. •double knee to chest: grasp both your knees with your hands and pull toward your shoulders. Hold the stretch for 1 second. Let your knees return, but keep them bent at arms length. ‰ •lumbar spine stretches: lie on your back. Bring your knees towards your chest. Rotate your knees towards the pain. •side-lying position: lie on your side and face forward. Have both arms straight in front and bend your knees. Turn your head as you move your top arm across your body as far as you can. Keep your arm in place and turn your head back to the starting position. Look back again and turn your head farther if you can. Bring your head and arm back to the starting position. Relax and repeat 10 times on each side. •hamstring stretch: lie on your back with your legs out straight. Raise your leg up and put your hands around the upper leg for support. Slowly straighten the raised knee until you feel a stretch in the back of the upper leg. Hold, then relax and repeat 10 times on each leg. •standing arch: stand with your feet apart and hands on the small of your back with fingers pointing backwards. Bend backwards at the waist, supporting the trunk with your hands. Keep your knees straight. Hold for 5 seconds. Repeat 3 to 5 times. Side glides: stand at a right angle to the wall about 2 feet o eliminate your pain improve your muscular endurance and strength attain better posture, balance, body awareness and co-ordination improve your balance and flexibility learn to lift properly. posture when standing: make sure you have a neutral pelvic position. Stand upright, head facing forward, back straight, and balance your weight evenly on both feet. Keep your legs straight and your head in line with your spine. Posture when sitting: a good seat for working should have good back support, arm rests and a swivel base. When sitting, try to keep your knees and hips level and keep your feet flat on the floor, or use a footstool. You should ideally be able to sit upright with support in the small of your back. If you are using a keyboard, make sure your elbows are at right-angles and that your forearms are horizontal. Shoes: flat shoes place less of a strain on the back. Driving: it is important to have proper support for your back. Make sure the wing mirrors are properly positioned so you do not need to twist. The pedals should be squarely in front of your feet. If you are on a long journey, have plenty of breaks. Get out of the car and walk around. Bed: you should have a mattress that keeps your spine straight, while at the same time supporting the weight of your shoulders and buttocks. Use a pillow, but not one that forces your neck into a steep angle. 

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