Skin Diseases On Lower Legs

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

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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 might 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. 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. 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. •patellar tendinitis: •risk factor •a combination of factors may contribute to the development of patellar tendinitis, including: •physical activity. •running and jumping are most commonly associated with patellar tendinitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes. •tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon. ••muscular imbalance. •if some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis. •chronic illness. •some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes. •complications •if you try to work through your pain, ignoring your body's warning signs, you could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist if you don't tend to the problem, and you may progress to the more serious patellar tendinopathy. •prevention •to reduce your risk of developing patellar tendinitis, take these steps: •don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, including: •patellar tendon strap. A strap that applies pressure to your patellar tendon can help to distribute force away from the tendon and direct it through the strap instead. This may help relieve pain. •iontophoresis. This therapy involves spreading a corticosteroid medicine on your skin and then using a device that delivers a low electrical charge to push the medication through your skin. •platelet-rich plasma injection. This type of injection has been tried in some people with chronic patellar tendon problems. Studies are ongoing. It is hoped the injections might promote new tissue formation and help heal tendon damage. •probably your stamina would've gone down due to over use of the joints and the metabolic activity is more due to running. You need to consume good protein diet so that your body will act as a reservoir. It will help you to fight against rather than affecting one particular area of your body for eg. Knee joint. For knee ligament pain or inflammation you need to keep ice which will help you to prevent the inflammation progressing further. •patellofemoral pain syndrome •usually fully relieved with simple measures or physical therapy. It may recur, however, if you do not make adjustments to your training routine or activity level. It is essential to maintain appropriate conditioning of the muscles around the knee, particularly the quadriceps and the hamstrings. •there are additional steps that you can take to prevent recurrence of patellofemoral •they include: •wearing shoes appropriate to your activities •warming up thoroughly before physical activity •incorporating stretching and flexibility exercises for the quadriceps and hamstrings into your warm-up routine, and stretching after physical activity •increasing training gradually •reducing any activity that has hurt your knees in the past •maintaining a healthy body weight to avoid overstressing your knees ••d cartilageacl •joints, ie. In the upper limbs if the pain is present in the fingers/wrist and in the lower limbs it the pain is present in the toes/ ankle, then we shall definitely say it is rheumatic arthritis. •if your proximal joints (ie. Shoulder, hip & knee has pain) then you can pour hot (warm) water in that area to reduce the inflammation. If you have pain in the distal joints ie. Wrist, fingers, ankle, toes then you can wear either elbow brace or wrist brace which will help you to feel warm and very protective. And also immerse the distal joints in the hot water tub which will help you to reduce the pain. ••knee pain during driving or watching movie. •it might due to lack of movements in the knee while the joints are immobilized during driving and while watching movies. It is important that you need to have movements in and around the knee so that the blood flow will not be disturbed. •knee ligament laxity•if you have problem in your legs then it might be due to ligament laxity where your legs would become very weak due to the old ligament injury and that should be treated immediately. •wear knee cap so that you will feel firm while walking or climbing stairs.•this is a general strain 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, if pain still persists you can stretch your body by twisting the waist on both sides how we used to do in the school drill similarly you can try! one time you can do hot water fermentation that would help to reduce the muscle strain.•legs becoming numb and also pain is there when the patient walks for 10-15 minutes?•it looks like you are anaemic. If you feel that the legs are becoming numb then keep your legs warm which is important, probably you can wear mcr chappals inside the house/ socks inside the house. Put a door mat when ever you sit so that you will feel comfortable. Also pour warm water in the legs which would help you to get better circulation. •knee pain. If you are overweight, losing weight will also help to reduce pressure on your knee. •knee pain, when leg folding time get pain. 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 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. You need to consume good protein and iron diet in your body which will help you to break the fatigue and body pain. You have to reduce the weight by walking minimum 1 km per day. Slowly reduce the weight and slowly avoid adding salt in the diet which will help you to prevent water retention in the body. Excess salt in general leads to water in the body which might be the reason for you to have leg pain. Hotwater fermentation that would help you to get relieved from joint pains. But food precautions, it is better to avoid tamarind in the food rather to add lime or mango. You can generally do basic aerobic exercises which will definitely help to improve the body weakness. Consume good protein and vitamin diet which will help you to improve your weakness of the whole body. You can give good vitamin d and calcium which will help to have quick healing. If you are a non veg person consume seer fish or if you are a veg person eat mushrooms which has vitamin d3. You need to consume water content vegetables which will make you feel hydrated. A good brace will protect your knee and take the pressure off your meniscus, allowing it to rest. Your doctor may recommend the rice regimen—rest, ice, compression, and elevation—to treat a eroded cartilage which is the main reason for the synovial fluid to get drained. Resting your knee can help relieve your symptoms. Steps to heal a worn out cartilage naturally: rest: it's crucial to rest your knee after it starts to ache. You should not participate in activities where you could cause additional strain. Ice: apply ice to your knee for 15 minutes at four-hour intervals. 

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

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Symptoms of arthritis symptoms of osteoarthritis may include joint pain and progressive stiffness that develops gradually. Symptoms of may include painful swelling, inflammation, and stiffness in the fingers, arms, legs, and wrists occurring in the same joints on both sides of the body, especially upon waking up in the morning. Knee arthritis can be painful and debilitating. For osteoarthritis (oa) of the knee, self-care early on can often help significantly. It is important to stretch and strengthen the surrounding leg muscles to provide more support and reduce stresses around the joint. The following best bet exercises will help you get started on your path to feeling stronger, more flexible and more active. Remember: exercise should not be painful – if you experience pain, discontinue and consult with your physician. Advice: 1.must take adequate rest 2.apply hot water with mild heat with cotton towel 3.avoid cross leg sitting and long time standing 4. Put the small size chair under the ankle during sitting in the chair for leg elevation 5.do the exercise given below 2 times per day 1.quadriceps setting exercise helps to strengthen the quadriceps muscle (the big muscle on the front of the thigh), an important stabilizer of the knee. Lie on your back with the leg you want to exercise straight. Place a small rolled towel underneath the knee. Slowly tighten the muscle on top of the thigh (quadriceps) and push the back of the knee down into the rolled towel. Hold contraction for 5 seconds and then slowly release, resting 5 seconds between each contraction. Perform 3 sets of 10 repetitions, 1 time daily. 2.straight leg raise also helps to strengthen the quadriceps muscle. Lie on your back with the leg you want to exercise straight. The other knee should be bent to support your lower back. Tighten the muscle on the top of your thigh and lift to the level of your other knee. Slowly lower. Perform 3 sets of 10 repetitions, 1 time daily. Knee pain •patellar tendinitis: •risk factor •a combination of factors may contribute to the development of patellar tendinitis, including: •physical activity. •running and jumping are most commonly associated with patellar tendinitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes. •tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon. •muscular imbalance. •if some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis. •chronic illness. •some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes. •complications •if you try to work through your pain, ignoring your body's warning signs, you could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist if you don't tend to the problem, and you may progress to the more serious patellar tendinopathy. •prevention •to reduce your risk of developing patellar tendinitis, take these steps: •don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, including: •patellar tendon strap. A strap that applies pressure to your patellar tendon can help to distribute force away from the tendon and direct it through the strap instead. This may help relieve pain. •iontophoresis. This therapy involves spreading a corticosteroid medicine on your skin and then using a device that delivers a low electrical charge to push the medication through your skin. •platelet-rich plasma injection. This type of injection has been tried in some people with chronic patellar tendon problems. Studies are ongoing. It is hoped the injections might promote new tissue formation and help heal tendon damage. •probably your stamina would've gone down due to over use of the joints and the metabolic activity is more due to running. You need to consume good protein diet so that your body will act as a reservoir. It will help you to fight against rather than affecting one particular area of your body for eg. Knee joint. For knee ligament pain or inflammation you need to keep ice which will help you to prevent the inflammation progressing further. •patellofemoral pain syndrome •usually fully relieved with simple measures or physical therapy. It may recur, however, if you do not make adjustments to your training routine or activity level. It is essential to maintain appropriate conditioning of the muscles around the knee, particularly the quadriceps and the hamstrings. •there are additional steps that you can take to prevent recurrence of patellofemoral •they include: •wearing shoes appropriate to your activities •warming up thoroughly before physical activity •incorporating stretching and flexibility exercises for the quadriceps and hamstrings into your warm-up routine, and stretching after physical activity •increasing training gradually •reducing any activity that has hurt your knees in the past •maintaining a healthy body weight to avoid overstressing your knees •joints, ie. In the upper limbs if the pain is present in the fingers/wrist and in the lower limbs it the pain is present in the toes/ ankle, then we shall definitely say it is rheumatic arthritis. •if your proximal joints (ie. Shoulder, hip & knee has pain) then you can pour hot (warm) water in that area to reduce the inflammation. If you have pain in the distal joints ie. Wrist, fingers, ankle, toes then you can wear either elbow brace or wrist brace which will help you to feel warm and very protective. And also immerse the distal joints in the hot water tub which will help you to reduce the pain. •knee pain during driving or watching movie. •it might due to lack of movements in the knee while the joints are immobilized during driving and while watching movies. It is important that you need to have movements in and around the knee so that the blood flow will not be disturbed. •knee ligament laxity•if you have problem in your legs then it might be due to ligament laxity where your legs would become very weak due to the old ligament injury and that should be treated immediately. •wear knee cap so that you will feel firm while walking or climbing stairs.•this is a general strain 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, if pain still persists you can stretch your body by twisting the waist on both sides how we used to do in the school drill similarly you can try! one time you can do hot water fermentation that would help to reduce the muscle strain. •legs becoming numb and also pain is there when the patient walks for 10-15 minutes?•it looks like you are anaemic. If you feel that the legs are becoming numb then keep your legs warm which is important, probably you can wear mcr chappals inside the house/ socks inside the house. Put a door mat when ever you sit so that you will feel comfortable. Also pour warm water in the legs which would help you to get better circulation. •knee pain. If you are overweight, losing weight will also help to reduce pressure on your knee. Knee pain 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 .•don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, includingback pain it looks like you are anaemic. If you have back pain after you sit for long hours then it is due to your haemoglobin levels as it is important to check that. Anaemia always leads to the symptoms of being tired and also having back / leg pain though there may not be any pathological reasons for back pain. It looks like you are anaemic. And also you have to check with your vitamin and calcium, if the bones are weak then automatically the pain gets triggered more as there is less severity of the painbe strengthened 1.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. 2•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 •stretching exercises. Regular, steady stretching exercises can reduce muscle spasm and help lengthen the muscle-tendon unit. Don't bounce during your stretch. 3•strengthening exercises. Weak thigh muscles contribute to the strain on your patellar tendon. Exercises that involve lowering your leg very slowly after extending it can be particularly helpful, as can exercises that strengthen all of the leg muscles in combination, such as a leg press.•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. 

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

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If you are suffering from burning pain or tingling sensation in hands or feet; sharp shooting pain in legs; numbness in hands or feet, then you might be suffering from neuropathic pain. What is a neuropathic pain? Neuropathic pain is a special type of pain which occurs when there is damage to nerve fibres, which produces tingling or burning type of pain. It is of two types: 1. Peripheral neuropathic pain: it occurs when there is an injury to peripheral nerve fibres (a-delta or c-fibers) which carries pain sensation to the brain (thalamus) for interpretation. 2. Central neuropathic pain: it occurs due to sensitization of central pain interpreting mechanisms (thalamus) to falsely feel pain when peripheral nerve fibres are no longer sending pain impulses to them. Worldwide-estimates of the prevalence of neuropathic pain is 7% i.e. 7 persons out of 100 people are suffering from different types of neuropathic pain. Symptoms: •tingling sensation or feeling of ants crawling under skin •burning sensation •sharp shooting pain or electric current-like sensation •stabbing pain •dull pain with numbness or heaviness reasons for neuropathic pain: •diabetes mellitus: most common cause worldwide due to uncontrolled blood sugar levels, causing damage to nerve fibres. •alcohol consumption/cigarette smoking: damage to nerve fibres or damage to blood vessels supplying nerve fibres. Burning pain in feet •neck pain/low back pain/glutei pain •vit. B12 deficiency •chemotherapy for cancer patients •post-herpes virus infection •post-spine surgery •post-amputation •diseases like spinal cord injury, multiple sclerosis, hiv, lead toxicity, etc. Special neuropathies: 1. Carpal tunnel syndrome: tingling, burning sensation in hand which occurs due to compression of median nerve in the wrist area. It occurs in women especially due to pregnancy, hypothyroidism, diabetes, etc. And in men due to improper position of the wrist during working on computers. 2. Cervical radiculopathy: pain in neck and shoulder region (which increases with neck movements), along with sharpshooting pain radiating from neck to hand occurs in cases of cervical radiculopathy. This is due to compression of the cervical nerve root by disc prolapse, facet subluxation, muscle spasm, trauma, etc. 3. Lumbar radiculopathy: pain in lower back or glutei region with sharp shooting pain radiating from hip to leg/foot region, occurs in cases of lumbar radiculopathy or sciatica. This is due to compression of lumbar nerve root or sciatic nerve by disc prolapse, facet joint, trauma, hypertrophied ligamentumflavum, piriformis syndrome, etc. 4. Meralgiaparesthetica: tingling or burning sensation in front of the thigh, occurs due to compression of lateral cutaneous nerve of thigh, near waist region. Usual causes are tight or constrictive clothing at waist region, prolonged sitting, protuberant abdomen, etc. Prevention of neuropathy: 1. Avoid alcohol consumption and cigarette smoking. 2. Maintain ideal body weight/bmi (body mass index) 3. Lifestyle changes: daily exercises (>30 minutes per day) or brisk walking or swimming; avoid prolonged sitting or standing (>30 minutes). 4. Food/diet should have following components: •green vegetables e.g. Spinach, fenugreek leaves (methi), radish, etc •coloured vegetables e.g. Tomato, carrot, capsicum (green/red), ladies-finger (bhindi) •milk products e.g. Milk, buttermilk, curd, cheese (paneer) •protein-rich foods e.g. Fish, egg, chicken, pulses (daal) •fibre-rich foods e.g. Bran, oats, brown-rice •fruits e.g. Apple, orange, guava, papaya, pomegranate, berries 5. Blood sugar control (in diabetics) 6. Care of feet: •regular inspection of feet (with mirror) •comfortable, well-fitted shoes •regular consultation with a podiatrist •treatment of wounds, foot deformities 7. Adequate sleep 8. Warm water bath (increases blood flow to the affected area) treatment: •consult pain medicine specialist. •neuropathic painkillers e.g. Amitriptyline, pregabalin, gabapentin, capsaicin, duloxetine, etc. •vit. B12 supplements, anti-oxidants, multi-vitamins. •transcutaneous electrical nerve stimulation (tens) •acupuncture •relaxation and yoga •neural prolotherapy. 

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

91% (41326 ratings)

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Knee arthritis can be painful and debilitating. For osteoarthritis (oa) of the knee, self-care early on can often help significantly. It is important to stretch and strengthen the surrounding leg muscles to provide more support and reduce stresses around the joint. The following best bet exercises will help you get started on your path to feeling stronger, more flexible and more active. Remember: exercise should not be painful – if you experience pain, discontinue and consult with your physician. Advice: 1.must take adequate rest 2.apply hot water with mild heat with cotton towel 3.avoid cross leg sitting and long time standing 4. Put the small size chair under the ankle during sitting in the chair for leg elevation 5.do the exercise given below 2 times per day 1.quadriceps setting exercise helps to strengthen the quadriceps muscle (the big muscle on the front of the thigh), an important stabilizer of the knee. Lie on your back with the leg you want to exercise straight. Place a small rolled towel underneath the knee. Slowly tighten the muscle on top of the thigh (quadriceps) and push the back of the knee down into the rolled towel. Hold contraction for 5 seconds and then slowly release, resting 5 seconds between each contraction. Perform 3 sets of 10 repetitions, 1 time daily. 2.straight leg raise also helps to strengthen the quadriceps muscle. Lie on your back with the leg you want to exercise straight. The other knee should be bent to support your lower back. Tighten the muscle on the top of your thigh and lift to the level of your other knee. Slowly lower. Perform 3 sets of 10 repetitions, 1 time daily. Knee pain •patellar tendinitis: •risk factor •a combination of factors may contribute to the development of patellar tendinitis, including: •physical activity. •running and jumping are most commonly associated with patellar tendinitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes. •tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon. •muscular imbalance. •if some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis. •chronic illness. •some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes. •complications •if you try to work through your pain, ignoring your body's warning signs, you could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist if you don't tend to the problem, and you may progress to the more serious patellar tendinopathy. •prevention •to reduce your risk of developing patellar tendinitis, take these steps: •don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, including: •patellar tendon strap. A strap that applies pressure to your patellar tendon can help to distribute force away from the tendon and direct it through the strap instead. This may help relieve pain. •iontophoresis. This therapy involves spreading a corticosteroid medicine on your skin and then using a device that delivers a low electrical charge to push the medication through your skin. •platelet-rich plasma injection. This type of injection has been tried in some people with chronic patellar tendon problems. Studies are ongoing. It is hoped the injections might promote new tissue formation and help heal tendon damage. •probably your stamina would've gone down due to over use of the joints and the metabolic activity is more due to running. You need to consume good protein diet so that your body will act as a reservoir. It will help you to fight against rather than affecting one particular area of your body for eg. Knee joint. For knee ligament pain or inflammation you need to keep ice which will help you to prevent the inflammation progressing further. •patellofemoral pain syndrome •usually fully relieved with simple measures or physical therapy. It may recur, however, if you do not make adjustments to your training routine or activity level. It is essential to maintain appropriate conditioning of the muscles around the knee, particularly the quadriceps and the hamstrings. •there are additional steps that you can take to prevent recurrence of patellofemoral •they include: •wearing shoes appropriate to your activities •warming up thoroughly before physical activity •incorporating stretching and flexibility exercises for the quadriceps and hamstrings into your warm-up routine, and stretching after physical activity •increasing training gradually •reducing any activity that has hurt your knees in the past •maintaining a healthy body weight to avoid overstressing your knees •joints, ie. In the upper limbs if the pain is present in the fingers/wrist and in the lower limbs it the pain is present in the toes/ ankle, then we shall definitely say it is rheumatic arthritis. •if your proximal joints (ie. Shoulder, hip & knee has pain) then you can pour hot (warm) water in that area to reduce the inflammation. If you have pain in the distal joints ie. Wrist, fingers, ankle, toes then you can wear either elbow brace or wrist brace which will help you to feel warm and very protective. And also immerse the distal joints in the hot water tub which will help you to reduce the pain. •knee pain during driving or watching movie. •it might due to lack of movements in the knee while the joints are immobilized during driving and while watching movies. It is important that you need to have movements in and around the knee so that the blood flow will not be disturbed. •knee ligament laxity•if you have problem in your legs then it might be due to ligament laxity where your legs would become very weak due to the old ligament injury and that should be treated immediately. •wear knee cap so that you will feel firm while walking or climbing stairs.•this is a general strain 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, if pain still persists you can stretch your body by twisting the waist on both sides how we used to do in the school drill similarly you can try! one time you can do hot water fermentation that would help to reduce the muscle strain. 

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

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Burning pain or tingling sensation in hands or feet if you are suffering from burning pain or tingling sensation in hands or feet; sharp shooting pain in legs; numbness in hands or feet, then you might be suffering from neuropathic pain what is a neuropathic pain? Neuropathic pain is a special type of pain which occurs when there is damage to nerve fibres, which produces tingling or burning type of pain. It is of two types: 1. Peripheral neuropathic pain: it occurs when there is an injury to peripheral nerve fibres (a-delta or c-fibers) which carries pain sensation to the brain (thalamus) for interpretation. 2. Central neuropathic pain: it occurs due to sensitization of central pain interpreting mechanisms (thalamus) to falsely feel pain when peripheral nerve fibres are no longer sending pain impulses to them. Worldwide-estimates of the prevalence of neuropathic pain is 7% i.e. 7 persons out of 100 people are suffering from different types of neuropathic pain. Symptoms: •tingling sensation or feeling of ants crawling under skin •burning sensation •sharp shooting pain or electric current-like sensation •stabbing pain •dull pain with numbness or heaviness reasons for neuropathic pain: •diabetes mellitus: most common cause worldwide due to uncontrolled blood sugar levels, causing damage to nerve fibres. •alcohol consumption/cigarette smoking: damage to nerve fibres or damage to blood vessels supplying nerve fibres. Burning pain in feet •neck pain/low back pain/glutei pain •vit. B12 deficiency •chemotherapy for cancer patients •post-herpes virus infection •post-spine surgery •post-amputation •diseases like spinal cord injury, multiple sclerosis, hiv, lead toxicity, etc. Special neuropathies: 1. Carpal tunnel syndrome: tingling, burning sensation in hand which occurs due to compression of median nerve in the wrist area. It occurs in women especially due to pregnancy, hypothyroidism, diabetes, etc. And in men due to improper position of the wrist during working on computers. 2. Cervical radiculopathy: pain in neck and shoulder region (which increases with neck movements), along with sharpshooting pain radiating from neck to hand occurs in cases of cervical radiculopathy. This is due to compression of the cervical nerve root by disc prolapse, facet subluxation, muscle spasm, trauma, etc. 3. Lumbar radiculopathy: pain in lower back or glutei region with sharp shooting pain radiating from hip to leg/foot region, occurs in cases of lumbar radiculopathy or sciatica. This is due to compression of lumbar nerve root or sciatic nerve by disc prolapse, facet joint, trauma, hypertrophied ligamentumflavum, piriformis syndrome, etc. 4. Meralgiaparesthetica: tingling or burning sensation in front of the thigh, occurs due to compression of lateral cutaneous nerve of thigh, near waist region. Usual causes are tight or constrictive clothing at waist region, prolonged sitting, protuberant abdomen, etc. Prevention of neuropathy: 1. Avoid alcohol consumption and cigarette smoking. 2. Maintain ideal body weight/bmi (body mass index) 3. Lifestyle changes: daily exercises (>30 minutes per day) or brisk walking or swimming; avoid prolonged sitting or standing (>30 minutes). 4. Food/diet should have following components: •green vegetables e.g. Spinach, fenugreek leaves (methi), radish, etc •coloured vegetables e.g. Tomato, carrot, capsicum (green/red), ladies-finger (bhindi) •milk products e.g. Milk, buttermilk, curd, cheese (paneer) •protein-rich foods e.g. Fish, egg, chicken, pulses (daal) •fibre-rich foods e.g. Bran, oats, brown-rice •fruits e.g. Apple, orange, guava, papaya, pomegranate, berries 5. Blood sugar control (in diabetics) 6. Care of feet: •regular inspection of feet (with mirror) •comfortable, well-fitted shoes •regular consultation with a podiatrist •treatment of wounds, foot deformities 7. Adequate sleep 8. Warm water bath (increases blood flow to the affected area) treatment: •consult pain medicine specialist. •neuropathic painkillers e.g. Amitriptyline, pregabalin, gabapentin, capsaicin, duloxetine, etc. •vit. B12 supplements, anti-oxidants, multi-vitamins. •transcutaneous electrical nerve stimulation (tens) •acupuncture •relaxation and yoga •neural prolotherapy. 

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

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Burning pain or tingling sensation in hands or feet if you are suffering from burning pain or tingling sensation in hands or feet; sharp shooting pain in legs; numbness in hands or feet, then you might be suffering from neuropathic pain what is a neuropathic pain? Neuropathic pain is a special type of pain which occurs when there is damage to nerve fibres, which produces tingling or burning type of pain. It is of two types: 1. Peripheral neuropathic pain: it occurs when there is an injury to peripheral nerve fibres (a-delta or c-fibers) which carries pain sensation to the brain (thalamus) for interpretation. 2. Central neuropathic pain: it occurs due to sensitization of central pain interpreting mechanisms (thalamus) to falsely feel pain when peripheral nerve fibres are no longer sending pain impulses to them. Worldwide-estimates of the prevalence of neuropathic pain is 7% i.e. 7 persons out of 100 people are suffering from different types of neuropathic pain. Symptoms: •tingling sensation or feeling of ants crawling under skin •burning sensation •sharp shooting pain or electric current-like sensation •stabbing pain •dull pain with numbness or heaviness reasons for neuropathic pain: •diabetes mellitus: most common cause worldwide due to uncontrolled blood sugar levels, causing damage to nerve fibres. •alcohol consumption/cigarette smoking: damage to nerve fibres or damage to blood vessels supplying nerve fibres. Burning pain in feet •neck pain/low back pain/glutei pain •vit. B12 deficiency •chemotherapy for cancer patients •post-herpes virus infection •post-spine surgery •post-amputation •diseases like spinal cord injury, multiple sclerosis, hiv, lead toxicity, etc. Special neuropathies: 1. Carpal tunnel syndrome: tingling, burning sensation in hand which occurs due to compression of median nerve in the wrist area. It occurs in women especially due to pregnancy, hypothyroidism, diabetes, etc. And in men due to improper position of the wrist during working on computers. 2. Cervical radiculopathy: pain in neck and shoulder region (which increases with neck movements), along with sharpshooting pain radiating from neck to hand occurs in cases of cervical radiculopathy. This is due to compression of the cervical nerve root by disc prolapse, facet subluxation, muscle spasm, trauma, etc. 3. Lumbar radiculopathy: pain in lower back or glutei region with sharp shooting pain radiating from hip to leg/foot region, occurs in cases of lumbar radiculopathy or sciatica. This is due to compression of lumbar nerve root or sciatic nerve by disc prolapse, facet joint, trauma, hypertrophied ligamentumflavum, piriformis syndrome, etc. 4. Meralgiaparesthetica: tingling or burning sensation in front of the thigh, occurs due to compression of lateral cutaneous nerve of thigh, near waist region. Usual causes are tight or constrictive clothing at waist region, prolonged sitting, protuberant abdomen, etc. Prevention of neuropathy: 1. Avoid alcohol consumption and cigarette smoking. 2. Maintain ideal body weight/bmi (body mass index) 3. Lifestyle changes: daily exercises (>30 minutes per day) or brisk walking or swimming; avoid prolonged sitting or standing (>30 minutes). 4. Food/diet should have following components: •green vegetables e.g. Spinach, fenugreek leaves (methi), radish, etc •coloured vegetables e.g. Tomato, carrot, capsicum (green/red), ladies-finger (bhindi) •milk products e.g. Milk, buttermilk, curd, cheese (paneer) •protein-rich foods e.g. Fish, egg, chicken, pulses (daal) •fibre-rich foods e.g. Bran, oats, brown-rice •fruits e.g. Apple, orange, guava, papaya, pomegranate, berries 5. Blood sugar control (in diabetics) 6. Care of feet: •regular inspection of feet (with mirror) •comfortable, well-fitted shoes •regular consultation with a podiatrist •treatment of wounds, foot deformities 7. Adequate sleep 8. Warm water bath (increases blood flow to the affected area) treatment: •consult pain medicine specialist. •neuropathic painkillers e.g. Amitriptyline, pregabalin, gabapentin, capsaicin, duloxetine, etc. •vit. B12 supplements, anti-oxidants, multi-vitamins. •transcutaneous electrical nerve stimulation (tens) •acupuncture •relaxation and yoga •neural prolotherapy. 

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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. Helps prevent rolling provides stability to lumbar and sacral regions of the back can be used when performing actions like lifting and handling heavy items can also be used when playing sports restricts 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 1. Bridges •lie on the ground and bend the knees, placing the feet flat on the floor hip-width apart. •press the feet into the floor, keeping the arms by the sides. •raise the buttocks off the ground until the body forms a straight line from the shoulders to the knees. •squeeze the buttocks with the shoulders remaining on the floor. •lower the buttocks to the ground and rest for a few seconds. •repeat 15 times and then rest for 1 minute. •do 3 sets of 15 repetitions. 2.lying lateral leg lifts •lie on one side with the legs together. •keep the lower leg slightly bent. •draw the bellybutton into the spine to engage the core muscles. •raise the top leg about 18 inches, keeping it straight and extended. •hold the position for 2 seconds. •repeat 10 times. •turn onto the other side of the body and repeat, lifting the other leg. •perform 3 sets on each side. 3.supermans •lie face down on the ground and stretch both arms out in front of the body, keeping the legs stretched out and flat on the ground. •raise both the hands and feet, aiming to create a gap of about 6 inches between them and the floor. •try to pull in the bellybutton, lifting it off the floor to engage the core muscles. •keep the head straight and look at the floor to avoid neck injury. •stretch the hands and feet outward as far as possible. •hold the position for 2 seconds. •return to the starting position. •repeat 10 times. 4.partial curls •lie back on the floor and bend the knees, keeping the feet flat and hip-width apart. •cross the hands over the chest. •breathe in deeply. •on the breath out, engage the abdominal muscles by pulling in the stomach. •gently raise the head and shoulders 2 inches off the ground while keeping the neck in line with the spine. •hold for 5 seconds then return to the starting position. •repeat the exercise 10 times. •perform 3 sets. 5.knee-to-chest stretches •lie on the back on the floor. •bend the knees, keeping both feet flat on the floor. •use both hands to pull one knee in toward the chest. •hold the knee against the chest for 5 seconds, keeping the abdominals tight and pressing the spine into the floor. •return to the starting position. •repeat with the opposite leg. •repeat with each leg 2–3 times twice a day. 6.lower back rotational stretches •lie back on the floor with bent knees and feet flat on the ground. •keeping the shoulders firmly on the floor, gently roll both bent knees over to one side. •hold the position for 5–10 seconds. •return to the starting position. •gently roll the bent knees over to the opposite side, hold, and then return to the starting position. •repeat 2–3 times on each side twice a day. 7.seated lower back rotational stretches •sit on a stool or chair without arms, keeping the feet flat on the floor. •twist at the core to the right, keeping the hips square and the spine tall. •position the hands behind the head or place the left hand on the right knee to support the stretch. •hold the position for 10 seconds. •repeat the exercise on the left-hand side. •repeat on each side 3–5 times twice a day. 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 angle. 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. 

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

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We cannot give suggestions about homeopathy medicine as we are physiotherapists. I have given the following suggestions and protocols for your other pain in the back, heel and shoulder. Please follow it up and let us know if you have further questions or issues. 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. Helps prevent rolling provides stability to lumbar and sacral regions of the back can be used when performing actions like lifting and handling heavy items can also be used when playing sports restricts 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. Ice. Use an ice pack or cold compress on your foot for 10 to 15 minutes at a time. This is especially beneficial at the end of a long day or when you’ve spent a lot of time on your feet. Or, roll a frozen water bottle under your foot. This method incorporates a bit of massage, relieving tightness in the bottom of your foot. Massage. Massaging the arch of your foot helps to relieve pain and promote mobility. Use your fingers and knuckles to deeply massage your foot for 1 to 5 minutes at a time. One technique is to place both thumbs at the center line of your arch and move them to the outer edges of your feet. Inserts. Use cushion inserts in your shoes for additional support and cushioning. Inexpensive options can be purchased off the shelf. Wear supportive shoes with thicker soles and extra cushioning for additional support that can help to reduce tension in the plantar fascia. Kinesiology tape can be used to improve arch and heel support. Night splints. Many people find quick and effective results by using night splints. They can be worn while sleeping to stretch the plantar fascia. They help to keep the plantar fascia relaxed and prevent you from pointing your feet down. Exercisefoot flexuse your hand to pull your toes back toward your shin. Hold this position for about 30 seconds.Do each side two to three times.Toe towel grab place a small towel under your foot. Curl your toes to grip the towel. Raise the front of your foot off the floor. Hold this position for a few seconds. Release the towel as you lift up your toes and spread them as far apart as possible. 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. Golf ball roll roll a golf baell under your right foot. Continue for up to 1 minute. Do each foot two to three times. Prevention: maintain a healthy weight. Choose supportive shoes. Don't wear worn-out shoes. Apply ice. Do’s and don’ts for shoulder pain do’s do the prescribed exercise regularly to maintain strength, flexibility and range of motion. Do keep the affected arm supported. Use an ice pack for pain relief. Apply the ice pack 3-4 times a day for 10 minutes. Don’ts don't sleep on the affected side. Don't lift heavyweight with the affected arm. Don't jerk your shoulder to avoid stress. Don't use the arm to push yourself up in bed or from a chair. Don't participate in contact sports or do any repetitive heavy lifting. We suggest you to wear shoulder support brace which is available in two different sizes which makes the patient to feel comfortable as it maintains the shoulder in anatomical position and the short lever is maintained. The reason to maintain the short lever in the shoulder joint is it helps the shoulder to prevent the movements which itself is the key to have better progression of healing in the shoulder region. This is suggested for the following conditions. This shoulder support brace what we are suggesting for you 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. 

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

91% (41326 ratings)

Ask Free Question

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. Helps prevent rolling provides stability to lumbar and sacral regions of the back can be used when performing actions like lifting and handling heavy items can also be used when playing sports restricts 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 1. Bridges •lie on the ground and bend the knees, placing the feet flat on the floor hip-width apart. •press the feet into the floor, keeping the arms by the sides. •raise the buttocks off the ground until the body forms a straight line from the shoulders to the knees. •squeeze the buttocks with the shoulders remaining on the floor. •lower the buttocks to the ground and rest for a few seconds. •repeat 15 times and then rest for 1 minute. •do 3 sets of 15 repetitions. 2.lying lateral leg lifts •lie on one side with the legs together. •keep the lower leg slightly bent. •draw the bellybutton into the spine to engage the core muscles. •raise the top leg about 18 inches, keeping it straight and extended. •hold the position for 2 seconds. •repeat 10 times. •turn onto the other side of the body and repeat, lifting the other leg. •perform 3 sets on each side. 3.supermans •lie face down on the ground and stretch both arms out in front of the body, keeping the legs stretched out and flat on the ground. •raise both the hands and feet, aiming to create a gap of about 6 inches between them and the floor. •try to pull in the bellybutton, lifting it off the floor to engage the core muscles. •keep the head straight and look at the floor to avoid neck injury. •stretch the hands and feet outward as far as possible. •hold the position for 2 seconds. •return to the starting position. •repeat 10 times. 4.partial curls •lie back on the floor and bend the knees, keeping the feet flat and hip-width apart. •cross the hands over the chest. •breathe in deeply. •on the breath out, engage the abdominal muscles by pulling in the stomach. •gently raise the head and shoulders 2 inches off the ground while keeping the neck in line with the spine. •hold for 5 seconds then return to the starting position. •repeat the exercise 10 times. •perform 3 sets. 5.knee-to-chest stretches •lie on the back on the floor. •bend the knees, keeping both feet flat on the floor. •use both hands to pull one knee in toward the chest. •hold the knee against the chest for 5 seconds, keeping the abdominals tight and pressing the spine into the floor. •return to the starting position. •repeat with the opposite leg. •repeat with each leg 2–3 times twice a day. 6.lower back rotational stretches •lie back on the floor with bent knees and feet flat on the ground. •keeping the shoulders firmly on the floor, gently roll both bent knees over to one side. •hold the position for 5–10 seconds. •return to the starting position. •gently roll the bent knees over to the opposite side, hold, and then return to the starting position. •repeat 2–3 times on each side twice a day. 7.seated lower back rotational stretches •sit on a stool or chair without arms, keeping the feet flat on the floor. •twist at the core to the right, keeping the hips square and the spine tall. •position the hands behind the head or place the left hand on the right knee to support the stretch. •hold the position for 10 seconds. •repeat the exercise on the left-hand side. •repeat on each side 3–5 times twice a day. 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 angle. 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. 

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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. Helps prevent rolling provides stability to lumbar and sacral regions of the back can be used when performing actions like lifting and handling heavy items can also be used when playing sports restricts 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 1. Bridges •lie on the ground and bend the knees, placing the feet flat on the floor hip-width apart. •press the feet into the floor, keeping the arms by the sides. •raise the buttocks off the ground until the body forms a straight line from the shoulders to the knees. •squeeze the buttocks with the shoulders remaining on the floor. •lower the buttocks to the ground and rest for a few seconds. •repeat 15 times and then rest for 1 minute. •do 3 sets of 15 repetitions. 2.lying lateral leg lifts •lie on one side with the legs together. •keep the lower leg slightly bent. •draw the bellybutton into the spine to engage the core muscles. •raise the top leg about 18 inches, keeping it straight and extended. •hold the position for 2 seconds. •repeat 10 times. •turn onto the other side of the body and repeat, lifting the other leg. •perform 3 sets on each side. 3.supermans •lie face down on the ground and stretch both arms out in front of the body, keeping the legs stretched out and flat on the ground. •raise both the hands and feet, aiming to create a gap of about 6 inches between them and the floor. •try to pull in the bellybutton, lifting it off the floor to engage the core muscles. •keep the head straight and look at the floor to avoid neck injury. •stretch the hands and feet outward as far as possible. •hold the position for 2 seconds. •return to the starting position. •repeat 10 times. 4.partial curls •lie back on the floor and bend the knees, keeping the feet flat and hip-width apart. •cross the hands over the chest. •breathe in deeply. •on the breath out, engage the abdominal muscles by pulling in the stomach. •gently raise the head and shoulders 2 inches off the ground while keeping the neck in line with the spine. •hold for 5 seconds then return to the starting position. •repeat the exercise 10 times. •perform 3 sets. 5.knee-to-chest stretches •lie on the back on the floor. •bend the knees, keeping both feet flat on the floor. •use both hands to pull one knee in toward the chest. •hold the knee against the chest for 5 seconds, keeping the abdominals tight and pressing the spine into the floor. •return to the starting position. •repeat with the opposite leg. •repeat with each leg 2–3 times twice a day. 6.lower back rotational stretches •lie back on the floor with bent knees and feet flat on the ground. •keeping the shoulders firmly on the floor, gently roll both bent knees over to one side. •hold the position for 5–10 seconds. •return to the starting position. •gently roll the bent knees over to the opposite side, hold, and then return to the starting position. •repeat 2–3 times on each side twice a day. 7.seated lower back rotational stretches •sit on a stool or chair without arms, keeping the feet flat on the floor. •twist at the core to the right, keeping the hips square and the spine tall. •position the hands behind the head or place the left hand on the right knee to support the stretch. •hold the position for 10 seconds. •repeat the exercise on the left-hand side. •repeat on each side 3–5 times twice a day. 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 angle. 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. 

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