Tight Skin 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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Cold compresses can help reduce swelling in the area. Cooling also helps to numb sharp pain. Apply an ice pack for up to 20 minutes, up to five times a day. Use a frozen gel pack, ice cubes in a plastic bag, or a bag of frozen peas. Wrap the cold pack in a soft towel. Do not apply a cold pack directly to skin. Heat therapyheat helps to relax tense muscles and soothe a stiff area. It can help with muscle pain and arthritis in the shoulder. Use a heated gel pack, heating pad or a hot water bottle. Anaemia always leads to the symptoms of being tired that can also be reason to have frequent sprains in the leg once the oxygen levels in the blood comes down it automatically leads to improper functioning of the joints and muscles. Treating a sprained ankle promotes recovery and prevents further discomfort. It’s important not to put weight on the injured area while you’re recovering from an ankle sprain. Home treatments you may be able to treat mild sprains at home. Recommended home care treatments include: •using elastic bandages (such as an ace bandage) to wrap your ankle, but not too tightly •wearing a brace to support your ankle •using crutches, if needed •elevating your foot with pillows as necessary to reduce swelling •taking ibuprofen (such as advil) or acetaminophen (such as tylenol) to manage pain •getting plenty of rest and not putting weight on your ankle it’s also helpful to apply ice to the injured area as soon as you can to reduce swelling. On the first day, you should apply ice every 20 to 30 minutes, three to four times per day. Afterward, apply ice every three to four hours for the next two days. Your doctor may tell you to stay off of your injured ankle until the pain subsides. For mild sprains, this may take a week to 10 days, while more severe sprains may take up to several weeks to heal. How can I prevent an ankle sprain? You can lower your risk for future sprains by: •wrapping the affected ankle in an elastic bandage •wearing a brace, if necessary •performing strengthening exercises •avoiding high heels •warming up before exercising •wearing sturdy, quality footwear •paying attention to surfaces you’re walking on •slowing or stopping activities when you feel fatigued call your doctor right away if you think you’ve sprained your ankle again. When left untreated, an ankle sprain can lead to long-term pain and instability in the. 

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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

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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. Karuna ChawlaBHMSHomeopathy Doctor

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U can do the following exercises for knee pain url/articles/311138. Php follow these dos and don’ts to help your knees feel their best. 1. Don’t rest too much. Too much rest can weaken your muscles, which can worsen joint pain. Find an exercise program that is safe for your knees and stick with it. If you're not sure which motions are safe or how much you can do, talk with your doctor or a physical therapist. 2. Do exercise. Cardio exercises strengthen the muscles that support your knee and increase flexibility. Weight training and stretching do, too. For cardio, some good choices include walking, swimming, water aerobics, stationary cycling, and elliptical machines. 3. Don’t risk a fall. A painful or unstable knee can make a fall more likely, which can cause more knee damage. 4. Rest, ice, compression, and elevation (rice) is good for knee pain caused by a minor injury or an arthritis flare. Give your knee some rest, apply ice to reduce swelling, wear a compressive bandage, and keep your knee elevated. 5. Don't overlook your weight. If you're overweight, losing weight reduces the stress on your knee. You don’t even need to get to your "ideal" weight. Smaller changes still make a difference. 6. Don't be shy about using a walking aid. A crutch or cane can take the stress off of your knee. Knee splints and braces can also help you stay stable. 7. Don't let your shoes make matters worse. Cushioned insoles can reduce stress on your knees. 8. Do play with temperature. For the first 48 to 72 hours after a knee injury, use a cold pack to ease swelling and numb the pain. A plastic bag of ice or frozen peas works well. Use it for 15 to 20 minutes three or four times a day. Wrap your ice pack in a towel to be kind to your skin. After that, you can heat things up with a warm bath, heating pad, or warm towel for 15 to 20 minutes, three or four times a day. 9. Don’t jar your joint (s). High-impact exercises can further injure painful knees. Avoid jarring exercises such as running, jumping, and kickboxing. Also avoid doing exercises such as lunges and deep squats that put a lot of stress on your knees. These can worsen pain and, if not done correctly, cause injury. Homeopathy is a very effective for this problem n has very encouraging results. And homeopathic medicines are safe and do not have any side effects at all. 

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

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Side plank with rotation this exercise is an advanced version of the basic plank. It strengthens the arms, shoulders, and obliques by combining a side plank with arm movements. Lie on your right side with your right forearm below your shoulder. Extend your legs, left foot on top of right. Tighten your core. Lift your hips to form a straight line with your body. Raise your left arm straight up. Rotate your torso toward the floor and bring your left arm under your body. Rotate your torso and straighten your left arm to return to the starting position. Start with 1 set of 8–12 reps. Repeat on the other side. Bird dog with elbow to knee this variation on the basic bird dog incorporates fluid movement to engage your abs and back while improving core mobility. Start on all fours, hands below your shoulders and knees below your hips. Tighten your core. Lift and straighten your right leg to hip level. Simultaneously lift and extend your left arm to shoulder level, palm down. Bring your right knee and left elbow toward each other. Return to the starting position. Start with 1 set of 8–12 reps. Repeat on the other side bicycle crunch this classic exercise strengthens your abs by placing them under constant tension. Start on your back. Bend your knees and plant your feet on the floor at hip width. Line up your head and spine. Place yours behind your head, elbows pointing out to the sides. Tighten your core and move your shoulders back and down. Bend your right knee toward your chest and extend your left leg, lifting it a few inches off the floor. Lift your left shoulder and upper back, bringing your left elbow toward your right knee. Tap your left shoulder on the floor and simultaneously switch your legs. Continue alternating elbows and knees, starting with 1 set of12 reps. Pushups this one may seem basic, but there’s no denying that pushups are one of the best ways to strengthen the pectoral muscles. These can be done on the knees or toes. If you’re not ready for full pushups, start with your hands resting on a solid surface higher than your feet — like a very sturdy coffee table or the edge of a couch, cushions removed, that’s pressed up against a wall — and start on the toes. Having your hands higher than your feet and your body at an angle can be a good way to start a pushup regimen. As you get stronger, you can begin to lower the angle of your body. This will help you transition to full pushups more easily than going from knees to toes. A full plank engages the muscles differently, even at an angle. When doing pushups, aim for 2 sets of 10 reps per day. 1.start in plank position with your hands under your shoulders and your core engaged. 2.as you lower, inhale. 3.as you engage your muscles to push yourself up, exhale. Keep your elbows hugging in close to your body. Keep your focus on slowly breathing as you do these, and on engaging the pectorals while keeping the core tight. Don’t just crank these out to get them done — this can compromise your form and do more harm than good. If the movement is really tough, break the sets into three or five to start, or find a higher point to begin after a week of exercise. If necessary, you can even stand and do pushups pushing against a wall. Chest fly for this exercise, you’ll need a bench or exercise ball as well as some dumbbells. If you don’t have weights, you can always use the old standby: a soup can in each hand. Just keep in mind that dumbbells are easier to hold and you can get more out of using them, as even 5-pound weights are heavier than your heaviest canned goods. 1.lie with your upper and middle back on a bench or ball, with your legs at a 90-degree angle. Hold a weight in each hand and extend your arms to the sky, elbows slightly bent. 2.as you inhale, lower your arms out wide, until your elbows are at shoulder height. 3.as you exhale, raise your hands until they meet above your chest again. 4.do 2 sets of 10. If that feels pretty easy, up it to 2 sets of 15 or increase the weight you’re using. Dumbbell row strengthening your back muscles is an important component of treating pectusexcavatum. The dumbbell row targets your lat muscles. The way it’s described below also strengthens your core, another important component of treating the condition. You’ll need some dumbbells to complete this move — err on the lighter side if you’ve never done a row before. 1.hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle. 2.keeping your neck in line with your spine and your gaze straight down, pull your elbows straight back and squeeze between your shoulder blades. 3.extend your arms back to the starting position. Complete 2 sets of 10. Dumbbell rear delt fly another move to strengthen your back, a dumbbell rear delt fly also focuses on the lats, as well as the rhomboids and the traps. Choose a light pair of dumbbells to complete this move and ensure that you’re pinching your shoulder blades together at the top to get the most out of it. 1.hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle and bring the dumbbells together. 2.keeping your spine and neck neutral, inhale and push the dumbbells out and up to the side until your arms are parallel to the floor. 3.exhale and return to the start in a slow and controlled motion. Complete 2 sets of 10. Exercise is a key component to treating pectusexcavatum. By strengthening your chest, back, and core muscles and stretching your chest cavity, you can combat the condition’s effects. Aim to complete these exercises several times a week to maximize results. 

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

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•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. 

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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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