What Is A Stiff Heart

Ms. Annie Roselin BMsc psychology , Diploma in Psychotherapy and Counseling, BA(Psychology, English Literature and Economics)Psychologist

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Hi lybrate-user, greetings of the day. It sounds like you are experiencing significant challenges that may require professional help given the impact on your daily life and studies, it is crucial to consult with a mental health professional, preferably a psychologist or psychiatrist, who can conduct a thorough assessment. They can help determine the underlying issues contributing to your difficulties, whether they stem from anxiety, attention-related concerns, or any other emotional factors. In the meantime, consider implementing stress-reducing techniques such as mindfulness, deep breathing exercises, workout, prayers, and establishing a structured study routine. Prioritize self-care, including adequate sleep, working on childhood concerns, and a balanced diet. However, these are general suggestions, and personalized guidance from a mental health professional is essential for an accurate diagnosis and tailored intervention. Don't hesitate to seek support – reaching out to a mental health provider is an important step toward understanding and managing your challenges. 

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

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If you have leg pain then you have to rule out the casues for having leg pain. First of all check your weight and your haemoglobin levels, as anaemia always leads to the symptoms of being tired and also having leg pain though there are no issues with the knee joint or back pain. Since you met with an accident probably you would've had blood loss and also you must be having mineral or calcium deficiency that is one reason to feel very rigid or stiff in that area. Hot water fermentation that would help to reduce the muscle strain. Keep ice in the area where you have pain/or where the muscle is injured.Rest avoid using your muscle for a few days, especially if movement causes an increase in pain. But too much rest can cause muscles to become weak. This can prolong the healing process. After two days, slowly begin using the affected muscle group, taking care not to overdo it. Ice apply ice immediately after injuring your muscle. This will minimize swelling. Don’t put ice directly on your skin. Use an ice pack or wrap ice in a towel. Keep the ice on your muscle for about 20 minutes. Repeat every hour on the first day. For the next several days, apply ice every four hours. Compression to reduce swelling, wrap the affected area with an elastic bandage until swelling comes down. Be careful not to wrap the area too tightly. Doing so can reduce your blood circulation. Elevation whenever possible, keep the injured muscle raised above the level of your heart. 

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Hello lybrate-user. Have you had any thing stressful in your life, any negative incident etc. Need more details to suggest solution. Feel free to consult online and talk. 

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Dr. Rahul (Pt)BPTh/BPTPhysiotherapist

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Hi lybrate-user, the most common causes include injury, arthritis and normal wear and tear. Depending on the cause, you may feel pain or stiffness anywhere around the ankle. Your ankle may also swell, and you may not be able to put any weight on it. Usually, ankle pain gets better with rest, ice and over-the-counter pain medications. Contact near by physiotherapy clinics, where physiotherapist assess you and make drug free treatment plan for you. You might need to join 4 weeks continues physio session. Thanks 

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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 have developed due to weakness of the ligaments &inflammed cartilage. Specific knee exercises will also help ie. Keeping ball underneath the knee and keep pressing it. That's the simple exercise which will help you to strengthen the knee. • ultrasound- which heals the damaged tissues and heals • electric stimulation / ift- which reduces the pain • kinesiology taping • application of heat or ice • soft tissue massages or knee joint mobilization 5 do’s & don’ts to reduce your knee pain. 1. Don’t take too much rest- not only your body muscles may become weaker even your joint’s pain may become worse. Take consultation from your physiotherapist to guide you with knee pain exercises which are safe for your knees & keep doing it. 2. Do exercise– exercises help in strengthening the muscles, increase flexibility & also support your knee. You can also do swimming, walking, elliptical machines & bicycles, etc. 3. Don’t avoid your weight– excess weight may increase the stress on your knee and if you have inflammatory arthritis then it may become worse. You don’t need to have ideal weight, you just need to start working to reduce the weight. 4. Rice -this process is good for joint pain caused due to minor injury or an arthritis. • • r (rest) – give some rest to your knees. • I (ice) – massage your knees with ice to reduce swelling. • c (compression)- start wearing compression bandage. • e (elevation)- keep your knee elevated. 5. Don’t wear bad shoes- we actively wear shoes in our daily life for hours without noticing how it can affect your knees badly. So, if you are facing knee pain, then check your shoes first. Is it giving you good comfort? If not then change it urgently. The importance of buying braces and splints from us – orthopaedic support braces we suggest you to wear knee brace which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Resisted terminal knee extension: make a loop with a piece of elastic tubing by tying a knot in both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed. Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise. Standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep as arthritis is very common that you get generally bilaterally. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone 1. Heel and calf stretch to do this stretch: 1. Stand facing a wall. 2. Place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3. Lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4. Change legs and repeat. 5. Do this stretch twice for both legs. Short arc quad / isometeric quad exercise the short arc quad exercise is a great way to really focus in on properly contracting your quadriceps muscles. Here is how you do it: lie on your back and use a yoga block or basketball to prop your knee up. Slowly straighten your bent knee until it is all the way straight. Tighten your quad muscle with your toes pointed toward the ceiling and hold it tight for five seconds. Slowly lower your leg down. Repeat for 15 repetitions. Quadriceps, isometric (strength) this exercise is for an injured right knee. Switch sides if the injury is to your left knee. 1. Sit on the floor with your straight in front of you. Bend your left knee up and put your left foot flat on the floor. Right leg 2. Flex your right foot and tighten the thigh muscles of your right leg. Press the back of your right knee toward the floor. Don’t arch your back or hunch your shoulders. 3. Hold for 5 to 10 seconds. Then relax. 4. Repeat 10 times, or as instructed. 5. Do this exercise 3 times a day, or as instructed. 2. Quadriceps stretch to do this stretch: 1. Stand next to a wall or use a chair for support. Your feet should be shoulder-width apart. 2. Bend one knee so your foot goes up toward your glutes. 3. Grab your ankle and gently pull it toward your glutes as far as you can comfortably. 4. Hold for 30 seconds. 5. Return to the starting position and change legs. 6. Repeat 2 times on each side. Hamstring stretch • take a break from strenuous activities to allow the injury to heal. • use a cane or crutches to avoiding putting your full weight on your injured leg. • apply ice packs several times a day to relieve pain and reduce swelling. • wrap the injured area with a compression bandage or wear compression shorts to minimize swelling. • rest with your leg elevated above the level of your heart, if possible, to improve drainage and minimize swelling. To do this stretch: to do this stretch: 1. For this stretch, you can use a mat to add cushioning under your back. 2. Lie down on the floor or mat and straighten both legs. Or, if it’s more comfortable, you can bend both knees with your feet flat on the floor. 3. Lift one leg off the floor. 4. Place your hands behind your thigh, but below the knee, and gently pull your knee toward your chest until you feel a slight stretch. This shouldn’t be painful. 5. Hold for 30 seconds. 6. Lower and change legs. 7. Repeat 2 times on each side. Strengthening exercises 5. Half squat to do this exercise: 1. Get into a standing squat position with your feet shoulder-width apart. Place your hands on your hips or out in front of you for balance. 2. Looking straight ahead, slowly squat down about 10 inches. This is the halfway point to a full squat. 3. Pause for a few seconds, then stand up by pushing through your heels. 4. Do 2 to 3 sets of 10 repetitions. 5. Calf raises to do this exercise: 1. Stand with your feet shoulder-width apart. Position yourself next to a wall or hold on to the back of a chair for support. 2. Lift both your heels off the ground so that you’re standing on the balls of your feet. 3. Slowly lower your heels to the starting position. Control is important with this exercise for strengthening your calf muscles. 4. Do 2 to 3 sets of 10 repetitions. 6. Hamstring curl 7. Leg extensions to do this exercise: 1. Sit up tall in a chair. 2. Put your feet flat on the floor, hip-width apart. 3. Look straight ahead, contract your thigh muscles, and extend one leg as high as possible without raising your buttocks off the chair. 4. Pause, then lower to the starting position. 5. Do 2 to 3 sets of 10 repetitions for each leg. 8. Straight leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning under your back. 2. Lie down on the floor with one leg bent and one leg straight out in front of you. 3. Contract the quadricep of your straight leg and slowly raise it up off the floor until it’s the same height as your bent knee. 4. Pause at the top for 5 seconds, then lower to the starting position 5. Do 2 to 3 sets of 10 repetitions for each leg. 9. Side leg raises to do this exercise: 1. Lie on your side with your legs stacked on top of each other. Cradle your head in your hand, and place your other hand on the floor in front of you. 2. Raise your top leg as high as you comfortably can. You should feel this on the side of your hips. 3. Pause briefly at the top, then lower your leg. 4. Do 2 to 3 sets of 10 repetitions for each leg. 10. Prone leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning beneath you. 2. Lie on your stomach with your legs straight out behind you. You can let your head rest on your arms. 3. Engage your glute and hamstring muscles in your left leg and lift your leg as high as you exercise. 4. Hold your leg in the lifted position for 5 seconds. 5. Lower your leg, rest for 2 seconds, then repeat. 6. Do 2 to 3 sets of 10 repetitions for each leg. Lifestyle and home remedies rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time. Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You also can use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don't use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin. Heat. You may experience temporary pain relief by applying a heat pack or hot-water bottle to the painful area on your knee. Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that's lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with cot oirculation. Elevation. To help reduce swelling, try propping your injured leg on pillows or sitting in a recliner. 

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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 have developed due to weakness of the ligaments &inflammed cartilage. Specific knee exercises will also help ie. Keeping ball underneath the knee and keep pressing it. That's the simple exercise which will help you to strengthen the knee. • ultrasound- which heals the damaged tissues and heals • electric stimulation / ift- which reduces the pain • kinesiology taping • application of heat or ice • soft tissue massages or knee joint mobilization 5 do’s & don’ts to reduce your knee pain. 1. Don’t take too much rest- not only your body muscles may become weaker even your joint’s pain may become worse. Take consultation from your physiotherapist to guide you with knee pain exercises which are safe for your knees & keep doing it. 2. Do exercise– exercises help in strengthening the muscles, increase flexibility & also support your knee. You can also do swimming, walking, elliptical machines & bicycles, etc. 3. Don’t avoid your weight– excess weight may increase the stress on your knee and if you have inflammatory arthritis then it may become worse. You don’t need to have ideal weight, you just need to start working to reduce the weight. 4. Rice -this process is good for joint pain caused due to minor injury or an arthritis. • • r (rest) – give some rest to your knees. • I (ice) – massage your knees with ice to reduce swelling. • c (compression)- start wearing compression bandage. • e (elevation)- keep your knee elevated. 5. Don’t wear bad shoes- we actively wear shoes in our daily life for hours without noticing how it can affect your knees badly. So, if you are facing knee pain, then check your shoes first. Is it giving you good comfort? If not then change it urgently. The importance of buying braces and splints from us – orthopaedic support braces we suggest you to wear knee brace which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Resisted terminal knee extension: make a loop with a piece of elastic tubing by tying a knot in both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed. Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise. Standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep as arthritis is very common that you get generally bilaterally. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone 1. Heel and calf stretch to do this stretch: 1. Stand facing a wall. 2. Place your hands on the wall and move one foot back as far as you can comfortably. Toes on both feet should be facing forward, heels flat, with a slight bend in your knees. 3. Lean into the stretch and hold for 30 seconds. You should feel the stretch in your back leg. 4. Change legs and repeat. 5. Do this stretch twice for both legs. Short arc quad / isometeric quad exercise the short arc quad exercise is a great way to really focus in on properly contracting your quadriceps muscles. Here is how you do it: lie on your back and use a yoga block or basketball to prop your knee up. Slowly straighten your bent knee until it is all the way straight. Tighten your quad muscle with your toes pointed toward the ceiling and hold it tight for five seconds. Slowly lower your leg down. Repeat for 15 repetitions. Quadriceps, isometric (strength) this exercise is for an injured right knee. Switch sides if the injury is to your left knee. 1. Sit on the floor with your straight in front of you. Bend your left knee up and put your left foot flat on the floor. Right leg 2. Flex your right foot and tighten the thigh muscles of your right leg. Press the back of your right knee toward the floor. Don’t arch your back or hunch your shoulders. 3. Hold for 5 to 10 seconds. Then relax. 4. Repeat 10 times, or as instructed. 5. Do this exercise 3 times a day, or as instructed. 2. Quadriceps stretch to do this stretch: 1. Stand next to a wall or use a chair for support. Your feet should be shoulder-width apart. 2. Bend one knee so your foot goes up toward your glutes. 3. Grab your ankle and gently pull it toward your glutes as far as you can comfortably. 4. Hold for 30 seconds. 5. Return to the starting position and change legs. 6. Repeat 2 times on each side. Hamstring stretch • take a break from strenuous activities to allow the injury to heal. • use a cane or crutches to avoiding putting your full weight on your injured leg. • apply ice packs several times a day to relieve pain and reduce swelling. • wrap the injured area with a compression bandage or wear compression shorts to minimize swelling. • rest with your leg elevated above the level of your heart, if possible, to improve drainage and minimize swelling. To do this stretch: to do this stretch: 1. For this stretch, you can use a mat to add cushioning under your back. 2. Lie down on the floor or mat and straighten both legs. Or, if it’s more comfortable, you can bend both knees with your feet flat on the floor. 3. Lift one leg off the floor. 4. Place your hands behind your thigh, but below the knee, and gently pull your knee toward your chest until you feel a slight stretch. This shouldn’t be painful. 5. Hold for 30 seconds. 6. Lower and change legs. 7. Repeat 2 times on each side. Strengthening exercises 5. Half squat to do this exercise: 1. Get into a standing squat position with your feet shoulder-width apart. Place your hands on your hips or out in front of you for balance. 2. Looking straight ahead, slowly squat down about 10 inches. This is the halfway point to a full squat. 3. Pause for a few seconds, then stand up by pushing through your heels. 4. Do 2 to 3 sets of 10 repetitions. 5. Calf raises to do this exercise: 1. Stand with your feet shoulder-width apart. Position yourself next to a wall or hold on to the back of a chair for support. 2. Lift both your heels off the ground so that you’re standing on the balls of your feet. 3. Slowly lower your heels to the starting position. Control is important with this exercise for strengthening your calf muscles. 4. Do 2 to 3 sets of 10 repetitions. 6. Hamstring curl 7. Leg extensions to do this exercise: 1. Sit up tall in a chair. 2. Put your feet flat on the floor, hip-width apart. 3. Look straight ahead, contract your thigh muscles, and extend one leg as high as possible without raising your buttocks off the chair. 4. Pause, then lower to the starting position. 5. Do 2 to 3 sets of 10 repetitions for each leg. 8. Straight leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning under your back. 2. Lie down on the floor with one leg bent and one leg straight out in front of you. 3. Contract the quadricep of your straight leg and slowly raise it up off the floor until it’s the same height as your bent knee. 4. Pause at the top for 5 seconds, then lower to the starting position 5. Do 2 to 3 sets of 10 repetitions for each leg. 9. Side leg raises to do this exercise: 1. Lie on your side with your legs stacked on top of each other. Cradle your head in your hand, and place your other hand on the floor in front of you. 2. Raise your top leg as high as you comfortably can. You should feel this on the side of your hips. 3. Pause briefly at the top, then lower your leg. 4. Do 2 to 3 sets of 10 repetitions for each leg. 10. Prone leg raises to do this exercise: 1. For this exercise, you can use a mat to add cushioning beneath you. 2. Lie on your stomach with your legs straight out behind you. You can let your head rest on your arms. 3. Engage your glute and hamstring muscles in your left leg and lift your leg as high as you exercise. 4. Hold your leg in the lifted position for 5 seconds. 5. Lower your leg, rest for 2 seconds, then repeat. 6. Do 2 to 3 sets of 10 repetitions for each leg. Lifestyle and home remedies rest. Take a break from your normal activities to reduce repetitive strain on your knee, give the injury time to heal and help prevent further damage. A day or two of rest may be all you need for a minor injury. More severe damage is likely to need a longer recovery time. Ice. Ice reduces both pain and inflammation. A bag of frozen peas works well because it covers your whole knee. You also can use an ice pack wrapped in a thin towel to protect your skin. Although ice therapy is generally safe and effective, don't use ice for longer than 20 minutes at a time because of the risk of damage to your nerves and skin. Heat. You may experience temporary pain relief by applying a heat pack or hot-water bottle to the painful area on your knee. Compression. This helps prevent fluid buildup in damaged tissues and maintains knee alignment and stability. Look for a compression bandage that's lightweight, breathable and self-adhesive. It should be tight enough to support your knee without interfering with cot oirculation. 

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

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

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

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Also called: fibrositis self-carephysical exercise aerobic activity for 20–30 minutes 5 days a week improves cardiovascular health. If injured, pursuing an activity that avoids the injured muscle group or joint can help maintain physical function while recovering. Stress management pursuing an enjoyable activity or verbalising frustration to reduce stress and improve mental health. Relaxation techniques deep breathing, meditation, yoga, rhythmic exercise and other activities that reduce symptoms of stress hydrotherapy using water to relieve pain, treat diseases and maintain health. For example, mineral baths and hot tubs. Stretching stretching exercises can improve flexibility and improve physical function. Graded exercise therapy physical exercise that starts very slowly and gradually increases over time. Massage relaxes tense muscles. Heat therapy using heat is an excellent way to help relax muscles and encourage blood flow to areas that are particularly painful. This can easily be done at home using dry or damp hot towels. Simply hold the towel against the affected area until you feel relief. Ultrasound an ultrasound uses sound waves to produce heat which improves blood flow to deep muscle tissue. It can be used to relieve pain, stiffness, spasms, and inflammation widespread muscle pain and tenderness. Symptoms requires a medical diagnosis widespread muscle pain and tenderness are the most common symptoms. People may experience: pain areas: in the muscles, abdomen, back, or neck pain types: can be chronic, diffuse, sharp, or severe pain circumstances: can occur at night gastrointestinal: constipation, nausea, or passing excessive amounts of gas whole body: fatigue, feeling tired, or malaise muscular: muscle tenderness, delayed onset muscle soreness, or muscle spasms sensory: pins and needles, sensitivity to cold, or sensitivity to pain mood: anxiety, mood swings, or nervousness sleep: difficulty falling asleep or sleep disturbances cognitive: forgetfulness or lack of concentration hand: sensation of coldness or tingling also common: depression, flare, headache, irritability, joint stiffness, painful menstruation, or tingling feet treatment consists of self care and therapy medication, talk therapy and stress reduction may help in controlling the symptoms. Self-carephysical exercise aerobic activity for 20–30 minutes 5 days a week improves cardiovascular health. If injured, pursuing an activity that avoids the injured muscle group or joint can help maintain physical function while recovering. Stress management pursuing an enjoyable activity or verbalising frustration to reduce stress and improve mental health. Relaxation techniques deep breathing, meditation, yoga, rhythmic exercise and other activities that reduce symptoms of stress therapies support group a forum for counseling and sharing experiences among people with a similar condition or goal, such as depression or weight loss. Biofeedback controlling the body's heartbeat, brainwaves, breathing and blood pressure by monitoring them with sensors. Cognitive behavioral therapy a talk therapy focused on modifying negative thoughts, behaviours and emotional responses associated with psychological distress. Hydrotherapy using water to relieve pain, treat diseases and maintain health. For example, mineral baths and hot tubs. Chiropractic treatment techniques adjusting the spine and massaging the back muscles to relieve pain. Stretching stretching exercises can improve flexibility and improve physical function. Graded exercise therapy physical exercise that starts very slowly and gradually increases over time. Massage relaxes tense muscles. Acupuncture insertion of needles into specific points on the body to relieve pain and treat other conditions. A form of traditional chinese medicine. Medications selective serotonin reuptake inhibitor (ssri) eases symptoms of depressed mood and anxiety. Analgesic relieves pain. Nonsteroidal anti-inflammatory drug relieves pain, decreases inflammation and reduces fever. Nerve pain medication blocks pain caused by damaged nerves. Muscle relaxant reduces muscle tension and helps relieve muscle pain and discomfort. Fibromyalgia medications can help reduce the pain of fibromyalgia and improve sleep. Common choices include: •pain relievers. Over-the-counter pain relievers such as acetaminophen (tylenol, others), ibuprofen (advil, motrin ib, others) or naproxen sodium (aleve, others) may be helpful. Your doctor might suggest a prescription pain reliever such as tramadol (ultram). Narcotics are not advised, because they can lead to dependence and may even worsen the pain over time. •antidepressants. Duloxetine (cymbalta) and milnacipran (savella) may help ease the pain and fatigue associated with fibromyalgia. Your doctor may prescribe amitriptyline or the muscle relaxant cyclobenzaprine to help promote sleep. •anti-seizure drugs. Medications designed to treat epilepsy are often useful in reducing certain types of pain. Gabapentin (neurontin) is sometimes helpful in reducing fibromyalgia symptoms, while pregabalin (lyrica) was the first drug approved by the food and drug administration to treat fibromyalgia. Therapy a variety of different therapies can help reduce the effect that fibromyalgia has on your body and your life. Examples include: •physical therapy. A physical therapist can teach you exercises that will improve your strength, flexibility and stamina. Water-based exercises might be particularly helpful. •occupational therapy. An occupational therapist can help you make adjustments to your work area or the way you perform certain tasks that will cause less stress on your body. 

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

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

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

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The "normal" range (or negative test result) for rheumatoid factor is less than 14 iu/ml. Any result with values 14 iu/ml or above is considered abnormally high, elevated, or positive. Treatmentthere is no cure for rheumatoid arthritis. But clinical studies indicate that remission of symptoms is more likely when treatment begins early with medications known as disease-modifying antirheumatic drugs (dmards). Medicationsthe types of medications recommended by your doctor will depend on the severity of your symptoms and how long you've had rheumatoid arthritis. •nsaids. Nonsteroidal anti-inflammatory drugs (nsaids) can relieve pain and reduce inflammation. Over-the-counter nsaids include ibuprofen (advil, motrin ib) and naproxen sodium (aleve). Stronger nsaids are available by prescription. Side effects may include stomach irritation, heart problems and kidney damage. •steroids. Corticosteroid medications, such as prednisone, reduce inflammation and pain and slow joint damage. Side effects may include thinning of bones, weight gain and diabetes. Doctors often prescribe a corticosteroid to relieve acute symptoms, with the goal of gradually tapering off the medication. •disease-modifying antirheumatic drugs (dmards). These drugs can slow the progression of rheumatoid arthritis and save the joints and other tissues from permanent damage. Common dmards include methotrexate (trexall, otrexup, others), leflunomide (arava), hydroxychloroquine (plaquenil) and sulfasalazine (azulfidine). Side effects vary but may include liver damage, bone marrow suppression and severe lung infections. •biologic agents. Also known as biologic response modifiers, this newer class of dmards includes abatacept (orencia), adalimumab (humira), anakinra (kineret), baricitinib (olumiant), certolizumab (cimzia), etanercept (enbrel), golimumab (simponi), infliximab (remicade), rituximab (rituxan), sarilumab (kevzara), tocilizumab (actemra) and tofacitinib (xeljanz). These drugs can target parts of the immune system that trigger inflammation that causes joint and tissue damage. These types of drugs also increase the risk of infections. In people with rheumatoid arthritis, higher doses of tofacitinib can increase the risk of blood clots in the lungs. Biologic dmards are usually most effective when paired with a nonbiologic dmard, such as methotrexate. Therapy your doctor may send you to a physical or occupational therapist who can teach you exercises to help keep your joints flexible. The therapist may also suggest new ways to do daily tasks, which will be easier on your joints. For example, you may want to pick up an object using your forearms. Assistive devices can make it easier to avoid stressing your painful joints. For instance, a kitchen knife equipped with a hand grip helps protect your finger and wrist joints. Certain tools, such as buttonhooks, can make it easier to get dressed. Catalogs and medical supply stores are good places to look for ideas. Surgeryif medications fail to prevent or slow joint damage, you and your doctor may consider surgery to repair damaged joints. Surgery may help restore your ability to use your joint. It can also reduce pain and improve function. Rheumatoid arthritis surgery may involve one or more of the following procedures: •synovectomy. Surgery to remove the inflamed lining of the joint (synovium) can be performed on knees, elbows, wrists, fingers and hips. •tendon repair. Inflammation and joint damage may cause tendons around your joint to loosen or rupture. Your surgeon may be able to repair the tendons around your joint. •joint fusion. Surgically fusing a joint may be recommended to stabilize or realign a joint and for pain relief when a joint replacement isn't an option. •total joint replacement. During joint replacement surgery, your surgeon removes the damaged parts of your joint and inserts a prosthesis made of metal and plastic. Surgery carries a risk of bleeding, infection and pain. Discuss the benefits and risks with your doctor. Rheumatoid arthritis multiple joint pains / early morning painit is called as rheumatic arthritis. Treatment goals •to protect the joint from further damages. •provide pin relief. •prevent deformity and disabilities. •increase functional capacity. •improve flexibility and strength. •encourage regular exercise. •improve general fitness. Physiotherapy modalities - hot/cold applications- electrical stimulation- hydrotherapy and spa therapy rehabilitation treatment technique - rest and splinting - compression gloves - assistive devices and adaptive equipment - massage therapy - therapeutic exercise - patient education assistive devices and adaptive equipment occupational therapy improves functional ability in patients with ra. Occupational therapy interventions such as assistive devices and adaptive equipments have beneficial effects on joint protection and energy conservation in arthritic patients.Assistive devices are used in order to reduce functional deficits, to diminish pain, and to keep patients' independence and self-efficiency. Loading over the hip joint may be reduced by 50% by holding a cane. In fact, most of these instruments are originally designed for patients with neurologic deficits; therefore, certain adaptations may be needed for them to be used in patients with arthritis. Elevated toilet seats, widened gripping handles, arrangements related with bathrooms, etc. Might all facilitate the daily life. The procedures needed to increase compliance of the patient with the environment and to increase functional independence are +mainly determined by the occupational therapist. Massage therapy that improves flexibility, enhances a feeling of connection with other treatment modalities, improves general well being, and can help to diminish swelling of inflamed joints. Massage is found to be effective on depression, anxiety, mood, and pain. Therapeutic exercise every joint should be moved in the rom at least once per day in order to prevent contracture. In the case of acutely inflamed joints, isometric exercises provide adequate muscle tone without exacerbation of clinical disease activity. Moderate contractures should be held for 6 seconds and repeated 5–10 times each day. Dynamic exercise therapy in improving joint mobility, muscle strength, aerobic capacity and daily functioning in patients with rheumatoid arthritis (ra). Finally, in chronic stage with inactive arthritis, conditioning exercises such as swimming, walking, and cycling with adequate resting periods are recommended. They increase muscle endurance and aerobic capacity and improve functions of the patient in general, and they also make the patient feel better. It might be due to lack of blood circulation which is the reason for you to have scrotum pain / back pain. You have to do basic aerobic exercises for you to become fit and also to maintain the blood circulation and tone. Patient education in patients with ra, sociopsychological factors affecting the disease process such as poor social relations, disturbance of communication with the environment, and unhappiness and depression at work are commonly encountered. The treatment of rheumatic diseases should provide education and information to their patients about their condition and the various physical therapy and rehabilitative options that are available to improve their quality of life. Passive treatments for rheumatoid arthritis •cold therapy reduces circulation, which ultimately decreases swelling. For example, a cold compress may be placed on the painful area. •cold therapy in acute phase •dosage 10-20mints/1-2 times a day. •heat therapy eases muscle tension and gets blood to flow more quickly to the painful area. For example, a moist, warm cloth may be used to promote circulation. •heat therapy in chronic phase •dosage 20-30mints/1-2 times a day. •hydrotherapy involves reducing your ra-related pain and other symptoms with water. With hydrotherapy, you will be submerged in warm water to relieve your symptoms. •massage can help reduce muscle tension and promote good circulation. It's also a fantastic way to help you manage stress (especially important for people with rheumatoid arthritis). •transcutaneous electrical nerve stimulation (tens) works by blocking pain signals from getting to your spinal cord. It also helps decrease muscle spasms. •tens short term pain relief (6 to 18 hrs) •ultrasound creates warmth using sound waves, whichenchanes circulation and decreases joint pain, inflammation, and stiffness. Exercise for acute phase: •preformed exercise at least once a day. •general assisted movement through normal range (joint mobilisation). •isometric-“static movements” helps to maintain muscle tone without increasing inflammation. Exercise for the chronic phase: •can progress the above exercise to include use of light resistance. •postural/core stability exercises. •swimming/walking/cycling to maintain cardiovascular fitness. •gentle stretch for areas that become tight, such as knees &calves. Regular exercises: •maintaing muscle strength is important for joint stability & preventing injury. •muscles can become weak following reduced activity. •pain signals from yours nerves and swelling can both inhibits muscles. •muscle length can be affected by prolonged positions immobilization and tightness can limit daily activities. Alternative therapies: •thi chi. •musical therapy. •yoga therapy. •relaxation techniques. •pilates. Active treatments for rheumatoid arthritis •flexibility and strengthening exercises improve your range of motion and help you build muscle strength. Yoga and pilates are flexibility and strengthening exercises. •low-impact aerobic exercise is gentle but effective at helping you manage rheumatoid arthritis symptoms. Light walking is an example of this type of exercise. Your physical therapist will let you know how often to do these exercises. For example, you may need to do a few specific exercises 3 times a day, or your physical therapist may recommend a routine that incorporates 30 minutes of low-impact aerobic exercise a day and 30 minutes of strengthening exercises every other day. If your pain is more in the proximal 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. Wear elbow brace and wrist brace which will make her to feel warm and that will make the joints become firm. Hot water fermentation will helpknee cap will also help to prevent the damaged cartilagesif your pain is more in the distal 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. 

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