physiotherapist at work

Being Physio: Physiotherapist at Work

A real story or shall we say slice of life from a physiotherapist who was pronounced as the best physiotherapist by her own patient? Afterall, what it takes to being a physio?! Read on, in her own words.

During our college days when we were being trained to be a physio, we were told a story. It was about this huge ship which gets stuck in the middle of the ocean. No one among the marine engineers on the ship could rescue the ship. Help was sought from far and near. But absolutely no one could help. After a while when all the efforts start to seem waste, someone suggested a local mechanic staying on a nearby island. Not leaving any stone unturned, he was brought to the ship. This poor local guy comes, observes and examines the engine and then takes out a tool out of his backpack and taps a few times on a particular area of the engine. To everyone’s surprise engine starts whirring in no time. When they ask him about his service charges, he demands a big amount. No one expected a visibly poor and local basic mechanic lacking any fancy degrees to charge so much. When he demands such an amount, they ask him for the split of the services to justify the bill. He calmly replies, “The technique I used to solve your problem doesn’t cost much, but having an understanding and knowledge about which technique needs to be used for this particular problem and how effectively it needs to be used is costing you so much.”

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Vertigo & Vestibular Rehab Therapy

वर्टिगो (Vertigo): वेस्टिबुलर रीहैब थेरेपी (वी०आर०टी०)

वीआर टी  I  वर्टिगो  I  कारण  I  रिकवरी  I  उपचार  I  घरेलू देखभाल


वेस्टिबुलर रिहैबिलिटेशन थेरेपी (वीआरटी) एक व्यायाम आधारित कार्यक्रम है जो वर्टिगो जैसी समस्याओं के साथ जुड़े असंतुलन और चक्कर आने के लक्षणों को कम करने के लिए एक व्यायाम आधारित कार्यक्रम है। रिलिवा फिजियोथेरेपी मुंबई, नवी मुंबई, ठाणे और पुणे में अपने फिजियोथेरेपी क्लीनिक में ऐसे लक्षणों के प्रबंधन के लिए एक न्यूरो-ओटोलॉजिकल दृष्टिकोण के साथ वेस्टिबुलर रीहैब प्रदान करता है।

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Common Gym Injuries & Prevention

7 Common Gym Injuries And How To Prevent Them

Whether you workout on your own or at a gym, exercises when not done with proper form may result in injuries. Sometimes a freak accident during a workout may cause your fitness goals to take an abrupt break. Either way, you know that there exists a risk of injury while exercising.

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Common Dance Injuries

7 Common Dance Injuries And How To Prevent Them

Preventing Dance Injuries  I  Ankle Sprain Achilles and Tendonitis  I  Snapping Hip Syndrome  I  Stress fracture  I  Neck Strain  I  Rotator Cuff Tendonitis   I  Shoulder impingement  I  Meniscus Knee Tear  I  Lumbopelvic complex

Whether it is Zumba, Ballet, jazz, hip hop, Bollywood dance or bhangra; Dance has grown beyond an art form and has fast gained acceptance as a great exercise for physical fitness. Today dance is being vouched as the best exercise to boost your energy: physical as well as mental. And it works for all genders and all age groups.

Infact, dance and physical fitness share a symbiotic relationship: they go hand in hand. Regular dancers are meant to be fit and flexible. Physical strength and flexibility are of key importance for a skilled dancer. However, dancers do suffer with injuries, that too very often.

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Vertigo & Vestibular Rehab Therapy

Vertigo, Vestibular Rehabilitation Therapy

VRT  I  Vertigo  I  Causes  I  Recovery  I  Treatment   I  What to expect  I  Selfcare

Vestibular Rehabilitation Therapy (VRT) is an exercise-based program for reducing the symptoms of disequilibrium and dizziness associated with vestibular problems like vertigo. ReLiva Physiotherapy provides vestibular rehabilitation with a neuro-otological approach for managing such symptoms at its Physiotherapy clinics across Mumbai, Navi Mumbai, Thane and Pune.

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Sciatica pain

साइटिका दर्द (Sciatica) और उपचार

साइटिका दर्द :  यह क्या है?

साइटिका एक सामान्य प्रकार का दर्द है जो कि साइटिका / कटिस्नायुशूल तंत्रिका को प्रभावित करता है, जो जांघ के पीछे और पैर के नीचे की तरफ से फैली है। निर्भर करता है, दर्द पैर या पैर की उंगलियों तक भी बढ़ सकता है। आमतौर पर निचले शरीर के केवल एक तरफ प्रभावित होता है।

रीढ़ की हड्डी को हमारे ट्रंक का भार सहन करना पड़ता है, और रीढ़ की हड्डी के निचले भाग में साइटिका तंत्रिका होती है। यदि मुद्रा, मांसपेशियों की ताकत, और श्रोणि संरेखण में परिवर्तन होते हैं, जिसके माध्यम से यह गुजरता है, तंत्रिका संपीड़ित होती है जो काफी आम तौर पर होने वाला पीठ और साइटिका /तंत्रिका दर्द पैदा करती है।

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neuro rehab

Neuro Rehabilitation: How it helps in recovery of patient

Treatment and Recovery after Stroke

Neurological conditions affect all ages and people. We come across many such people and think that they will hardly be able to restore their normal functions anymore.

Neurological conditions would include:

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Sciatica pain

Sciatica Pain and its Treatment

Read this post in Hindi

Last Updated on 15 Oct, 2018

What is Sciatica?

Sciatica is a common type of pain affecting the sciatic nerve, which extends from the lower back all the way through the back of the thigh and down through the leg. Depending on where the sciatic nerve is affected, the pain may also extend to the foot or toes. Usually only one side of the lower body is affected

The spine has to bear the weight of our trunk, and at the bottom of the spinal column is the sciatic nerve. If there are changes in posture, muscle strength, and pelvic alignment through which it passes, the nerve is compressed which leads to the quite common low back and sciatic nerve pains

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back pain and obesity

Obesity and Back Pain

Last updated on 24 Jan 2019

Most people know that obesity contributes to the development of heart diseases, diabetes, high blood pressure and colon cancer. Did you know that obesity has a connection with back pain?

Whether obesity is the cause or aggravator to lower back pain, it is clear that the excess weight does no good to the back. When a person is obese, any extra weight creates added pressure as well as added work for the muscles. From a statistical point of view, there are multiple research studies that indicate a strong relationship between excess weight and lower back pain.

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fibromyalgia chronic pain


Fibromyalgia is a chronic syndrome, characterized by body aches and pain, weakness, stiffness, tender points around joints and stressful mind.

According to Arthritis India, 0.5-2% of the population is affected by Fibromyalgia & females are 3-7 times more frequently affected. 10-16% of the times, it is associated with the rheumatologic conditions.Fibromyalgia Awareness

The important consideration is that the diagnosis of this condition often gets delayed, before a definitive diagnosis is made.

We at ReLiva Physiotherapy & Rehab help you deal with the various symptoms of fibromyalgia present at any point of this chronic condition in the best possible ways at our clinics in Pune, Mumbai, Thane, Vashi, Nerul and Navi Mumbai.

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Developmental Milestones

Developmental milestones of each child are unique and develops at her/his own pace. Many parents worry a lot about their child and the time when the child should be achieving these milestones. Parents can educate themselves about the milestones and the opportunities for treatment and intervention in case of any disorder. Whether a child has a developmental delay or disorder, early identification and intervention are essential for achieving the best possible outcome.

The most common disorders are mental retardation, cerebral palsy, followed by autism spectrum disorders.Read More

Carpal Tunnel Syndrome

Carpal Tunnel Syndrome

Home Treatment  I  Physiotherapy treatment  I Understanding  I  Prevention  I  Symptoms  I Causes

Carpal tunnel syndrome is a type of repetitive stress injury characterized by pain, paralysis, or weakness in the wrist area. It is caused by compression of a nerve that passes through the carpal tunnel in the wrist

CTS is a common condition that occurs in 2.7% of the general population. Studies report that It is more common in women than men, and the average age of people with CTS is 40–50 years.

At an early stage, Carpal tunnel syndrome may cause you more inconvenience than pain owing to trouble in movement and use of your wrist. You could ease these early symptoms yourself.

Here are five ways you can treat your carpal tunnel syndrome at home:

  1. Discontinue the repetitive movement that is causing pain
  2. Heat/cold packs
  3. Wear a wrist splint to support your wrist in a neutral position. Splinting works the best when done within three months of having pain.
  4. Sleep with your hand in a neutral position on or alongside the bed.
  5. Shaking or massage the wrist to relieve burning sensation at night.




When is the time to see doctor for Carpal Tunnel Syndrome?

carpal tunnel syndrome

Early diagnosis and treatment is important in order to avoid any kind of permanent damage to the wrist nerve. If these home treatments don’t ease your pain in one or two weeks, it might be time to see a doctor. Physiotherapy is often recommended as part of your treatment plan to reduce the pain, swelling and help in stretching the muscles and retinaculum around and strengthening them.

Generally, surgery is only an option for severe cases of CTS and if the other treatments have failed for a period of at least six months.


How will physiotherapy help in the treatment of Carpal Tunnel Syndrome?

A good physiotherapy program would include:

  • Carpal bone mobilization and flexor retinaculum stretching to open the carpal tunnel
  • Nerve and tendon gliding exercises to ensure full unrestricted nerve motion is available.
  • Muscle and soft tissue extensibility.
  • Comprehensive upper limb, wrist and hand ROM strengthening and endurance exercises.
  • Grip and pinch, thumb and forearm muscle strengthening in later phases.

ReLiva physiotherapist will help you with:

  • Quickly relieve pain and swelling
  • Nerve gliding exercises
  • Loosen stiff muscles and ligaments
  • Strengthen your wrist and hand muscles
  • Improve your everyday living

In line with ReLiva’s 3 step Recovery Process, we also spend time in educating you about your condition, home exercises and dos and dont's, so that you can continue to remain healthy at your home even after the treatment is complete.

How can CTS be prevented?

As they say, prevention is better than cure. One can take care of the following things to prevent onset of CTS:


  • The positions of wrist while working.
  • Take frequent breaks from repetitive activities.
  • Stretch your wrists / arms periodically between activities.
  • A therapist may be helpful in reviewing ergonomic tips or performing a work place evaluation.



What Are the Symptoms of Carpal Tunnel Syndrome (CTS)?

Carpal Tunnel Syndrome (CTS) is usually associated with complaints in the hand, wrist and forearm, of:

  • numbness
  • tingling
  • pain, especially at night
  • decreased grip strength

A lot of patients report this as pins and needles in the hand / wrist and forearm. A person with CTS may also experience clumsiness in handling objects, usually caused by decreased grip strength.

What is Carpel Tunnel Syndrome?

Our wrist is made up of eight small bones. A ligament (also called retinaculum) lies across the front of the wrist. Between this ligament and the carpal bones is a space called the carpal tunnel. This carpel tunnel is a cramped up space, crowded with the muscle tendons attaching the forearm and the fingers and a median nerve.

The median nerve gives sensation to the thumb, index and middle fingers, and half of the ring finger. It also controls the movement of the small muscles at the base of the thumb.

Any tension in this canal due to various reasons can compress the median nerve giving rise to the symptoms. This is known as Carpal tunnel syndrome (CTS).

The main symptoms are pain, burning sensation, numbness and tingling in the thumb, index finger, middle finger, and the thumb side of the ring finger. Pain may extend up the arm. Weak grip strength may occur and after a long period of time the muscles at the base of the thumb may waste away.

Typically, burning, acing, tingling sensations in the hand are present in the night. It is relieved by shaking or massaging the wrist.

What causes Carpal Tunnel Syndrome?

As stated above, the symptoms occurring in carpel tunnel is due to the nerve compression leading to inflammation. This in turn produces pain, swelling and at times obstructed blood flow. Causes of carpal tunnel syndrome are:

  • Congenital: the carpal tunnel is simply smaller in some people than in others
  • Obesity
  • Rheumatoid
  • Repetitive movements: repeated use of vibrating hand tools; poor positioning of the wrists while using keyboards, mouse; repeated movements at the wrist such as playing piano, typing
  • Development of a cyst or tumor in the canal
  • Diabetes 
  • Thyroid dysfunction
  • Fluid retention from pregnancy or menopause
  • High blood pressure (high BP)
  • Fractures or trauma to the wrist

Something you may not know about CTS:

Women are three times more likely to have CTS than men. It may be that the wrist bones are naturally smaller in most women, creating a tighter space through which the nerve passes. Women also deal with strong hormonal changes during pregnancy and menopause that makes them more likely to suffer from CTS.


How is CTS treated?

Treatment of carpal tunnel syndrome should begin as early as possible, under a doctor's direction.  Underlying causes such as diabetes or arthritis should be treated first.

Overall the treatment for CTS will include some or all of the following:

A. Non- surgical treatment

  1. Care at home(see above for things to do at home)
  2. Splinting: Initial treatment is usually a splint worn at night.
  3. Avoiding daytime activities that may provoke symptoms. Some people with slight discomfort may wish to take frequent breaks from tasks, to rest the hand.  If the wrist is red, warm and swollen, applying cool packs can help.
  4. Medicines: In special circumstances, your doctor may prescribe you some medication to ease the pain and swelling associated with carpal tunnel syndrome.
  5. Physiotherapy: Physiotherapy is often recommended as part of your treatment plan to reduce the pain, swelling and help in stretching the muscles and retinaculum around and strengthening them. Physiotherapy at Reliva involves three main components -:
  1. Passive treatments,
  2. Active treatments and
  3. Education and self management.

B. Surgery:

Generally, surgery involves severing a ligament around the wrist to reduce pressure on the median nerve. You may choose to have one of the following:

a. Open Release surgery

b. Endoscopic surgery: This may allow somewhat faster functional recovery and less post-operative discomfort than traditional open release surgery but it may also have a higher risk of complications and the need for additional surgery. Your surgeon is best equipped to decide.

Following surgery, the ligaments usually grow back together and allow more space than before.  Although symptoms may be relieved immediately after surgery, full recovery from carpal tunnel surgery can take months.  Almost always there is a decrease in grip strength, which improves over time.

How is CTS treated during Pregnancy?

CTS is common in pregnancy. If you have tingling, numb and painful hands during pregnancy, it's likely to be caused by carpal tunnel syndrome (CTS). It happens when there is a build-up of fluid (oedema) in the tissues in your wrist.

A lot of pain medications are not safe during pregnancy, hence it may be best to consult a prenatal pain specialist like those at FabMoms or a physiotherapist to find relief from the symptoms.


What will happen if carpal tunnel syndrome is not treated?

If left untreated, carpal tunnel syndrome can lead to weakness and lack of coordination in your fingers and


Pain may radiate up the arm all the way to the shoulder. Over time, if untreated, carpal tunnel syndrome can cause the muscles on the thumb side of your hand to waste away (atrophy). Even with surgical treatment, strength and sensation may never be completely restored.

How long does it take to recover from carpal tunnel syndrome?

Early diagnosis and compliance of treatment suggestions (see above) may mean early relief from pain. However, numbness may take longer to be relieved, even up to 3 months. ReLiva physiotherapist will also spend time in educating you about your condition, home exercises and dos and dont's, so that you can continue to maintain your recovery and avoid recurrence of CTS.

Surgery won't help if carpal tunnel syndrome is the wrong diagnosis. When the carpal tunnel syndrome has become severe, relief may not be complete. There may be some pain in the palm around the incisions that can last up to a few months.

Can Carpal tunnel happen all of a sudden?

In most cases, one can sense pain in the wrist which grows to include numbness and tingling at night. This can continue to aggravate over a prolonged period of time. In the case of acute CTS, symptoms may be sudden and severe. The may appear over a matter of hours rather than weeks or months and may be triggered by specific causes ( see causes of CTS above). Whether acute or chronic, pain associated with carpal tunnel syndrome may even spread up the arm to the shoulder.

Occupations with High Risks of Carpal Tunnel Syndrome:

Statistically it is reported that profession has a large role in incidence of CTS. Here are few occupations with High risk (greatest risk to lowest):

  • Cooks and other cafeteria workers
  • Installers and repairers of electrical power lines
  • Construction and maintenance personnel (including painters)
  • Painters, construction and maintenance
  • Highway workers
  • Metal workers, and mechanics
  • Housekeepers and maids
  • Industrial machine mechanics

Last Updated on 6 August, 2018

This post is based on the inputs from Dr Carol Johnson (PT). Dr Carol is an expert with musculoskeletal issues pertaining to office ergonomics, sports injury and women’s health.


Related Reading:

All about DeQuervains Syndrome

Ergonomics Programme for Corporate Employees

5 minute Office Stretch exercises: Back, Neck pain

Ergonomics: Does it matter in your workplace

Neck Pain : Managing at Home

Physiotherapy, a sustainable solution for workplace Health & Wellness


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