Sciatica pain and treatment

Sciatica Pain and its Treatment

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Sciatica: What it is

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

SYMPTOMSSciatica pain and treatment

  • Pain - vary widely from a mild ache to a sharp, burning sensation or excruciating discomfort. Sometimes it may feel like a jolt or electric shock. It may be worse when you cough or sneeze, prolonged sitting and activities like bending forward can aggravate symptoms.
  • Tingling or numbness
  • Difficulty moving the leg or foot
  • Loss of feeling in the affected leg
  • Weakness in the affected leg
  • Loss of bowel or bladder function


Sciatica most commonly occurs when a herniated disk or a bone spur on the spine compresses part of the nerve causing inflammation, pain and numbness in the affected leg.

  • Irritation of the roots of the lower lumbar and lumbosacral spine
  • Lumbar spinal stenosis (narrowing of the spinal canal)
  • Degenerative disc disease (breakdown of discs, which act as cushions between the vertebrae)
  • Spondylolisthesis (a condition in which one vertebra slips forward over another one)
  • Piriformis Syndrome(Entrapment of nerve due to tight piriformis muscle)
  • More rarely, the nerve can be compressed by a tumor or damaged by a disease such as diabetes.

Risk factors for sciatica include:

  • Age
  • Obesity
  • Prolonged sitting
  • Diabetes affects the way your body uses blood sugar, increases your risk of nerve damage

Physical Therapy or Physiotherapy Treatment

  • Ultrasound– decrease healing time and relieve stiff and inflexible muscles by improving the circulation and gently heating the muscle.
  • Transcutaneous Electrical Nerve Stimulation – In some cases using a very small and controlled amount of electricity can decrease the intensity and muscle spasms .
  • Nerve Gliding Activities: Exercises that move and "glide" your nerves. Nerve gliding focuses on allowing the nerves to move more easily as you bend and straighten your joints.
  • Mobilisation techniques to increase joint mobility and correct joint mechanics.
  • Sensory integration
  • Stretching to alleviate sciatic pain (Piriformis and hamstrings)
  • Strengthen the spinal column and the supporting muscles, ligaments and tendons,the abdominal muscles, gluteus and hip muscles. (McKenzie exercises and Dynamic Lumbar Stabilization)
  • Posture correction and spinal stabilisation - Focusing on core muscles — the muscles in your abdomen and lower back that are essential for proper posture and alignment.
  • Good body mechanics and ergonomic modifications

Physiotherapy Benefits

  • With manual physical therapy, specific exercises, and muscle retraining, you can correct posture and lessen the stress on the lumbar area of your spine minimizing the occurrence of this ailment.
  • Exercise is usually better for relieving sciatic pain than bed rest. Patients may rest for a day or two after their sciatic pain flares up, but after that time period, inactivity will usually make the pain worse.
  • Without exercise and movement, the back muscles and spinal structures become weak and less able to support the back, that can lead to back injury and strain, which causes additional pain.
  • Active exercise is important for the health of the spinal discs. Movement helps exchange nutrients and fluids within the discs to keep them healthy and prevent pressure on the sciatic nerve
  • A thorough and individualized treatment plan is created to guide you through the recovery process and maximize your success.
Sciatica pain and treatment

साइटिका के दर्द

Hindi Disclaimer

कटिस्नायुशूल (साइटिका) कटिस्नायुशूल दर्द का एक आम प्रकार sciatic तंत्रिका, जो और नीचे जांघ के पीछे पैर के माध्यम से सभी तरह के माध्यम पीठ के निचले हिस्से से फैली प्रभावित हो रहा है। जहां sciatic तंत्रिका प्रभावित होता है पर निर्भर करता है, दर्द भी पैर या पैर की उंगलियों को बढ़ा सकता है। आमतौर पर कम शरीर के केवल एक तरफ प्रभावित है रीढ़ हमारे ट्रंक का वजन सहन करने के लिए है, और स्पाइनल कॉलम के नीचे sciatic तंत्रिका है। आसन, मांसपेशियों की शक्ति में परिवर्तन, और श्रोणि संरेखण जिसके माध्यम से यह गुजरता देखते हैं, तो तंत्रिका संकुचित है जो काफी कम आम वापस करने के लिए और sciatic तंत्रिका दर्द होता है लक्षण • दर्द – एक तेज, जलन या कष्टदायी असुविधा के लिए एक हल्के दर्द से व्यापक रूप से भिन्न हो। कभी कभी यह एक झटका या बिजली के झटके की तरह महसूस कर सकते हैं। यह बुरा हो सकता है जब आप आगे झुकने लक्षण बढ़ सकता है की तरह लंबे समय तक बैठे और गतिविधियों खांसी या छींक,। • झुनझुनी या अकड़ना • कठिनाई पैर या पैर चलती • प्रभावित पैर में महसूस की हानि • प्रभावित पैर में कमजोरी • आंत या मूत्राशय समारोह का नुकसान कारण कटिस्नायुशूल सबसे अधिक होता है जब एक herniated डिस्क या रीढ़ की हड्डी पर एक हड्डी प्रेरणा तंत्रिका प्रभावित पैर में सूजन, दर्द और अकड़ना के कारण का हिस्सा compresses।  • कम काठ और lumbosacral रीढ़ की जड़ों की जलन  • काठ का रीढ़ की हड्डी में एक प्रकार का रोग (स्पाइनल कैनाल के संकुचन)  • अपक्षयी डिस्क रोग (डिस्क, जो कशेरुकाओं के बीच कुशन के रूप में कार्य का टूटना)  • स्पोंडिलोलिस्थीसिस (एक शर्त है जो एक बांस आगे एक और एक पर फिसल जाता है)  • piriformis सिंड्रोम (तंत्रिका की फंसाने तंग piriformis मांसपेशियों की वजह से) • अधिक शायद ही कभी, तंत्रिका मधुमेह जैसे एक ट्यूमर से संकुचित किया जा सकता है या क्षतिग्रस्त एक बीमारी से। कटिस्नायुशूल के लिए जोखिम कारकों में शामिल हैं:  • आयु  • मोटापा • लंबे समय तक बैठे  • मधुमेह तरह अपने शरीर को रक्त शर्करा का उपयोग करता है को प्रभावित करता है, तंत्रिका क्षति का खतरा बढ़ जाता है भौतिक चिकित्सा • Ultrasound- उपचार समय कम होती है और रक्त परिसंचरण में सुधार और धीरे पेशी हीटिंग द्वारा कठोर और अनम्य मांसपेशियों को राहत देने के लिए। • Transcutaneous विद्युत तंत्रिका उत्तेजना – बिजली का एक बहुत छोटा और नियंत्रित राशि का उपयोग तीव्रता और मांसपेशियों की ऐंठन कम कर सकते हैं कुछ मामलों में। • तंत्रिका ग्लाइडिंग क्रियाएँ: व्यायाम कि चाल और “फिसलना” अपने तंत्रिकाओं। तंत्रिका ग्लाइडिंग के रूप में आप मोड़ और अपने जोड़ों सीधा नसों और अधिक आसानी से स्थानांतरित करने की अनुमति पर केंद्रित है। • लामबंदी तकनीक संयुक्त गतिशीलता और सही संयुक्त यांत्रिकी बढ़ाने के लिए। •    संवेदी एकीकरण • sciatic दर्द को कम करने के लिए टूटती (piriformis और हैमस्ट्रिंग) • स्पाइनल कॉलम और समर्थन की मांसपेशियों, ligaments और tendons, पेट की मांसपेशियों, gluteus और कूल्हे की मांसपेशियों को मजबूत बनाना। (मैकेंजी अभ्यास और गतिशील काठ का स्थिरीकरण) • मुद्रा सुधार और रीढ़ की हड्डी में स्थिरीकरण – अपने पेट में मांसपेशियों और पीठ के निचले हिस्से को उचित आसन और संरेखण के लिए आवश्यक हैं – कोर की मांसपेशियों पर केंद्रित है। • अच्छा शरीर यांत्रिकी और ergonomic संशोधनों शारीरिक थेरेपी लाभ • मैनुअल भौतिक चिकित्सा, विशिष्ट व्यायाम, और मांसपेशियों में फिर से शिक्षित के साथ, आप रवैया सही है और इस बीमारी की घटना को कम से कम अपनी रीढ़ की काठ क्षेत्र पर तनाव को कम कर सकते हैं। • व्यायाम आम तौर पर बिस्तर पर आराम से sciatic दर्द से राहत के लिए बेहतर है। मरीजों को उनकी sciatic दर्द फ्लेयर्स के बाद एक या दो दिन के लिए आराम कर सकते हैं, लेकिन उस समय अवधि के बाद, निष्क्रियता आम तौर पर दर्द बदतर कर देगा। • व्यायाम और आंदोलन के बिना, पीठ की मांसपेशियों और रीढ़ की हड्डी के ढांचे को कमजोर और कम पीठ, कि पीठ की चोट और तनाव है, जो अतिरिक्त दर्द का कारण बनता है के लिए नेतृत्व कर सकते हैं समर्थन करने में सक्षम हो जाते हैं। • सक्रिय व्यायाम रीढ़ की हड्डी में डिस्क के स्वास्थ्य के लिए महत्वपूर्ण है। आंदोलन के लिए उन्हें sciatic तंत्रिका पर स्वस्थ रखने के लिए और दबाव को रोकने के लिए डिस्क के भीतर विनिमय पोषक तत्वों और तरल पदार्थ में मदद करता है • एक पूरी तरह से और व्यक्तिगत उपचार योजना वसूली की प्रक्रिया के माध्यम से मार्गदर्शन और अपनी सफलता को अधिकतम करने के लिए बनाई गई है।

Bells palsy physiotherapy treatment

Bells Palsy: Treatment with ReLiva Physiotherapy

Bell’s palsy is a condition that causes temporary weakness or paralysis of the muscles in one side of the face. It is the most common cause of Facial Paralysis.

It usually results from a dysfunction of the cranial nerve VII (the facial nerve) causing paralysis of one side of the face. The very peculiar feature of this condition is a rapid onset of partial or complete paralysis that often occurs overnight.

It is named after Scottish Anatomist Charles Bell (1774-1842) who first described this condition and hence the name – Bell’s Palsy.


Why does it happen?Bell's Palsy: Symptoms and treatment

Bell’s palsy is believed to occur when the nerve that controls the muscles in your face becomes compressed.

The exact cause is unknown, although it’s thought to be because the facial nerve becomes inflamed, possibly due to a viral infection. The herpes virus is thought to be the most common cause but other viruses may also be responsible.

Some conditions considered to be related to it are Brain tumors, Ear infection, Extreme cold exposure, Herpes zoster infection, Mumps etc.

What are the symptoms?

The symptoms of Bell’s palsy vary from person to person. The weakness on one side of the face can be described as either:

1. Partial Palsy, which is mild muscle weakness

2. Complete Palsy, which is no movement at all (Paralysis) – although this is very rare

Bell’s palsy can also affect

  • The eyelid and mouth, making it difficult to close and open them
  • Paralysis of one side of the face causing inability to close the affected side eye, loss of whistling, frowning, lip protrusion. In other words, “loss of expressions
  • Loss of sensation in the anterior 2/3rd of the tongue.
  • Excessive lacrimation (tears)
  • Upward & outward movement of the eyeball when patient attempts to close his eyes. This is called as Bell’s Phenomenon.
  • Some people even experience tingling in face, pain, moderate to severe headache, memory and balance issues.
  • In rare cases, it can affect both sides of a person’s face.

Who gets Bell’s Palsy?

Bell’s Palsy is a rare condition that affects about one in 5,000 people a year. It’s most common in people aged 15-60, with 15- to 44-year-olds experiencing the highest incidence

But people outside this age group can also suffer from the condition. Both men and women are affected equally.

Bell’s palsy is more common in pregnant women and those with diabetes and HIV, for reasons that are not yet fully understood.

YES! Babies can be born with facial palsy but this condition is more common in Adults.

Treating Bell’s Palsy

When you face weakness in the face, meet your physician/Neurologist immediately.

  • The first line of treatment is usually Medication to reduce inflammation of the facial nerve and Antivirals (if it is related to herpes infection). Steroids have been shown to be effective.
  • Physiotherapy treatment for Bell’s Palsy may consist of facial massage, exercises, acupuncture and electrical stimulation.
  • The third line of treatment is Surgery.

Most people with Bell’s palsy will make a full recovery within nine months. There are ways to accelerate the process and reduce the chance of complications. However, if you have not recovered by this time, there is a risk of more extensive nerve damage and further treatment may be needed.

How can Physiotherapy be helpful?Physiotherapy treatment for Bell's Palsy

Physiotherapy has been known to be successful in a big number of Bell’s Palsy cases.

  • Physiotherapy includes muscle re-education exercises and soft tissue techniques to prevent permanent contractures of the paralyzed facial muscles.
  • It helps to maintain the muscle tone of the affected facial muscles and stimulate facial nerve using Galvanic/Faradic Electrical Stimulation.
  • Physiotherapy is also helpful in reducing pain with the use of various pain relief modalities.

At ReLiva we can assess, treat and monitor your condition from the acute onset of Bell’s Palsy through the various stages of recovery. Our Physiotherapists will follow the standardized 4 step ReLiva process to identify your goals and aim to restore facial muscle strength and symmetry, and help to stimulate facial nerve and maintain muscle tone and improve their co-ordination and range of movement.

Self Help Advice

  • You should take care when eating not to bite the inside of your cheek or lip.
  • Check that your cheek and gums are free of food after eating.
  • Try use both sides of your mouth to chew food thus encouraging the muscles on the affected side to work.
  • Sometimes your speech may be affected. You may find giving your mouth a little extra support from your hand while you talk will ease this at times.
  • If the muscles around your eye are affected you should take particular care to remove dust from your eye. You can imitate blinking by gently closing your eye with your finger tips.
  • Glasses may be useful to protect against dust particles when you are outdoors.
  • You may need artificial teardrops to cleanse your eye.

You are invited to book a session with one of our clinics at ReLiva Physiotherapy & Rehab for Bell ’s Palsy rehabilitation exercises and advice. Our Physiotherapy experts will surely help you to “Smile”, “whistle” and “Express” yourself all over again!

This article is purely for general information. Please contact your healthcare expert for specialised medical care. Please go through our Disclaimer and Privacy policy 

stroke recovery

Stroke Treatment and Life after Rehabilitation

There is life even after Stroke

Just Experienced Stroke?

If you just experienced a stroke, you are most likely scared and confused. Some of the questions you have may include: “Why did I have a stroke?”; “What kind of stroke treatment is available?”; and “What kind of rehabilitation do I need?”.

Your experiences will vary depending on where in your brain the stroke occurred and the type of stroke. Learn more about stroke, risks, types of treatment and rehabilitation, and recovery for your specific post-stroke challenges.


What is STROKE?

Also referred as “ Brain Attacks” or CVA (Cerebro Vascular Accident); Stroke is loss of brain function due to a disturbance in the blood supply to the brain.

This disturbance is caused by either Ischemia (lack of blood flow) or Haemorrhage ( rupture of blood vessels). Ischemia can be caused because of thrombosis (blood clot) blocking the flow of blood to brain and accounts to 80% of stroke cases.

Stroke and Ischemic heart disease together form the most lethal disease in India, causing long lasting brain damage and debilitating disabilities among those who survive

Why did I have a Stroke?

A stroke occurs when the blood supply to part of your brain is interrupted, depriving brain tissue of oxygen and food. Within minutes, brain cells begin to die. There are many factors that may contribute to having a stroke.

Risk Factors that can cause Stroke

Stroke is preventable with manageable risk factors such as Hypertension, Diabetes, Cigarette Smoking, High Alcohol Consumption, Sedentary lifestyle, Obesity and high cholesterol.

But there are certain non-modifiable risk factors such as Aging, Gender (males more affected than females) and Cardiac disease.

The cause of some strokes is never known. The good news is that strokes can be treated and prevented.

How do I know – Signs & Symptoms

Symptoms usually appear suddenly, over seconds to minutes and symptoms depending upon the area of the brain affected. Following are some of the main symptoms:

  • Hemiplegia (paralysis of one side of the body including face)
  • Numbness and Loss of sensations in the affected side of the body
  • Altered smell, taste, hearing or vision, difficulty in swallowing and speech
  • Balance problems, altered walking pattern and activity of daily living such as eating, dressing, mobility etc. get affected


Immediate treatment can help minimize effects of stroke and improve recovery outcomes. Since stroke is a medical emergency, Rush the affected person to a medical facility.

The first line of treatment is Thrombolysis ( breaking the clot down) or Thrombectomy (removal of the clot by surgery).

Stroke affects everybody differently. Many stroke survivors continue to improve over a long time, sometimes over a number of years.  Recovery from stroke involves making changes in the physical, social and, emotional aspects of your life.

After the hospital discharge, a sustained Rehabilitation is required to resume lost body functions.

Rehabilitation is about getting back to normal life and living as independent a life as possible. It involves taking an active approach to ensure that your life goes on. This can mean learning new skills or relearning old ones. It may involve adapting to new limitations and post-stroke conditions. Or it can mean finding new social, emotional, and practical support to live your best life post-stroke.Stroke Recovery via Physiotherapy led Rehabilitation at ReLiva

With good care and rehabilitation, there is life after stroke.

Stroke Rehabilitation Programme

It is a process to help the stroke affected people to return back to normal life as much as possible by regaining & relearning the skills of everyday living. Physiotherapy, Occupational therapy and Speech therapy – together form the cornerstones of the Rehabilitation process for such people.

How Physiotherapy can help in Stroke Rehabilitation

  • Physiotherapist focuses on educating the patient and family members about the condition, improving the joint range and strength by performing exercises & relearning functional tasks such as bed mobility, transfers, walking etc.
  • Physiotherapist also works with patient to improve awareness and use of hemiplegic side with use of various neurological methods such as NDT/BOBATH.
  • Advanced Physiotherapy setups like those of ReLivaTM also offer novel non-invasive rehabilitation methods like Mirror therapy/ Motor Imagery etc.
  • Stroke also reduces general fitness thus a Cardiorespiratory Training under the supervision of a trained physiotherapist can improve the walking speed, tolerance & independence during walking.

Stroke Rehabilitation should be started as quickly as possible and can last anywhere from few months to over a year. Early recovery and rehabilitation can improve functions and sometimes result into remarkable recoveries for someone who suffered a stroke. Maximum return of function can be achieved/seen in the very first few months after the stroke incidence, so it is advisable – “Sooner the Better

This article is purely for general information. Please contact your healthcare expert for specialised medical care. Please go through our Disclaimer and Privacy policy.

SI Pain & Pregnancy: Tips

Pregnancy is known to trigger Sacroiliac Joint Dysfunctions specially Sacroiliitis. ISI Pain in Pregnancyt may cause significant discomfort in turning sides in bed, getting up, rolling over and so on. The increased weight and therefore pressure on the muscles only aggravates the pain further. Here are some tips for expectant women with posterior pelvic pain (Sacroiliac joint dysfunction). You may also enroll for specialised Pregnancy exercise program ( FAB Moms) to keep all these pains at bay.

Lying down

  • Avoid lying on your back for long periods of time, particularly after the 19th week of your pregnancy.
  • Try lying on your side (preferably your left) with a pillow placed between your knees and another under your tummy.
  • If your waist sags down into the bed, try placing a small rolled up towel under your waist.


Turning over in bed

  • To turn to your right while lying on your back, arch your lower back, tighten your pelvic floor muscles and lower abdominal muscles and bend both knees one by one.
  • Turn your head to the right and take your left arm over to the right of your body. Hold onto the side of your bed if you can.
  • To turn, pull with your left hand and take both knees over to the right so that you roll to the right. As soon as possible, bend your knees up as high as they will go – this helps to lock out your pelvis and lessen pain.
  • Reverse this to turn to the left.

Getting out of bed

  • Roll onto your side with your knees bent up, move your feet over the edge of the bed and push yourself up sideways with your arms.
  • Reverse the process when you lie down.

Standing from a sitting position

  • Sit on the edge of the chair.
  • Keeping your knees apart slightly and lean forwards till your head is directly over your knees, keeping your back straight.
  • Stand up by pushing up with your arms, with your back straight and tummy tucked in. This helps to hold your pelvic joints in their most stable position and may reduce your pain significantly.

Expecting moms who participated in FAB Moms, a supervised Pregnancy Exercise Program were able to avoid or deal with such pregnancy related aches & pains far more easily. To learn more about FAB Moms, click here.

Related Articles:

FAB Moms, Pregnancy Exercise Program

Benefits of exercise during Pregnancy

Posture in Pregnancy: Do’s & Don’ts

Happy& Fit Pregnancy ; Back to Shape afterwards

SI Pain & Pregnancy Tips

Infographic on Why Exercise while Pregnant

FAB Moms, Prenatal Exercise Program

This article is purely for general information. Please contact your healthcare expert for specialised medical care. Please go through our Disclaimer and Privacy Policy.

Six Active Stretches

Stretching for sport and exercise improves flexibility, which increases the ability of a joint to move through its full range of motion; in other words, how far it can bend, twist and reach.

What happens when we stretch?

Regular stretching is thought to increase flexibility, both by making muscles more supple and by retraining the nervous system to tolerate stretching further. Flexibility from regular stretching gradually disappears once you stop stretching – typically after four weeks.

How to stretch properly?

To stretch properly and safely, slowly stretch the muscle just until you feel resistance. Resistance is the point at which you feel a slight pull. It should not be painful. Stop and hold each stretch for 10 to 20 seconds without bouncing up and down. During the stretch, breathe deeply and regularly. Don’t hold your breath. Make sure your muscles are warmed up before you stretch. The best time to stretch is after exercise, when your muscles are most supple. Learn to make the most of stretching by clicking here.

Active stretches you should be doing

Each of the exercises here is a dynamic stretch, which means it increases flexibility through movement, rather than by simply holding a position. “Active stretching decreases your risk of injury, relieves back pain, and boosts your athletic performance,” says Tanja Djelevic, who includes this series in her bendable body class at crunch fitness in West Hollywood. Try this routine before a race, after a workout, or at the end of the day—and experience the difference a little motion can make.

Pile stretch


1) Pile stretch   

What: Stretches inner and outer thighs, arms, shoulders, and back

How: Stand with feet wide, toes turned out, and raise arms overhead. Squat deep and lower the arms in front of you, elbows touching knees and palms facing forward. Pull right shoulder back as you raise right arm [shown], then twist in opposite direction, raising left arm. Rise up to starting position. Do 8 reps.


Low Lunge

2) Low lunge

What : Stretches intercostal muscles (between the ribs) and the thoracic cage aiding the lungs to take in more oxygen

How: Lunge forward with left leg until thigh is parallel to floor, and place hands on floor on either side of left foot. Raise left arm straight up toward ceiling as you rotate left shoulder back [shown]. Lower hand to starting position, and move into next stretch (active pigeon).


3) Active Pigeon      Active Pigeon

What : Stretches hip flexors, butt, and abs

How: Pull left knee in toward right hand, then lower left leg to floor so foot is below right hip. Lower hips as you push through hands, lifting head and chest [shown]. From this position, move into the next stretch (down-dog extension).


wrap around  


4) Wrap around

What : Stretches neck and shoulders

How : Stand with feet hip-width apart and reach right arm behind your back, palm facing away from you. Clasp hands and pull left elbow back as you draw shoulder blades together. Hold as you circle head slowly [shown] to complete 1 rep. Do 8 reps.


 5) Take a bow         take a bow

What : Stretches shoulders, legs, chest, and back

How : Stand with feet wide, left foot turned out, and rotate torso to the left. Clasp hands behind you with palms together and arms extended. Bend forward from hips until back is parallel to floor as you raise arms [shown]. Slowly rise up to starting position. Do 8 reps.



 6) The standing side stretchStanding side stretch

What: Stretches arms, torso

How: Stand with your feet together and your arms straight overhead. Clasp your hands together, with your fingers interlaced and pointer fingers extended. Inhale as you reach upward. Breathe out as you bend your upper body to the right. Take five slow breaths. Slowly return to the center. Repeat on the left side.

walking for physical activity

Fitness Essentials : Walking

Walking is as simple as it gets for fitness. All you need is a good pair of shoes, comfortable clothing, and desire. Start walking towards a healthier you. Walking forms an essential part of our Activity Pyramid too.

Plan your routine. If you walk every morning, that’s perhaps the best! For it is during mornings when you beat all the traffic and catch the freshest air after the pollution has long settled down. Nature is just waking up with all its sound and visual beauty and most of us would love to witness it all during our walk.

Make it a habit! Usually it works best to have more-or-less the same time everyday for a walk. Form a routine – Morning or evening – whatever works for you (I know of some who have been walking even at 4 in the afternoon!) Afterall some exercise is better than none at all!

Build up your walk. Get Started. If you’re not active now, start walking three times a week at a stroll for 20 minutes.  Add five minutes to your walks next week (total walking time 20-25 minutes). Keep adding 5 minutes until you are walking as long as desired. Then start walking every day.

Distance or time? Some walkers focus on distance, others target time. Finally, it all boils down to speed. So use both distance and time as well as heart rate. Any reasonable health gadget or fit-bit will be able to track the heart rate while you walk. What should your heart rate be? “Most recommendations suggest starting out at 70% to 75% of your maximum heart rate,” Dr Neelam Patel, Sports Physiotherapist from ReLivaTM says. “But this may not be enough if you’re fit.”

How much is good ? Walking daily will help (a minimum of 5 days a week is a good goal). You should walk fast enough to maximize the benefits but a good thumb rule to judge it is that you should not be gasping for air.

If you are walking for weight loss you should walk a minimum of five days a week, 45 to 60 minutes at a brisk pace. ReLivaTM suggests “Talk test” to check your pace – You may consider the pace of walk to be good enough when you are walking fast, yet you can hold a conversation (atleast 4-5 word sentence) comfortably while walking.

As you start your walking routine, remember to:

  1. Get the right gear. Choose shoes with proper arch support, a firm heel and thick flexible soles to cushion your feet and absorb shock. If you walk outdoors very early in the morning when it is almost dark, wear white or bright colors or a windsheeter (during monsoons 7 winters) with reflective tape for visibility.
  2. Carry a reasonable size napkin or sweat cloth so you can wipe yourself dry and not get hassled with the sweat trickling on your face and neck.
  3. Drink up water before you begin. Proper hydration is very important as you are likely to loose important nutrients alongwith the sweat. If you are planning to walk for a long time, it may be nice idea to carry a small water bottle along.
  4. Choose your walking path If you’ll be walking outdoors, avoid paths with broken sidewalks, potholes, puddles, uneven pebbled roads or slippery tracks.
  5. Warm up. Walk slowly for five to 10 minutes to warm up your muscles and prepare your body for a brisker walk to exercise.
  6. Cool down. At the end of your walk, walk slowly for five to 10 minutes to help your muscles cool down and taper off the routine.
  7. Stretch. After you cool down, gently stretch your muscles. It may be a good idea to stretch before as well as after you walk.

There really are so many benefits for such a simple activity! Hope you are making the most of it!

Don’t forget to leave your memorable moments or anecdotes related to your walking routine with us in the comments section below.

fall prevention balance training

Falls of Seniors: What to do

More than one third of person 65 years of age or older fall each year and in half of such cases the falls are recurrent.

If you are a senior, ie 60 year or older that means you need to take more care and precautions for yourself. Other than medical conditions or diseases which you take care by doing routine blood tests and investigations, you should not forget to keep yourself free from falls.

What are falls?

Falls include dropping from a standing or sitting position or from ladder or stepladder.

Falls are common in elderly. It has been proven scientifically that with aging, a lot of brain structures, muscles strength, vision, hearing and sensations show a gradual decline.

Causes of fall

Many things can put you at higher (double or triple) risk for a fall.

Medical Risk Factors

·         Impaired musculoskeletal function, gait (read walking style) abnormality and osteoporosis                 falls

·         Cardiac arrhythmias (irregular heartbeat), blood pressure fluctuation

·         Depression, Alzheimer’s disease and senility

·         Arthritis, hip weakness and imbalance

·         Neurologic conditions including stroke, Parkinson’s disease, multiple sclerosis etc.

·         Urinary and bladder dysfunction

·         Vision or hearing loss

·         Cancer that affects the bones

·         Side effects of medications

Personal Risk Factors

·         Age. The risk for a fall increases with age. Normal aging affects our eyesight, balance, strength, and ability to quickly react to our environments.

·         Activity. Lack of exercise leads to decreased balance, coordination, and bone and muscle strength.

·         Habits. Excessive alcohol intake and smoking decrease bone strength. Alcohol use can also cause unsteadiness and slow reaction times.

·         Diet. A poor diet and not getting enough water will deplete strength and energy, and can make it hard to move and do everyday activities.


Falls and accidents seldom “just happen”      People should not fall

Why should you NOT fall?

As a result of fall, you may get a small injury like a bruise or mild bleeding or a muscle pull to some serious injuries like fracture (break in bone) or brain injury and deaths too.

If you are osteoporotic (a condition in which bones are already weak) chances of fracture increases.

Fall risk increases with age. Henceforth, falls are common and serious health problem with devastating consequences in elderly

Prevention of fall is possible by early diagnosis and awareness about intervention. Fall should not be perceived as inevitable part of aging. All elderly, be sure to discuss the fall with doctor, even if you are not hurt. It can also be a sign of new medical condition like diabetes or change in blood pressure.

Physiotherapists play a vital role in prevention of falls.


Physiotherapy and rehabilitation at ReLivaTM for fall prevention

Reliva therapists conduct a detail check of elderly muscles strength and sensations of body more specifically for legs. Reliva therapists also conduct scientifically proven validated scales (Fall risk assessment scale and Berg Balance scale) to know if there is any risk of fall and to know balance problems in elderly.

Based on which, Reliva therapists design an exercise protocol to improve strength and balance in sitting, standing as well as walking. Physiotherapists are specially trained for balance specific exercises.  If required, they will prescribe an assistive device (walker or stick which can later be gradually discontinued ) with regular supervised exercise sessions.

Call Reliva if:

You are an elderly

You want to get fall risk check

You want to get balance check

You want strengthening and balance exercises

You want home modification tips.

For simple Tips to Prevent Falls, click here and see the infographic.

What to do if you had a Fall

  • Do not panic. Assess the situation and determine if you are hurt.
  • Slide or crawl along the floor to the nearest couch or chair and try to get up.
  • If you cannot get up, call for help.
  • If you are alone, slowly crawl to the telephone and call nearest hospital or relatives.
  • Once you are ok, do see a doctor or a Physiotherapist even if you haven’t hurt yourself, to ascertain the reason for the fall.

Related articles: Falls Prevention Tips

This article is purely for general information. Please contact your healthcare expert for specialised medical care. Please go through our Disclaimer and Privacy policy.

Dementia and Alzheimer

Dementia & Alzheimer’s: Points of care

What is Dementia & Alzheimer’s Disease?

Dementia, a brain condition that causes problems with thinking and memory, is a major worldwide health problem among older people. Alzheimer’s Disease contributes approximately 70% of all Dementia cases. Epidemiological studies in India suggest about 1/3rd of the prevalence of Dementia & Alzheimer’s Disease (AD) as compared to The United States and other developed countries. Incidence of AD increases sharply after age 65.

Alzheimer’s is a progressive disease of the brain that slowly impairs memory and cognitive function. It is characterised by decline and loss of multiple Cognitive functions such as loss of memory and atleast one of the following:

  • Loss of Ability to understand (Aphasia): for example, Inability to respond to “Your daughter is on the phone”.
  • Loss of Ability to perform Complex tasks of daily routine (Apraxia): for example, Dressing, Bathing etc.
  • Loss of ability to plan, organise, execute normal activities of daily living:  for example, going Shopping etc.

Alzheimers vs Dementia

The task of being Caregiver for a loved one with Alzheimer’s or Dementia, can be extremely daunting. One may have to experience behavioral problems such as wandering, aggressiveness, hallucinations, or sometimes sleeping and eating difficulties. By learning how to make changes in the caring atmosphere, you can improve the Quality of life for both the patient and your ownself.

Tips for the Caregiver

  • Try to put yourself in the person’s situation. Look at your loved one’s body language &  imagine what he/she might be feeling or trying to express.
  • Are the patient’s needs being met? Is the patient hungry, thirsty or in pain?
  • Make necessary changes in the home environment or atmosphere to comfort the patient.
  • Create a calm & soothing environment. Keep yourself calm and stop being anxious or upset in response to their behavioral problems as it can increase patient’s stress or agitation.
  • Establish a daily routine for the patient such as a schedule for bathing; as all these tasks would be difficult and can be done only when the patient is very calm and agreeable.
  • Expect things to take longer than they used to and give step by step instructions when you ask your loved one to do something.
  • Encourage them to participate in physical activity or Exercises as it is a great way to reduce stress, improve balance and coordination and other activities of daily routine.


How does Physiotherapy help in Alzheimer’s disease?Care for Alzheimers dementia

Regulated and supervised exercises during Physiotherapy can help the patient of Alzheimer’s disease in several ways, some of which are listed below:


  • Exercise is an excellent stress reliever and it can give solutions to most of the problems such as aggression, wandering and lack of sleep or sleep disturbance.
  • Physiotherapy improves muscle strength, mobility, balance and Co-ordination and ensures proper training for activities of daily living such as eating, dressing, etc.
  • Physiotherapy is crucial for patients in pain and reduces symptoms with use of Electrotherapy.
  • Physiotherapy can assess one’s ability to walk safely, the risk of falls & other functional tasks. The therapist will develop a treatment program, including exercise, to help maintain your loved one’s current abilities.
  • Even in late stages of Alzheimer’s, physiotherapy can help prevent & manage shortening of the muscles or joints.
  • Physical activity creates valuable opportunities to socialise with others & can help improve & maintain a person’s independence which is beneficial both to the people with Alzheimer’s & Dementia & also to their Caregivers.
  • Several studies show that exercises performed for 15-30 minutes, thrice a week, prove to be beneficial for patients with Alzheimer’s disease.


“A Person does not need to remember having engaged in an Exercise Program to reap the benefits of Exercise- they just have to participate!”


Every person is unique & will have different levels of ability and activities they enjoy. If you want to find out more about suitable Exercise & Physical activities, Contact us at ReLivaTM

Related Articles : Seniors Fall: What to do, Fall Prevention Tips

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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.

We have tried to cover various developmental milestones for children from birth till the age of 3 years in this article. However, there’s a wide range of what’s considered normal, the parents probably don’t need to be concerned unless they notice one of the red flags described in this article. If you have any concerns, you could get your child screened at a ReLiva Physiotherapy clinic in Thane and Navi Mumbai (Vashi, Nerul and Kharghar)

1 Month Infant: Developmental Milestones

Your initial responsibilities could be feeding, changing diapers, settling her to sleep and responding to her wails. But within a few weeks she’ll start to take more notice of your voice, face and touch.

  • VISION: Your baby can’t focus farther than 8-12 inches away- just the right distance for her to gaze at your face. Black and white patterns also draw her attention.
  • HEARING: Hearing is fully developed and baby turns towards familiar sounds, such as your voice.
  • HEAD & NECK MOVEMENTS: baby can lift her head briefly and turn it to the side when she’s on her stomach, but when she’s upright her head and neck still need support.
  • ARM MOVEMENTS: arms move jerkily but she can get her hands close to her mouth.


  • Feeds slowly or doesn’t suck well
  • Doesn’t seem to focus her eyes or watch things moving nearby
  • Seems especially stiff or floppy.
  • Doesn’t respond to loud sounds.

3 Months Infant: Developmental Milestones

By now you are basking in the warmth of your baby’s delighted Smiles! You will be amused to see your baby imitating your expressions and mimic the sounds you make. You no longer need to support his head. When he is on his stomach, he can lift his head and chest, and even do mini-pushups that set the stage for rolling over. He can open and close his hands, shake toys, bring his hands to his mouth, and push down with his legs if you hold him in standing position.

You will notice his hand eye co-ordination improving and closely tracking objects and focusing intently on faces. The baby will be able to recognize you from across the room!


  • Can’t support his head well
  • Cant grasp objects
  • Cant focus on moving objects
  • Doesn’t smile
  • Doesn’t react to loud sounds
  • Ignores new faces
  • Seems upset by unfamiliar people or surroundings

4 to 7 Months: Developmental milestones

Your baby is fully engaged with the world now: She smiles, laughs, and has babbling “conversations” with you. And she’s on the move-by 7 months she can probably roll to her tummy and back again, sit without your help, and support her weight with her legs well enough to bounce when you hold her. She uses a raking grasp to pull objects closer and can hold toys and move them from one hand to another.

Your baby is more sensitive to your tone of voice and may heed your warning when you tell her “no”. The baby also knows his/her name now and turns to look at you when you call.


  • Seems very stiff or floppy
  • Can’t hold her head steady
  • Can’t sit on her own
  • Doesn’t respond to noises or smiles
  • Isn’t affectionate with those closest to the baby
  • Doesn’t reach for objects.


development stages of baby

8 – 12 Months: Developmental milestones

Your baby has become an eager explorer and it might surprise you how quickly he can get around when he crawls. He can sit on his own now and grabs anything he can to pull himself up to standing and “cruise”. He might even take some solo steps before his first birthday.

You will hear his first words-often “mama” or “dada”. Soon he will talk in simple phrases but in the meantime uses gestures to indicate what he wants-or doesn’t want!

He can use his thumb and finger in a pincer grasp to eat finger food. Your baby loves to be just like you by combing his own hair, drinking from a cup, and pretending to talk on the phone.

Separation anxiety is normal at this age-baby may have fear of you leaving him.


  • Doesn’t crawl
  • Seems to drag one side while he is crawling for a month or more
  • Cant stand with support
  • Doesn’t try to find objects you have hidden in front of him
  • Doesn’t say any words
  • Doesn’t use gestures such as shaking his head “no” and pointing

13 – 24 Months (toddler): Developmental milestones

Your toddler will grow confident on his feet. Now he/she can go up and down stairs, stand on his tiptoes, kick a ball, and maybe even run by the time he turns 2 and climb up/down sofas and chairs.

By 18months, he can say at least several single words, and by 24 months he uses words in short phrases and sentences.

He/she can follow two-step directions, such as “Pick up your book and bring it to me”.

Your toddler can identify shapes and coloursand scribbles with crayon, builds towers of four or more blocks, throws a ball and enjoys filling and emptying containers. You will also notice first signs that will indicate whether he is left- or right handed.

He might also start to show interest in learning new things and imitate you like feeding a doll or pretending to drive a car.

Separation anxiety peaks midyear and by 24 months he will be more comfortable playing along other children.


  • Can’t walk by 18 months
  • Doesn’t understand the use of everyday objects
  • Doesn’t speak at least six words by 18 months or two-word sentences by 24 months
  • Doesn’t imitate words and actions
  • Doesn’t follow simple instructions
  • Loses skills he previously had


Skill development of toddlers

25 to 36 Months: Developmental Milestones

Your preschooler’s imagination is taking off: Playing make-believe is a hallmark of this age, along with fears about imaginary monsters and more ordinary things such as the dark.

Speech becomes clear enough that strangers can usually understand.

Child can walk up and down stairs, jump,and pedal a tricycle.Child’s manual dexterity is improving too.


  • Struggles with separation anxiety
  • Doesn’t interact with people outside family
  • Avoids eye contact
  • Can’t throw or catch a ball or jump
  • Can’t climb stairs with alternating feet
  • Has trouble scribbling
  • Doesn’t use more than 3 words in a sentence
  • Strangers feel it difficult to understand what the child says
  • Doesn’t play make-believe
  • Loses any skills that the child previously had

Role of Physiotherapy:

All the above red flags can be well diagnosed and managed by the well equipped and skilled therapists at ReLiva Physiotherapy and Rehab. Under the guidance and supervision of a Physiotherapist, the child can be trained and treated to achieve the lacking milestones. Developmental delay is not only dealt well but also treated with the techniques and methods that help in the child slowly and gradually mastering the actions that he was once unable to do.

At ReLiva Physiotherapy and Rehab, your child would be:

  • Assessed and evaluated for his/her current condition
  • Understanding of the current milestones present and the milestones that are delayed and lacking.
  • Set short term and long term goals based on the child’s condition.
  • Start activities, practice skills and teach the child actions to reach the desired goals.
  • Set a Home Exercise Program for the child, teach and guide the parents in administering the same on the patient.
  • Review the plan of action regularly based on the goals achieved.
  • Make the child as functionally independent as possible.


development disorder       skill learning milestone delay



physiotherapy after surgery

Recovering After Surgery With Physiotherapy

Physiotherapy post surgery in the hospital and at Home

Physiotherapy after surgery is an integral part of treatment for patients who are or have been hospitalized as prolonged immobilization puts patients at risk for complications such as deconditioning, muscle weakness, myopathy and neuropathy, respiratory infections, and contractures. It is important for such patients to consider physiotherapy at home as an integral part of the recovery process.

The main aim of a physiotherapist is to assist your return to normal activities of daily living after hospitalisation. Physiotherapists typically help with many aspects of your treatment while in the intensive care unit (ICU) and will continue working with you when you transfer to a general ward until you leave hospital to go home. Even at home, in many cases a physiotherapy home care program can significantly aid the recovery of patient. ReLiva Physiotherapy's home care program is designed and our physiotherapists understand the requirements for post surgical/ post ICU patients

Our home visit physiotherapist will assess and treat neurological, musculoskeletal and cardiorespiratory complications of the patients and help them in recovery. The physiotherapist is involved in specific patient positioning, suctioning, mobilization, ambulation, strengthening and balance exercises, passive range of motion exercises and airway clearance techniques.

As per Dr Farhad Kapadia, Consultant Physician, M.D, M.R.C.P, D.A (U.K.), E.D.I.C, FRCP: "Physiotherapy may be our best tool in getting the patient rapidly functional after a critical illness, and it needs to become an integral aspect of intensive care"

Benefits of physiotherapy:

  • Enables the patients to recover from the episodes of hospital as early as possible
  • Prevent post op complications
  • Teach the patient how to manage their own recovery post discharge
  • Facilitate safe and early discharge by reducing the length of stay in the hospital
  • Improves the quality of life

Physiotherapy helps in:

  • Improve the cardiovascular endurance
  • Improved performance of daily tasks
  • Improves the strength and endurance of the muscles
  • Improves the lung capacity
  • Makes the patient mobile and independent
  • Improves the airway clearance
  • Early mobilization of ventilated patients by a physiotherapist reduces mortality, and results in improved physical function and mobility

Physiotherapy post surgery:

The main aim is to return to the normal activities as early as possible.

Routine post operative physiotherapy intervention comprises of breathing exercises, circulatory exercises and early mobilisation to prevent complications and education in home management cardiovascular fitness, limiting restrictions due to medical procedure and

Positioning: To prevent complications like bedsores, congestion in the lungs, change of positions after regular intervals become important.

Chest PT:

  • Breathing exercises are important for the patient to reduce the chest infections and improve the air entry in the lungs. It also helps complete expansion of the thorax in order to have an effective breathing. Breathing exercises includes deep breathing exercises, segmental breathing exercises, thoracic expansion exercises, pursed lip breathing exercises and active cycle of breathing techniques.
  • Coughing huffing techniques where the patient is taught how to do forceful expiration by supporting the wound to get rid of the accumulated sputum actively
  • Airway clearance: physiotherapists help to clear the excess sputum by different techniques like positioning the patient, postural drainage, suctioning and use of different expiratory devices

Limb PT:

  • It is important to maintain blood circulation following surgery to reduce the risk of deep vein thrombosis due to immobility. Hence mobility exercises are important.
  • Also, it helps to improve and maintain the joint mobility and muscle strength which eventually gets deconditioned due to illness


  • Early mobilisation is a key factor in reducing post operative complications, enabling a quick recovery and timely discharge from hospital. Patient is assisted to get out of bed by physiotherapist on the day of your operation or the following day depending upon the type of the surgery. The final goal is to increase patients mobility making them independent and training stair climbing if required.

The above mentioned treatment principles were the general ones. But the treatments differs in different surgeries viz; orthopedic surgeries, abdominal surgeries, cardiothoracic surgeries, vascular surgeries, neuro surgeries.

To determine the treatment needs,the physiotherapist assesses the patients physical function including:

  • Pain, swelling, joint range of motion, muscle strength, muscle coordination, mobility status, balance, respiratory status and cardiovascular fitness in ortho surgeries
  • Pain, discrepancies in balance, coordination, muscle weakness and fatigue, work of breathing, and loss of range of movement, loss of cardiovascular fitness and mobility status in abdominal and cardiovascular surgeries
  • Pain, muscle tone, consciousness, orientation, work of breathing, balance and coordination, sitting and standing ability, synergy patterns, gait in neuro surgeries.

If you or your loved ones, have been recently discharged from the hospital after a long stay, the patient needs to continue supervised physiotherapy treatment to ensure complete recovery in the long term basis. Please feel free to give us a call and speak to our physiotherapists should you require any assistance.

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