back pain

Back Pain – Causes, Self Care, FAQ and Home Exercise

Eighty percent of us will experience back problems at some point in our lives. Back pain is ranked second only to headaches as the most frequent cause of pain, and tops the list of workplace injuries, causing more loss of time, disability and money than any other workplace injury. Our backs are a carefully engineered network of bones, tendons, ligaments, and nerves that help balance and bear the weight of our bodies and the loads we carry. Any minor damage or imbalance to this delicate system can stress muscles and joints, causing pain and injury. A lifetime of poor posture, poor lifting, bending and reaching, and twisting activities can gradually weaken your back’s supportive structures as well as cause pain and injury.

Risk Factors for Back Pain
Being overweight. Your back has to support too much weight when you’re carrying extra pounds.
Poor muscle tone. If your muscles are not well toned, they can’t meet the challenge when you ask something extra of them.
Poor posture. Poor posture creates bodily stress, which can result in pain.
Improper lifting. Heavy lifting, carrying children, as well as occupational lifting can cause injury.
Desk /computer jobs. Our bodies don’t thrive sitting for long periods of time hunched over keyboards or other workspaces.
Unhappiness. Researchers have found that general dissatisfaction with our social and economic situations can double or triple the risk of low back pain.

With all these risk factors, it’s no wonder so many of us suffer from back pain. But it’s not a part of life you have to passively accept.

Frequently Asked Questions
Take a look at the following frequently asked questions—they’ll help you further understand this condition, and better care for yourself and your family.

Do I need surgery for my bad back?
No, not usually. More times than not, your back pain can be treated without going under the knife. However, some conditions, like a herniated disk, may benefit
from surgery. Even still, herniated disks may heal on their own. Bottom line—you should carefully consider your options, and then consider them again, before thinking about surgery.

What about alternative therapy?
Non-traditional therapy is becoming more widely accepted these days. It wasn’t long ago that chiropractic treatment was viewed as an “alternative” therapy. Now these specialists are a common part of the back care landscape. Other alternative therapies have received praise from sufferers, too. The choice is up to you.

Sit at a desk all day. Am I at risk for back pain and injury?
Yes. It’s a common misconception that physical laborers and construction workers are at a higher risk for back injuries. The fact is, those individuals in sedentary jobs are at risk for back injury, too. Exercise and regular movement are important factors in maintaining a healthy back.

How can I arrange my office environment to protect my back?
A chair with good back support and height adjusters that allow you to keep both feet flat on the floor can do wonders to keep your back in a healthy state. If you don’t have an adjustable chair, try to use a chair with a simple straight back whenever possible. Also, when it comes to your desk, arrange items (phone, keyboard, monitor, etc.) where you won’t have to twist and turn excessively to access them.

Will my back pain ever go away?
There’s good news and bad news. First the good news. With proper self-care and good prevention techniques you can be well on your way to fighting off back pain. Now the bad news. Considering that 80 percent of Indians experience back pain at some point in their lives—much of it recurring—you may never get rid of back pain altogether. That’s why it’s important to practice the prevention tips included in this section—and keep doing them even when you’re feeling better.

You may see an expert at ReLivaTM Physiotherapy & Rehab to ease your back pain and get a customised plan to keep your back happy.

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

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 

frozen shoulder treatment

Frozen Shoulder: Understanding and Care

About Frozen ShoulderFrozen shoulder

Frozen shoulder, also known as adhesive capsulitis, is a condition that leads to pain and stiffness of the shoulder. Signs and symptoms begin gradually, worsen over time and then resolve, usually within one or two years. You will typically experience shoulder pain, followed by increasing stiffness. The stiffness may affect your ability to carry out everyday activities and, sometimes, you may not be able to move your shoulder at all.
1 Painful Stage
2 Frozen Stage
3 Thawing Stage

How does Frozen Shoulder progress?

Painful stage: During this stage, pain occurs with any movement of your shoulder, and your shoulder’s range of motion starts to become limited. This stage lasts for 3 to
9 months.
Frozen stage: Pain may begin to diminish during this stage. However, your shoulder becomes stiffer, and your range of motion decreases notably. This stages lasts from 4 to 12 months.
Thawing stage: During the thawing stage, the range of motion in your shoulder begins to improve with recovery. It may take anywhere from 12 to 42 months.

Frozen shoulder typically develops slowly, and in three stages. Each of these stages can last a number of months.

What are the Causes and Risk Factors?

Prolonged immobilization of the shoulder, such as after surgery (mastectomy) or an arm fracture. Usually affects woman above the age of 40 years. People who have certain medical problems appear to be predisposed to develop frozen shoulder.
Examples include:

  • Diabetes
  • Overactive thyroid (hyperthyroidism)
  • Underactive thyroid (hypothyroidism)
  • Cardiovascular disease
  • Tuberculosis
  • Parkinson’s disease

TIPS to Ease Your Symptoms

1. Use a hot pack on your shoulder for 10 to 15 minutes several times each day. Place a thin towel between your skin and the hot pack to prevent a burn.
2. Move your arm often, every hour if possible.
3. Use medication as prescribed by your doctor.
4. Sleeping Comfortably : If you sleep on your back, place a pillow under your involved arm and allow your hand to rest on your stomach. If you sleep on your side, sleep on the uninvolved side hugging a pillow across your chest.
5. Sitting Positions : Sit with good posture. Avoid slumping and slouching. Try to keep your shoulders back and down away from your ears.

Why is Physiotherapy Required?  Self diagnose frozen shoulder

This condition though self limiting, leads to decreased movement at the shoulder joint. Even though pain may reduce to negligible
after a particular time, stiffness and range will continue to remain affected. If you’ve had an injury that makes it difficult to move your
shoulder, talk to your doctor about it.

TIPS to Ease Your Symptoms

1. Use a hot pack on your shoulder for 10 to 15 minutes several times each day. Place a thin towel between your skin and the hot pack to prevent a burn.
2. Move your arm often, every hour if possible.
3. Use medication as prescribed by your doctor.
4. Sleeping Comfortably : If you sleep on your back, place a pillow under your involved arm and allow your hand to rest on your stomach. If you sleep on your side, sleep on the uninvolved side hugging a pillow across your chest.
5. Sitting Positions : Sit with good posture. Avoid slumping and slouching. Try to keep your shoulders back and down away from your ears.
A visit to your physical therapist may be beneficial to help you regain normal functional use of your arm. Your Physiotherapist can help you manage the pain and provide you with strategies to help you start using your arm normally again.

Do’s

  • Continue to move your shoulder else it will progress to the next stage of stiffness.
  • Use hot pack before exercise for improving movement, relaxation and reduction in pain.
  • Continue to use the shoulder for more functional activities like combing hair, reaching out for over head objects etc.
  • Keep your diabetes under control.
  • Take your pain medications on time.

Don’ts

  • Avoid vigorous shoulder movements.
  • Avoid wearing an arm sling to promote arm movement even if it keeps your arm in a pain-free zone,

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

office stretch for pain relief

5 minute Office Stretch exercises: Back, Neck pain

Make time for Office stretch and improve your productivity.

Taking the time to stretch throughout the day anywhere – in office or at home, can have numerous health benefits. Stretching can improve flexibility and is an important activity to warm up or cool down after exercise. Stretching can also be a fun and healthy break from your computer screen during the work day. These stretches along with correct sitting posture at workplace, also helps you to keep all those pain in the back and neck away.

This Office Stretch Sheet provides you with 6 simple and effective stretches that you can complete whilst sitting at your work station. The newly developed Standing Stretch Sheet is perfect to do before a lunchtime walk, and for those who have standing roles.

Try The Banana,  The Emu,  Reach for the Sky, The Rock, The Twister and The Yes & No today.

We recommend you repeat each stretch twice, and hold each time for 20 seconds.

Print a copy and pin it up next to your workstation to remind you and your colleagues – Have you stretched today?

 

5minute ReLiva office stretching exercises while Sitting at your desk in office

cardiac physiotherapy

CardioVascular Diseases – Improving Heart Health via Cardiac Rehab Program

India is one of the most populous countries in the world. The present health scenario suggests that our country is undergoing an epidemiological transition. The epidemiological infectious diseases are getting superseded by the non-communicable diseases (NCD). Estimates indicate that NCDs account for 53% of total deaths in India & Cardiovascular diseases (CVD) mortality tops the list of NCD deaths with 45% of deaths accounted by CVD.#1

Increasingly even the government setups in India are also acknowledging and approving of Cardiac Rehab Programs as effective and needed to ensure SPEEDY Recovery and enhance surgical OUTCOME (cardiac surgery).

CARDIOVASCULAR DISEASES

Cardiovascular diseases (CVDs) are a class of diseases that involves heart or blood vessels.

Common CVDs include-

  • Ischaemic Heart Disease (IHD)
  • Hypertensive Heart Disease (HHD)
  • Rheumatic Heart Disease (RHD)
  • Cardiomyopathies
  • Congenital Heart Disease (CHD)
  • Peripheral Artery Disease (PAD)

The underlying mechanism varies for the above mentioned diseases; the most common cause being atherosclerosis.

RISK FACTORS FOR CVDs

  • Hypertension
  • Smoking
  • Excessive alcohol intake
  • Diabetes
  • Obesity
  • High blood cholesterol
  • Poor diet
  • LACK OF EXERCISE & SEDENTARY LIFE STYLE

However it is estimated that 90% of CVDs are preventable.

Also most of the CVD patients can help lower their risk of future heart problems if they make changes to improve their health.

CARDIAC REHABILITATION

What is Cardiac Rehabilitation?

Cardiac Rehabilitation (Cardiac Rehab) is a professionally supervised program to help people recover from heart attacks, heart surgeries, percutaneous coronary intervention procedures such as stenting & angioplasties.

Cardiac Rehab program usually provide education & counselling services to help heart patients increase physical fitness, reduce cardiac symptoms & improve health.

BENEFITS OF CARDIAC REHAB

  • Reduction in all cause mortality rate by 20-30% (as per AHA)
  • Reduced cardiac symptoms (angina, dyspnea, fatigue)
  • Improved adherence & preventive medication
  • Increased exercise performance
  • Improved quality of life.

Increasingly even the government setups in India are also acknowledging and approving of Cardiac Rehab Programmes as effective and needed to ensure SPEEDY Recovery and enhance surgical OUTCOME.

What kind of services does the Cardiac Rehab Program offer?

(Read more details at http://reliva.in/knowledge_center/cardiac-rehab–staying-heart-healthy )

  • Appropriate recommendations are made for medical examination, physical activity & exercises,  based on the risk stratification process as per the American College of Sports Medicine (ACSM) that assigns participants into 3 categories-
  • Low Risk
  • Moderate risk
  • High Risk
  • A comprehensive health fitness evaluation typically includes the following before the planning & prescription of the Cardiac Rehab program
  • Resting Heart rate, BP, Height, Weight, BMI, ECG
  • Cardiorespiratory Fitness (if required) – TMT
  • Muscular Strength – RM method
  • Flexibility
  • An exercising training program is best designed to meet the individual’s health & physical fitness goals.

COMPONENTS OF EXERCISE TRAINING

  • Cardiovascular (aerobic) fitness
  • Muscular strength & endurance
  • Flexibility

Exercises that improve neuromuscular fitness such as balance & agility are also recommended by ACSM particularly for older adults & highly deconditioned persons.

ACSM also recommends loading exercises (i.e. weight bearing & resistance exercises) to maintain bone health.

A single exercise session includes the following-

Cardiac Rehab in Progress at Reliva
Cardiac Rehab in Progress at Reliva
  • Warm –up – at least 5 to 10 minutes of low <40% to moderate intensity cardiovascular & muscular endurance activities.
  • Stretching – at least 10 minutes of stretching exercises performed after warm up or cool down phase
  • Conditioning – this phase includes aerobic/resistance &/or sports related exercises
  • Cool Down – at least 5-10 minutes of low (<40% to moderate 40% -<60%)intensity of cardiovascular & muscular endurance activities.

Cardiac rehabilitation takes place as

  • In-patient Rehabilitation Programs
  • Outpatient exercise Programs

Outpatient cardiac rehab programs should begin as soon as hospital dismissal.

Most patients are capable of beginning a supervised exercise program with 1-2 weeks of leaving the hospital.

SUMMARY OF THE ACTUAL CARDIAC REHAB PROGRAM

  • While actual training program for each patient would differ, an indicative plan would be as follows:
COMPONENTSACTIVITIESRECOMMENDED TIME
Warm upStretching/low level calisthenics10 minutes
Aerobic ConditioningTreadmill (Mod Bruce/Bruce protocols or other protocols as indicative), cycle ergometer, cross trainer, stair stepping20-30 minutes as tolerated
Muscular ConditioningWeight training15-30 minutes as tolerated
Cool DownSlow walking/ stretching5-10 minutes
  • An indicative exercise prescription would be as follows (FITT Priciple) :
Frequency3-5 days/week
IntensityRPE- 11-16/ 20-80% using Heart rate Reserve
TimeApprox 60 minutes
TypeTreadmill/elliptical/ Cycle ergometer/Cross trainer/stair climber
Resistance Training8-10 exercises (1 set per exercise of 8-12 reps) that conditions the major musle groups atleast 2 days per week
Initial level of FitnessHigh = higher work loadLow =  lower work load

 

Having the essence of the details about Cardiac rehabilitation, it is important to take up these best benefitting programs seriously by moving out of the cages of ignorance & myths about CVD’s.

The larger group of hospitals do provide the cardiac rehab services but they reach out to the very few.

Its time we start giving importance to clinic based Cardiac Rehab programs who plan for the Outpatient Exercise programs for cardiac patients.

ReLiva Physiotherapy & Rehab Clinic in Navi Mumbai has taken an initiative towards providing this utmost care to the cardiac patients by providing clinically monitored & supervised Cardiac Rehab Outpatient programs.

We believe in “Exercise is Medicine”. (Read what our Cardiac Rehab patients have to say about us by clicking here.)

Like all medicines, ‘Effective Dosage” of exercise is important for achieving the desired results. “More” is not better. For cardiac patients, more exercise could be as or more dangerous as consuming higher dosage of medication than prescribed.

“Less” would not deliver desired & long term outcomes. Patients’ cardiovascular capabilities may remain suboptimal; thus impacting the quality of life & overall health.

Monitoring while cardiac rehab
Monitoring while cardiac rehab

“ Effective dosage” changes as physical capacity & capabilities change. Hence regular monitoring is critical to evaluate & arrive at “effective Dosage” at different stages of Cardiac rehab.

Read about Contribution of progress in a patient due to Cardiac Rehab Program : Patient at ReLivaTM in the next post by clicking here.

With these advances in Cardiac rehab, this program can become recognized as a cornerstone in a comprehensive management of cardiac patients.

More awareness is the prime necessity to optimize the effectiveness of the cardiac rehab program.

With such initiatives together we can definitely contribute towards a better life for the Cardiac patients.

Contributed by Dr. Anuradha Purohit – Mandlekar (PT). She is BPT, MPT(Cardio-thoracic), MIAP, American Health Association (AHA) certified specialist at ReLiva Physiotherapy & Rehab and pioneers the Cardiac Rehab Program.

#1- (ref – 2013, Vol.2, No.2,ISSN 2319-4154,Health Sciences E-Journal)

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

Treatment

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.

fibromyalgia chronic pain

Fibromyalgia

Fibromyalgia is a chronic condition that presents itself as a syndrome, characterized by body aches and pain, weakness, stiffness, tender points around joints and stressful mind. We at ReLiva Physiotherapy and 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 Thane, Vashi, Nerul and Navi Mumbai.

While there is no definite cure of this condition, physiotherapy helps in reducing the symptoms as well as improving the quality of life of an individual suffering from fibromyalgia. Something as easy as postural correction and correct postural habits taught by the physiotherapist helps the patient in relieving the stress placed on the tissues as well as relaxes the body.

Pain, which is the most disabling symptom of this condition, is dealt aptly by using hydrotherapy in the form of moist hot packs that is applied at the painful area or also by using cryotherapy, as per the patients’ condition and need. Along with this, myofascial release techniques may be used to release the tension off the muscles as well as produce relaxation. Tender point release therapy is used to treat the tender points while is followed by cryotherapy to reduce pain, promote healing and prevent any muscle soreness. Pain may also be treated with the help of electrotherapy equipment like Transcutaneous Electrical Nerve Stimulation (TENS) depending on the severity of the pain.

Stiffness is reduced by incorporating various stretching exercises that help improving the flexibility of the muscles. By loosening up the tight and stiff muscles, it helps reduce the tension built up in the muscles and helps relieve any stress placed on them. This also leads to pain reduction and induces relaxation. Various active and passive stretching exercises are done and also taught to the patient with the correct dosage and method. Along with this accurate range of motion (ROM) exercises are taught to the patient that helps in keeping the joints healthy and preventing any stiff joint conditions in the future. Strength training of the muscles forms the basic line of treatment for the weakness that the muscles develop in fibromyalgia. Gradual and slowly progressing strengthening exercises are taught to the patients, starting with free exercises and moving on to resistance training.

Aerobic exercises (low-speed, low-impact) also form a very important line of treatment in patients suffering from fibromyalgia. Aerobic training not only prevents the deconditioning of the body but also helps induce relaxation. They have significant beneficial effects on physical function, well being and potentially reducing pain. Stationary bicycle, steppers (to perform graded and controlled stair-case climbing) and other devices are used to perform aerobic training. Aerobic exercises help improving the overall quality of life by training the lungs and heart and increasing their ability to function.

Relaxation techniques that are taught to the patients help relax their mind and body and hence bring the stress levels down. This in turn induces good sleep and helps fight sleep disturbances. In this way it helps the patient maintain good health by taking necessary rest periods along with supervised physical activity. Lifestyle modification would be incorporating activities like walking, cycling, swimming, gardening, etc in leisure time that not only help in relaxing the mind but also maintain the body strength to fight fatigue and pain. Outdoor sports should be taken up to maintain good body functioning, as well as aid relaxation.

What is Fibromyalgia?

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. It is a chronic condition diagnosed by the doctors based on patient’s symptoms and physical examination. Fibromyalgia mainly includes widespread muscle pain along with painful point around the joints, which is not actually joint pain but pain in the tissues around the joint. It is usually referred to as ‘fibromyalgia syndrome’ as it presents with a group of symptoms together. Common fibromyalgia symptoms may include generalized aches and pains and crippling fatigue. Presence of tender points, disturbed sleep, mood disturbances and depression is also seen. Muscles give the feeling of being over worked all the time. There may be pain and achiness around joints in the neck, shoulder, back and hips which make it difficult for the patient to sleep or exercise. Other symptoms may include abdominal pain, chronic headaches, and dryness in mouth, nose and eyes, incontinence, irritable bowel syndrome, stiffness, numbness/tingling in fingers and feet. Tender points at specific areas around the joints give a clear picture of the condition.

Diagnosis is mainly made on comprehensive physical examination and on the patient’s medical history. Research still continues on devising any specific blood test that could help confirm the diagnosis (e.g. FM/a) to rule out any other serious condition, your doctor may ask you to carry out a compete blood count(CBC), tests for thyroid, etc. Also, since the pain and symptoms are similar to that seen in arthritic conditions like Osteoarthritis and Rheumatoid Arthritis, specific tests to rule out these conditions is also done. A detailed FAQ regarding fibromyalgia can be found here.

What causes Fibromyalgia

It is still unclear why people develop fibromyalgia but theories suggest that it is not the outcome of a single factor but combination of factors working together. One of the researches suggests that poor physical conditioning leads to the symptoms of fibromyalgia while other suggests that continuous microtrauma leads to ongoing cycle of pain and fatigue. Combination of many physical and emotional stressors is believed to be responsible for the condition. Genetics is also believed to be one of the causes and fibromyalgia is seen running in families. Environmental factors like trauma, infections, etc are also believed to be contributing to causing fibromyalgia. Hormonal and chemical disturbances are also responsible in causing pain.

It is mainly thought to be a glitch in the way the body perceives pain. One of the main theories suggests that people suffering from fibromyalgia have developed changes in the way the Central Nervous System (CNS) processes the pain messages carried out by the body. Also low level of hormones like serotonin, noradrenaline and dopamine in the brain lead to alteration in mood, appetite, sleep, behave and response to stressful situations. Also hormones help regulate the processing of pain messages in the brain.

Benefits of Physiotherapy Treatment for Fibromyalgia patients

The benefit of physiotherapy is that it allows a person with fibromyalgia to work closely with a trained professional who can design a fibromyalgia-specific treatment program. The therapist documents your progress and gauges whether you are performing/practicing good therapy habits, alignments, and movement patterns when doing ‘homework’ or exercises at home.

Anne Reicherter, PT, DPT, PhD, a licensed physical therapist and associate professor in the department of physical therapy in the School of Medicine of the University of Maryland in Baltimore, says physical therapy can help fibromyalgia patients “manage” their daily living with less pain and generally make life more enjoyable”. She explains that people with fibromyalgia pain are often caught in a vicious cycle: Pain and fatigue prevent them from being active and exercising, but inactivity can trigger more pain and fatigue.

ReLiva Physiotherapy and Rehab helps you deal with fibromyalgia by using the following in their tailor-made and effectively designed treatment program:

    • Stretching Exercises
    • Strengthening Exercises
    • Pain Relief Methods
    • Aerobic Training
    • Myofascial Release
    • Relaxation Techniques

Myths and Facts about Fibromyalgia

1.   Myth: Fibromyalgia is rare.

Fact: Fibromyalgia is one of the most common types of chronic pain disorders. Census reports more than 10 million cases per year in India.

2.   Myth: Fibromyalgia is “all in the head.”

Fact: Fibromyalgia has been described for centuries. But it wasn’t until 1981 that the first scientific study formally confirmed fibromyalgia symptoms and tender points in the body. Since then, researchers have future tested pain reaction in people with fibromyalgia.

  • Imaging studies show that the brains of people with fibromyalgia have more activity in reaction to pain.
  • Studies also have shown that people with fibromyalgia feel pain more intensely at lower levels than people without the condition.
posture in pregnancy

Posture in Pregnancy: Do’s & Don’ts

Posture is the position in which you hold your body while standing, sitting, or lying down. Good posture during pregnancy involves training your body to stand, walk, sit, and lie in positions where the least strain is placed on your back.

As your pregnancy progresses, everyday activities such as sitting and standing can become uncomfortable. Following good postures and regular pregnancy exercises (supervised by an expert) could help you avoid certain common aches and pain related to increasing baby bump. Here are few do’s and don’ts that will help you improve your posture during pregnancy and keep your body happy.

Do’s

  • Irrespective of what your doing – cooking or working on a desk, remember to take a break every few hours
  • Take a longer meal break every four hours
  • Vary work positions continuously, from sitting to standing and walking.
  • While sitting – use small pillow or cushion to provide extra support for your back
  • Keep your hips and knees at a right angle when sitting (use a foot rest or stool, if needed). Your feet should be flat on the floor. (See this video to understand good posture for sitting: Good posture)
  • While sitting, Point your feet in the same direction, with weight balanced evenly on both feet
  • Sleep on your left side with knees slightly bent with a pillow between your knees
  • Try simple stretches or any sort of movements to keep the blood flowing. (Contact a ReLivaTM expert for a customized stretching program as per your stage of pregnancy)
  • Try to practice relaxation techniques for stress free pregnancy. Learn more : FabMoms
  • If you have to, then use both your hands to lift a weight.
  • Even when you’re lifting something light, proper form can spare your back. Bend at your knees, not your waist. Keep the load close to your body, lifting with your legs — not your back.
  • While standing, hold your head up straight with your chin in. Keep shoulder blades back and your chest forward, knees straight, buttocks tucked in.

 

Posture in Pregnancy: Incorrect & correct

Don’ts

  • Avoid prolonged standing.
  • Avoid sitting in the same position for more than 30 mins
  • Avoid crossing the leg while sitting
  • Avoid sitting in lounging position or chair
  • Don’t worry about frequent urination due to drinking plenty of fluids. It only gives you extra chance to change your position and move around.
  • Avoid sleeping on your stomach
  • Minimise heavy lifting, climbing or carrying.
  • Avoid bending from waist. Only bend your knees while lifting
  • Avoid twisting your body while lifting
  • Do not wear high heels. The arches of your feet should be supported with low-heeled (but not flat) shoes to prevent stress on your back

Expecting moms who have participated in FAB Moms, a Prenatal Exercise Program have often reported lesser pregnancy related pains. To learn more about FAB Moms, click here.

Related Articles:

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

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

sacroiliac joint pain

SI Joint / Pelvic Pain – Do’s & Don’ts

Sacroiliac (SI) Joint Dysfunction can cause significant discomfort and pain in sitting and lying down. The Hip joint seems to have got locked and does not allow smooth transition from one position to another. Following are few techniques that can help significantly to ease such restricted movement and pain.

1. Rolling Over in Bed:

To roll over from your back to your side, bend one knee, placing your foot on the bed.  Push the heel down, slightly lifting your buttocks and turn towards the side on which the leg is still extended straight. The top arm helps the turning motion.

 

2. Sitting:tailor position

  1. When sitting (whether you are driving a car, riding a bicycle or sitting on a chair), press your chest upward and let your shoulder blades relax and drop.
  2. Sitting in a tailor’s position is good (crossed legged with your feet crossed underneath your legs) on the floor or on a very firm bed; use your hands to pull your knees gently back towards your hips and lift your chest, and keep your shoulders low.
  3. If you have been sitting in this position for a while, stretch forward as far as you can and touch the floor in front of you while keeping your spine straight.  At the same time, look up.  Practice this stretch as often as it feels necessary and good.

Static Sitting Positions:

  • Sit on a chair with your knees apart and slightly turned out
  • Sit in positions that relax your lower back while it remains supported, using a cushion or a rolled towel behind your back; sit upright when the back is not supported
  • You can also stretch your hips by sitting high enough so that your knees are lower than your hips or by crossing your feet under your chair.
  • Use a ball cushion while you are sitting, or sit on a therapy ball; sitting on a ball cushion allows your tailbone to be free.  When you use a ball cushion or ball, you develop active stomach and back muscles over time as a result of trying to maintain your balance
  • A good posture for resting is lying on your back on the floor, putting your feet up on the couch or bed, with a small pillow to support your back and/or head
  • If you have tailbone pain, this may be caused by your pelvic floor being too tight.  Favor positions that open your hips, push your legs downward away from your torso (sitting on the edge of the chair or on a ball) or crossing your feet under your chair; let your vaginal muscles relax as much as possible

3. Standing:

  • Bend your knees slightly
  • Distribute your weight evenly on both legs
  • Point your toes slightly outward
  • This posture may feel unnatural in the beginning, but if you look in the mirror, you’ll see that it looks quite normal.

Related Articles:

Sacroiliitis, Sacroiliac Joint dysfunction

SI Pain & Pregnancy – 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.

running without injuries

Marathon Training: Running without Injuries

Marathon runners push the body's limit to increase their exercise capacity. But they shouldn't ignore the vital signs of injury and learn to differentiate a serious injury from a minor one.

This article is an attempt to make the runners aware of the general thumb rules about running related injuries.

Warning Signs of Injury                                                                                                                                                                 

What pain is ok?

• General muscle soreness

• Slight joint discomfort after workout or next day that is gone in 24 hours

• Slight stiffness at beginning of run or walk that goes away after first 10 minutes

 

What pain is not okay? (You should not train!)

• Pain that is keeping you awake at night

• Pain that is evident at beginning of run/walk then becomes worse as run/walk continues

• Pain that changes your stride/ style of run

 

What to do if I get reinjured / injured?

• Ice area: 15-20 minutes several times per day  (Refer to the ReLiva document on RICE protocol at the Knowledge Center)

• Elevate injured part while icing

• Rest (at least initially)

• Analyze program for possible causes

o What did I do differently in training?

o Big jump in speed of running?

o Significant pace increase?

o Shoes worn out? Or change in shoe model?

o Change from all treadmill or soft surface to road running?

• Cross-train on non-impact cardio – follow similar minutes that you were doing running/walking (elliptical or swimming or cycling)

• Determine plan to return to full program, return to running very slowly

• Physical therapist and/or orthopedic

Warning Signs of Overtraining

• Difficulty performing typical workouts for more than a week

• Excessive fatigue

• Higher resting heart rate

• Decreased appetite

• Sorer muscles

• Troubled sleep

• Irritability

• Increased perspiration

• Decreased desire to train

Whether you happened to injure yourself by accident or by overtraining, do not lose heart. If you reach out to a trained physiotherapist soon enough after the injury, the chances are that you can recover much faster  and get back to your training than if you just sit back and wait for it to heal itself.

These guidelines should not take the place of medical advice if attempting to return to sports following an injury. If an athlete requires assistance during or in the progression of a return to sport program they should consult with their medical expert, or physiotherapist
Pregnancy exercise

Pregnancy Exercise, Antenatal Fitness Program

Congratulations! You’re pregnant  

Exercises do wonders during pregnancy. Carefully planned exercise under Expert supervision can have a powerful and positive contribution to pregnancy. It helps to prepare you for childbirth by strengthening your muscles and building endurance. Moreover, it helps getting your body back in shape, once the baby is born.

What do our FAB Moms say?

My doctor referred me to ReLiva FabMoms for Prenatal sessions. The sessions have been very helpful as I know how to keep myself active & fit. I would recommend others too to visit FabMoms for this program.”   – Richa Jha, Vashi

I joined FabMoms during my 6th month of pregnancy. My expert Physiotherapist helped me with lower back pain exercise which generally pregnant women face. Stretching exercises were also very beneficial. I never got cramps in my leg during night thereafter. They also teach good labour preparation techniques. I would like to recommend FabMoms to all pregnant women.”   – Misba Modak, Nerul

To read more about Benefits of antenatal exercisesclick here.

Now you can be a F.A.B. Mom too ! Fill the “Ask for call Back” form to register or Click here to contact us and know more about ReLiva’s FabMoms Program for Prenatal and Postnatal fitness programs. The Programs are available in

  • GROUPS as ‘Better Together’ at any of our clinics or a maternity set-up near you.
  • One-on-one personalised Prenatal / Postnatal care Program designed specially for you by our experts.

The various modules of the Program cover the following topics:

  • Education about stages of pregnancy.
  • Exercise as per the stage of pregnancy.
  • Relaxation and breathing techniques.
  • Postural guidance.
  • Post partum changes.
  • Diet & Nutrition.

To begin with, you can click here, to contact us & register with your details and we will send you a copy of The 5 Safest Pregnancy Exercises Guide, absolutely FREE.

Related Articles:

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

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

Mobilisation:

  • 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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