zumba injury prevention

Zumba: Tips to prevent injuries

How to keep away from Zumba injuries

Last month we had three patients coming to our clinics, who had suffered injuries while doing Zumba.  Interestingly, all had the same issue - pain in their knees.Interestingly, all had the same issue - pain in their knees.

Zumba is the closest you could get to having fun and having a cardio workout at the same time. And surely, it's popular! But like any other sport, there is a risk of getting aches and pains. How do you fix it?  If you have no pre-existing conditions that have caused trouble in your knees earlier, you could easily prevent  injuries during Zumba.

Tips to avoid Zumba injuries:

  • Check your shoes – are they comfortable and not too tight?

 

  • Do not use your running shoes for Zumba. Instead, go for shoes meant for cross-training or dancing ie. those with a flat base.

 

  • Choose an appropriate level. Not all Zumba classes are equal. Some are designed for first-timers and beginners, while some are targeted at regulars.

 

  • Minimise or best to avoid pivoting movements during Zumba. Make sure you are always keeping your knees pointing in the same direction as your toes.
Knee pain surgery

Ageing Knees? Don’t go weak in your Knees

Ageing Knees

Don't go weak in your knees

Do you hear a sudden click in your knee while bending down? Do your knees hurt while squatting? Well, your knees are trying to convey their ageing story. It may not be wise to ignore the click sound, minor pain or swelling once you have crossed your 50's.

Osteoarthritis (OA) is common among ageing population and one of the leading causes of disability. It is the second most common problem & the most frequent joint disease with a prevalence of 22% to 39% in India.

In Knee OA, the cartilage in the knee joint gradually wears away and it becomes frayed & rough and the space between the bones decreases. Arthritic knee usually begins with symptoms of joint click, pain and swelling that worsen in the morning. Knee arthritis can make it hard to do many activities such as walking and climbing stairs.

If unattended; the joint may become stiff & swollen, making it difficult to bend & straighten the knee. The knee may “lock” during the movement. It may creak, click, snap or make a grinding noise (crepitus). The pain can cause a feeling of weakness or buckling in the knee. Weather changes usually aggravate the symptoms - You may notice increased knee pain during rainy & cold weather.

Since OA is a degenerative condition; the damage occurred cannot be reversed. But timely intervention in the form of regular exercise and early Physiotherapy can arrest degeneration & maintain joint integrity.

Easy ways to manage OA knee :

  • Manage your Weight
  • Keep a check on your Calcium & Vitamin D levels
  • Avoid offending movements like squatting
  • Do not delay : Address the signs of pain in time
  • Specific knee exercises

We have some very easy and convenient tips to manage arthritis pain on our website. Read Here

Knee Replacement Surgery – Care & Exercise

You are about to have Knee Replacement Surgery (TKR). A lot of the long term results of knee replacements depend on how much work you put into it following your operation. Patients who prepare for surgery and actively take part in their care can recover in less time and with less pain. This guide has general information along with tips for things to do before and after surgery to help you make it a success.
You may get different instructions from your surgeon, doctor or physiotherapist. Always follow the directions of your care team. This guide is meant to be used under the direction of your physiotherapist.
Caution: If you have too much pain in your knee to exercise, or if any of the exercises cause more pain or swelling in your knee, stop. Tell your physiotherapist or doctor. If your whole leg becomes swollen or hot, tell your doctor right away!

General Guidelines: Before Surgery                  TKR- Total Knee replacement recovery

If you exercise before surgery you can have a faster and easier recovery. Exercise helps to:

  • Maintain the range of movement of your knee
  • Make your muscles strong
  • Control your pain
  • Build your knowledge of how to exercise after surgery
  • Improve your sleep

Do activities that put less stress on your knee. Try cycling on a stationary bike (upright or seated) for 5-10 minutes, walking in water (water level should be atleast thigh deep). It is best to do specific knee movements and strengthening exercises (in guidance of physiotherapist).

  • Always warm up before exercising. Your physiotherapist may tell you to:
  • Apply moist heat to the front and back of your knee for 5-10 minutes OR Have a warm shower or bath

General Guidelines: After Surgery

Exercise after surgery will help you recover and regain the movement and strength of your knee. Exercise also helps to:

  • Reduce swelling
  • Prevent blood clots (Thrombosis)
  • Control your pain
  • Prevent constipation
  • Improve your sleep

Tips to help you make the most of your Knee (TKR) surgery

DO’s

  • Take your recovery and rehab seriously. Exercise regularly as per the programme charted by your physiotherapist.
  • Continue with your knee replacement rehab programme for at least 3 weeks after surgery, probably 3 months of physiotherapy guided knee exercises to get the best result from your knee replacement.
  • Follow-up regularly with your surgeon, to monitor internal recovery.
  • Walker or crutches should be used until discontinued by Doctor or Physiotherapist.
  • Change knee position at least once an hour, while awake, to avoid stiffness.
  • Home exercises should be performed 3 times everyday unless advised differently by your Physiotherapist.
  • Walking is an excellent activity and you are strongly encouraged to gradually increase your walking distance after you leave hospital.
  • Walk outdoors as long as sidewalks are dry. Consider going to a mall to walk when the sidewalks are wet and slippery.
  • Swimming or walking inside swimming pool (where water level is at least till your thigh) is a very good strengthening exercise that prevents jerks and unnecessary strain on the knee.
  • Stay positive and committed. Don’t give up, and do what you can to keep a good attitude.

Don’ts : For 6-8 weeks after surgery, avoid:

  • Any pivoting (twisting) on your knee 2.Kneeling down 3.Squatting
  • Avoid high impact activities that cause jerk and stress on the knee joint, example running, jogging, rock climbing etc.
  • Avoid unnecessary stress on your knee by lifting very heavy objects. This can cause damage to your new knee.
  • Avoid using Indian traditional toilet, instead use a Western Commode (WC) or toilet chair.

Immediately after surgery, you can continue to do the following in bed :

1. Deep Breathing and Coughing Exercises : Knee replacement rehab - Pump your ankles
Until you are up and moving well, take at least 10 deep breaths, followed by a cough, every hour that you are awake.
2. Pump Your Ankles :
When lying down, move feet up and down and in circles. Repeat 10 -15 times every hour you are awake.
3. Buttock Contractions
Tighten your buttock muscle and hold for a count of 5 seconds. Repeat five to ten times, three to four times each day

Moving your new knee :

It is important to move your knee soon after the operation unless your surgeon or physiotherapist tells you not to. This will minimize stiffness, pain and swelling, and reduce the formation of scar tissue. Check with your physiotherapist for guidance about the best way to warm up your new joint.

To Keep Pain and Swelling under control, once you are home:

1. Rest Your Joint          TKR - Rest your joint

  • Change positions often (every 20 minutes) when you are awake. Try sitting, standing, and walking.
  • Pace yourself. Take things easy and slow.
  • Lie down 3 times a day for 30 minutes on your bed.
  • Put your leg up and support it with a rolled towel or with pillows (as shown).

2. Use Ice
Ice your knee when it is hot and red, painful and after exercises. (If your knee is very stiff and painful, check with your physiotherapist before icing
Follow these steps:

  • If your scar is not healed, cover it with a clean bandage and clean plastic wrap
  • Put a damp hand towel over your knee
  • Put a flexible gel pack, or plastic bag with crushed ice on your knee
  • Leave the ice ON for 10 minutes. Take it OFF for 10 minutes. Put it back ON for 10 minutes. Repeat 4-6 times a day
  • DO NOT use ice if your doctor has told you that the circulation to your legs is poor and that you should avoid using ice or heat

3. Use Pain Medicine
Use your pain medicines as prescribed by your doctor. Tell your doctor if the pain is too much or not improving.
4. Use Walking Aids
Use the walking aid that your physiotherapist has measured and recommended. Do not change or stop using the walking aid until your physiotherapist or surgeon tells you to. Walkers, crutches and canes help to:

  • Reduce the stress on your knee Reduce pain Improve your balance and reduce falls
  • Remember it is better to have a good walking pattern using two crutches than to limp and risk losing balance.

5. Sleep : It helps with rest and recovery. It is normal to have some sleepless nights up to 12 weeks after your knee surgery.

Consult an expert at ReLivaTM Physiotherapy & Rehab to learn more about rehab, Mobility Techniques and tips to make your Total Knee Replacement (TKR) Surgery a success.

Obesity and Knee Pain

Are our knees paying the price of Obesity?

According to the World Health Organization (WHO), obesity is one of the most common, yet among the most neglected, public health problems in both developed and developing countries . According to the WHO World Health Statistics Report 2012, globally one in six adults are obese and nearly 2.8 million individuals die each year due to overweight or obesity. Due to the increased risk of morbidity and mortality, obesity is now being recognized as a disease in its own right. Additionally, obesity is strongly associated with other metabolic disorders including diabetes, hypertension, muscular problems, dyslipidaemia, cardiovascular disease and even some cancers. The risk for these disorders appears to start from a body mass index (BMI) of about 21 kg/m. Obesity is generally classified as generalized obesity (GO) and abdominal obesity (AO). Individuals with obesity have higher rates of mortality and morbidity compared to non obese individuals.

India, with 1.2 billion people is the second most populous country in the world and is currently experiencing rapid epidemiological transition. Undernutrition due to poverty which dominated in the past is being rapidly replaced by obesity associated with affluence.

In a study done in India, the prevalence of obesity was 72.5% among women and 1.1% among men.Obesity is much more than a cosmetic problem, as its associated health problems is increasing.

Link between obesity and Knee OA:

Despite the multifactorial nature of musculoskeletal disease, obesity consistently emerges as a key and potentially modifiable risk factor in the onset and progression of musculoskeletal conditions of the hip, knee, ankle, foot and shoulder. A recent World Health Organization report on the global burden of disease indicates that knee OA is likely to become the fourth most important cause of disability in women, and the eighth most important cause in men. It suggests that primary prevention of knee OA should become a major aim of health care. Several investigations of risk factors for knee OA have been reported previously. Most common important risk factors include obesity, previous knee injury, selected physical activities, the presence of hand OA, and a family history of the disease.

Under normal conditions, articular cartilage provides a near frictionless surface, aiding in the distribution of pressure loads within the joint. OA has a logical link to obesity: The more weight that’s on a joint, the more stressed the joint becomes, and the more likely it will wear down and be damaged.

Weight plays an important role in joint stress, so when people are very overweight, it puts stress on their joints, especially their weight-bearing joints, like the knees and the hips. In OA, there is an imbalance of the anabolic and catabolic processes of the chondrocytes(cells which protect the surface of the joints), leading to damage of the structural and functional integrity of the cartilage and adjacent bone and other joint tissues. Excess weight has been identified as an important risk factor for OA of the knee. Obese individuals have 1.5-2 times the risk of developing knee OA than their leaner counterparts. While the link between excess weight and higher risk of knee OA is well accepted, the mechanism of association is debated.

Carrying extra body fat may also lead to the releases of a hormone called leptin, which some experts think may play a role in the development of osteoarthritis. In addition, body fat can release substances that promote inflammation in your body.

Ways to Recover from Knee pain:

Get a consultation.If you have knee pain, discuss types of activities with your physiotherapist that might be safe for you.

Exercise. Those who think they have no time for bodily exercise will sooner or later have to find time for illness. Good types of exercises for heavier people include walking – even for just a few minutes when you’re starting out – bicycling indoors or outside, and strength training to build stronger muscles under the supervision of the physiotherapist.

  • Diet modification.Plays an important role in reducing and achieving healthy lifestyle, thereby reducing the load on the knees. The “stoplight diet,” can be followed one does not forbid any foods but instead stresses an appropriate balance of high-, medium-, and low-calorie foods. In this diet, “green light” foods contain 20 fewer calories per average serving than standard food in that group, “yellow light” foods contain not > 20 calories above the standard for food in that group, and “red light” foods contain > 20 calories above the standard for food in that group and should be eaten infrequently.

As obesity and musculoskeletal problems are linked to each other, one must pay attention to their muscular flexibility, strength and weight parameters for longer healthy functioning of their knees. The fitter the body the better the life.

So appropriate weight and healthy knees go hand in hand.

high heels cause pain

High Heels: To Wear or Not to Wear?

There will hardly be a woman who would not love to wear high heels (having put rationale aside) and appear as a long legged, stylish lady! And there are a lot of them who cannot forego the attraction, despite the discomfort that high heeled shoes bring with them!

Here are few facts related to High heel shoes

what do high heels do to our body

High heels are one of the biggest causes of knee pain because they throw your whole body out of alignment. Your feet are forced up at an unnatural angle, so your body is pushed forward and the balls of your feet are supporting all of your weight. This causes your knees to tense up and work harder to keep you upright, while the forward position puts more pressure on the shock-absorbing cartilage under your kneecaps. After a few hours, you will probably feel some discomfort in heels, but the real damage — such as chronic knee and back pain and osteoarthritis — may not be apparent for some time.

Shoes that have no heel at all can also cause knee pain

As a general rule, wearing shoes with heels no higher than three-quarters of an inch will help to maximize knee support. However, shoes that have no heel at all can also cause knee pain by not adequately cushioning your feet as they hit the ground and increasing the amount of shock the joint has to absorb. For this reason, avoid shoes with heels that are lower than half an inch.

arthritis joint pain treatment

Arthritis – Do your Joints Pain?

The disorder commonly affecting the knee and other joints is called as Arthritis.

We commonly see our mothers or grandmothers groaning in pain when they try to do simple activities like getting up from the floor or climbing steps. Daily simple chores seem very difficult for them. They dread even the pleasant rains and winters as they are likely to experience increase in their aches and pains with the fall in temperature.

Arthritis is an inflammation of one or more joints. It is common in adults 65 and older, but it can affect people of all ages. There are many types of arthritis but most common types of arthritis are osteoarthritis and Rheumatoid Arthritis.

1. Rheumatoid Arthritis : It is an autoimmune disease in which the body immune system attacks the lining of the joint capsule, a tough membrane that encloses the joint parts known as synovial membrane. It is characterized by fluctuating course, with periods of flares and remission.

2. Osteoarthritis : It is a chronic degenerative disorder involves wear and tear damage to the joint’s cartilage. Enough damage results in bone grinding which causes pain and restricted movement and joint effusion.

Symptoms of Arthritis

The most common symptoms of Arthritis include pain, redness in the area, swelling,  limited movement & stiffness in the joint.

Unpaid attention to these symptoms can lead you to be under the surgeon’s knife.  But timely attention to the soft ringing of bells of your joints can help you deal effectively with your joint pain.

 

Arthritis, Joint pain : Facts, symptoms, Physiotherapy treatment

Treatment 

Physiotherapy is key to the treatment and management of arthritis.  It can help you to maintain independence through improving your mobility, strength and flexibility.

Used along with medication it can also help to minimise pain.

Physiotherapy for arthritis focuses on the reduction of pain and stiffness as well as increasing the level of movement and range of motion for the individual.

Our experts at ReLivaTM use a combination of modalities, manual therapy techniques and exercise and movement programmes to suit your specific condition. They will aim to reduce the swelling in the affected area along with making a strategy to control pain and stiffness. They will also devise simple exercise programmes that you can practise at home to help you build your strength and flexibility.

Physiotherapy uses a mix of Modalities

  • Heat treatments : These treatments produce heat within your body tissues. The application can be directed towards superficial or deeper parts of the body. The most common types of treatment used are infra-red radiation (heat lamps) and hot packs for superficial treatments.
  • Electrotherapy : These treatments produce electrical stimulation of your body tissues. They may be extremely useful in the treatment of both acute and chronic arthritis, where pain, swelling and muscle spasms are present. Physiotherapy exercise for Arthritis, joints pain
  • Exercise : A balanced programme of rest and exercise, and careful attention to joint posture is an important part of pain management, joint protection and maintenance of your joint function.
  • Manual therapy: Mobilisation and manipulation techniques are passive movements applied to a joint or soft tissue by the therapist in a specific manner to help restore full movement to a joint that is painful and restricted. Manual therapy is often useful in the chronic forms of arthritis and is often successful when other methods such as heat therapy and exercises have given little or no relief.
  • TENS : Transcutaneous electrical nerve stimulation (TENS) therapy is a commonly used electrostimulation method for relieving pain in rheumatoid arthritis.

 

Simple Tips to help avoid pain and stiffness:

  • Avoid staying in one position for long.
  • Avoid positions or movements that place extra stress on sore joints.
  • Avoid sitting on floor.
  • Modify your activities to make them easier.
  • Take proper rest when your symptoms are on a rise.
  • Try to lose weight if over-weight, as it reduces pressure on joints and alleviates pain.

ReLiva Tips for an Injury-free Run

5 Tips to Prepare for an Injury-free Run                                                            

For runners, taking on a run for the first time, the key is to have a solid training base and a detailed plan that allows
for a gradual increase in SPEED as well as DISTANCE.

Too Much. Too Soon. Too Fast

The most common issue that we see is the “Terrible Too’s”. You suddenly get up and start to train without a plan and end up doing “ Too much. Too soon, Too fast”
And that is the most common cause of Injury!
Chalk out a plan of training! Even better, if you do it along with a trained expert. The training plan should strike a balance between speed and strength. It would help you build up stamina, strength and endurance gradually, without causing any injury.

Prevention is better than Cure

Always remember to warm up, before you start running. Many injuries can be avoided by:
warming up  and stretching regularly
Spending 10 minutes to warm up before each run will definitely cost you much lesser time than if you injure yourself and wait back to recover.
However if you do injure, it’s best to see a physiotherapy expert immediately to chalk out a quick recovery plan.

Mix Things Up

It is very easy to get into a habit of running the same route, at the same pace during your training. That begins to limit your muscles and their strength.
“Mix things up!”
Challenge your body with harder runs on certain days and recover at a slower pace another day. This will work-out many more muscles in a much more variety and keep them prepared against injuries.

Keep Moving

Any good training plan needs no more than four days of running or walking every week. That’s not too much to do!
It is important that you don’t overdo it! And equally important, that you keep doing it sincerely! You can make the switch from run & Walk to only run if you
find it too easy. The day you feel, you’re not ready, continue to do walking! But ensure that you ‘Keep Moving’.

Look after your Body

While you train for your run, your body and muscles undergo a lot of wear and tear. Listen to your body! If you are tired, it’s a sign that the body needs rest! Overtraining immediately shows in form of decreased performance and injuries !
Look after your body. Swimming, Sauna or steam room can really help relax and stretch on a bit.

With these 5 things you can easily train for your run without worrying to injure yourself. Enjoy every step that you take to prepare yourself. Remember – “It only makes you stronger and better than what you were before!”

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

Running Injury : WARNING signs and Care

Marathon runners push the body’s limit to increase their exercise capacity. But they shouldn’t ignore the vital signs of injury andRunning Injuries- Warning signs and care 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  (RICE Protocol)

• Elevate injured part while icing

• Rest (at least initially)

• Analyze program for possible causes

o What did I do differently in training?                                                     reliva- the official Physiotherapy Partner for Navi Mumbai Mayor's Marathon

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 over training, 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.

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