SMART PHYSIOTHERAPY CENTRE

Physiotherapy Hits

2009-03-11T22:48:00.000-07:00

Yes ! I'm very much happy today because physiotherapy is getting very much popular in these days. I think there are lots of articles & visuals are coming in our magazines, newspapers and channels about the importance of physiotherapy in health management. patients now directly coming to our clinic. These articles stress on the importance of the fitness programs, and value of exercises therapy in healing musculoskeletal, neurological and cardiac problems. Another reason is , physiotherapy has no side effects like anlgesic drugs and physiotherapy also promotes health and physios focusing on dysfunctions of the patients. People are very much aware of the side effects of the drugs and they tell doctors to refer physiotherapy and we don't need painkillers and injections. This is very positive for us.

But most of our physios are not ready to start a clinic in India. The main reason is fear of faliure. Nobody knows its potential. Recent reports shows that orthopaedicians and neurologists are aware of this market and they going to start physiotherapy clinics and then our physios are very much happy to work under them. Why? We are not interested in risk taking, not interested in patient making, not even interested in ourselves. We are waiting to others to do something for the fullfillment of physiotherapy. They blame goverment, orthopaedicians, neurologists, and public. What we are doing for the development of our profession is not a question.

India is the best for physiotherapists, because lots of oppurtunities are here in private, and public hospitals. But we have to work hard.

Why SMART Physiotherapy Centre

2009-03-10T21:33:00.000-07:00

What is special in SMART Physiotherapy Centre...That is our culture, our way to deal with our patients, follow up with patients, follow up with referring doctors, all these makes us special.

Smart is a unique Rehabilitation Centre specialized in the prevention, assessment, treatment and research of Musculoskeletal Disorders, Soft Tissue Injuries, Sports Injuries, Neurological Disorders, Repetitive Strain Injuries and various Childhood Disabilities, through the most advanced and specialized Physiotherapy protocols.

Our primary focus is to restore function and improve your quality of life through caring, skilful and personalized applications of exemplary physiotherapy services for clients of all ages.

We are treatment and rehabilitation specialists in back and neck pain, joint problems, Shoulder & Knee pain, Sports injuries and Nerve impingement. We also specialise in running injuries, overuse injuries, repetitive strains, sciatica, work related injuries, osteoarthritis, & postural problems

Antenatal & Postnatal Fitness program

2009-03-10T10:32:00.000-07:00

We offer a safe course of antenatal / postnatal care for expectant mothers and new mothers. During these sessions effective exercise techniques for the child bearing year and after childbirth will be taught including gentle stretching, toning and relaxation.This will help you to understand the basic changes of your body and common problems occurring during pregnancy and after childbirth. We teach you, how to prevent these problems.Postnatal Exercise class : A course of progressive exercises to help return muscles to their prepregnancy state and improve muscle tone.Exclusively for you, we also provide a bonus class about BACK PAIN, the most common problem during pregnancy and after childbirth. 80-90% ladies are suffering from back pain during thesew stages. So it will help you most.Our one hour session covers :

Basic body changes during pregnancy.
Antenatal fitness
Diet & nutrition
Comfort , Back care programs
Pelvic floor & abdominal muscle strengthening
Breast feeding
Prevention of urinary incontinence
Postnatal exercises
Postural correction techniques
Postnatal depression prevention
Video demonstration of exercises
Book let for new mothers – will explain why exercises, when to stop exercises, pictures of all exercises with simple instructions, a beautiful session for your baby, vaccination chart and reminders etc.. etc…

What happens to this Infraspinatus

2009-03-10T10:01:00.000-07:00

What happens to Infraspinatus ? For last week we have four patients having shoulder pain and four of them having the same symptoms. They complains pain over shoulder joint, restriction of shoulder movement. pain mainly over anterior aspect of the shoulder. Passive shoulder movements have no restrictions but actively they are unable to lift their shoulder, rotate their shoulder and these movements produces pain also. No tenderness over anterior region of the shoulder.

But on further examination severe tenderness over infraspinatus muscles is noted. Trigger points noted in all these patients. Treatment focused on infraspinatus includes Myotherapy, Trigger point therapy, stretching and active exercises for infraspinatus.

After one week our treatment protocol gives us a dramatic improvement in their conditions. Three of them have 90% decrease in frequency of pain and 100% improved ROM of shoulder. One patient required further treatment because his supraspinatus was also affected. But after 10 days he also got 90% result.

Infraspinatus :The Infraspinatus, one of the rotator cuff muscles, lies on the outside of the lower 2/3 of the shoulder blade. It functions primarily to rotate your arm outwards and to pull your arm back.It is a external rotator of the glenohumeral joint and adductor of the arm.

The Infraspinatus and Teres minor rotate the head of the humerus outward (external rotation); they also assist in carrying the arm backward. Trigger Points in the Infraspinatus are commonly overlooked, due to the unique referral pattern. Although this muscle is located on the back, the primary referral pain is to the front of the shoulder. Pain can also be found along the outer portion of the shoulder, extending into the upper arm as well.

A common condition known as “Frozen Shoulder” causes weakness and stiffness in the shoulder. This true condition is caused by adhesions and scar tissue in the joint. Trigger Points in the Infraspinatus muscle can mimic the symptoms of “Frozen Shoulder.”

So next time you sees a patient with shoulder pain or diagnosed as frozen shoulder rule out Infraspinatus trigger points.

Interesting Websites..

2009-03-06T22:43:00.000-08:00

Last day i go through some interesting websites one of them is "www.shape.com" which have very useful tips for weight loss, diet, exercises, lifestyle, etc.. The most catching is the 10 steps to Sure Fire Weight Loss... very practical and very useful for obese patients. Also have some popular articles like " 8 things you always wanted to know about dieting", "5 smarter ways to loss weights", and "sneaky ways to beat overeating".

You can also enjoy www.mensfitness.com

Some Useful Websites

2009-03-06T21:53:00.000-08:00

http://www.bl.uk/ British Library

http://www.health.library.mcgill.ca/ On line library, McGill University, USA

http://www.ipl.org/ Internet public library

http://www.isep.org.au/ International Society of Physiotherapy Educators

http://www.ncchta.org/Health Technology Assessment Programme (UK Government funded research reports and reviews)

http://www.nlm.nih.gov/ National Library of Medicine, USAAnd in case any of you don't know about this one for classics in literature.............

http://www.gutenberg.org/wiki/Main_Page Project Gutenberg[You won't find anything about physiotherapy on it]

Pes Anserinus Cont....

2009-03-04T22:24:00.000-08:00

Today is the fifth day of his treatment...

On further examination we noted tightness of hamstrings and calf muscles.

Our treatment plan is Ultrasound therapy with hydrocortisone cream (phonophoresis) X 7 days.

Stretching of hamstring muscles, calf muscles.

We applied taping technique, with lower leg on internal rotation from third day , that also reduced pain. He is still on rest.. Ask him to avoid stressful activities like hill climbing, stair climbing, twisting, prolonged marching etc..

Now there is 50% reduction in frequency of pain. Weight bearing and walking improved.

We r also waiting for further improvement... after hamstring stretching exercises

RSI- Repetitive Strain Injury

2009-03-02T21:38:00.000-08:00

What is RSI - Repetitive Strain Injuries

From the Glossaries :

An injury to the muscles, Tendons, nerves and other soft tissues as a result of repeated stress. Injury may be caused by any combination of repetative, unacustomed, or prolonged movements, forcefulness, or an awkward position (often due to bad ergonomics).

The symptoms are Pain, tingling, Weakness, numbness, swelling, cracking, stiffness, or reduced co-ordination

RSI are on rise and can easily be prevented. Much of this damage is workplace related, and few changes in your environment can alleviate it.

We at Smart Physiotherapy Centre provide RSI Management wellness program, Work station evaluation for corporate companies. We conducting seminars on RSI and ergonomic care.

Our clinic provides treatment for RSI (mainly the employees complains with neck pain, arm pain, wrist pain and misdiagnosed as cervical spondylosis or carpal tunnel syndrome) include myotherapy, trigger point therapy, INMT (integrated neuro muscular inhibition techniques),Ultrasound therapy, Interferential therapy , office stretches, mobilizations and manipulations

We give proper guidence for the employees, how to work in front of computer to avoid further work related injuries.

Pes Anserinus Bursitis / Tendinitis

2009-03-01T20:53:00.000-08:00

Last week a 35 year old person comes with severe pain on the medial side of the knee. He is unable to walk properly. Weight bearing and hanging freely increases his symptoms. He is referred from medical college, Thrissur.

He is a policeman.Pain starts one week back after a intense period of police camp training. Training

includes vertical jumps, sudden twisting, hill climbing, running etc..

He consulted with orthopaedician and sports medicine specialist

and they diagnosed as PES ANSERINUS TENDINITIS and referred him for physiotherapy.

There is marked tenderness over the medial side of the knee.

What is PES ANSERNUS TENDINITIS:

Pes anserinus is the anatomic term used to identify the insertion of the conjoined tendons into the anteromedial proximal tibia. From anterior to posterior, the pes anserinus is made up of the tendons of the sartorius, gracilis, and semitendinosus muscles. The tendon's name, which literally means "goose's foo

t," was inspired by the pes anserinus's webbed, footlike structure. The conjoined tendon lies superficial to the tibial insertion of the medial collateral ligament (MCL) of the knee.

Pes anserine bursitis/tendonitis is a painful, inflammatory condition affecting the tendons and/or lubricating sac (bursae) between your shinbone and the hamstring tendons at the inside of your knee; typically caused by stress to the area. Specifically, the pes anserinus is the area where the tendons of 3 muscles (sartorius, gracilis, and semitendinosus) come together. The three tendons merge together in the skin of the bone on the inside surface of the shinbone. The term, pes anserinus means "goose´s foot" in Latin - owing to the webbed-foot pattern the three tendons make when they meet.

The sartorius, gracilis, and semitendinosus muscles are primary flexors of the knee. These 3 muscles also influence internal rotation of the tibia and protect the knee against rotary and valgus stress. Theoretically, bursitis results from stress to this area (eg, stress may result when an obese individual with anatomic deformity fromarthritis ascends or descends stairs). Pathologic studies do not indicate whether symptoms are attributable predominantly to true bursitis, to tendinitis, or to fasciitis, at this site.

Inflammation of the bursae

or tendons serving these muscles usually develops due to overuse, trauma, or degradation typically from:

Tight hamstrings
Obesity
Poor sport technique, including improper warm-up, excessive hill work, increased mileage
Biomechanical issues, such as foot rolling, out-turned knees
Osteoarthritis
A medial meniscus tear

Causes

Pes anserine bursitis and tendonitis is common in athletes (particularly runners), overweight individuals, an

d often, people with osteoarthritis of the knee. The symptoms of pes anserine bursitis include:

pain located 2 to 3 inches below the kneecap
swelling in front of the kneecap (prepatellar) or underneath the kneecap (infrapatellar)
Pain increasing with exercise or climbing stairs
Pain and often warmth and tenderness when touched
Pain when bending or straightening the knee.
Pain that radiates to the back and inside of the thigh
Visible swelling and/or redness of the tendon sheaths (tendonitis)

It is generally agreed that hamstring tightness is the most common cause of pes anserine bursitis/tendonitis. Athletes and non-athletes alike need to ensure their hamstrings are properly warmed-up and stretched before they place any stress on their knee; from extensive hill running to simply climbing stairs. If you are susceptible to PATB or are suffering from it now, you need to take steps to prevent re-injury or ensure recovery.

Treatment:

Physiotherapy and NSAID are the best options for treating Pes Anserinus.

URICE

U- Ultrasound Therapy

R- Rest

I- Ice

C- Compression

E- Elevation

Ultrasound is an excellent tool for reduction of swelling and pain when treating the injury. If treatment does not require surgery, rest the area, apply ice for 10-20 minutes at a time for at least 3 times a day. Do this to the injured area for the first day up to 3 days. Moist heat may be used after the acute swelling is improved and rest prevents further muscle injury. Ice will reduces initial inflammation and swelling and the moist heat circulates blood through the area to speed the healing process. This can be further helped by the use of ultrasound applications over the affected area, as it reduces swelling quickly and increases blood flow to the area, helping the tendon heal more quickly.

Manualtherapy & Myotherapy Works

2009-02-27T22:22:00.000-08:00

2 months back one patient came to our department with severe pain , swelling and restricted ankle movements. He is unable to walk without support. He is a lecturer and medically diagnosed with psoriatic arthritis. Disease started 2 years back and his ankle problem started one year back. All other joints are normal. ROM of his both ankle joint is nearly zero.
Most of the ortho specialists advised arthrodesis (surgical fusion of the joint). But he went for a second opinion and consulted with a physician and he directed him to our department for physiotherapy.

We started with hotpacks, then we slowly started mobilization of the joint in classic way. But it was very painful to him. So we applied Mulligan's movement with mobilization for 10mts, followed by myotherapy, deep friction technique over the ankle joint, Ultra sound therapy to reduce swelling. After 2 session we got dramatic result. On second day he has got 25% movement of his ankle joint and swelling reduced to 50%. We continued the same treatment plan and applied crepe bandage after treatment. After 10 days there is 90% reduction in the frequency of pain, swelling disappered and ROM become near normal. He is able to walk without support but mild limping was present... Then we strated some conditioning exercises for leg muscles first with very minimal resistance and progressed with moderate resistace, by the time we continued the mobilization and myotherapy for 10 more days.

Now he is able to walk without support, gait near normal and ankle movemts are 100%!!
Mobilizations , myotherapy and exercises worked in this condition....

Is It Frozen Shoulder???

2009-02-27T22:11:00.000-08:00

One of our patient comes with left shoulder pain and stiffness. He is having this problem 6 months back and he consulted many orthopaedicians and took lot of analgesics. Professionally he is a martial art tutor. The pain started gradually and decreased range of motion slowly. Now he has 110 degree of shoulder flexion and 100 degree abduction and 50%movement loss of rotations. All orthopaedicians diagnosed as frozen shoulder , but during the movement of his shoulder the restriction or end point feels rubbery or elastic end feel.

He came 4 days back in our clinic for physiotherapy services. On first day, our treatmentprotocol is same as that of frozen shoulder but we feel the end feel... so we changed the treatment protocol... we reassessed patient that find out trigger points over subscapularis, and tightness of latissmus dorsi muscles.

So we applied myofascial therapy, neuro muscular therapy and trigger point therapy for the particular muscle groups along with usual mobilization (mulligan techniques) and exercises... on third day there is 80% decrease in pain and 85% increase in range of motion...

Subscapularis is a rotator cuff muscle whose job is to stabilize the humeral head and seat it deeply into the glenoid fosa. It is the powerful medial rotator of the humerus. Problems oversubscapularis produces loss of lateral rotation and abduction movement..that mimics the frozen shoulder syndrome.

A through knowledge about the muscles and their function is most useful when treating this type of disorders..where traditional physiotherapy fails..............

Talk On Work Related Musculoskeletal Disorders In Dentistry

2009-02-27T22:01:00.000-08:00

On 15th December , Indian Dental Association- Thrissur Branch (award winning IDA Branch in Kerala, India) on their annual meeting, organized a talk on Work related Musculoskeletal Disorders and Ergonomics in Dentistry.. Talk given by Dr.Grinto Davy Chirakekkaren (PT) on behalf of SMART Healthcare - Centre for musculoskeletal Disorders and Rehabilitation. The response was tremendous and most of the Dentists attended in the conference had met with one of the MSDs during their professional life.

Work Related Musculo-skeletal Disorders In Dentists

2009-02-27T21:53:00.000-08:00

Work related musculo skeletal disorders are very common in dentists due to the type of work and posture during their time of work.Recent surveys shows that 40-60% dentists are affected with work related musculo skeletal disorders. The most common affected sites are neck, shoulder, hand, wrist and back. The disorders around neck and shoulder are
1.myofascial pain syndrome
2.cervical spondylosis
3.Rotator cuff injuries
4.Thoracic outlet syndrome etc..
The disorders affecting forearm,hand and wrist are
1.DeQuervains disease
2.Carpal Tunnel syndrome
3.Tennis Elbow
4.Guyon's disease
5.Trigger finger
The disorders affecting back are
1.Lumbar spondylosis
2.Low back pain
3.Sciatica
4.Herniated disc

M pain and trigger points are common and most of the time they misdiagnosed simply as Cervical spondylosis and Carpal Tunnel Syndrome. So a through clinical examination is needed for every patient before starting the physio program.

Arthritis- SMART Protocol

2009-02-27T21:42:00.001-08:00

Smart Health Care ..A leading centre for musculoskeletal disorders and rehabilitation... introduces special protocol for Rehabilitation for Arthritic patients, who were suffering from joint pain, joint stiffness and even bed ridden. This specialized protocol mainly based on exercise therapy have greater relief for these patients in addition to the modern drug management. So this combination therapy including drugs and physical therapy produces more effective results especially on patient's functional activity

Arthritis

2009-02-27T21:36:00.001-08:00

At Smart Health Care , our researches shows that , patients with Arthritis (joint pain) of any type, our treatment protocol, includes myotherapy, mobilization ,stretching and specific active exercises produces greater results instead of conventional physiotherapy methods like wax bath and exercises.

SMART Physitherapy Centre - Specialised For Musculoskeletal Disorders

2009-02-27T21:18:00.001-08:00

Smart Physiotherapy Centre- ..is located in Thrissur city, Kerala, India. This clinic manily deals with musculo skeletal disorders, Joint pain, RSI (Repitative strain injuries), Ergonomic consultancy, Sport injuries rehabilitation. & Antenatal and postnatal fitness program. We treat all aspects of orthopaedic & Sports injuries.

SMART stands for

S - Soft tissue & sports injuries

M- Manipulations & Myotherapy

A- Arthritic pain

R- RSI & Rehabilitation

T- Trigger point therapy

Welcome to SMART Physiotherapy Centre

2009-02-19T21:14:00.000-08:00

Smart Physiotherapy Centre offers advice and Treatment for a range of health problemsto help you make the most of your lifestyle.

Smart is a unique physiotherapy Centre specialized in the prevention, assessment,treatment and research of musculoskeletal disorders, joint pain, soft tissue injuries, sports injuries, repetitive strain injuries (RSI), neurological disorders and various childhood disabilities, through the most advanced and specialized tretment protocols.

In SMART Physiotherapy Centre, we offer advice and treatment equivelent to international standards for a range of health problems to help you make the most of your lifestyle.