DrAli_Physiotherapist

CONGENITAL DISLOCATION OF THE HIP/ DEVELOPMENTAL DYSPLASIA OF THE HIP

Developmental dysplasia of the hip, often shortened as DDH, is a condition where the "ball and socket" joint of the hip does not properly form in babies and young children. It's sometimes called congenital dislocation of the hip, or hip dysplasia.

The hip joint attaches the thigh bone (femur) to the pelvis. The top of the femur (femoral head) is rounded, like a ball, and sits inside the cup-shaped hip socket. In DDH, this socket of the hip is too shallow and the femoral head is not held tightly in place, so the hip joint is loose. In severe cases, the femur can come out of the socket (dislocate).

Developmental hip dysplasia seems to run in families. In addition, being in the breech position in utero sometimes puts stress on the baby’s hip and thigh muscles, causing a hip to move out of joint.

DDH occurs in approximately one in 1,000 births. Risk factors for hip dysplasia in babies include:

1. A family history of DDH.
2. Being female.
3. Being in a breech position during pregnancy.
4. Being part of a multiple gestation pregnancy (twins, triplets).
5. Being the firstborn child.

6. Environmental factors, such as poor nutrition and certain positioning (some forms of swaddling). In some cases, most of the babies that are carried more often in baby carriers stands higher risk of developing shallow socket. We therefore advocates that babies be carried on their mothers back rather than in man made carriers.

It is enough to say that, human being can not surpass the natural way of doing things all the time. Civilization is now cleaning most of the natural ways of doing things and this is the main reason to the numerous health problems befalling us all day long.

Meet me in my next post as I bring you other important areas of congenital hip dislocation you must know for better understanding.

DrAli_Physiotherapist

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PROXIMAL TIBIA FRACTURE!!!

FIXATION WITH TIBIAL T PLATE
osteoclausis _medial column elevation_strut graft_ BS _BG

Rehabilitation Protocol;
immobilizer applied from the very first day
patient will walk with the assistive device( walker)
NON WEIGHT BEARING would be the status for next 6 weeks
Active assisted movement will progress to active movements.
EARLY ROM at the knee is required which can be the controlled ones .slight through heel slider and in sitting position.
ankle pumps
SLR
Abd
Add
quadr
hams
knee immobilizer will remain for 2 weeks.
partial wt bearing after 6 weeks following by full wt bearing.

Plantar Fasciitis. Diagnosis, treatment & exercises....
DEFINITION
Plantar fasciitis (PLAN-tur fas-e-I-tis) is one of the most common causes of heel pain. It involves pain and inflammation of a thick band of tissue, called the plantar fascia, that runs across the bottom of your foot and connects your heel bone to your toes.

Plantar fasciitis commonly causes stabbing pain that usually occurs with your very first steps in the morning. Once your foot limbers up, the pain of plantar fasciitis normally decreases, but it may return after long periods of standing or after getting up from a seated position.

Plantar fasciitis is particularly common in runners. In addition, people who are overweight and those who wear shoes with inadequate support are at risk of plantar fasciitis.SYMPTOMS
Plantar fasciitis typically causes a stabbing pain in the bottom of your foot near the heel. The pain is usually worst with the first few steps after awakening, although it can also be triggered by long periods of standing or getting up from a seated position.

CAUSES
Under normal circumstances, your plantar fascia acts like a shock-absorbing bowstring, supporting the arch in your foot. If tension on that bowstring becomes too great, it can create small tears in the fascia. Repetitive stretching and tearing can cause the fascia to become irritated or inflamed.

RISK FACTORS
Factors that may increase your risk of developing plantar fasciitis include:

Age. Plantar fasciitis is most common between the ages of 40 and 60.
Certain types of exercise. Activities that place a lot of stress on your heel and attached tissue — such as long-distance running, ballet dancing and dance aerobics — can contribute to an earlier onset of plantar fasciitis.
Faulty foot mechanics. Being flat-footed, having a high arch or even having an abnormal pattern of walking can adversely affect the way weight is distributed when you're standing and put added stress on the plantar fascia.
Obesity. Excess pounds put extra stress on your plantar fascia.
Occupations that keep you on your feet. Factory workers, teachers and others who spend most of their work hours walking or standing on hard surfaces can damage their plantar fascia.
COMPLICATIONS
Ignoring plantar fasciitis may result in chronic heel pain that hinders your regular activities. If you change the way you walk to minimize plantar fasciitis pain, you might also develop foot, knee, hip or back problems.

PREPARING FOR YOUR APPOINTMENT
While you may initially consult your family physician, he or she may refer you to a doctor who specializes in foot disorders or sports medicine.

What you can do
You may want to write a list that includes:

Detailed descriptions of your symptoms
Information about medical problems you've had
Information about the medical problems of your parents or siblings
All the medications and dietary supplements you take
Questions you want to ask the doctor
What to expect from your doctor
Your doctor is likely to ask you a number of questions. Being ready to answer them may reserve time to go over any points you want to spend more time on. For instance, your doctor may ask:

Do your symptoms tend to occur at a particular time of day?
What types of shoes do you usually wear?
Are you a runner, or do you participate in any sports that involve running?
Do you have a physically demanding job?
Have you experienced any injuries to your feet in the past?
Besides your foot, do you feel pain anywhere else?
What, if anything, seems to improve your symptoms?
What, if anything, appears to worsen your symptoms?
TESTS AND DIAGNOSIS
During the physical exam, your doctor checks for points of tenderness in your foot. The location of your pain can help determine its cause.

Imaging tests
Usually no tests are necessary. The diagnosis is made based on the history and physical examination. Occasionally your doctor may suggest an X-ray or magnetic resonance imaging (MRI) to make sure your pain isn't being caused by another problem, such as a stress fracture or a pinched nerve.

Sometimes an X-ray shows a spur of bone projecting forward from the heel bone. In the past, these bone spurs were often blamed for heel pain and removed surgically. But many people who have bone spurs on their heels have no heel pain.

TREATMENTS AND DRUGS
Most people who have plantar fasciitis recover with conservative treatments in just a few months.

Medications
Pain relievers such as ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve) may ease the pain and inflammation associated with plantar fasciitis.

Therapies
Stretching and strengthening exercises or use of specialized devices may provide symptom relief. These include:

Physical therapy. A physical therapist can instruct you in a series of exercises to stretch the plantar fascia and Achilles tendon and to strengthen lower leg muscles, which stabilize your ankle and heel. A therapist may also teach you to apply athletic taping to support the bottom of your foot.
Night splints. Your physical therapist or doctor may recommend wearing a splint that stretches your calf and the arch of your foot while you sleep. This holds the plantar fascia and Achilles tendon in a lengthened position overnight and facilitates stretching.
Orthotics. Your doctor may prescribe off-the-shelf heel cups, cushions or custom-fitted arch supports (orthotics) to help distribute pressure to your feet more evenly.
Surgical or other procedures
When more-conservative measures aren't working, your doctor might recommend:

Steroid shots. Injecting a type of steroid medication into the tender area can provide temporary pain relief. Multiple injections aren't recommended because they can weaken your plantar fascia and possibly cause it to rupture, as well as shrink the fat pad covering your heel bone.
Extracorporeal shock wave therapy. In this procedure, sound waves are directed at the area of heel pain to stimulate healing. It's usually used for chronic plantar fasciitis that hasn't responded to more-conservative treatments. This procedure may cause bruises, swelling, pain, numbness or tingling and has not been shown to be consistently effective.
Surgery. Few people need surgery to detach the plantar fascia from the heel bone. It's generally an option only when the pain is severe and all else fails. Side effects include a weakening of the arch in your foot.
LIFESTYLE AND HOME REMEDIES
To reduce the pain of plantar fasciitis, try these self-care tips:

Maintain a healthy weight. This minimizes the stress on your plantar fascia.
Choose supportive shoes. Avoid high heels. Buy shoes with a low to moderate heel, good arch support and shock absorbency. Don't go barefoot, especially on hard surfaces.
Don't wear worn-out athletic shoes. Replace your old athletic shoes before they stop supporting and cushioning your feet. If you're a runner, buy new shoes after about 500 miles of use.
Change your sport. Try a low-impact sport, such as swimming or bicycling, instead of walking or jogging.
Apply ice. Hold a cloth-covered ice pack over the area of pain for 15 to 20 minutes three or four times a day or after activity. Or try ice massage. Freeze a water-filled paper cup and roll it over the site of discomfort for about five to seven minutes. Regular ice massage can help reduce pain and inflammation.
Stretch your arches. Simple home exercises can stretch your plantar fascia, Achilles tendon and calf muscles.

***Facts about Dupuytren’s Contracture vs. Trigger Finger***

It’s easy to see why people may confuse the two conditions. They are similar in some ways. First of all, both conditions can affect any finger. Another similarity is the appearance. The affected fingers are typically curved inward toward the palm, although in some cases they can be bent to the left or right.

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What is Trigger Finger?
The technical name for trigger finger is stenosing tenosynovitis. Trigger finger is caused when an injury causes a finger to get stuck in a bent position. This occurs when inflammation narrows the sheath around the tendons, leading to the formation of a nodule. When you flex this finger, the nodule must slide through the narrow sheath, causing a snapping sensation.

_Treatment for trigger finger may include:

*The use of medications to relieve pain
*Physiotherapy that includes rest, stretching exercises, and the use of a splint
*Steroid injections
*A percutaneous release procedure, where the hand surgeon uses a needle to break apart the constriction that is blocking proper movement
Surgery to loosen the constricted area
*Trigger finger is usually caused by an injury and is most common in the thumb, index finger, and middle finger.
*Trigger finger is usually caused by an injury and is most common in the thumb, index finger, and middle finger.

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What is Dupuytren’s Contracture?
Dupuytren’s contracture develops over time. It begins when tissue forms knots under the skin of the palm. As these knots form, they create a cord that pulls the fingers into a bent position. Everyday activities like gripping silverware can become difficult with this condition.

*Similar to one of the trigger finger treatment options, Dupuytren’s contracture can be treated with the needling procedure to break the cord of tissue that is causing a finger to contract. Other treatment options include self-care, Xiaflex enzyme injections, and surgery.

*Surgery for Dupuytren’s contracture entails removing all the tissue that is affected, including the skin. A skin graft may be required to repair the wound. Because this is a serious procedure with a lengthy recovery time, it is ideal only for those who have a diminished quality of life due to the condition.

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____Differences Between the Two Hand Conditions____
____Dupuytren’s contracture vs. trigger finger.___

1_Trigger finger starts with the fingers while Dupuytren’s contracture stems from the palm.

2_Dupuytren’s contracture involves the tissue, but trigger finger involves the tendons.

3_Trigger finger is most common in the thumb, index finger, and middle finger. Dupuytren’s contracture is most likely to occur in the fourth finger and the pinky.

4_Someone who has trigger finger can straighten the finger if they tried, but someone with Dupuytren’s contracture cannot.

5_Whereas trigger finger is usually the result of an injury, the causes of Dupuytren’s contracture are not

𝐓𝐫𝐢𝐠𝐠𝐞𝐫 𝐅𝐢𝐧𝐠𝐞𝐫
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📚Trigger finger or ‘stenosing tenosynovitis’ describes a condition in which inflammation of the sheath that envelops the finger flexor tendons occurs leading to impaired finger movement.

🔎In these cases, stiffness is the typical first symptom, which can progress to the point where the finger becomes locked in a bent positio and the other hand is needed to push the finger straight. A painful snap or click will often occur as the finger is straightened.

🧠Traumatic injuries, repetitive gripping and arthritis can lead to the development of trigger finger. However, there are other cases where the cause is unknown and can be related to systemic disorders such as rheumatoid arthritis and diabetes.

👉Trigger finger can often be managed conservatively and should involve a combination of behavior modification (managing finger usage), anti-inflammatory medication, cortisone injections, ice, splinting (if necessary) and tendon gliding exercises. In more severe cases, surgery may be required to restore normal finger function.

✅10 repetitions of each movement 2-3 times per day.

1️⃣Duck
2️⃣Curl
3️⃣Squeeze
4️⃣Trace
5️⃣Splay

محبت کو امر کرنا ہے تو اس شخص سے بچھڑ جاؤ جسے چاہت کی آخری حد تک چاہا ہے اس کی جدائی کا اپنا ایک حسن ہے۔

جدائی کی اپنی میٹھی میٹھی کسک زیست کے آخری لمحوں تک ساتھ رہتی ہے
وہ شخص چاندنی رات میں یاد آتا ہے خزاں رسیدہ پتوں پر پاؤں رکهتے ہوئے کبھی اس کے ہجر کے نوحے سنائی دیتے ہیں بہاروں کے موسم میں پھولوں کے بیچ چلتے ہوئے کبھی اس شخص کی خوشبو ہمارا تعاقب کرتی ہے .

یہاں تک کہ پھر وہ لمحہ سے جدا نہیں ہوتا ہر وقت ساتھ ساتھ رہتا ہے سائے کی طرح جسے ہم کبھی بھی نہیں بهول سکتے۔۔۔🌈

How do we treat tendinopathy ?

Sciatica:
Also known as: lumbar radiculopathy

A severe pain that radiates from the back into the hip and outer side of the leg caused by compression of the sciatic nerve.

Causes:

Most common causes of sciatica is a slipped disc that results in compression of the sciatic nerve causing pain.
Other less common causes are:

Lumbar spinal stenosis
Spondylolisthesis
Piriformis syndrome
Pregnancy

The risk factors include:

Age - Common among elderly persons
Diabetes
Being overweight
Wearing high heels
Smoking
Sleeping on too soft or hard mattress

Symptoms:

The symptoms include:
Pain radiating from the back into the hip and outer side of the leg
Leg Pain which is more common on the inner side of the thigh
Constant Pain
Lower back Pain
Weakness, Pain, numbness or difficulty while moving the leg
Pain that is worse when sitting
Tingling sensation along the thigh and leg

Diagnosis:

Diagnosis involves physical examination, imaging tests and previous medical history.
Physical examination
Doctor may check your muscle strength and reflexes.
X-ray
X-ray of spine may reveal overgrowth of bone.
Magnetic resonance imaging (MRI)
MRI of the spine will provide detailed image of bone and herniated disks.
CT scan
CT scan of spine provides detailed image of spinal cord and nerves.
Electromyography (EMG)
Can confirm nerve compression caused by herniated disks or narrowing of spinal canal.

Physiotherapy Treatment protocol:

Sciatica physiotherapy treatment plans consist of two components namely passive physical therapy and active exercises. Passive sciatica physiotherapy treatment focuses on reducing your pain by heat or ice therapies, etc. Active sciatica physiotherapy treatment includes stretching exercises for specific muscle groups with core strengthening exercises.

Knee to chest stretch –

Bend one knee up towards your chest and hold it with both hands. Hold this position for 20-30 seconds with controlled deep breaths.

Back extension –

Keep your neck straight, arch your back up by pushing down on your hands. Breathe and hold this position for 5-10 seconds. Return to the start position.

Sciatic mobilizing stretch –

Bend one knee up to your chest, hold the back of your upper leg with both hands and then slowly straighten the knee. Hold for 20-30 seconds while taking deep breaths. Bend the knee and go back to the starting position.

Standing hamstring stretch –

Keep your back straight and lean forward. Hold this position for 20-30 seconds.

Lying deep gluteal stretch –

Pull your left thigh towards you, keeping your base of spine on the floor throughout and your hips straight. Hold this position for 20-30 seconds while taking deep breaths.

Things to take care of during sciatica physiotherapy treatment

Poor sitting posture – Change your workstation to ensure these activities are not worsening your symptoms
Poor lifting technique – Know how to lift objects while properly supporting and protecting your spine
Poor core strength – Exercise regimen to enhance your strength may be necessary
Poor spinal mobility – You might need to include mobility exercises as a stiff spine is at risk of developing pain