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total knee replacement
10Apr

POSTOPERATIVE KNEE REPLACEMENT EXERCISE

Author dynafisio 2 Comments on POSTOPERATIVE KNEE REPLACEMENT EXERCISE Categories Knee Pain Treatment Gurgaon

OVERVIEW

The most common indication for a primary knee replacement, TKA, is Osteoarthritis. Osteoarthritis causes the cartilage of the joint to become damaged and no longer able to absorb shock. Risk factors for knee osteoarthritis include gender, increased body mass index, history of a knee injury.  Pain is typically the main complaint of patients with knee osteoarthritis.

A TKA surgery typically lasts 1 to 2 hours. The majority of individuals begin physiotherapy during their inpatient stay, within 24 hours of surgery. Range of motion and strengthening exercises, cryotherapy and gait training are typically initiated, and a home exercise programme is prescribed before discharge from hospital.

PHYSIOTHERAPY GOALS

The goal of physical therapy intervention during the early post-operative phase is to decrease swelling, increase range of motion, enhance muscle control and strength in the involved lower extremity and maximize patients’ mobility with a goal of functional independence. Physical therapy interventions are also directed towards identifying other sensomotor or systemic conditions that may influence a patients’ rehabilitation potential.

EXERCISES

Ankle Pumps

  • Move your foot up and down rhythmically by contracting your calf and shin muscles.
  • Perform this exercise for 2 to 3 minutes, 2 or 3 times an hour in the recovery room.

 

STATIC QUADS

  • Tighten your thigh muscle.
  • Try to straighten your knee.
  •  Hold for 5 to 10 seconds.

Towel Roll under the Heel

  • Place a small rolled towel just above your heel so that your heel is not touching the bed. Tighten your thigh.
  •  Try to fully straighten your knee and to touch the back of your knee to the bed.
  •  Hold fully straightened for 5 to 10 seconds.

Straight Leg Raises

  • Tighten your thigh muscle with your knee fully straightened on the bed, as with the quadriceps set above. Lift your leg 30-70 degree.
  •  Hold for 5 to 10 seconds.
  •  Slowly lower.

Bed-Supported Knee Bends

  • Slide your foot toward your buttocks, bending your knee and keeping your heel on the bed
  • . Hold your knee in a maximally bent position for 5 to 10 seconds and then straighten.

Sitting Supported Knee Bends

  • While sitting at your bedside or in a chair with your thigh supported, place your foot behind the heel of your operated knee for support.
  • Slowly bend your knee as far as you can.
  • Hold your knee in this position for 5 to 10 seconds.

Sitting Unsupported Knee Bends

  • While sitting at bedside or in a chair with your thigh supported, bend your knee as far as you can until your foot rests on the floor.
  •  With your foot lightly resting on the floor, slide your upper body forward in the chair to increase your knee bend.
  • Hold for 5 to 10 seconds.
  • Straighten your knee fully.

Walking

  • Proper walking is the best way to help your knee recover.
  •  At first, you will walk with a walker or crutches

 

Stair Climbing and Descending

  • At first, you will need a handrail for support and will be able to go only one step at a time
  •  Always lead up the stairs with your good knee and down the stairs with your operated knee.
  • Remember, “Up with the good” and “down with the bad”.
Standing Knee Bends Standing erect with the aid of a walker or crutches, lift your thigh and bend your knee as much as you can. Hold for 5 to 10 seconds. Then straighten your knee, touching the floor with your heel first.  
Tail Bone Pain Treatment
24Mar

COCCYDYNIA – TAILBONE PAIN TREATMENT

Author dynafisio Categories Tail Bone Pain Physiotherapy

The coccyx, or tailbone, is the lowest region of your spine, and it sits directly below the sacrum. Your tailbone is made up of 3 to 5 small bones that naturally fuse together by about age 30. It’s positioned at the bottom of your spine, and the coccyx helps support your weight while you sit.

RISK FACTORS-

-Adolescents and adults

-Women

-People who are obese

Being female and obese are the 2 biggest risk factors. Women are affected by coccydynia 5 times more than men, which is likely due to injuries during childbirth. Also, the female coccyx is positioned farther back than its male counterpart, making it more vulnerable to trauma.

CAUSES-

Trauma from falling or being bumped

Repetitive action, such as extensive bike riding or rowing

Childbirth

Other possible causes of coccydynia include:

-Bone spurs on the coccyx

– Joint instability

-Spinal arthritis

SYMPTOMS-

The main symptom is pain and tenderness in the area just above the buttocks.

The pain may:

-be dull and achy most of the time, with occasional sharp pains

-be worse when sitting down, moving from sitting to standing, standing for long periods

-make it very difficult to sleep and carry out everyday activities, such as driving or bending over

TREATMENTS FOR COCCYDYNIA-

-self-care measures, such as avoiding prolonged sitting, using a specially-designed coccyx cushion

-non-steroidal anti-inflammatory drugs

-physiotherapy

PHYSIOTHERAPY MANAGEMENT-

-Ergonomic adjustments

– Pain management by electrotherapy including TENS and UST

-Manual Therapy which includes- stretchings, mobilisation and soft tissue releases .

– Dry needling has proven to be very effective as well.

– Stretching of Piriformis muscle, Iliopsoas and glute stretch (PIGEON POSE)

– Exc like single  kee hugging

If you are suffering from chronic tailbone pain than visit your nearest Physician or Physiotherapy centre .

Or visit us at Dynafisio – www.dynafisio.com or call at 8929294515

Stretching
16Mar

ROLE OF STRETCHING

Author dynafisio Categories full body stretches

The importance of stretching-

It’s not enough to build muscle and achieve aerobic fitness. You need to think about flexibility, too. Stretching can help.

In this video Dr Apurva Thakur Physiotherapist in Sector 83 Gurgaon is demonstrating full body stretches for better understanding and you can remain pain free Link

Stretching keeps the muscles flexible, strong, and healthy, and we need that flexibility to maintain a range of motion in the joints. Without it, the muscles shorten and become tight. Then, when you call on the muscles for activity, they are weak and unable to extend all the way. That puts you at risk for joint pain, strains, and muscle damage.

TECHNIQUES

Static Stretching–

Static stretching (SS) is a type of stretching exercises in which elongation of muscle with application of low force and long duration (usually 30 sec).Static stretching has a relaxation, elongation effect on muscle,improving range of motion (ROM),decreasing musculotendinous stiffness and also reduces the risk of acute muscle strain injuries. It is a slow controlled movement with emphasis on postural awareness and body alignment.It is suitable for all patient types.

Dynamic Stretching-

Dynamic Stretching (DS) involves the performance of a controlled movement through the available ROM. DS involves progressively increasing the ROM through successive movements till the end of the range is reached ie the stretch is repetitive and progressive. DS is good to use in advanced sports related rehabilitation and active sports persons.

Proprioceptive Neuromuscular Facilitation Stretching (PNFS)-

Multiple PNF stretching techniques exist, all of them rely on stretching a muscle to its limit.This triggers the inverse myotatic reflex, a protective reflex that calms the muscle to prevent injury. Regardless of technique, PNF stretching can be used on most muscles in the body.

Ballistic Stretching-

Ballistic stretching includes rapid, alternating movements or ‘bouncing’ at end-range of motion; however, because of increased risk for injury, ballistic stretching is no longer recommended.

Indication of stretching-

  • ROM is limited because soft tissues have lost their extensibility
  • Muscle weakness and shortening of opposing tissue have led to limited ROM.
  • Maybe a component of a total fitness or sport-specific conditioning program designed to prevent or reduce the risk of musculoskeletal injuries.
  • May be used prior to and after vigorous exercise to potentially reduce post-exercise muscle soreness

Contraindications to Stretching-

Bony block on end of range (EOR) on passive assessment

Unstable/recent fracture

Acute soft tissue injury

Infection/haematoma in tissues

Post surgical repairs e.g, skin grafts, tendon repair

Hypermobility

PERFORM FULL BODY STRETCHES INSTRUCTED BY ONE OF OUR VERY SKILLED PHYSIOTHERAPIST AT DYNAFISIO https://youtu.be/UXDAVwLd8DI

For more info contact our best team of physiotherapists on www.dynafisio.com or call us at 8929294515

Knee Osteoarthritis
11Mar

Knee Osteoarthritis: Role of Physiotherapy

Author dynafisio Categories Knee Pain Treatment Gurgaon

Knee osteoarthritis (OA), also known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage.

Treatment for knee osteoarthritis begins with conservative methods and progresses to surgical treatment options when conservative treatment fails. While medications can help slow the progression of RA and other inflammatory conditions, no proven disease-modifying agents for the treatment of knee osteoarthritis currently.

Physiotherapy Management

Physiotherapy should be started with all patients with a diagnosis of OA

Pain is a common symptom that occurs at different intensities depending on the individual, it is not necessarily related to severity of OA progression

Exercise has been proven to be effective as pain management and also improves physical functioning in the short term. Exercises have to take place under the supervision of a physiotherapist initially and when properly instructed these exercises can be performed at home, though research has shown that group exercise combined with home exercise is more effective.[

Role of Physiotherapy

Education

Understanding what OA is

Explaining pain

Explain long term management of OA

Educate regarding activity modification

Role of weight loss

Promote active, healthy lifestyle

Exercise

Reduce knee pain and inflammation.

Normalise knee joint range of motion.

Strengthen lower kinetic chain

Cardio-vascular exercise

Improve proprioception, agility and balance.

Improve function

Use of walking aids as needed

Land-based exercises are ideal for most people and are strongly recommended.

Exercise has also been found to be beneficial for other co-morbidities and overall health. Walking, resistance training, cycling, yoga and Tai Chi are examples of such exercises. An individualised exercise program should be set by a physiotherapist initially, taking into account the patient’s goals and hobbies to ensure long term exercise compliance.

Other Interventions

There are various forms of therapeutic interventions that may or may not be helpful for patients with various degrees of evidence to support them:

Hydrotherapy – this may be particularly helpful if pain is very high and analgesia is not tolerated. It can be useful to build up strength and reduce stiffness around the knee joint in a non-weight bearing position.

Taping – works to offload the joint similar to bracing, this is useful in the short term.

Manual therapy – effective to improve ROM

Massage – may be useful to control pain in some subjects, but this has low evidence to show its effectiveness

Bracing

Electrotherapy – such as TENS and muscle stimulation may be used to improve quadricep strength and has some evidence to show it can help with pain reduction.

AT our Physiotherapy centre in Gurgaon we have got the best team of physios who are specialised in advance techniques.For more info contact our best team of physiotherapists on www.dynafisio.com or call us at 8929294515

Peripheral Artery
10Mar

PERIPHERAL ARTERIAL DISEASE

Author dynafisio Categories foot pain

Peripheral arterial disease (PAD) is known as a condition where by the blood flow in the limb arteries are obstructed . Commonly, the legs are the most affected. These arteries are obstructed due to plaque deposits that restrict blood flow through the peripheries. Although blood flow may be also restricted by deep vein thrombosis, which may be a blood clot that occurs in the periphery of the limbs 

Aetiology

The most common cause of PAD is atherosclerosis, similarly, they share the same risk factors: smoking, diabetes, age, hypertension, and hyperlipidemia. Uncommon vascular symptoms, such as vasculitis, thromboangiitis obliterans, popliteal entrapment syndrome, and fibromuscular dysplasis, account for less than 10% of cases.  It is estimated that up to 60% of patients with PAD will have ischaemic heart disease, and 30% have cerebrovascular disease.

Risk Factors

Cigarette Smoking-Cigarette smoking increases the chance of having PAD by seven-fold

Diabetes-  Diabetes Mellitus leads to a two-to fourfold increase in risk of cardiovascular events

Age-The risk of PAD increases as the population approaches the age of 50. It has been reported that PAD affects 0.9% of 40-49 year olds and increases to 14.5% of 70 year olds and above .Studies also have shown that men are the target population of PAD 

Gender- TASC II guidelines conclude that men are affected at a younger age than women. However, overall there is no clear distinction in risk.

Hypertension-Hypertension can be a risk for developing PAD.

Symptoms

-claudication

– burning and aching sensation in legs

-Occlusion or stenosis of the aorta commonly causes bilateral buttock, thigh, and calf claudication. 

Clinical Manifestations

  • Non-healing wounds on legs or feet
  • Unexplained leg pain
  • Pain on walking that resolves when stopped
  • Pain in foot at rest made which worsens with elevation
  • Ulcers
  • Gangrene
  • Dry skin
  • Cramping
  • Aching

Physiotherapy Management

  • Supervised treadmill exercise improves treadmill walking performance in patients with PAD.
  • Supervised treadmill exercise has greater benefit on treadmill walking performance than home-based walking exercise.
  • Home-based walking exercise interventions that involve behavioral techniques are effective for functional impairment in people with PAD and improve the 6-min walk distance more than supervised treadmill exercise.
  • Upper and lower extremity ergometry improve walking performance in patients with PAD and improve peak oxygen uptake.
  • Lower extremity resistance training can improve treadmill walking performance in PAD, but is not as effective as supervised treadmill exercise.
  •  

AT our Physiotherapy centre in Gurgaon we have got the best team of physios who are specialised in advance techniques.

For more info contact our best team of physiotherapists on www.dynafisio.com or call us at 8929294515

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