Monday, 8 August 2016

Love hiking??..Take care of your knees newbies..

Oh yes! Hiking is new cool! Many of us, otherwise couch potatoes are finding their way off to treks on weekends.. It is definitely a very good idea to burn those extra calories from "extra cheese burgers". But guys watch out for your knees.

As with many of us, exercising on weekdays is not always possible due to hectic schedule. So, practically you are losing muscle mass by inactivity on weekdays, sitting for more than 6 hours a day has lot of negative effects not only on heart and lungs but also on muscular-skeletal systems.

And it doesn’t end there; performing physically challenging activities needs lot of muscle strength and endurance, when you have poor strength; the stress starts coming on joints in motion and their degeneration starts faster.

Hiking in particular needs lot of muscle strength in quadriceps and hamstrings muscles of the knee. When these muscles are stronger they can take care of portion of load coming on the knee, this ensures improved physical performance, delayed fatigue and most importantly slowing down of joint wear out. 

These muscle groups along with calf and hip muscles are required for hiking and balancing. Weakness or tightness in any of these muscle structures causes undue stress on knee joint leading to knee pain.

What to do to avoid knee joint pain on trekking?

*     Follow these simple exercises daily at least once a day. Start with these exercises minimum 3 weeks before the trek to build muscle strength. For better results, start earliest and increase exercise intensity gradually.

Knee press: 
Keep a towel roll under your knee and press the knee down on a roll.

Straight leg raise: Lay flat on back, lift your leg straight up.

Side lying leg raise:In side lying pose, lift your upper leg straight up.

Hams curls: Lie on your stomach and bend your knee.

Sitting quadriceps contraction:
 Raise your lower leg up, while keeping the thigh steady.

Half squats: Squat down from knees but don’t go beyond 90 degrees. (Mini squats)

Wide squats

Front lunges:
Take wall support, bend your right knee while keeping left leg straight. Repeat with left leg.  

 Quads stretching:
Stand with support and pull thigh backwards from ankle, while keeping the back straight.

Hams stretching:   In long sitting pose, try to reach the toes keeping your back straight.

*     Wear comfortable footwear while on hiking.

·        Choose pair of shoes which are light weight but give good stability on uneven terrain.
·        Medial arch support is recommended, as it gives stability to mid-foot and avoids excess strain on ankle muscles.
·        Nowadays, hiking shoes with ankle support are available, one can go for those as well to have greater stability. But you need to confirm that you are not having any pressure points over ankle or else you will end having shoe bites.
·        Check out for toe space. It is one of the very crucial aspects when buying shoes. You should be able to move your toes in the shoe when you are wearing it snugly.
·        Buying right pair of socks is definitely important. Socks should provide mid arch support. It will be a good idea to wear sports socks which are knee high.

Tuesday, 2 August 2016

What to look for in an office chair?

Average desk bound fellow spend 40 hours per week sitting in chair, they’d sum up to approximately 1900 hours over the course of a year. Multiply that by the average number of years a person works, and it’s easy to see that a large portion of one’s life is spent in an office chair.
Some people are spending more time in front of a computer than they spend sleeping. So, it only makes sense to have an office chair for both the office and the home that is comfortable and supportive.
Lower back Support: A good office chair will have support for the lower back. Some of the better ones will even have an adjustable lumbar support that allows the user to fit the chair to their lower back. This is important in preventing back strain and sciatic nerve irritation.
Adjustability:  The best office chairs have at least five adjustments.
Important features that should be adjustable include
*     Lumbar support
*     Arm width and height
*     Seat back width and height
*     Seat and back angle
There are many benefits to having a good office chair in addition to having less back strain. A good, supportive office chair prevents fatigue and discomfort that can come from sitting in the same chair for hours on end.
Tips to find right office chair:-
Chair owners should look for these things when purchasing new chairs:
  • The backrest should be adjustable and follow the shape of the spine. It should also support the curve in the lower back.
  • Feet should rest flat on the floor comfortably. If not, adjust the chair height or add a footrest.
  • Arm rests should be close the body and allow the shoulder to relax.
  • Arm height should be adjustable and match the height of the desk. This will prevent strain to the shoulders.
  • In a sitting position looking forward, the center of the computer screen is what should be seen.
  • The seat of the chair should be long enough to put two or three finger lengths between it and the knee.

Finding the right chair that is comfortable and keeps strain and injury from occurring is important for having happy & productive work life. 

Wednesday, 15 July 2015

Going for stilettos? Think again..

 Going for stilettos? Think again..
The perfect, pointy pair of 4-inch heels can make any outfit, but with this style comes much suffering. High heels have the stigma of being bad for health, but this barely stops you from wearing them occasionally and often daily. We often make sacrifices for foot fashion, but at what price? Studies have shown that these towering shoes can be costly in more ways than one, taking their toll on your spine, hips, knees, ankles and feet, while altering your posture and gait.
Here's how they affect different parts of your body—and why that's something you might not want to stand for anymore.
• Normally your feet act like weight-distributing shock absorbers, cushioning your skeleton from forces of body weight. These engineering marvels fail once you wear high heels and. ..ouch! You've shifted much of your mass onto the balls of your feet and your tiny, delicate toe bones.
      • The higher the heel, the bigger the impact: One study found that four-inch stilettos can up the amount of pressure on the front of the foot by 30 percent or more.
• Your heel-to-toe transition becomes abrupt, forcing you to adapt to more awkward posture (which actually thought is elegant!!??). Walking like this all the time could usher in bone and nerve damage (not to mention blisters and ingrown toenails).

Ankles and Calves

Wearing heels forces your ankles to bend forward, a movement that could restrict circulation in your lower limbs. This could eventually lead to spider veins or varicose veins.
• Walking in heels also stiffens your calf muscles. You can work to offset this stiffness by flexing your feet—shoeless—several times throughout the day.
• Over time, stiletto devotees can develop chronically shortened ankle and calf tendons, making walking—even in flats—painful.

• The knee is the largest joint in your body. It's built to take certain amount of excessive stresses, but frequent high-heel use can put extra stress on the inner sides of the knees, fast-tracking the wear and tear that leads to osteoarthritis.
• To keep from keeling over in stacked shoes, you have to thrust your hips forward, arch your back, and push out your chest. That familiar sexy stance works the outer hip muscles and tendons hard (and not in a good way).
• In order to be in line with heels, your spine needs to sway unnaturally, a process that stresses your lower back muscles. Result: sore lower back.
• As with your other body parts, your back needs a break. If you wear high heels one day, wear cushioned flats the next. Or save your spikes for special nights out—and never walk around in them for longer than a few hours at a time.

Wednesday, 8 July 2015

Avoid "Backaches" in road trips..

Avoid “Backache” in Road trips

So, you are planning for a great road trip coming weekend, don’t let your back pain come in your way..

Follow these simple steps to get you going.. Knowing how to sit in the car in a way that will avoid back pain is important to happy car travels. This will help to ensure that you don't miss out on a trip.

*         Take the time to make sure you are comfortable from the moment you set off on your trip. The smallest irritant in the beginning can turn into raging pain hours later.

*         Don't sit on your wallet or cell phone that may throw your spine out of whack.
*         Reduce reaching for the steering wheel, which places more stress on the lumbar spine, neck, shoulder and wrists. Instead, sit as close to the steering wheel as possible.
*         If your car seat provides little back support, roll up a towel or pillow and place it between your lower back and the seat for some more support. There are many specialized cushions and pillows available for purchase that can help.
*         Bring your seat forward some more if needed or you may have to push the seat back, depending on your leg length.  The base of your spine should be in contact with the seat. If driving, position yourself until your knees are slightly bent when you depress the pedals.
*         Press your shoulders firmly against the seat.
*         Arrange the headrests in the right place as a passenger. Headrests are not normally comfortable for many people. You just have to learn to let your head rest on it and pretty soon your neck will begin to relax.
*         Since staying still is bad for your back, don't just pick a position and stay in it. Adjust your seat and change your position slightly every 20-30 minutes.
*         Exercise is often a good treatment for lower back pain. While at each rest stop, try to do the following:
o               Get out of your car to stretch and work the hamstrings.
o               Walk around a bit to increase circulation and stretch out the back muscles.

Have a great time..

Monday, 29 June 2015

Dealing with varicose veins..

What are varicose veins?

Our body has two major blood vessels — Artery and Vein. Artery is the blood vessel carrying oxygenated blood from the heart to other parts of the body. Vein is a blood vessel that carries de-oxygenated blood from the other parts to the heart. That is why it appears bluish. The longest veins in the body are those in the legs. They have to pump blood from legs to the heart. They also have to overcome the effect of gravity in sitting or standing position when pressure in them increases.
Under normal circumstances, in order to avoid any backward flowing of blood, veins have valves at regular intervals. These valves open only for blood flowing towards the heart (i.e. in upward direction). When these valves do not work properly some amount of blood flows in backward direction leading to “varicose veins”. 

Who can get varicosities?

Varicose veins are predominantly found in legs. It commonly affects females over 40 years of age. It is especially seen in individuals who need to sit or stand for long or who have the habit of sitting in cross-legged position for long durations. This is because static positions put excessive pressure on the veins. The chance of getting varicosities is more in obese persons due to weight. Injury to leg in form of fracture or an open wound may also initiate valve dysfunction. Varicose veins can affect pregnant females too due to increased weight of the uterus.

What are the symptoms?

Usually the first sign is the visible blue veins on the legs. You may also get itching in the area around the veins due to accumulation of toxic waste products. But never scratch as it may lead to ulcers. There could be swelling around the ankles on sitting or standing for long, or you may develop cramps on walking. There may be also brownish shiny discolouration around veins. You may as well experience delayed wound healing.
Varicose veins, if left untreated, reduce stamina, and give pain in the legs on slightest movement even while resting. In complicated cases, there may be ulcer development due to lack of proper blood circulation and in severe cases it may also cause thrombosis in veins (blood clot in veins).

How to treat varicose veins?

It is important that you never neglect them. Most of the times, varicose veins can be treated with exercises if you see a doctor soon. Severe cases though may require medication or surgery. Exercises for varicose veins need to be tailor made — they should be specific to your condition.

Along with exercises, taking the following precautions is necessary:
  • Wear compressive stockings when sitting or standing for long durations.
  • Elevate your legs on pillows after prolonged static postures.
  • Do not sit in cross-legged position.
  • When traveling long distances, stop periodically and walk around.
  • Avoid wearing ill fitting shoes.
  • Avoid wearing clothing that restricts circulation such as socks with tight bands.
  • Do not wear jewellery like anklets, toe rings etc.
  • Do not use hot packs for varicosity pains.
  • Keep the skin clean and supple. Use moisturizers but avoid perfumed lotions.
  • Pay immediate attention to skin cuts, rashes, bites, etc.
  • Avoid hot baths and saunas.
  • Properly done massage therapies help as well. 

Dr.Supriya Antarkar Joshi
Sakaal Times | Friday, 11 March 2011 AT 09:05 PM IST

Friday, 26 June 2015

How to choose a right mattress in backache?

Mr. Raju, 35 year old, software professional, came to Cura physiotherapy clinic with lot of back stiffness and pain. The pain, he said was more in the morning times and reduces once he starts moving. We checked him clinically for muscle flexibility and strength but both seemed quite good. He told us, though he had sit for hours in his office, he was quite active person. He used to go for gym daily and did muscle training and cardio very regularly. We also asked him to get photograph of his workstation and car postures to rule out any fault in there. All were up to the mark! He was really taking all possible steps at home and in office to take care of his backache. Meanwhile, his physician asked him to go for blood factors. That also came normal..

Now the only problem could have been.. the mattress! The type of mattress he was using was the spring variety. Okay now.. this can be an issue. As with spring or any soft mattress, the body is not supported well. What happens is, with our body weight it tends to sink down and actually leaves spine support less. 

To understand this, let’s clear basics first. Human beings have acquired erect posture from quadruped in the process of evolution as we needed to be more mobile. But this as compromised our spinal stability. When we sit/ stand/ walk, we are doing it against gravity. Lying down is the only position when gravity is not acting on spine in vertical position. But it is acting in horizontal position. So in order to keep spine flat and straight one must go for mattress that is “firm”, not too soft or too tight.

The problem with soft mattress is, it can not support the body and we tend sink in it with curved spine, which is very uncomfortable position for the spine. With tight mattresses the problem is exactly opposite, they are too stiff to support spine so practically your spine can not relax on it. The mid way is using firm mattress, it does support your spine but doesn’t let your body sink in it.

Coming back to Raju’s case:“Good news! I woke up with no pain!!” Raju said that day. He had changed his mattress 10 days back and he feeling absolutely okay now..  

To make it easy:

Too soft
Very poor
Too firm/tight
Coir > Foam
Very less
High density foam

Wednesday, 24 June 2015

Success story 1: Frozen shoulder

Frozen Shoulder pain
June 24, 2015
Mrs. K 65 year old, housewife, came to Cura physiotherapy with complaints of right shoulder pain, it was acute onset and she had lot of difficulty in performing daily chores especially overhead. Lifting objects from top shelf in kitchen was giving her tears. Taking right shoulder behind her back was almost impossible for her, this was so painful that wearing cloths was a big task for her. The symptoms had actually started 3 weeks back but she delayed the physiotherapy visit thinking, pain will reduce on its own.

On her first consultation, we recorded capsular tightness- the shoulder ranges were very restricted and painful. There was no history of trauma or fall. But just lot of stiffness and pain in shoulder. We also asked her to go for blood sugar level (BSL) check up, as many times capsulitis (shoulder pain and restriction) is related to high blood sugar level or diabetes. This unfortunately in her case came positive. Now she needed treatment from both diabetologist and physiotherapist.

In physiotherapy treatment, we planned for electrotherapy for pain relief as pain was really bad to start off with and we couldn’t have started with any exercises. After 3 sessions of electrotherapy, when pain was manageable we introduced capsular stretches and pendulum exercises. In next 4-5 days, her pain & stiffness was much better when we discontinued with electrotherapy and moved on to next phase of rehabilitation i.e. muscle strengthening with resistance bands and postural stabilization exercises. She was given a set of home exercise program for continuation.

Now after 3 weeks of physical therapy, she is much better. We are so happy that she can do overhead activities, can reach top shelf easily. She can wear cloths comfortably without much of difficulty. But we still strongly recommend her to continue with her home exercise program for next one month for full-fledged recovery. Also, she needs to keep her blood sugar levels in control for her well-being. We wish her all the best!