Shoulder Pain With Certain Movements

Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Shoulder pain - left and also chest pain and also back pain. If you have left hand shoulder back pain and also chest pain it might be due to shoulder pain which itself is called peri arthritis shoulder perhaps if you have movement restriction in the shoulder joint especially in the left side it could be also due to diabetes mellitus or due to pa shoulder. This can be ruled out with my above suggestions. But if you don't have any above mentioned issues or symptoms, then we need to rule out the gastric trouble which you might be the reason for you to have shoulder back pain as well as chest pain. If it is due to gastritis the you can avoid tamarind in the food and also you can avoid smoking if you are a smoker. You can drink hot water to feel better along with regular aerobic activities and breathing exercises involving deep breathing exercises involving both the shoulder and abdomen - diaphragmatic breathing exercises which will help you to come out of this issue. Hope you find better and let us know. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone. Stiffness might have developed due to weakness of the ligaments &inflammed cartilage. Specific knee exercises will also help ie. Keeping ball underneath the knee and keep pressing it. That's the simple exercise which will help you to strengthen the knee. You need to consume good protein and iron diet in your body which will help you to break the fatigue and general body pain. However non veg foods definitely makes you to get increased with the toxin levels in the body and it makes your knee to have less fluid content in the system. In general we suggest patients who has knee pain to eat more water content vegetables which will definitely help you to feel better. This is a general knee pain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, it looks like you are is important to check that. Anaemia always leads to the symptoms of being tired and also having body pain though there may not be any pathological reasons for knee pain. With knee exercises you will definitely feel better and muscles must be strengthened. •patellar tendinitis: •risk factor •a combination of factors may contribute to the development of patellar tendinitis, including: •physical activity. •running and jumping are most commonly associated with patellar tendinitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes. •tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon. ••muscular imbalance. •if some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis. •chronic illness. •some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes. •complications •if you try to work through your pain, ignoring your body's warning signs, you could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist if you don't tend to the problem, and you may progress to the more serious patellar tendinopathy. •prevention •to reduce your risk of developing patellar tendinitis, take these steps: •don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, including: •patellar tendon strap. A strap that applies pressure to your patellar tendon can help to distribute force away from the tendon and direct it through the strap instead. This may help relieve pain. •iontophoresis. This therapy involves spreading a corticosteroid medicine on your skin and then using a device that delivers a low electrical charge to push the medication through your skin. •platelet-rich plasma injection. This type of injection has been tried in some people with chronic patellar tendon problems. Studies are ongoing. It is hoped the injections might promote new tissue formation and help heal tendon damage. •probably your stamina would've gone down due to over use of the joints and the metabolic activity is more due to running. You need to consume good protein diet so that your body will act as a reservoir. It will help you to fight against rather than affecting one particular area of your body for eg. Knee joint. For knee ligament pain or inflammation you need to keep ice which will help you to prevent the inflammation progressing further. •patellofemoral pain syndrome •usually fully relieved with simple measures or physical therapy. It may recur, however, if you do not make adjustments to your training routine or activity level. It is essential to maintain appropriate conditioning of the muscles around the knee, particularly the quadriceps and the hamstrings. •there are additional steps that you can take to prevent recurrence of patellofemoral •they include: •wearing shoes appropriate to your activities •warming up thoroughly before physical activity •incorporating stretching and flexibility exercises for the quadriceps and hamstrings into your warm-up routine, and stretching after physical activity •increasing training gradually •reducing any activity that has hurt your knees in the past •maintaining a healthy body weight to avoid overstressing your knees ••d cartilageacl •joints, ie. In the upper limbs if the pain is present in the fingers/wrist and in the lower limbs it the pain is present in the toes/ ankle, then we shall definitely say it is rheumatic arthritis. •if your proximal joints (ie. Shoulder, hip & knee has pain) then you can pour hot (warm) water in that area to reduce the inflammation. If you have pain in the distal joints ie. Wrist, fingers, ankle, toes then you can wear either elbow brace or wrist brace which will help you to feel warm and very protective. And also immerse the distal joints in the hot water tub which will help you to reduce the pain. ••knee pain during driving or watching movie. •it might due to lack of movements in the knee while the joints are immobilized during driving and while watching movies. It is important that you need to have movements in and around the knee so that the blood flow will not be disturbed. •knee ligament laxity•if you have problem in your legs then it might be due to ligament laxity where your legs would become very weak due to the old ligament injury and that should be treated immediately. •wear knee cap so that you will feel firm while walking or climbing stairs.•this is a general strain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, if pain still persists you can stretch your body by twisting the waist on both sides how we used to do in the school drill similarly you can try! one time you can do hot water fermentation that would help to reduce the muscle strain.•legs becoming numb and also pain is there when the patient walks for 10-15 minutes?•it looks like you are anaemic. If you feel that the legs are becoming numb then keep your legs warm which is important, probably you can wear mcr chappals inside the house/ socks inside the house. Put a door mat when ever you sit so that you will feel comfortable. Also pour warm water in the legs which would help you to get better circulation. •knee pain. If you are overweight, losing weight will also help to reduce pressure on your knee. •knee pain, when leg folding time get pain. The importance of buying braces and splints from us – orthopaedic support braces we suggest you to wear knee brace which is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Resisted terminal knee extension: make a loop with a piece of elastic tubing by tying a knot in both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed. Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise. Standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep as arthritis is very common that you get generally bilaterally. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone 1. Heel and calf stretch 2. Quadriceps stretch to do this stretch: 1. Stand next to a wall or use a chair for support. Your feet should be shoulder-width apart. 2. Bend one knee so your foot goes up toward your glutes. 3. Grab your ankle and gently pull it toward your glutes as far as you can comfortably. 4. Hold for 30 seconds. 5. Return to the starting position and change legs. 6. Repeat 2 times on each side. You need to consume good protein and iron diet in your body which will help you to break the fatigue and body pain. You have to reduce the weight by walking minimum 1 km per day. Slowly reduce the weight and slowly avoid adding salt in the diet which will help you to prevent water retention in the body. Excess salt in general leads to water in the body which might be the reason for you to have leg pain. Hotwater fermentation that would help you to get relieved from joint pains. But food precautions, it is better to avoid tamarind in the food rather to add lime or mango. You can generally do basic aerobic exercises which will definitely help to improve the body weakness. Consume good protein and vitamin diet which will help you to improve your weakness of the whole body. You can give good vitamin d and calcium which will help to have quick healing. If you are a non veg person consume seer fish or if you are a veg person eat mushrooms which has vitamin d3. You need to consume water content vegetables which will make you feel hydrated. A good brace will protect your knee and take the pressure off your meniscus, allowing it to rest. Your doctor may recommend the rice regimen—rest, ice, compression, and elevation—to treat a eroded cartilage which is the main reason for the synovial fluid to get drained. Resting your knee can help relieve your symptoms. Steps to heal a worn out cartilage naturally: rest: it's crucial to rest your knee after it starts to ache. You should not participate in activities where you could cause additional strain. Ice: apply ice to your knee for 15 minutes at four-hour intervals. 

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Dr. Sirish PhysiotherapistBPTh/BPTPhysiotherapist

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It's important to address your concerns about the pain in your shoulders and overall weakness, especially since you work in a physically demanding environment and are experiencing discomfort. Here are some steps you can take: follow up with your doctor: since you experienced relief from pain after taking the prescribed medication but are now experiencing pain again, it's essential to follow up with your doctor for further evaluation. They can reassess your condition, determine if there are any underlying issues contributing to your symptoms, and adjust your treatment plan accordingly. Rest and recovery: allow your shoulders to rest and avoid activities that exacerbate the pain. Avoid lifting heavy objects or putting excessive strain on your shoulders until you've had a chance to consult with your doctor and address the underlying cause of your pain. Maintain good posture: pay attention to your posture, both at work and during other activities. Poor posture can contribute to shoulder pain and muscle fatigue. Be mindful of how you sit, stand, and move throughout the day, and make adjustments as needed to maintain proper alignment and reduce strain on your shoulders. Exercise and stretching: gentle stretching and strengthening exercises for the shoulders and upper body muscles can help improve flexibility and alleviate muscle tension. However, it's essential to consult with a healthcare professional or physical therapist before starting any new exercise program to ensure it's safe and appropriate for your condition. Healthy lifestyle habits: pay attention to your overall health and lifestyle habits. Eating a balanced diet, staying hydrated, getting regular exercise, and prioritizing rest and relaxation can all contribute to overall well-being and may help alleviate symptoms of fatigue and weakness. Environmental factors: consider how environmental factors such as air conditioning and diet may be impacting your health. Ensure that you're staying hydrated, especially in a hot climate like dubai, and consider incorporating more nutritious foods into your diet to support overall health and energy levels. Seek support: don't hesitate to seek support from your healthcare provider, colleagues, friends, or family members if you're feeling worried or overwhelmed. It's important to address your concerns and prioritize your health and well-being. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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It looks like you are anaemic. And also you have to check with your vitamin and calcium, if the bones are weak then automatically the pain gets triggered more as there is less energy during any metabolic activity. Multiple pain in the joints if you still have pain it might due to the following reasons: 1. Anaemia - iron deficiency 2. Uric acid more in the system 3. Vitamin d deficiency leading to bone weakness and brittleness 4. Any other mineral deficiency mainly phosphorous if your test is normal then there is some other issues might be the phosphorus is very important which leads to joint tightness and stiffness. Mountain climber this intermediate exercise combines a plank with knee movements, so it’s an excellent move for balance and core strength. Start in a plank with your hands below your shoulders. Tighten your core. Lift your right knee toward your chest, keeping your back straight and hips down. Return your right leg to the starting position as you simultaneously lift your left knee toward your chest. Continue alternating legs. Start with 1 set of 8–12 reps. Warrior crunch this crunch variation works your core and lower body, including your thighs, glutes, and quads. Stand with your feet slightly wider than shoulder width and your toes turned outward. Put your hands behind your head and open your chest. Tighten your core and glutes. Bend your knees until your thighs are parallel to the floor. Bend your torso to the side, moving your right elbow toward your right thigh. Repeat on the left side. Start with 1 set of 8–12 reps. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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It looks like cervical pain that's the reason you have pain in the shoulder and along side until wrist. You need to take rest and you need to consult physiotherapist you need to do intermittent cervical traction and also inferential therapy treatment which will help you to get subsided with pain. Neck pain cervical spondylosis– chronic condition with radiating pain this is cervical pain (neck pain) and that's the reason the pain radiates until the shoulder blades. If you keep ice that would help and along side you can do hot water fermentation. You shall use cervical collar which would help you to reduce the radiating pain ie. Due to the nerve compression. You have to go for traction and also you can do ift. Please consult the near bytherapist for quick relief. Use collar will definitely be helpful for him to maintain the good posture. And also cervical pillow can be used which might make you to have better posture of the shoulder neck and arm. Neck tilt: from the sitting position, tilt your head down so your chin touches your chest. Hold this position for 5 second s. Return to the starting position and repeat. Do this five times. Side-to-side neck tilt. From the same starting position, tilt you neck toward one shoulder, leading with your ear. Hold for 5 seconds and then return to the starting position. Do this five times on each side. Neck turn. Look straight ahead, then turn your head to one side, keeping your chin at the same level. Do this five times on each side. Neck stretch. Holding the rest of your body straight, push your chin forward, stretching your throat. Hold for 5 seconds. From the same starting position, push your chin backward and hold for 5 seconds. Do the forward and backward stretch five times each. If any of these exercises cause severe pain or weakness in your hands or arms, stop right away and talk with your doctor. We suggest you to wear cervical collar which will help you to improve the cervical angle and also it definitely helps you to improve the neck posture due to which your neck pain is triggered more. The importance of wearing cervical collar is to give good stability to the neck and also it definitely prevents you to have excess neck movements which makes the condition worse. If you wear cervical collar you cannot turn your neck as you like which itself will help you to have better functioning of the cervical spine. This cervical soft collar what we are suggesting for you is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Pushups this one may seem basic, but there’s no denying that pushups are one of the best ways to strengthen the pectoral muscles. These can be done on the knees or toes. If you’re not ready for full pushups, start with your hands resting on a solid surface higher than your feet — like a very sturdy coffee table or the edge of a couch, cushions removed, that’s pressed up against a wall — and start on the toes. Having your hands higher than your feet and your body at an angle can be a good way to start a pushup regimen. As you get stronger, you can begin to lower the angle of your body. This will help you transition to full pushups more easily than going from knees to toes. A full plank engages the muscles differently, even at an angle. When doing pushups, aim for 2 sets of 10 reps per day. 1.start in plank position with your hands under your shoulders and your core engaged. 2.as you lower, inhale. 3.as you engage your muscles to push yourself up, exhale. Keep your elbows hugging in close to your body. Keep your focus on slowly breathing as you do these, and on engaging the pectorals while keeping the core tight. Don’t just crank these out to get them done — this can compromise your form and do more harm than good. If the movement is really tough, break the sets into three or five to start, or find a higher point to begin after a week of exercise. If necessary, you can even stand and do pushups pushing against a wall. Chest fly for this exercise, you’ll need a bench or exercise ball as well as some dumbbells. If you don’t have weights, you can always use the old standby: a soup can in each hand. Just keep in mind that dumbbells are easier to hold and you can get more out of using them, as even 5-pound weights are heavier than your heaviest canned goods. 1.lie with your upper and middle back on a bench or ball, with your legs at a 90-degree angle. Hold a weight in each hand and extend your arms to the sky, elbows slightly bent. 2.as you inhale, lower your arms out wide, until your elbows are at shoulder height. 3.as you exhale, raise your hands until they meet above your chest again. 4.do 2 sets of 10. If that feels pretty easy, up it to 2 sets of 15 or increase the weight you’re using. Dumbbell row strengthening your back muscles is an important component of treating pectusexcavatum. The dumbbell row targets your lat muscles. The way it’s described below also strengthens your core, another important component of treating the condition. You’ll need some dumbbells to complete this move — err on the lighter side if you’ve never done a row before. 1.hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle. 2.keeping your neck in line with your spine and your gaze straight down, pull your elbows straight back and squeeze between your shoulder blades. 3.extend your arms back to the starting position. Complete 2 sets of 10. Dumbbell rear delt fly another move to strengthen your back, a dumbbell rear delt fly also focuses on the lats, as well as the rhomboids and the traps. Choose a light pair of dumbbells to complete this move and ensure that you’re pinching your shoulder blades together at the top to get the most out of it. 1.hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle and bring the dumbbells together. 2.keeping your spine and neck neutral, inhale and push the dumbbells out and up to the side until your arms are parallel to the floor. 3.exhale and return to the start in a slow and controlled motion. Complete 2 sets of 10. Exercise is a key component to treating pectusexcavatum. By strengthening your chest, back, and core muscles and stretching your chest cavity, you can combat the condition’s effects. Aim to complete these exercises several times a week to maximize results. Anterior pelvic tilt 1.lie on the back with the knees bent and feet flat on the floor, hip-width apart. 2.squeeze the buttocks and tilt the pelvis upward. 3.the back should feel as though it is flattening to the ground. 4.return to normal pelvis position. 5.repeat 10–12 times. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Do’s and don’ts for shoulder pain do’s do the prescribed exercise regularly to maintain strength, flexibility and range of motion. Do keep the affected arm supported. Use an ice pack for pain relief. Apply the ice pack 3-4 times a day for 10 minutes. Don’ts don't sleep on the affected side. Don't lift heavyweight with the affected arm. Don't jerk your shoulder to avoid stress. Don't use the arm to push yourself up in bed or from a chair. Don't participate in contact sports or do any repetitive heavy lifting. We suggest you to wear shoulder support brace which is available in two different sizes which makes the patient to feel comfortable as it maintains the shoulder in anatomical position and the short lever is maintained. The reason to maintain the short lever in the shoulder joint is it helps the shoulder to prevent the movements which itself is the key to have better progression of healing in the shoulder region. This is suggested for the following conditions. This shoulder support brace what we are suggesting for you is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Strenghtening exercises 1.pendulum stretch do this exercise first. Relax your shoulders. Stand and lean over slightly, allowing the affected arm to hang down. Swing the arm in a small circle — about a foot in diameter. Perform 10 revolutions in each direction, once a day. As your symptoms improve, increase the diameter of your swing, but never force it. When you're ready for more, increase the stretch by holding a light weight (three to five pounds) in the swinging arm. 2. Towel stretch hold one end of a three-foot-long towel behind your back and grab the opposite end with your other hand. Hold the towel in a horizontal position. Use your good arm to pull the affected arm upward to stretch it. You can also do an advanced version of this exercise with the towel draped over your good shoulder. Hold the bottom of the towel with the affected arm and pull it toward the lower back with the unaffected arm. Do this 10 to 20 times a day. 3. Finger walk face a wall three-quarters of an arm's length away. Reach out and touch the wall at waist level with the fingertips of the affected arm. With your elbow slightly bent, slowly walk your fingers up the wall, spider-like, until you've raised your arm as far as you comfortably can. Your fingers should be doing the work, not your shoulder muscles. Slowly lower the arm (with the help of the good arm, if necessary) and repeat. Perform this exercise 10 to 20 times a day. 4. Cross-body reachsit or stand. Use your good arm to lift your affected arm at the elbow, and bring it up and across your body, exerting gentle pressure to stretch the shoulder. Hold the stretch for 15 to 20 seconds. Do this 10 to 20 times per day. 5. Armpit stretch using your good arm, lift the affected arm onto a shelf about breast-high. Gently bend your knees, opening up the armpit. Deepen your knee bend slightly, gently stretching the armpit, and then straighten. With each knee bend, stretch a little further, but don't force it. Do this 10 to 20 times each day. Starting to strengthen as your range of motion improves, add rotator cuff–strengthening exercises. Be sure to warm up your shoulder and do your stretching exercises before you perform strengthening exercises. 6. Outward rotationhold a rubber exercise band between your hands with your elbows at a 90-degree angle close to your sides. Rotate the lower part of the affected arm outward two or three inches and hold for five seconds. Repeat 10 to 15 times, once a day. 7. Inward rotation stand next to a closed door, and hook one end of a rubber exercise band around the doorknob. Hold the other end with the hand of the affected arm, holding your elbow at a 90-degree angle. Pull the band toward your body two or three inches and hold for five seconds. Repeat 10 to 15 times, once a day. Shoulder exercises and stretches regular exercises and stretches can keep your shoulder strong and flexible. A few things to remember before swinging in to exercises: •stop any exercise if you have more shoulder pain. It may be too soon for you to try. •watch your form. Exercising incorrectly can also cause or worsen shoulder problems. •warm up, even before deep stretching. Light shoulder rolls, gentle movements, or even a warm shower are all ways to warm up your muscles before exercise and stretching. Pendulum stretch for range of motion•stand and bend at the waist. •let your arm on the injured side hang straight down. •keep your neck relaxed. •move your arm in a circle up to 20 times. •do once or more times in a day. Overhead shoulder stretch•sit or stand to do this shoulder stretch. •intertwine your fingers in front of you. •bend your elbows and raise your arms above your head. You can also place your hands on your head or behind it. •gently squeeze your shoulder blades together to move your elbows back. •continue for up to 20 repetitions. Repeat 5 to 10 times a day.Pa shoulder: do’s: •exercise regularly and immediately follow a physical therapy program. •use an ice pack for pain relief. Apply the ice pack 3-4 times a day for 10 minutes. •take pain relievers as directed by your shoulder doctor. Don’ts: •don’t stop moving your shoulders entirely because of the pain. •do not do activities that involve sudden movements, such as heavy lifting on the affected side. As your body recovers, continue to make gentle movements, but avoid irritating and moving your shoulders. •doesn’t sleep on a sore shoulder •don’t miss your workout routine and physical therapy. •don’t neglect your diet. Frozen shoulder is associated with general health. Frozen shoulder is strongly associated with many low-grade systemic inflammatory conditions. Your body needs healthy, anti-inflammatory food to recover. •stop smoking and drinking alcohol. No it will definitely help you to come out of pain. You can consume preferably one tablet per day and not more than that. Drink lot of hot water during your cycle time as there might be gastric trouble during menstrual cycle. We cannot give suggestions about homeopathy medicine as we are physiotherapists. I have given the following suggestions and protocols for your other pain in the back, heel and shoulder. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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This is cervical pain (neck pain) and that's the reason the pain radiates until the shoulder blades. If you keep ice that would help and along side you can do hot water fermentation. You shall use cervical collar which would help you to reduce the radiating pain ie. Due to the nerve compression. You have to go for traction and also you can do ift. Please consult the near bytherapist for quick relief. Use collar will definitely be helpful for him to maintain the good posture. And also cervical pillow can be used which might make you to have better posture of the shoulder neck and arm. Neck tilt: from the sitting position, tilt your head down so your chin touches your chest. Hold this position for 5 second s. Return to the starting position and repeat. Do this five times. Side-to-side neck tilt. From the same starting position, tilt you neck toward one shoulder, leading with your ear. Hold for 5 seconds and then return to the starting position. Do this five times on each side. Neck turn. Look straight ahead, then turn your head to one side, keeping your chin at the same level. Do this five times on each side. Neck stretch. Holding the rest of your body straight, push your chin forward, stretching your throat. Hold for 5 seconds. From the same starting position, push your chin backward and hold for 5 seconds. Do the forward and backward stretch five times each. If any of these exercises cause severe pain or weakness in your hands or arms, stop right away and talk with your doctor.We suggest you to wear cervical collar which will help you to improve the cervical angle and also it definitely helps you to improve the neck posture due to which your neck pain is triggered more. The importance of wearing cervical collar is to give good stability to the neck and also it definitely prevents you to have excess neck movements which makes the condition worse. If you wear cervical collar you cannot turn your neck as you like which itself will help you to have better functioning of the cervical spine. This cervical soft collar what we are suggesting for you is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. If you have pain for more than a year it is advisable to undergo physiotherapy treatment in your near by locality, heat therapy and ultrasonic therapy will be beneficial. If this doesn't work then it is also advisable to do some trigger release, massage and stretches to get rid out of the pain. Let us know where you reside we can help you accordingly. Physical therapy to relieve myofascial pain syndrome may involve: stretching. Posture training. Massage. Heat. Ultrasound. We also advise cervical collar and cervical pillow for better benefits. Let me know which way we can assist you we can guide you accordingly. Our what's app no. Is mobile. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Symptoms of arthritis symptoms of osteoarthritis may include joint pain and progressive stiffness that develops gradually. Symptoms of may include painful swelling, inflammation, and stiffness in the fingers, arms, legs, and wrists occurring in the same joints on both sides of the body, especially upon waking up in the morning. Knee arthritis can be painful and debilitating. For osteoarthritis (oa) of the knee, self-care early on can often help significantly. It is important to stretch and strengthen the surrounding leg muscles to provide more support and reduce stresses around the joint. The following best bet exercises will help you get started on your path to feeling stronger, more flexible and more active. Remember: exercise should not be painful – if you experience pain, discontinue and consult with your physician. Advice: 1.must take adequate rest 2.apply hot water with mild heat with cotton towel 3.avoid cross leg sitting and long time standing 4. Put the small size chair under the ankle during sitting in the chair for leg elevation 5.do the exercise given below 2 times per day 1.quadriceps setting exercise helps to strengthen the quadriceps muscle (the big muscle on the front of the thigh), an important stabilizer of the knee. Lie on your back with the leg you want to exercise straight. Place a small rolled towel underneath the knee. Slowly tighten the muscle on top of the thigh (quadriceps) and push the back of the knee down into the rolled towel. Hold contraction for 5 seconds and then slowly release, resting 5 seconds between each contraction. Perform 3 sets of 10 repetitions, 1 time daily. 2.straight leg raise also helps to strengthen the quadriceps muscle. Lie on your back with the leg you want to exercise straight. The other knee should be bent to support your lower back. Tighten the muscle on the top of your thigh and lift to the level of your other knee. Slowly lower. Perform 3 sets of 10 repetitions, 1 time daily. Knee pain •patellar tendinitis: •risk factor •a combination of factors may contribute to the development of patellar tendinitis, including: •physical activity. •running and jumping are most commonly associated with patellar tendinitis. Sudden increases in how hard or how often you engage in the activity also add stress to the tendon, as can changing your running shoes. •tight leg muscles. Tight thigh muscles (quadriceps) and hamstrings, which run up the back of your thighs, can increase strain on your patellar tendon. •muscular imbalance. •if some muscles in your legs are much stronger than others, the stronger muscles could pull harder on your patellar tendon. This uneven pull could cause tendinitis. •chronic illness. •some illnesses disrupt blood flow to the knee, which weakens the tendon. Examples include kidney failure, autoimmune diseases such as lupus or rheumatoid arthritis and metabolic diseases such as diabetes. •complications •if you try to work through your pain, ignoring your body's warning signs, you could cause increasingly larger tears in the patellar tendon. Knee pain and reduced function can persist if you don't tend to the problem, and you may progress to the more serious patellar tendinopathy. •prevention •to reduce your risk of developing patellar tendinitis, take these steps: •don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, including: •patellar tendon strap. A strap that applies pressure to your patellar tendon can help to distribute force away from the tendon and direct it through the strap instead. This may help relieve pain. •iontophoresis. This therapy involves spreading a corticosteroid medicine on your skin and then using a device that delivers a low electrical charge to push the medication through your skin. •platelet-rich plasma injection. This type of injection has been tried in some people with chronic patellar tendon problems. Studies are ongoing. It is hoped the injections might promote new tissue formation and help heal tendon damage. •probably your stamina would've gone down due to over use of the joints and the metabolic activity is more due to running. You need to consume good protein diet so that your body will act as a reservoir. It will help you to fight against rather than affecting one particular area of your body for eg. Knee joint. For knee ligament pain or inflammation you need to keep ice which will help you to prevent the inflammation progressing further. •patellofemoral pain syndrome •usually fully relieved with simple measures or physical therapy. It may recur, however, if you do not make adjustments to your training routine or activity level. It is essential to maintain appropriate conditioning of the muscles around the knee, particularly the quadriceps and the hamstrings. •there are additional steps that you can take to prevent recurrence of patellofemoral •they include: •wearing shoes appropriate to your activities •warming up thoroughly before physical activity •incorporating stretching and flexibility exercises for the quadriceps and hamstrings into your warm-up routine, and stretching after physical activity •increasing training gradually •reducing any activity that has hurt your knees in the past •maintaining a healthy body weight to avoid overstressing your knees •joints, ie. In the upper limbs if the pain is present in the fingers/wrist and in the lower limbs it the pain is present in the toes/ ankle, then we shall definitely say it is rheumatic arthritis. •if your proximal joints (ie. Shoulder, hip & knee has pain) then you can pour hot (warm) water in that area to reduce the inflammation. If you have pain in the distal joints ie. Wrist, fingers, ankle, toes then you can wear either elbow brace or wrist brace which will help you to feel warm and very protective. And also immerse the distal joints in the hot water tub which will help you to reduce the pain. •knee pain during driving or watching movie. •it might due to lack of movements in the knee while the joints are immobilized during driving and while watching movies. It is important that you need to have movements in and around the knee so that the blood flow will not be disturbed. •knee ligament laxity•if you have problem in your legs then it might be due to ligament laxity where your legs would become very weak due to the old ligament injury and that should be treated immediately. •wear knee cap so that you will feel firm while walking or climbing stairs.•this is a general strain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, if pain still persists you can stretch your body by twisting the waist on both sides how we used to do in the school drill similarly you can try! one time you can do hot water fermentation that would help to reduce the muscle strain. •legs becoming numb and also pain is there when the patient walks for 10-15 minutes?•it looks like you are anaemic. If you feel that the legs are becoming numb then keep your legs warm which is important, probably you can wear mcr chappals inside the house/ socks inside the house. Put a door mat when ever you sit so that you will feel comfortable. Also pour warm water in the legs which would help you to get better circulation. •knee pain. If you are overweight, losing weight will also help to reduce pressure on your knee. Knee pain this is a general knee pain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, it looks like you are is important to check that. Anaemia always leads to the symptoms of being tired and also having body pain though there may not be any pathological reasons for knee pain. With knee exercises you will definitely feel better and muscles must be strengthened .•don't play through pain. As soon as you notice exercise-related knee pain, ice the area and rest. Until your knee is pain-free, avoid activities that put stress on your patellar tendon. •strengthen your muscles. Strong thigh muscles are better able to handle the stresses that can cause patellar tendinitis. Eccentric exercises, which involve lowering your leg very slowly after extending your knee, are particularly helpful. •improve your technique. To be sure you're using your body correctly, consider taking lessons or getting professional instructions when starting a new sport or using exercise equipment. •therapy •a variety of physical therapy techniques can help reduce the symptoms associated with patellar tendinitis, includingback pain it looks like you are anaemic. If you have back pain after you sit for long hours then it is due to your haemoglobin levels as it is important to check that. Anaemia always leads to the symptoms of being tired and also having back / leg pain though there may not be any pathological reasons for back pain. It looks like you are anaemic. And also you have to check with your vitamin and calcium, if the bones are weak then automatically the pain gets triggered more as there is less severity of the painbe strengthened 1.resisted terminal knee extension: make a loop with a piece of elastic tubing by tying a knot in both ends. Close the knot in a door at knee height. Step into the loop with your injured leg so the tubing is around the back of your knee. Lift the other foot off the ground and hold onto a chair for balance, if needed. Bend the knee with tubing about 45 degrees. Slowly straighten your leg, keeping your thigh muscle tight as you do this. Repeat 15 times. Do 2 sets of 15. If you need an easier way to do this, stand on both legs for better support while you do the exercise. 2•standing calf stretch: stand facing a wall with your hands on the wall at about eye level. Keep as arthritis is very common that you get generally bilaterally. Ice therapy would definitely help to reduce the inflammation. We also advise you to use knee cap which would help to prevent the knee from damaging further and also to maintain the quadriceps muscle tone •stretching exercises. Regular, steady stretching exercises can reduce muscle spasm and help lengthen the muscle-tendon unit. Don't bounce during your stretch. 3•strengthening exercises. Weak thigh muscles contribute to the strain on your patellar tendon. Exercises that involve lowering your leg very slowly after extending it can be particularly helpful, as can exercises that strengthen all of the leg muscles in combination, such as a leg press.•this is a general knee pain and for this you can follow these measures: one keep a pillow right under the knee while sleeping, next is you can keep ice in the painful area for about 5--10 minutes, it looks like you are is important to check that. Anaemia always leads to the symptoms of being tired and also having body pain though there may not be any pathological reasons for knee pain. With knee exercises you will definitely feel better and muscles must be strengthened. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Your bp shoot and also your pain in the left hand and shoulder is due to the neck pain that's the reason your bp is shooted. Please follow the suggestions given below: neck pain cervical spondylosis– chronic condition with radiating pain this is cervical pain (neck pain) and that's the reason the pain radiates until the shoulder blades. If you keep ice that would help and along side you can do hot water fermentation. You shall use cervical collar which would help you to reduce the radiating pain ie. Due to the nerve compression. You have to go for traction and also you can do ift. Please consult the near bytherapist for quick relief. Use collar will definitely be helpful for him to maintain the good posture. And also cervical pillow can be used which might make you to have better posture of the shoulder neck and arm. Neck tilt: from the sitting position, tilt your head down so your chin touches your chest. Hold this position for 5 second s. Return to the starting position and repeat. Do this five times. Side-to-side neck tilt. From the same starting position, tilt you neck toward one shoulder, leading with your ear. Hold for 5 seconds and then return to the starting position. Do this five times on each side. Neck turn. Look straight ahead, then turn your head to one side, keeping your chin at the same level. Do this five times on each side. Neck stretch. Holding the rest of your body straight, push your chin forward, stretching your throat. Hold for 5 seconds. From the same starting position, push your chin backward and hold for 5 seconds. Do the forward and backward stretch five times each. If any of these exercises cause severe pain or weakness in your hands or arms, stop right away and talk with your doctor. We suggest you to wear cervical collar which will help you to improve the cervical angle and also it definitely helps you to improve the neck posture due to which your neck pain is triggered more. The importance of wearing cervical collar is to give good stability to the neck and also it definitely prevents you to have excess neck movements which makes the condition worse. If you wear cervical collar you cannot turn your neck as you like which itself will help you to have better functioning of the cervical spine. This cervical soft collar what we are suggesting for you is available at our clinic. If you want you can buy from us, if you are far away from chennai we can send you by courier. The reason why we are conveying you to buy from us is we can demonstrate over the videocall (using whatsapp) and also we can monitor you throughout when to wear it and how long to wear it. And also if you find any difficulty wearing the brace you can also revert back to us for few more suggestions and we can propose you good solution how to go about it. Pushups this one may seem basic, but there’s no denying that pushups are one of the best ways to strengthen the pectoral muscles. These can be done on the knees or toes. If you’re not ready for full pushups, start with your hands resting on a solid surface higher than your feet — like a very sturdy coffee table or the edge of a couch, cushions removed, that’s pressed up against a wall — and start on the toes. Having your hands higher than your feet and your body at an angle can be a good way to start a pushup regimen. As you get stronger, you can begin to lower the angle of your body. This will help you transition to full pushups more easily than going from knees to toes. A full plank engages the muscles differently, even at an angle. When doing pushups, aim for 2 sets of 10 reps per day. 1.start in plank position with your hands under your shoulders and your core engaged. 2.as you lower, inhale. 3.as you engage your muscles to push yourself up, exhale. Keep your elbows hugging in close to your body. Keep your focus on slowly breathing as you do these, and on engaging the pectorals while keeping the core tight. Don’t just crank these out to get them done — this can compromise your form and do more harm than good. If the movement is really tough, break the sets into three or five to start, or find a higher point to begin after a week of exercise. If necessary, you can even stand and do pushups pushing against a wall. Chest fly for this exercise, you’ll need a bench or exercise ball as well as some dumbbells. If you don’t have weights, you can always use the old standby: a soup can in each hand. Just keep in mind that dumbbells are easier to hold and you can get more out of using them, as even 5-pound weights are heavier than your heaviest canned goods. 1.lie with your upper and middle back on a bench or ball, with your legs at a 90-degree angle. Hold a weight in each hand and extend your arms to the sky, elbows slightly bent. 2.as you inhale, lower your arms out wide, until your elbows are at shoulder height. 3.as you exhale, raise your hands until they meet above your chest again. 4.do 2 sets of 10. If that feels pretty easy, up it to 2 sets of 15 or increase the weight you’re using. Dumbbell row strengthening your back muscles is an important component of treating pectusexcavatum. The dumbbell row targets your lat muscles. The way it’s described below also strengthens your core, another important component of treating the condition. You’ll need some dumbbells to complete this move — err on the lighter side if you’ve never done a row before. 1.hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle. 2.keeping your neck in line with your spine and your gaze straight down, pull your elbows straight back and squeeze between your shoulder blades. 3.extend your arms back to the starting position. Complete 2 sets of 10. Dumbbell rear delt fly another move to strengthen your back, a dumbbell rear delt fly also focuses on the lats, as well as the rhomboids and the traps. Choose a light pair of dumbbells to complete this move and ensure that you’re pinching your shoulder blades together at the top to get the most out of it. 1.hold one dumbbell in each hand with your arms extended. Hinge at the hips until your upper body reaches a 45-degree angle and bring the dumbbells together. 2.keeping your spine and neck neutral, inhale and push the dumbbells out and up to the side until your arms are parallel to the floor. 3.exhale and return to the start in a slow and controlled motion. Complete 2 sets of 10. Exercise is a key component to treating pectusexcavatum. By strengthening your chest, back, and core muscles and stretching your chest cavity, you can combat the condition’s effects. Aim to complete these exercises several times a week to maximize results. Anterior pelvic tilt 1.lie on the back with the knees bent and feet flat on the floor, hip-width apart. 2.squeeze the buttocks and tilt the pelvis upward. 3.the back should feel as though it is flattening to the ground. 4.return to normal pelvis position. 5.repeat 10–12 times. 

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Dr. Julie Mercy J DavidErasmus Mundus Master in Adapted Physical Activity, MPT, BPTh/BPTPhysiotherapist

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Physical examination a thorough physical examination reveals much about the patient's health and general fitness. The physical part of the exam includes a review of the patient's medical and family history. Often laboratory tests such as complete blood count and urinalysis are ordered. The physical exam may include: •palpation (exam by touch) determines spinal abnormalities, areas of tenderness, and muscle spasm. •range of motion measures the degree to which a patient can perform movement of flexion, extension, lateral bending, and spinal rotation. •a neurologic evaluation assesses the patient's symptoms including pain, numbness, paresthesias (e.g. Tingling), extremity sensation and motor function, muscle spasm, weakness, and bowel/bladder changes. Particular attention may be given to the extremities. Either a ct scan or mri study may be required if there is evidence of neurologic dysfunction. Physical therapy which teaches the patient to strengthen the paravertebral and abdominal muscles which lend support to the spine. General exercises which help build flexibility, increase range of motion and strength. A corset or a brace could be used to provide support; cervical collars may be used to alleviate pain by restricting movement. Hot or cold packs on the affected area, ultrasound and electric stimulation are some of the other treatments which are used. Management of acute symptoms rest and support- with acute joint symptoms, a lumbar corset may be helpful to provide rest to inflamed facet joints. When acute symptoms decrease, discontinue corset by gradually increasing the time without the corset. Often the most comfortable position is flexion, esp. If there are neurologic signs due to decrease in the foraminal space from joint swelling or osteophytes. Education of posture- head, neck and shoulders should be supported by the back rest of chair with a small pillow in the lumbar spine, the feet supported and the arm resting on arm rests or on a pillow in the lap. Modalities- hot or cold packs on the affected area, ultrasound and electric stimulation are some of the other treatments which are used to decrease pain and reduce muscle spasm. Relaxation- by soft tissue techniques. Teach self relaxationtechniques, e.g like deep breathing exercises and physiological relaxation (laura mitchell method) and hydrotherapy. Traction- gentle intermittent joint distraction and gliding techniques may inhibit painful muscle responses and provide synovial fluid movement within the joint for healing. Gentle rom within the limits of pain. Management of subacute and chronic phase increase rom- free active exercises of lumbar spine. Pelvic tilting forward, backward in crook lying, quadriped, sitting and standing. Mobilization- restoration of intersegmental mobility by accessory pressure enables the patient to regain full functional painfree movement. Stretching exercises. Strengthening exercises.Posture correction. 

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