Showing posts with label Ankle Sprain. Show all posts
Showing posts with label Ankle Sprain. Show all posts

Tuesday, 25 July 2017

HOW PODIATRY: AN INNOVATIVE SOLUTION TO ANKLE, FOOT AND LOWER LIMB PROBLEMS



Podiatry must definitely be a new word for many people among us. But before we get into the details of Podiatry, let's answer the question that why is there a need to gain knowledge about foot or problem related to it ??? As we have commonly known that while constructing any structure it is essential for the basement to be strong and sturdy. Taking this fact into consideration, we infer that when it comes to the Human body, the Foot is that important base which is needed to perform the human functions of mobility and stability. There are 26 bones, 33 Joints, 107 Ligament & 19 Muscles which are intricately connected to each other to complete the anatomy of foot.  Hence, if the alignment of the base i.e. the foot is affected it will have repercussion that will affect our postural alignment. But unfortunately, most often, this amazing structure is neglected & not given the care & attention it needs.

Standing and walking are integral part of our daily routine. However, people do not give heed to foot problems until it hampers their standing or walking routine severely. This is the fundamental reason foot problems are not easily treated and hence are ignored. However, ignorance is not always bliss. Since our feet & the ability to move is what demarcates the difference between INDEPENDENCE & DEPENDENCE.

Podiatrist is a doctor who specialized in treating conditions related to foot, ankle and lower limb. Consequently, the medical science of diagnosis and treatment of foot, ankle and lower limb related problems called Podiatry. Although still an alien term, Podiatry has been in practice since early 1900s in America, Australia & Europe.


FOOT SCREENING
Now that we are acquainted to & agree on the importance of foot. Let’s get an insight on some common signs which will help you to identify any foot related problem and screen yourself. So you can check for yourself for following signs.

Other Toes
LOW BACK PAIN AND KNEE PAIN

 

The human musculoskeletal system can be considered facsimile to a chain link. If the position of any one end is changed or if anyone links, is broken, then it will damage the entire chain link.  Thus, altered foot alignment can result in knee pain & back pain. Therefore, there is an interconnectivity between the foot, knee and spine.

 

Diabetes is a multi system metabolic disorder which even has its implications on the normal functioning of foot. However, the treatment of foot complications related to diabetes is an entirely different domain (elaborated in previous article)
    It causes two major problems in feet

WHAT DO YOU DO NOW?

In case you have incurred any of the above enlisted problems, who do you approach for the same. The answer is a Podiatrist.

HOW DOES IT WORK?

Before starting the treatment it is essential to identify the root cause, which can only be known after a thorough assessment. This assessment involves the following-
       Understanding the patient’s complaints & lifestyle.
       Visual inspection of FEET- Skin Condition, Colour, Corn/Callus/Ulcer
       Gait Analysis.
       Foot sensation.
       Measure foot size- Length & width.
       Inspection of the patient’s footwear.

THE INNOVATIVE SOLUTION
Once you understand the main reason of the problem, Podiatry line of treatment includes following-
  1. Shoes: Appropriate shoes as per patients problem &  lifestyle demand, Doctor will guide you about sports shoe specifications, size & other details.
  2. Prescribe corrective Orthotics:
The main solution is corrective Orthotics (also known as insoles). Use of such orthotics helps re-align the body in a corrected posture & thus provides a long-term solution without any side effects.

COMMON FOOT RELATED CONDITIONS WHERE PODIATRY CAN HELP:


Friday, 11 September 2015

ACHILLES TENDINITIS


A Tendon is a connective tissue present at the end of the muscle & connect muscle to the bone. The Achilles tendon connects the calf muscle to the heel bone.
Inflammation of this tendon is termed as Achilles Tendinitis. It is characteristically an overuse injury. It results due to a sudden or gradual increase in repetitive activity which involves function of Achilles. But since the tendon is not exercised to bear the exerted stress, its fiber go into micro trauma. This micro trauma continues to accumulate overtime & results in injury to the tendon as the the body does not get the adequate time & rest required for healing.

Achilles tendinitis is more common in athletes involved in sports which require running & jumping activities. Therefore any such athletes who undergoes less than appropriate conditioning are more prone to such injury.

Apart from them another population in whom such common are the 'weekend athletes' i.e. who play sports occasionally without proper training. Another important variant is the type of shoes used while indulging in high impact sports. Not many people are aware about this predicament & hence damage their body. Therefore it is vital to select shoes which suit your arch type.

Symptoms:

  • Pain & swelling over the calf region or above the heel bone.
  • Early morning stiffness on walking after rest.
  • Difficulty on standing & walking for long duration.

Ankle Pain

Ankle pain is a wide term that includes many causes which predispose to the pain in the ankle joint, however some of the common causes of ankle pain may include fracture, tendon inflammation, arthritis, gout, ligament injuries and the list goes on….

But the most common and predominant cause of ankle pain, include injury to the ligaments that surround the ankle joint which could otherwise be called ankle sprain or ligament sprain.

What are ligaments??

Ligaments are band of tough elastic tissue around our joints. They connect bone, give our joints support, and limit their movement.
So, when there is an excessive movement to the joint, the ligaments gets stretched or eventually tears which leads to ligament sprain.

ANKLE SPRAIN

Similarly when excessive stretch is put to the ligaments of the ankle which could either be caused due to faulty alignment of the foot, walking patterns on different terrains or sudden ankle twist as in the case of sport injuries can cause ankle sprains.

There are medial (Inner side) ligaments (deltoid) and the lateral (outer side) ligaments that surround the ankle joint. The most common injury is at the lateral ligament is less common which is caused due to outward rotation of the foot (Eversion).



                There are 3 grades of sprains depending upon the severity of injury.

The most commonly affected ligament is the anterior talo-fibular ligament & gets affected due to injury resulting in inward rotation (inversion) of the ankle.
A less common type of ankle sprain occur due to outward rotation (eversion) of ankle & injuries the deltoid or medial ligament.
Foot arch is responsible for supination (High arch) & pronation (Flat Feet) throw ankle more outer
border or inner border of foot respectively. Chances of inversion ankle sprain in supinator which is more common & eversion ankle sprain in pronators are more.

Causes:

  • Trauma or fall is the most common cause.
  • Weak musculature.
  • Increased laxity &/ reduce stability of ligaments.
  • Walking in high heels or footwear with inappropriate platform.
  • Walking or running on uneven surface.
  • Faulty foot alignment.
  • Impaired balance.
Symptoms:
  • Pain & swelling over ankle.
  • Inability to bear weight over affected limb.
  • Stiffness in the joint.
Treatment:

The most basic approach is to follow the PRICE protocol. This abbreviation stand for the following:

P- Protection- which can be attained by use of brace while walking or standing activities. Selection of the brace should be according to the grade or level of ankle sprain. 

R- Rest- which is required for allowing healing. If the patient attempts to walk with the present injury then the chances of further damage are high.

I- Ice pack- This helps in reduction of inflammation & helps in draining out of the end product which helps in pain reduction.

C- Compression- which also can be achieved by the use of braces that provide adequate support.

E- Exercise- which is the most important aspect. 
  •  Physiotherapy for the ankle sprain includes strengthening of the weakened muscles around the ankle joint. Muscles around the ankle joint plays a very important role in maintaining the integrity of the ankle joint).
  • Balance Training
  • Proprioceptive Training

Similarly as mentioned earlier, the type of the foot (Flat Feet / High Arch) also plays a very important role in stability. Depending on the type of Arch, shoe modifications with proper insoles and firm ankle grip is important to prevent re-occurrence of the Ankle Sprain.

Apart from the above if the cause of ankle sprain is faulty foot alignment then it is necessary to administer appropriate treatment for the cause or consult podiatrist.


Thursday, 10 September 2015

HIGH ARCH

High Arch

High Arch

Pes cavus foot type is the complete opposite pattern to that of flat feet. People with pes cavus foot type have well defined & deep arch. The only areas of contact with the ground are the heel & forefoot.
Arch Patterns
Consequently these people have a tendency of bearing more weight on forefoot. As mentioned earlier the arch pattern influences gait pattern. As a result these people load on the outer border of foot while walking as there is no contact on the inner side of the foot with the ground, which is termed as "SUPINATOR". 
people with high arch are more susceptible to develop knee problems owing to hard heel strike which causes excessive pressure to act 
on the heel & knee.
Deviations












Most common problem faced by people with high arch are:

Thursday, 4 June 2015

ARE YOU BEING GYM SMART??? CHECK FOR YOURSELF…..

                       
 

People of 21st century seem to have been swept away by the maddening wave of being Healthy and Fit. It is no longer impossible to don the physique of your favorite actor or actress. This is the prime reason for us noticing a vast number of people with their gym gears on and hitting the gym-to be healthier and fitter.

But is it really so? Are all these people fit in the true sense? More often than not these fitness freaks are seen complaining of muscle cramps, shoulder pain, neck pain, low back strain, muscle overload and hoards of other injuries. All of these problems not only become a barrier for you in achieving your target but also de-motivate you. Exercise is a science. In each exercise you have to be aware of your posture, movement, strength, speed and repetition. Improper application of any of these variables can be harmful and instead of making you fit, it will deteriorate your physical condition. Epidemiological studies conclude a rapid increase in the number of injuries caused due to improper fitness training in the recent years. This directs us to the purpose of this article-To orient fitness seekers on being completely fit and how to prevent them from being a victim of injuries related to fitness training.

PREREQUISITES

Before you get all zest up and impatient to hit the gym you should get to know the prerequisites of starting with the actual workout. 
The degree of movement available at all joints is majorly dependant on the strength & flexibility of muscles, stability of ligaments and integrity of joints. So before you start, knowing these factors will aid your programme and help you work on any factor which is lacking short.

Shoes
Wearing appropriate shoes plays a pivotal role in imparting stability. In most of the
weight bearing and cardio exercises most of the body’s stability comes from the feet and core. Hence if the shoe provides with a good grip and is inflexible you need not worry about being unstable and can direct your attention to the target area. 70% people wear wrong size & type shoes. One essential point to keep in mind is that if you experience any pain or discomfort either around the feet, ankle, knees it is quite possible that your incorrect pattern of shoes are the culprit.
   
  Physiological Well Being
Scientifically speaking there are no two people with the same physiology. Various factors have a play in making up our physiology such as gender, age, nutritional status, metabolism, hormone level and most importantly any diagnosed medical condition. If you plan your workout with these factors in perspective it will give way to germane results.

  
IT’S ALL ABOUT THE BASICS-COMMON GROUND FACTORS THAT WE OVERLOOK.

1. Inadequate Warm Up and Cool Down: It's always a smart idea to incorporate adequate warm up & cool down. Warm up is the preparatory phase for exercising. It functions by increasing the blood flow subsequently increasing the oxygen supply which in turn increases speed & force of muscle contraction. All these factors prepare the various body systems for the upcoming activity in a safe & gradual manner. IN opposition, cooling down has the effect of returning the blood back to the heart rather than allowing it to pool in the exercised muscles which helps in returning the heart rate back to normal. In addition it helps in reducing lactic acid levels & ensures that the vital organs continue to receive a sufficient supply of blood & oxygen at the end.

2. Being over zealous: Being enthusiastic to exercise & to reach your goal is a positive attitude. But don't let it get the best of you as with all the adrenaline pumping through your vein you tend to ignore your limitations. This is possible by letting your system adapt to the challenge progressively & not forcing the change upon a system which is not prepared to handle it. So take your eyes off the heavier weights or kilometers indicator on the cardio machine & give time. Judge for yourself- Are you there yet?

3. Lifting too much or too little: Either of these extreme measures aren't going to fetch you desired results. Keep aside the condescending attitude & lower down the weights if you need to. Instead it would be wiser to increase the number of repetitions or set with the same amount of weights. This will prevent your muscle fibers from undue overload. On the contrary if you are lifting light weights, you might as well put them aside as they will prove to be nothing more than a wasted. So the ney is to strike the right balance between doing what you are capable of & loading the muscles with right amount of weight.

4. Improper management of rest interval: While it is important to allot a stipulated amount of time for various exercises it is also important to know when to stop & take adequate rest in between. Instead of taking longer or shorter breaks change the tempo of your exercise for better results. For instance, while doing Biceps curls lower the weight slowly (enhanced eccentric load) and lift it with a strong and controlled contraction (concentric load). This is very motivating as you can see your muscle working and will help you pump your guns without unprecedented damage.

5. Improper management of exercise and diet: It is popularly known that if you are working your calories off to get those cuts
& abs without following a designed diet plan, you are wasting your time. Diet & exercise are two sides of the same coin. So let your exercise regimen to be aided by your diet plan. Apart from this remember to keep yourself adequately hydrated at all times. Avoid working out on an empty stomach or heavy meals.
          


MOST POPULAR GYM EXERCISES AND MOST REGULAR BLUNDERS
     
     1. LATERAL PULL DOWNS
As we all know this exercise is designed to work the muscles situated over the lateral side of your back (Latissimus Dorsii).
The Blunder Approach: This movement requires excellent shoulder joint mobility, maintaining a straight spine and activation of core for stability.  Most of the people pull the barbell down the back of their head and keep their backs either too hunched or hyperextend from the low back while pulling the bar down. Consequently the load is not directed to the Lats and results in trick movements leading in Rotator cuff injury, Trapezius spasm, lower back & neck strain and Shoulder impingement syndrome.

The Correct Approach: If done correctly this exercise can prove to be a great way to

develop your back muscles. Place your hands slightly beyond shoulder width distance and instead of pulling the bar behind your head pull it in front of your head. Make sure you lean back a little from your back while maintaining an erect spine and using your core muscles for stabilizing your body. Concentrate on pinching your shoulder blades together and take care to avoid pulling the bar beyond the level of your collar bone. Maintain the contraction while the bar moves up and fight the momentum while leaving the bar. 

2. SQUATS
Squats are the pinnacle of lower body strength. In addition if done correctly squats also help to workout core muscles, arm muscles, low back muscles and with more repetition act as cardio exercise and aid in weight loss. But it is easily possible to goof up while doing squats.

Stand straight with your feet shoulder width apart with the knee pointing straight ahead. Bend your knee, keep the spine neutral and mimic the action of trying to sit in a chair. Take precaution to not let your knee cross over your toes and try making an angle of 90 degrees with your knee. Make sure you keep your chest up and don’t hunch your upper back. If you are lifting weights then roll your shoulders back before lifting. Practice this movement facing the mirror in the front and side view.

 3. DEAD LIFTS
This is the most effective manner of getting a strong and stable lower back along with the added bonus of working the core. Any form of exercises which requires core activation is great as all the movements of arms and legs can be carried out effectively if the core is active and working.
Set the bar over your mid-foot with the feet at shoulder width distance and pass your hand over the bar maintaining them at the same distance. Do not let your back hunch or hyper extend as either of the positions exert great stress on the disc and its structures when your lift weights. Drag the bar up just grazing your shin and squeeze your gluteal and thigh muscles while lifting up. When lowering the weight down the quintessential point is to bend from your hips rather than from your knee. If you bend from the knee the bar might hit or roll over your knees and land down over your forefoot instead of the midfoot. This will alter the mechanics and make lifting the weight up more strenuous for your back. 


4.     BICEPS CURLS
Mention of this exercise may have you raising your eyebrows and has you wondering who would go wrong while doing this simple exercise but a considerable number of people fail to execute this exercise correctly.
A major misconception that people have is that it’s good to lift heavier weights. This
transfers all the weight over to your chest and other shoulder muscles which are definitely not the target muscles. Instead pay attention to the form, direction and precision of your movement. Lift manageable weights with more reps; it will pay you greater dividends. Improper execution of this exercise can lead to Biceps tendinitis.
Adopt a posture with your spine straight with a slight bend in your knee. Roll your shoulders back and lift by using your upper arms strength in a straight line and lower down with a slow and steady pace.


5. CRUNCHES
Crunches are the most incorrectly and over performed exercises. It’s a trend to complete a 100 or 150 crunch challenge but what you forget in the process is that it’s the quality of exercise that matters and not always the quantity.
Begin with lying on the ground/mat with a neutral spine and relaxed neck. Cross your hands over the back of your head in order to support your neck slightly with your hands. Make sure you don’t hunch your upper back or bring your elbows close to each other. Lift up using your abdominals by imagining someone is punching you in the stomach. Slowly lower down your back. The commonest mistake people make is to strain their neck while lifting up. This is because they fail to connect with the muscle they have to work and instead of contracting their abdominals they lift up with their neck.


Apart from this there are numerous exercises where you can go wrong. Hence we conclude that if you carry out exercises with a scientific approach you can keep uninvited injuries at bay and focus on gain not pain. Another important fact to remember is that if you develop any injury, you should immediately visit an expert in exercise science - A Physiotherapist.


We have become tech smart, book smart & street smart, it’s time to become gym smart…

Monday, 29 December 2014

FLAT FEET: All You Need To Know ?



"The human foot is a masterpiece of engineering & a work of art."
                                                                                                           -Leonardo Da Vinci


The human foot consists of 26 bones, 33 joints, 107 ligaments & 19 muscles which work together to balance your whole body. No wonder this great artist has named it a masterpiece 1/4 of all bones in the human body are in the feet. Standing in the kitchen for cooking, walking down to buy vegetables playing any sport, or dancing are all the activities we can do because of our feet. Healthy feet are key to an active lifestyle. Human feet are designed to walk on natural surfaces like soil & sand, but instead of that, we are walking on hard surfaces like pavements or marble. That's why the incidence of foot problems. Out of all flat feet is the most common & unnoticed problem. If is it not diagnosed at the right age, it can lead to serious complications in the future. I get many patients saying, " My physiotherapist told me, I have flat feet & my family doctor says I don't have flat feet, I don't know what exactly flat feet mean...!"


Flat Feet
What is Flat Feet ?
We have a small gap on the inner side of our feet when we stand, when this gap is not there it's called flat feet. Everybody is born with flat feet, as a child starts walking his/ her arch starts developing. First, five years of age are crucial for arch development.

Effect OF Flat Feet On Posture:
All joints in our body work together. As feet are base of our body it affects entire posture. Following image will give you clear idea about how flat feet can affect alignment of all proximal joints.

Effect of Flat Feet







Causes:
Knee Pain
  • Ligament laxity.
  • Muscle weakness/ Hypotonia of muscles.
  • Fracture/ trauma around ankle joint.
  • Family history.
  • Obesity.
Symptoms:
  • Tired achy legs.
  • Heel pain, Knee pain & back pain.
  • Recurrent ankle sprain (Poor Balance)
  • Early osteoarthritis of joints.
  • Corn & Calluses etc.


Treatment:

Custom-made orthotics are the main line of treatment for flat feet. People always try to get some off
the shelf orthotics & course it doesn't help their problem. Orthotics correction should be based on lots of variables like the severity of flat feet, age, weight, lifestyle, alignment of proximal joints, etc. Thus shelf things are not advisable. A Podiatrist is a right person to prescribe the orthotics.

     Podiatry is a branch of medicine specializing in ankle & foot problems. A Podiatrist doctor will do a thorough assessment of your alignment, diagnose the problem & then provide a customized solution for the same.
After certain age flat feet are not correctable but orthotic intervention can prevent further damage.


Shoe Test


Good supportive shoes are recommended for flat feet. Criteria for supportive shoes are rigid soles & firm ankle control. One should not able to twist (Torsion Test) & or bend (Flexibility Test) easily. Usually spots shoes are the best supportive shoes. For a person with flat feet, anti-pronation shoes are recommended.

Exercise:
To strengthen foot & ankle muscles & maintain an ideal weight.

Case Study

Testimony