Parkinsonism is a clinical syndrome characterized by tremor, bradykinesia, rigidity, and postural instability.
Parkinsonism is any condition that causes a combination of the movement abnormalities seen in Parkinson's disease — such as tremor, slow movement, impaired speech or muscle stiffness — especially resulting from the loss of dopamine-containing nerve cells (neurons).
Parkinsonism disease (PD) is a degenerative, progressive disorder that affects nerve cells in deep parts of the brain called the basal ganglia and the substantia nigra. Nerve cells in the substantia nigra produce the neurotransmitter dopamine and are responsible for relaying messages that plan and control body movement. For reasons not yet understood, the dopamine-producing nerve cells of the substantia nigra begin to die off in some individuals. When 80 percent of dopamine is lost, PD symptoms such as tremor, slowness of movement, stiffness, and balance problems occur.
Body movement is controlled by a complex chain of decisions involving inter-connected groups of nerve cells called ganglia. Information comes to a central area of the brain called the striatum, which works with the substantia nigra to send impulses back and forth from the spinal cord to the brain. The basal ganglia and cerebellum are responsible for ensuring that movement is carried out in a smooth, fluid manner. STAGES:
Stages Of Parkinsonism Disease
1st STAGE - A Person usually has mild symptoms, such as tremors or shaking in a limb.Change such as poor posture, loss of balance,and abnormal facial expressions. 2nd STAGE - Symptoms affect both limbs and both sides of the body. The person has usually has problem walking or balancing, and the inability to complete physical tasks becomes more apparent. 3rd STAGE - Symptoms can be severe and include the inability to walk straight or stand. there is a noticeable slowing of physical movements. 4th STAGE - The ability to walk is often limited. 5th STAGE - The Person is often unable to take care of herself and may not be able to stand or walk .she may need constant one on one nursing care. CAUSES:- Brain injury
Diffuse Lewy body disease (a type of dementia)
Encephalitis
HIV/AIDS
Meningitis
Multiple system atrophy
Progressive supranuclear palsy
Stroke
Wilson disease
Other causes of secondary parkinsonism include:
Brain damage caused by anesthesia drugs (such as during surgery)
Carbon monoxide poisoning
Certain medicines used to treat mental disorders or nausea
Mercury poisoning and other chemical poisonings
Overdoses of narcotics
MPTP (a contaminant in some street drugs) SYMPTOMS: Symptoms of Parkinson's disease differ from person to person. They also change as the disease progresses.
Symptoms typically begin appearing between the ages of 50 and 60. They develop slowly and often go unnoticed by family, friends, and even the person who has them.
The most common one is tremor.
Tremor. A tremor, or shaking, usually begins in a limb, often your hand or fingers. You may notice a back-and-forth rubbing of your thumb and forefinger, known as a pill-rolling tremor. One characteristic of Parkinson's disease is a tremor of your hand when it is relaxed (at rest).
Slowed movement (bradykinesia). Over time, Parkinson's disease may reduce your ability to move and slow your movement, making simple tasks difficult and time-consuming. Your steps may become shorter when you walk, or you may find it difficult to get out of a chair. Also, you may drag your feet as you try to walk, making it difficult to move.
Rigid muscles. Muscle stiffness may occur in any part of your body. The stiff muscles can limit your range of motion and cause you pain.
Impaired posture and balance. Your posture may become stooped, or you may have balance problems as a result of Parkinson's disease.
Loss of automatic movements. In Parkinson's disease, you may have a decreased ability to perform unconscious movements, including blinking, smiling or swinging your arms when you walk.
Speech changes. You may have speech problems as a result of Parkinson's disease. You may speak softly, quickly, slur or hesitate before talking. Your speech may be more of a monotone rather than with the usual inflections.
Writing changes. It may become hard to write, and your writing may appear small.
DIAGNOSIS: Computed tomography (CT) scans of people with PD usually appear normal.
MRI has become more accurate in diagnosis of the disease over time, specifically through iron-sensitive T2* and SWI sequences at a magnetic field strength of at least 3T, both of which can demonstrate absence of the characteristic 'swallow tail' imaging pattern in the dorsolateral substantia nigra. MEDICAL TREATMENT:
GOAL OF PHYSIOTHERAPY- Maintain and improve levels of function and independence, which will help to improve a person’s quality of life Use exercise and movement strategies to improve mobility Correct and improve abnormal movement patterns and posture, where possible Maximise muscle strength and joint flexibility Correct and improve posture and balance, and minimise risks of falls Maintain a good breathing pattern and effective cough Educate the person with Parkinson’s and their carer or family members Enhance the effects of drug therapy
Gait Training In Parkinson Disease
TREATMENT PLAN:
Visual cueing – a focus point to step over and initiate gait; strips of tape on the floor to initiate or continue walking through areas that cause slowing or freezing
Auditory cueing – counting 1-2-3 to initiate walking; stepping to the beat of a metronome or specific music at a specified cadence to continue the rhythm of a walk
Attention – Thinking about taking a big step; making a wider arc turn
Proprioceptive cueing – rocking from side to side ready to initiate a step; taking one step backwards as a cue ready to then walk forwards.
Hallux valgus is a progressive foot deformity in which the first metatarso-phalangeal (MTP) joint is affected and is often accompanied with significant functional disability and foot pain.
CAUSES:-
Hallux Valgus in Lower Limb Foot
Bunions are a widespread foot ailment that can be caused by a number of factors including genetics
Excess weight gain,
Activity level, and
Ill-fitting shoes.
Other less common causes of bunions include trauma to the
MTP joint (sprains, fractures, and nerve injuries),
Neuromuscular disorders,
Limb-length discrepancies.
Some studies report that bunions tend to occur ten times more frequently in women than in men, primarily as the result of wearing narrow, pointy, tight fitting, and/or high-heeled shoes over a significant period of time. Repetitive stresses to the foot can also cause bunions. SYMPTOMS:-
Hallux Valgus
Your big toe points toward your second toe, or your second toe overlaps your big toe
A prominent bump on the inside of the MTP or big toe joint
Pain on the inside of your foot at the big toe joint when wearing any kind of shoe
Pain each time the big toe flexes when walking
Redness, swelling , or thickening of the skin on the inside of the big toe joint DIAGNOSIS:- Radiographic exmatination show the angle formed between longitudinal bisection of the 1st Metatarsal and proximal phalanx.
A big toe position with an angle of up to 10° is still considered normal.
A minor hallux valgus defect is 16-20°.
A moderate hallux valgus deformity has a deviation of 16-40°.
A severe hallux valgus deformity has a deviation of over 40°.
Magnetic resonance imaging (MRI) will detect cartilage damage, trapped soft tissue and bone damage. PHYSIOTHERAPY TREATMENT:
Exercise In Hallux Valgus
Adjusted footwear with wider and deeper tip
Increase extension of MTP joint
Relieve weight-bearing stresses (orthosis)
Sesamoid Mobilization:The physical therapist performs grade III joint mobilizations on the medial and lateral sesamoid of the affected first MPJ. One thumb is placed on the proximal aspect of the sesamoid and is used to apply a force from proximal to distal that causes the sesamoid to reach the end range of motion (distal glides). These are performed with large-amplitude rhythmic oscillations. No greater than 20° of movement of the MPJ should be allowed during the technique.
Splinting In Hallux Valgus
Strengthening of peroneus longus Electrotherapy Modalities - Ultrasound, ice, Electrical stimulation, MTJ mobilizations and exercises. This is more effective than physical therapy alone. The combination will result in a increase in ROM of the MTP joint, strength and function, and also a decrease in pain .
Pain is the main reason that patients seek treatment for a bunion. Inflammation is best eased using ice therapy, techniques (e.g. soft tissue massage, acupuncture, unloading taping techniques) or exercises that unload the inflamed structures. Anti-inflammatory medications may help. Orthotics can also be used to offload the bunion. For Restoring the Normal Joint Of Motion -
Joint mobilisation (abduction and flexion) and alignment techniques (between the first and the second metatarsal)
Massage
Muscle and joint stretches
Taping
Bunion splint or orthotics
bunion stretch and soft tissue release.
Tapping Technique In Hallux Valgus
For Strengthening Of Muscles -
Towel curls The patient spreads out a small towel on the floor, curling his/her toes around it and pulling the towel towards them.
The ends of the band are either held by an assistant or secured against an immovable object (e.g. a table leg). The patient then dorsiflexes the ankle, pulling "towards their nose," working against the resistance of the band.
Tennis elbow, or lateral epicondylitis, is a painful condition of the elbow caused by overuse. Tennis elbow is an inflammation of the tendons that join the forearm muscles on the outside of the elbow. The forearm muscles and tendons become damaged from overuse — repeating the same motions again and again. This leads to pain and tenderness on the outside of the elbow. There are many treatment options for tennis elbow. In most cases, treatment involves a team approach. Primary doctors, physical therapists, and, in some cases, surgeons work together to provide the most effective care.
ANATOMY:
Anatomy Of Muscle And Joint
Elbow joint is a joint made up of three bones: upper arm bone (humerus) and the two bones in forearm (radius and ulna). There are bony bumps at the bottom of the humerus called epicondyles. The bony bump on the outside (lateral side) of the elbow is called the lateral epicondyle.
Muscles, ligaments, and tendons hold the elbow joint together.
Lateral epicondylitis, or tennis elbow, involves the muscles and tendons of forearm. Forearm muscles extend wrist and fingers. Forearm tendons — often called extensors — attach the muscles to bone. They attach on the lateral epicondyle. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).
CAUSES:
Overuse.
Activities.
Age.
Unknown.
PAIN PHASES:
Phase 0: No pain or soreness.
Phase 1: Soreness after activity, usually gone in twenty-four hours.
Phase 2: Mild stiffness and soreness before activity which disappears with warm-up. No pain during activity, but mild soreness after activity that disappears within 24 hours.
Phase 3: Mild/moderate stiffness and soreness plus mild pain during activity which does not alter activity.
Phase 4: Pain during activity which alters activity.
Phase 5: Constant pain even at rest.
SYMPTOMS:
Diffuse achiness.
Morning stiffness.
Occasional night pain.
Dropping of objects/ weak grip strength.
Pain with palpation of lateral epicondyle.
Pain with active or resisted extension.
Pain with grasping objects with the effected hand.
Pain or tenderness on the outer side of the elbow.
Pain when you straighten or raise your wrist and hand.
Pain made worse by lifting a heavy object.
Pain when you make a fist, grip an object, shake hands, or turn door handles.
Pain that shoots from the elbow down into the forearm or up into the upper arm.
CONTRIBUTING FACTORS:
Weak muscles.
Overuse- playing or working with excessive and repetitive forceful gripping.
Gripping while extending or twisting of the wrist.
Racquets/ tools that are too heavy or unbalanced.
Improper equipment- incorrect grip size, strings too tight.
poor playing technique- too much wrist action, jerky strokes, poor ball contact.
DIAGNOSIS:
X-rays. MRI. EMG.
PHYSICAL THERAPY EXAMINATION:
Examination Of Patient
Cozen's test:
Resistive Tennis Elbow Test:The patient sits with the examiner stabilizing the involved elbow while palpating the lateral epicondyle With a closed fist, the patient pronates and radially deviates the forearm and extends the wrist against the examiner’s resistance”. A positive result would be if there is pain along the lateral epicondyle or objective muscle weakness.
TREATMENTS:
Tapping Technique In Tennis Elbow
Medication: Anti-inflammatory medication helps to reduce pain.
Steroid Inection: Steroids, such as cortisone, are very effective anti-inflammatory medicines.
Rest: You may have temporarily stop the aggravating activity. A period of rest is most important to allow the injury a chance to heal. You will make the condition worse by continuing the activity that cause the injury, especially if you experience pain. Avoid heavy liftting or carrying opening doors or repeatedly shaking hands.
Ice: Apply cold to your elbow three times a day for 20 to 30 minutes at a time in the early painful stage and for 20 minutes after active use of arm. Protect skin by putting a towel between elbow and the ice bag.
Brace: A counter force brace which is and elastic strap that is worn 1-2 inches below the elbow. This type of brace gives compression to the forearm muscle and helps lessen the force that the muscle transmits to the tendon.
Modalities:
Interferential current.
Ultrasound.
Cold pack.
Laser therapy. Physiotherapy Exercises:
Physiotherapy Treatment in Tennis Elbow
Exercise Of Grip Muscle
Resisted wrist extension.
Resisted wrist flexion.
Resisted forearm supination and pronation.
Wrist flexor stretch.
Wrist extensor stretch.
Finger extension.
Hand squeeze.
Strengthening Exercise Using Weight
Exercise in Tennis Elbow
Wrist range of motion: Bend your wrist forward and backward as far as you can. Repeat 10 times. Do 3 sets.
Forearm range of motion: With your elbow at your side and bent 90 degrees, bring your palm facing up and hold for 5 seconds then slowly turn your palm facing down and hold for 5 seconds. Repeat 10 times. Do 3 sets. Make sure you keep your elbow bent at 90 degrees throughout this exercise.
Elbow range of motion: Gently bring your palm up toward your shoulder and bend your elbow as far as you can. Then straighten your elbow out as far as you can. Repeat 10 times. Do 3 sets
Forearm pronation and supination: Hold a soup can or hammer handle in your hand, with your elbow bent 90 degrees. Slowly rotate your hand with palm upward and then palm down. Repeat 10 times. Do 3 sets.
Wrist extension: Stand up and hold a broom handle in both hands. With your arms at shoulder level, elbows straight and palms down, roll the broom handle backward in your hand as if you are reeling something in using the broom handle. Repeat for 1 minute and then rest. Do 3 sets.
Wrist strengthening.
(1) Wrist flexion: Holding a soup can or hammer handle with your palm up, slowly bend your wrist up. Slowly lower the weight and return to the starting position. Repeat 10 times. Do 3 sets. Gradually increase the weight of the can you are holding.
(2) Wrist extension: Holding a soup can or hammer handle with your palm down, gently bend your wrist up. Slowly lower the weight and return to the starting position. Repeat 10 times. Do 3 sets. Gradually increase the weight of the can you are holding.
(3) Wrist radial deviation: Hold your wrist in the sideways position with your thumb up. Holding a can of soup or . hammer handle, gently bend your wrist up with your thumb reaching towards the ceiling. Slowly lower to the starting position. Do not move your forearm throughout this exercise. Repeat 10 times. Do 3 sets.
Elbow rehabilitation program:
A gradual progression of the exercises is extremely important. Although they may seem easy at first you must follow the enclosed steps closely to prevent an increase or re-aggravation of your symptoms. Before beginning the strengthening exercises you should warm-up your body to a light sweat. Try 3 to 5 minutes of brisk walking, cycling, jogging etc. Do exercises only once a day: more is not better and can re-aggravate your symptoms. Wear the Count’R-Force brace if advised by your therapist or if you experience pain while performing the exercises. Do each exercise at its own rate. You will achieve higher weights faster on some exercises than others. Do each exercise properly and slowly do not work through peavierain. Stage 1 Exercises:
Keep your elbow bent to 90 degrees. If this is painful lean forward and bend your elbow even more. Your forearm should be well supported on your thigh or a table.
Begin with no weight, doing 10 to 15 repetitions for each exercise.
Slowly progress the repetitions in sets of 10, every few days as your elbow allows until you are comfortably doing 3 sets of 10 repetitions for 2 consecutive days without increasing your symptoms.
Increase to a one-pound weight (a small can of soup works well). Go back to 10 to 15 repetitions for each exercise.
Slowly work up to 3 sets of 10 repetitions again.
Increase to a two-pound weight and again cut back to 10 to 15 repetitions.
Slowly progress to 3 sets of 10 repetitions.
Continue this gradual progression until you are using a three-pound weight for 3 sets of 10 repetitions without increasing your symptoms.
Progress to next stage as able.
Stage 2 Exercises:
Rubber band and squeeze exercises:
Begin with your elbow bent at your side and progress by performing the exercises with your arm straight out in front of you as able. You should do these two exercises several times a day, every day. It is a good idea to have a ball and rubber band in convenient places like in your car, at your desk, or by the television. Be careful not to overdo these exercises as they can increase your pain.
Ice after exercises.
The rectus abdominis muscle, also known as the "abs", this is a paired muscle running vertically on each side of the anterior wall of the human abdomen. There are two parallel muscles, separated by a midline band of connective tissue called the linea alba.
It extends from the pubic symphysis, pubic crest and pubic tubercle inferiorly, to the xiphoid process and costal cartilages of ribs V to VII superiorly. The proximal attachments are the pubic crest and the pubic symphysis. It attaches distally at the costal cartilages of ribs 5-7 and the xiphoid process of the sternum. The rectus abdominis muscle is contained in the rectus sheath, which consists of the aponeuroses of the lateral abdominal muscles. Bands of connective tissue called the tendinous intersections traverse the rectus abdominus, which separates this parallel muscle into distinct muscle bellies.
The outer, most lateral line, defining the "abs" is the linea semilunaris. In the abdomens of people with low body fat, these bellies can be viewed externally and are commonly referred to as "four", "six", "eight", or even "ten packs", depending on how many are visible; although six is the most common. Origin/Insertion: The rectus abdominis is a long flat muscle, which extends along the whole length of the front of the abdomen, and is separated from its fellow of the opposite side by the linea alba.
The upper portion, attached principally to the cartilage of the fifth rib, usually has some fibers of insertion into the anterior extremity of the rib itself.
It's typically around 10 mm thick or 20 mm thick in young athletes such as handball players.
Nerve Supply
The muscles are innervated by thoraco-abdominal nerves, these are continuations of the T7-T11 intercostal nerves and p
ierce the anterior layer of the rectus sheath. Sensory supply is from the 7-12 thoracic nerves.
Blood Supply:
Several arterial blood sources supply the rectus abdominis. Categorization of the muscular vascular structure: The inferior epigastric artery and vein (or veins) supply blood to the lower portion of the muscle by running superiorly on the posterior surface of the rectus abdominis, entering the rectus fascia at the arcuate line.
Second, blood for the upper part is supplied by the superior epigastric artery, a terminal branch of the internal thoracic artery.
Lastly, the lower six intercostal arteries also contribute numerous small segmental amounts.
8 Pack Of Rectus Abdominis Muscle
Action:
The rectus abdominis is an important postural muscle. It is responsible for flexing the lumbar spine, as when doing a so-called sit up Exercise. The rib cage is brought up to where the pelvis is when the pelvis is fixed, or the pelvis can be brought towards the rib cage (posterior pelvic tilt) when the rib cage is fixed, such as in a leg-hip raise. The two can also be brought together simultaneously when neither is fixed in space.
Sit Up Exercise is Most Common Form Of Exercise Where Rectus Abdominal Musct is Chief Muscle Used In This Action. Six Pack Abs Workout Video:
Following are the Best Exercises of Rectus Abdominis Muscle. Sit Up Exercise:
Sit Up Exercise
In Supine Position Flexes Both Legas , Hands Behind Head And Flexes The Spine And Heads Towards Knee And Repetation Of Same.
Sit Up Exercise
Bilateral Leg Elevation In Supine Postion Uses Lower Abdominals Muscle.
Rectus Abdominis is strong Back Flexor Muscle.
Knee To Chest Exercise
To Reduce Lordosis Strengthening Of Rectus Abdominis Muscle is required.
strengthening of Rectus Abdominis And Other Back Flexor Muscle in Back Pain is Most Common And is Called Williams Abdominal Exercise.
Anatomical Variations
A variation of the rectus abdominis or pectoralis major may be the sternalis muscle. Occasionally, some fibers are joined to the side of the xiphoid process and the costoxiphoid ligaments.
Importance of the Muscles
The abdominalis recti, a muscle of the core, contribute to core stability. The rectus abdominis, transversus abdominis, erector spinae, and obliques are among the core muscles that work in collaboration to prevent lower back injuries. They look like a natural weight belt. People who have weak core muscles are more likely to have spinal issues.
At the linea alba, there is a midline separation known as diastasis recti abdominis. Diastasis is defined as any visible bulging during physical exertion or a palpable midline gap greater than 2.5 cm. It typically develops around the umbilicus, but it can occur anywhere between the pubic bone and the xiphoid process.
This spread belly is also common in newborns, and it should go away on its own. The majority of premature and African American infants exhibit it.
Assessment
Palpation
To ensure that the patient's muscles are relaxed, place a pillow under their knees and place them in a supine position. Palpate the patient's muscles along their xiphoid process, adjacent ribs, and pubis bone on both sides. After encouraging the patient to lift their trunk, ask them to relax.
Muscle Power Testing
It is more important to evaluate the strength of the abdominal muscles than their flexibility because weak abdominal muscles can lead to serious issues down the road.
When performing MMT for rectus abdominis, the patient is typically asked to raise his or her trunk against gravity while supine until the inferior angles of the scapula are off the table. The therapist then begins to grade the patient based on the patient's performance and capacity to complete the exercise as directed.
Clinical Significance
An injury to one of the abdominal wall's muscles is known as an abdominal muscle strain, sometimes known as a pulled abdominal muscle. Excessive stretching of the muscle results in a strain. The muscle fibers tear when this happens. Usually, a strain results in tiny tears within the muscle, but in extreme cases, the muscle may separate from its attachment.
An accumulation of blood in the rectus abdominis muscle's sheath is known as a rectus sheath hematoma. It can cause pain in the abdomen with or without a mass. Either a muscle tear or an epigastric artery rupture could be the source of the hematoma. Anticoagulation, coughing, pregnancy, abdominal surgery, and trauma are some of the causes of this.
There is evidence that the once-benign condition is becoming more common and serious due to the aging population and the widespread use of anticoagulant medications.
Individuals may have a positive Carnett's sign upon abdominal examination.
Although they usually go away on their own without treatment, hematomas can take months to go away.
In human anatomy, a hamstring is a Group Of three muscle in posterior side of thigh (from medial to lateral: semimembranosus, semitendinosus and biceps femoris).
Main Action Of Hamstring is Flexion Of Knee Joint. Working With Quadriceps And Mainly Doing Co-Contraction During Running And Our Day-to-day Activities And Tightness is the most common in this Muscle require Stretching Exercise At Regular Interval. Common Features Of Hamstring Muscle: They All Originates Arounds Tibial Tuberocity.
Insertion Below Knee Joint Over Tibia or Fibula.
Innervated By Tibial Nerve Branch Of Sciatic Nerve.
Must Flex The Knee And Extends The Hip Joint
All This Functionality is Compulsory to include in Hamstring Group. Origin and Insertion of Hamstring muscle: Semimembranosus: Origin From Ischial Tuberocity And Insertion over Medial Tibial Condyle.
Semitendinosus : Origin Also From Ischial Tuberocity And Insertion Over Medial Surface Of Tibia.
Biceps Femoris (Long Head ) : Origin Also From Ischial Tuberocity And Insertion Over Lateral Side Of The Head Of The Fibula.
Biceps Femoris (Short Head) : Origin From linea aspera & lateral supracondylar line of femur And Insertion Over Lateral Side of the Head of The Fibula with Long Head Common Tendon. Nerve Supply:
Semimembranosus,Semitendinosus and Biceps Femoris Long Head Nerve Supply is Tibial Nerve Part Of Sciatic Nerve.
Biceps Femoris Short Head Nerve Supply is Common Peroneal Nerve Part Of Sciatic Nerve. Action of Hamstring Muscle:
Strengthening Exercise Of Hamstring Muscle
Hamstring Muscle Crosses Two Joint So Working Chiefly Over The Knee Joint And Do Strong Action is Knee Flexion And Part time Also Helping in Hip Extension With Gluteus Maximus.
Semimembranosus,Semitendinosus Extends Hip Joint And Flex The Knee Joint And Also Rotate Knee Joint When Knee is Flexed.
Long Head Of Biceps Femoris is Extends The Hip Joint And Both Long And Short Head Flex The Knee Joint And Laterally Rotate The Hip When Knee Flexion Position.
Hamstring is One Of The Strongest Antagonist Muscle As Compared To Other Antagonist Muscle Require All Day To Day Activity Like Running, Jumping, Walking , Squating And Working With Quadriceps and Doing Co-contraction.
Co-Contraction Of Hamstring And Quadriceps Muscle
Clinical Significance: Hamstring Muscle is one of the common Muscle that become tight and Require regular stretching exercise to avoid to tear or damage to Muscle and related ligament. Sciatica is also associated with tightness of Hamstring muscles.
Semitendinosus is also used in Surgery of ACL Ligament reconstruction Surgery. Exercise Of Hamstring Muscle:
Strengthening Of Hamstring In Standing Position
Strengthening Exercise: Strengthening Exercise In Prone Position With Sandbag in Early Stage And Later Stages Standing Position Body Towards Wall And Flexed With Sand Bag is Most Common Exercise.
Home Based Stretching Exercise Of Hamstring Muscle
Stretching Exercise: Long Sitting Position And Toe Touch is One Of The Most Common Hamstring Stretching Exercise And This Position in Yoga Called " Paschimotanasan- Yoga Position"
Calf Muscle : ( 2nd Heart - Pumping action) Muscle Of Lower Limb. Calf Muscle is Located On Back Side Of The Leg And Is Made Of 2 Large Muscle To Join Make Tendo Achiilis.
Muscle Detail Of Back Side Of Leg
(1) Gastrocnemius Muscle : is the larger Calf Muscle Forming The Bulge Of Muscle Mass And Visible Beneath the skin. Gastrocnemius has 2 Heads Which Looks Like Diamond Shape.
Anatomy Of Calf Muscle
(2) The Soleus Muscle: Small Muscle , Flatt And Underneath The Gastrocnemius Muscle. A majority of soleus muscle fibers originate from each side of the anterior aponeurosis, attached to the tibia and fibula. Insertion : Both Muscle Insertion Merge Via Tendo Achiilis And The Achilles tendon inserts into the heel bone (calcaneus). Nerve Supply : (Calf Area- Lumbar 4-5 and Sacral 1-5 is of the sacral plexus) The sciatic nerve branches off of the sacral plexus in which the tibial and common fibular(Peroneal) nerves are wrapped in one sheath. The tibial nerve eventually separates from the sciatic nerve and innervates the gastrocnemius muscle. Action Of Calf Muscle :
Calf Muscle Stretching
Calf Muscle is one of Strong Lower Limb Muscle Which Planter Flex From Ankle Joint. This Muscle is Anti Gravity Muscle And Normally All Anti Gravity Muscle Require High Power That's Why All Anti Gravity Muscle Are Bulky And Strong. Running, Jumping, Dancing , Cycling All This Activity Use Calf Muscle. Jumping is The Highest Uses Calf Muscle. This Muscle is Also Called 2nd Hearst And Low Use Of This Muscle May Lead Vericose Vein And Oedema Around Ankle. Sports Person Usually High Use Of This Muscle May Lead Cramps. Classical Dancers And Gymanatics Also Use Calf Muscle More And Require Special Attention To Develop , strenthen Calf Muscle. Exercise Of Calf Muscle:
Calf Muscle Strengthening Exercise With Use Of Body Weight
Active Movement in Supine Position is Simple Planter Flex From Ankle. Resisted Exercise : Self Resisted Exercise is to High Hill Action In Standing Position.
Calf Muscle Exercise With Full Body Weight Single Leg-Tuff One
Gradually Increase Repetition And Jumping, Running, Cycling Are Other Exercise That Are Useful To Strengthen And Most Common Form Of Exercise.
Calf Muscle Strenthening Exercise With Weight
Stretching Exercise of Calf muscle : Use Of Belt Like And Wrap Around Ankle in Long Sitting With Stretch Towards Ankle is Home Made Calf Exercise.
Home Made Low Intensity Calf Stretching For Elderly
Standing Position : Both Leg In Same Line Position With Around Minimum Foot Distance With Forward Leg Flexed From Knee And Back Leg Straight , You Will Feel Stretching in Back Calf Muscle And Then Change Leg Again Do Some Practice.
Calf Stretching In Standing Position
Medical Use Of Calf Muscle: Use Of Calf Muscle in Medical Field is Too Important. Generally Blood Flow Upside Down is Easy But From Ankle To Up Towards Heart , It's Need Calf Muscle Active Exercise, In Paralysis And Other Bed Ridden Patient Ankle Swelling Are Most Common symptoms And That why Physiotherapist Start Active Exercise Of Calf Muscle With Elevation Of Ankle Joint.That's Why This Muscle Also Called 2nd Heart because of its Pumping action. Related Article :
Frozen shoulder (adhesive capsulitis) is stiffness, pain, and restricted R.O.M (range of movement) in your shoulder . It may happen after an injury or overuse or from a disease such as diabetes or a stroke,Post Operative surgeory Near to shoulder joint.
The tissues around the joint stiffen, scar tissue forms, and shoulder movements become restricted & painful. The condition usually comes on gradually, then recover slowly over the course of a year or more.
The exact cause of frozen shoulder is not well understood, but it is believed to involve the thickening and tightening of the capsule surrounding the shoulder joint. Certain risk factors may increase the likelihood of developing this condition, including diabetes, thyroid disorders, previous shoulder injuries or surgeries, and prolonged immobilization of the shoulder.
Treatment for frozen shoulder usually involves a combination of pain management, physical therapy, and occasionally, medications or corticosteroid injections to help reduce inflammation. Physical therapy exercises are aimed at improving range of motion and restoring strength to the shoulder. In severe cases that do not respond to conservative treatments, surgical interventions such as shoulder manipulation under anesthesia or arthroscopic release may be considered.
Related Anatomy:
The shoulder joint is a complex structure that allows for a wide range of motion and consists of several components. Understanding the anatomy of the shoulder can help provide context to the condition known as frozen shoulder.
Shoulder Bones: The main bones of the shoulder include:
Humerus: The upper arm bone that connects to the shoulder socket.
Scapula: Also known as the shoulder blade, it is a flat triangular bone that provides attachment for various muscles involved in shoulder movement.
Clavicle: Commonly known as the collarbone, it connects the scapula to the sternum (breastbone).
Shoulder Joints: The shoulder joint is comprised of three joints:
Glenohumeral Joint: This joint connects the head of the humerus with the glenoid cavity, a shallow socket in the scapula. It is the main joint responsible for shoulder movement and allows for a wide range of motion.
Acromioclavicular (AC) Joint: It is the joint between the acromion, a bony process of the scapula, and the clavicle.
Sternoclavicular (SC) Joint: It is the joint between the clavicle and the sternum.
Shoulder Muscles: Numerous muscles surround the shoulder joint, providing stability and enabling movement. Some key shoulder muscles include:
Deltoid: It forms the rounded contour of the shoulder and helps with lifting the arm.
Rotator Cuff Muscles: These muscles, including the supraspinatus, infraspinatus, teres minor, and subscapularis, surround the shoulder joint and work together to stabilize the humeral head within the glenoid cavity.
Biceps Brachii: Located in the upper arm, it helps with flexion and rotation of the shoulder.
Triceps Brachii: Located in the upper arm, it assists in extending the shoulder.
Shoulder Ligaments and Capsule: Ligaments are tough bands of connective tissue that connect bones to provide stability. The shoulder joint is supported by several ligaments, including:
Glenohumeral Ligaments: These ligaments reinforce the front, back, and bottom of the shoulder joint capsule, providing stability to the glenohumeral joint.
Acromioclavicular (AC) Ligament: It stabilizes the AC joint.
Coracoclavicular (CC) Ligament: It stabilizes the AC joint and helps support the clavicle.
Coracoacromial Ligament: It forms the roof of the shoulder joint, protecting the underlying structures.
The interaction between these bones, joints, muscles, and ligaments allows for the shoulder's wide range of motion and flexibility. When the capsule surrounding the shoulder joint thickens and tightens, as in the case of frozen shoulder, it leads to pain, stiffness, and limited movement.
Causes Of frozen shoulder : Frozen shoulder can develop when you stop using the joint normally because of pain, injury, or a chronic health condition, such as diabetes or a stroke. Any shoulder problem can lead to frozen shoulder if you do not work to keep full range of motion. Frozen shoulder main cause:
post operative surgery near to sholder.
After surgery or injury.
Most often in people 40 to 70 years old.
More often in women (especially in postmenopausal women) than in men.cover
Most often in people with chronic diseases.
chest pain and diabetes are often associated with.
Symptoms of Frozen Shoulder
The symptoms of frozen shoulder, or adhesive capsulitis, typically develop gradually and worsen over time. They can vary in severity from person to person. The primary symptoms include:
Shoulder pain: The pain is usually persistent and may be dull or aching in nature. It is often felt deep within the shoulder joint and can radiate down the arm. The pain may worsen with movement or pressure on the shoulder.
Stiffness: Stiffness is a hallmark symptom of frozen shoulder. The shoulder joint becomes increasingly difficult to move, and the range of motion progressively decreases. Activities such as reaching overhead, putting on clothes, or reaching behind the back may become challenging or impossible.
Limited range of motion: As the condition progresses, the shoulder's range of motion becomes significantly restricted. Both active movement (using your own muscles) and passive movement (someone else moving your arm) may be limited. The shoulder may have difficulty with abduction (lifting the arm away from the body), flexion (lifting the arm forward), and external rotation (rotating the arm outward).
Gradual onset and progression: Frozen shoulder typically develops in three stages, each characterized by different symptoms. The freezing stage is marked by increasing pain and stiffness. In the frozen stage, the pain may subside, but stiffness remains prominent. Lastly, in the thawing stage, the range of motion gradually improves.
Sleep disturbances: Shoulder pain and discomfort can interfere with sleep, particularly when lying on the affected side or trying to find a comfortable sleeping position.
It's important to note that these symptoms can also be indicative of other shoulder conditions, so it's recommended to consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan.
Stages of Frozen Shoulder
Frozen shoulder, also known as adhesive capsulitis, progresses through three stages, each characterized by different symptoms and duration. These stages are as follows:
Freezing Stage (Painful Stage):
Duration: This stage typically lasts 2 to 9 months.
Symptoms: The primary symptom during this stage is pain, which gradually increases in intensity. The pain may be persistent and worsen at night, making it difficult to sleep on the affected side. Shoulder movement becomes restricted, and there is a progressive loss of range of motion. Activities that involve reaching or lifting the arm become challenging.
Frozen Stage (Stiffness Stage):
Duration: The frozen stage typically lasts 4 to 12 months.
Symptoms: During this stage, the pain may decrease or become more intermittent, but stiffness and limited range of motion become the prominent symptoms. The shoulder joint becomes significantly stiff, making it difficult to move the arm in various directions. Everyday activities, such as putting on clothes or reaching behind the back, become extremely challenging or impossible.
Thawing Stage (Recovery Stage):
Duration: The thawing stage can last from several months to a couple of years.
Symptoms: In this stage, the shoulder gradually begins to regain its range of motion. The stiffness and pain gradually diminish, and day-to-day activities become easier to perform. The recovery is typically slow and gradual, with some variability among individuals.
It's important to note that the duration of each stage can vary from person to person. Some individuals may experience a faster progression through the stages, while others may have a prolonged course. It is also possible for the condition to resolve spontaneously over time without specific treatment, although treatment can help manage symptoms and expedite recovery.
Risk Factor
Several risk factors have been associated with an increased likelihood of developing frozen shoulder (adhesive capsulitis). These risk factors include:
Age: Frozen shoulder most commonly affects individuals between the ages of 40 and 60. It is less common in younger individuals.
Gender: Women are more likely to develop frozen shoulder than men.
Previous Shoulder Injury or Surgery: Individuals who have had a previous shoulder injury, trauma, or surgery may have an increased risk of developing frozen shoulder. Immobilization of the shoulder joint for an extended period due to injury or surgery can contribute to the development of adhesive capsulitis.
Systemic Diseases: Certain systemic conditions or diseases are associated with an increased risk of developing frozen shoulder, including:
Diabetes: People with diabetes are at a higher risk of developing frozen shoulder, and the condition may be more severe in individuals with poorly controlled blood sugar levels.
Thyroid Disorders: Hypothyroidism, in particular, has been linked to an increased risk of developing adhesive capsulitis.
Cardiovascular Disease: Some studies have suggested a possible association between cardiovascular diseases and frozen shoulder, although the exact mechanisms are not fully understood.
Dupuytren's Contracture: Dupuytren's contracture is a condition characterized by the thickening and tightening of the tissue beneath the skin of the palm and fingers. It has been associated with an increased risk of developing frozen shoulder.
Prolonged Immobilization: Keeping the shoulder joint immobile for an extended period due to factors such as post-surgical recovery, shoulder sling usage, or prolonged bed rest can increase the risk of developing frozen shoulder.
It's important to note that while these risk factors may increase the likelihood of developing frozen shoulder, the condition can still occur without any identifiable cause or risk factors. If you have concerns about your risk of developing frozen shoulder, it is advisable to consult with a healthcare professional for a comprehensive evaluation and appropriate management.
Differential Diagnosis
When evaluating a patient with symptoms suggestive of frozen shoulder, healthcare professionals consider several other conditions in the differential diagnosis. These conditions share some similarities with frozen shoulder but may have distinct characteristics that help differentiate them. Some common conditions to consider include:
Rotator Cuff Tendinitis or Tears: Inflammation or tears in the rotator cuff tendons can cause shoulder pain and limited range of motion. However, unlike frozen shoulder, the pain in rotator cuff injuries is often more localized to the front or side of the shoulder, and there may be specific movements or positions that exacerbate the pain.
Shoulder Impingement Syndrome: This condition involves compression or pinching of structures, such as the rotator cuff tendons, in the space beneath the acromion (a bony process of the scapula). Shoulder impingement syndrome can cause pain, weakness, and limited range of motion. Pain is typically felt during overhead activities and may radiate down the arm. However, in frozen shoulder, the primary issue is stiffness and restricted motion, while pain may be more constant.
Glenohumeral Osteoarthritis: Osteoarthritis of the shoulder joint can lead to pain, stiffness, and limited range of motion. However, osteoarthritis typically presents with a different pattern of pain and may involve additional symptoms, such as joint swelling and crepitus (grating or popping sensations).
Bursitis: Inflammation of the bursa, which are small fluid-filled sacs that reduce friction between tissues, can cause shoulder pain and limited range of motion. Bursitis pain is often localized to the outer aspect of the shoulder, and there may be tenderness over the affected bursa. Unlike frozen shoulder, bursitis usually does not result in significant stiffness.
Referred Pain: Pain originating from other structures, such as the neck or upper back, can radiate to the shoulder, mimicking symptoms of frozen shoulder. Evaluating for signs of referred Neck pain and performing a comprehensive examination can help identify the actual source of the symptoms.
Other less common conditions, such as shoulder instability, calcific tendinitis, and certain neurological disorders, can also present with shoulder pain and limited range of motion. A thorough evaluation by a healthcare professional, including a detailed medical history, physical examination, and possibly imaging studies, is crucial to reach an accurate diagnosis and develop an appropriate treatment plan.
Frozen shoulder Diagnoses : Your doctor specially phsiotherapist may suspect frozen shoulder if a physical exam reveals restricted shoulder movement. An X-ray may be done to see whether symptoms are from another condition such as arthritis or a broken bone.
The diagnosis of frozen shoulder typically involves a comprehensive evaluation by a healthcare professional, such as an orthopedic specialist or a physical therapist. The process usually includes the following:
Medical History: The healthcare provider will inquire about your symptoms, including the onset, duration, and progression of shoulder pain and stiffness. They will also ask about any previous injuries or surgeries involving the shoulder, as well as any underlying medical conditions, such as diabetes or thyroid disorders, which may increase the risk of developing frozen shoulder.
Physical Examination: The healthcare provider will perform a physical examination of the shoulder joint, assessing range of motion, strength, and any areas of tenderness. They will also check for signs of other shoulder conditions that may mimic frozen shoulder, such as rotator cuff injuries or shoulder impingement syndrome.
Imaging Tests: While imaging tests are not always necessary for diagnosing frozen shoulder, they may be performed to rule out other underlying causes of shoulder pain and stiffness. These tests may include:
X-rays: X-rays can help evaluate the bones and rule out conditions such as osteoarthritis or fractures.
Magnetic Resonance Imaging (MRI): An MRI may be ordered to assess the soft tissues of the shoulder, including the muscles, tendons, and ligaments, and to rule out other conditions.
Diagnostic Injections: In some cases, diagnostic injections may be used to help confirm the diagnosis. A local anesthetic or a corticosteroid medication may be injected into the shoulder joint to determine if it provides temporary pain relief or improves range of motion, suggesting that the symptoms are related to the capsule and not another condition.
Physical Therapist check your available passive range of motion of Shoulder joint.
Shoulder Joint movement( R.O.M) :
Flextion : 0-180 degree
Extension : 0-60 degree
Abduction: 0-180 degree
Adduction : 0-45 degree
Int.Rotation : 0-90 degree
Ext. Rotation : 0-90 degree
It's important to note that the diagnosis of frozen shoulder is primarily based on clinical evaluation, including the characteristic symptoms of pain and progressive shoulder stiffness. Other conditions with similar symptoms must be carefully ruled out through a combination of history, physical examination, and diagnostic tests.
Treatment Of Frozen Shoulder :
Treatment for frozen shoulder usually starts with Analgesic Drugs,Hot Pack, followed by gentle stretching. And physical therapy can help increase your range of motion. A frozen shoulder can take a 2 month to 3 months or more to get better.
The treatment of frozen shoulder aims to reduce pain, improve shoulder mobility, and restore functional use of the affected arm. The specific treatment approach may vary depending on the severity of symptoms and the stage of frozen shoulder. Common treatment options include:
Pain Management:
Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter or prescription NSAIDs may be recommended to help reduce pain and inflammation.
Analgesics: Pain-relieving medications may be prescribed to manage severe pain that is not adequately controlled with NSAIDs.
Physical Therapy:
Stretching and Range-of-Motion Exercises: A physical therapist can guide you through specific exercises to gradually stretch and improve the range of motion of your shoulder joint.
Strengthening Exercises: Once pain and range of motion improve, exercises to strengthen the muscles around the shoulder joint can be introduced.
Heat or Cold Therapy: Applying heat or cold to the shoulder may help alleviate pain and improve mobility.
Corticosteroid Injections:
In some cases, a corticosteroid injection into the shoulder joint may be recommended to reduce inflammation and provide temporary pain relief. These injections are typically used if conservative measures alone are insufficient.
Hydrodilatation:
This procedure involves injecting a sterile fluid (saline) into the shoulder joint to stretch and expand the capsule. It can help improve range of motion and reduce pain.
Manipulation Under Anesthesia (MUA):
In severe cases where other treatments have not been successful, MUA may be considered. It involves manipulating the shoulder joint while the patient is under anesthesia to break up adhesions and improve range of motion.
Surgical Intervention:
Surgery is typically considered a last resort and is reserved for cases where other treatments have failed. The surgical procedure, known as arthroscopic capsular release, involves cutting through tight and thickened portions of the shoulder joint capsule to improve mobility.
It's important to note that the treatment duration for frozen shoulder can be prolonged, ranging from months to years, and individual responses to treatment may vary. Regular follow-up with a healthcare professional is essential to monitor progress and adjust the treatment plan as needed.
If you are experiencing symptoms of frozen shoulder, it is recommended to consult with a healthcare professional, such as an orthopedic specialist or a physical therapist, for an accurate diagnosis and appropriate treatment plan based on your specific condition.
Physiotherapy Treatment:
Physiotherapy plays a crucial role in the treatment of frozen shoulder (adhesive capsulitis) and focuses on reducing pain, improving range of motion, and restoring shoulder function. A physiotherapy treatment plan for frozen shoulder may include the following components:
Gentle Range-of-Motion Exercises: Initially, the physiotherapist will guide you through gentle exercises to gradually improve the range of motion of your shoulder joint. These exercises may involve pendulum swings, wand exercises, or passive range-of-motion movements performed with the assistance of the therapist.
Stretching Exercises: As pain permits, stretching exercises are introduced to target the specific muscles and structures that are tight or contributing to limited shoulder mobility. These exercises are performed within a pain-free range and aim to gradually increase flexibility.
Strengthening Exercises: Once pain and range of motion improve, the focus shifts to strengthening the muscles around the shoulder joint. The physiotherapist will prescribe specific exercises to target the shoulder girdle muscles, including the rotator cuff muscles, to improve stability and support for the joint.
Manual Therapy Techniques: The physiotherapist may utilize manual therapy techniques, such as joint mobilizations and soft tissue mobilizations, to help improve joint mobility, reduce muscle tightness, and alleviate pain. These techniques are applied directly by the therapist to specific areas around the shoulder joint.
Modalities for Pain Relief: Modalities such as heat or cold therapy, ultrasound, Interferential Therapy(IFT), or transcutaneous electrical nerve stimulation (TENS) may be used to help manage pain, reduce inflammation, and promote tissue healing.
Home Exercise Program: The physiotherapist will provide you with a customized home exercise program consisting of stretching and strengthening exercises. Consistent adherence to the prescribed exercises is essential for optimal recovery and long-term shoulder function.
Education and Activity Modification: The physiotherapist will educate you about the condition, proper posture, body mechanics, and strategies to protect the shoulder joint during daily activities. They may also provide advice on activity modification to prevent aggravation of symptoms.
The frequency and duration of physiotherapy sessions will depend on the severity of your condition and your individual progress. Regular follow-up appointments with the physiotherapist allow for monitoring of your response to treatment and appropriate modifications to the program as needed.
It's important to note that physiotherapy is most effective when initiated early in the course of frozen shoulder and is often a crucial component of the overall treatment plan. Working closely with a skilled physiotherapist can help optimize your recovery and improve your shoulder function.
Exercise for Frozen Shoulder
Exercise plays a vital role in the treatment of frozen shoulder (adhesive capsulitis) by helping to improve shoulder mobility, reduce stiffness, and restore function. Here are some exercises commonly recommended for frozen shoulder:
Pendulum Swing Exercise:
Stand with your unaffected hand resting on a stable surface, such as a table or chair.
Lean forward and let your affected arm hang freely.
Gently swing your arm back and forth, side to side, and in circles to facilitate gentle movement in the shoulder joint.
Perform this exercise for a few minutes, several times a day.
Wand Exercises:
Hold a wand or a broomstick with both hands, palms facing down, and hands shoulder-width apart.
With your unaffected hand, gently guide the affected hand along the wand to perform the following movements:
Flexion: Raise the wand forward, keeping the elbows straight.
Abduction: Raise the wand to the side, keeping the elbows straight.
External Rotation: Rotate the wand away from your body.
Perform each movement for 10-15 repetitions, several times a day.
Wall Climbing:
Stand facing a wall with your fingers pointing upwards.
Walk your fingers up the wall as far as possible, maintaining a pain-free range of motion.
Hold the stretched position for a few seconds, then slowly walk your fingers back down.
Repeat this exercise 10-15 times, several times a day.
Passive Range-of-Motion Exercises:
Using your unaffected arm or with the assistance of a partner, gently move the affected arm to its pain-free range of motion.
Perform exercises such as forward flexion, abduction, external rotation, and internal rotation.
Aim for smooth and controlled movements, avoiding forceful or jerky motions.
Gradually increase the range of motion over time.
Shoulder Stretching Exercises:
Cross-Body Stretch: Use your unaffected arm to gently pull the affected arm across your body, feeling a stretch in the back of the shoulder.
Sleeper Stretch: Lie on your unaffected side with your affected arm at a 90-degree angle. Use your other hand to gently push the affected forearm towards the bed, feeling a stretch in the back of the shoulder.
Hold each stretch for 15-30 seconds and repeat 3-5 times, several times a day.
Remember to perform these exercises within a pain-free range and to consult with a healthcare professional or a physical therapist before starting any exercise program. They can provide specific guidance tailored to your condition and help ensure proper technique and progression. Consistency and regularity in performing the exercises are essential for optimal results.
Back Stretch with towel
shoulder ladder exercise
assisted back stretch with opposite hand
shoulder wheel and ladder exercise
If treatment is not helping, surgery is sometimes done to loosen some of the tight tissues around the shoulder. Two surgeries are often done. In one surgery, called under anesthesia Release, you are put to anaesthesize shoulder and then your arm is moved into positions that stretch the tight tissue. The other surgery uses an arthroscope to cut through tight tissues and scar tissue. These surgeries can both be done at the same time.
How to Prevent Frozen Shoulder?
Gentle, progressive range-of-motion exercises, stretching, and using your shoulder in day to day activity more may help prevent frozen shoulder after surgery or an injury.
Experts don't know what causes some cases of frozen shoulder, and it may not be possible to prevent these. But be patient and follow your doctor's advice. Frozen shoulder nearly always gets better over time.
While it is not always possible to prevent frozen shoulder completely, there are certain measures you can take to reduce the risk or minimize the severity of the condition. Here are some tips to help prevent frozen shoulder:
Maintain Shoulder Mobility: Regularly engage in exercises and activities that promote shoulder mobility. Perform range-of-motion exercises for your shoulders to keep them flexible and prevent stiffness.
Avoid Prolonged Immobilization: Try to avoid keeping your shoulder joint immobilized for extended periods, especially after injury or surgery. Follow your healthcare professional's instructions regarding the appropriate use of slings or immobilizers.
Gradually Increase Activity Levels: When resuming or initiating physical activities involving the shoulder, start gradually and progressively increase the intensity and duration. Sudden or excessive strain on the shoulder joint can increase the risk of developing frozen shoulder.
Practice Good Posture: Maintain proper posture to minimize stress and strain on your shoulders. Avoid prolonged slouching or rounding of the shoulders, especially during activities such as sitting at a desk or working on a computer.
Warm Up and Stretch: Prior to engaging in physical activities or exercises that involve the shoulder joint, warm up your muscles with gentle aerobic activity, and perform stretching exercises specific to the shoulders.
Avoid Overloading the Shoulder: Be mindful of the weight and load you place on your shoulders during activities such as lifting, carrying, or participating in sports. Use proper lifting techniques and consider using assistive devices or seeking help when necessary.
Manage Underlying Health Conditions: If you have underlying health conditions such as diabetes, thyroid disorders, or cardiovascular disease, it is important to manage these conditions effectively. Follow your healthcare professional's recommendations and maintain good overall health.
Seek Early Treatment for Shoulder Injuries: If you sustain a shoulder injury or experience persistent shoulder pain or limited mobility, seek medical attention promptly. Early intervention and appropriate management of shoulder injuries can help reduce the risk of developing frozen shoulder.
It's important to note that while these measures can help reduce the risk of frozen shoulder, the condition can still occur in some cases without any identifiable cause or preventive measures. If you have concerns about your shoulder health or risk of developing frozen shoulder, consult with a healthcare professional for personalized advice and guidance.
Summary
Frozen shoulder, also known as adhesive capsulitis, is a condition characterized by pain, stiffness, and limited range of motion in the shoulder joint. It typically progresses through three stages: freezing, frozen, and thawing. The exact cause of frozen shoulder is unknown, but certain factors can increase the risk, such as age, gender (more common in women), certain medical conditions (diabetes, thyroid disorders), and previous shoulder injuries or surgeries.
When diagnosing frozen shoulder, healthcare professionals consider the patient's symptoms, medical history, and physical examination. Imaging tests may be performed to rule out other conditions. Differential diagnosis is important to distinguish frozen shoulder from other shoulder-related conditions such as rotator cuff tendinitis or tears, shoulder impingement syndrome, and glenohumeral osteoarthritis.
Treatment for frozen shoulder aims to reduce pain, improve shoulder mobility, and restore function. It typically includes nonsteroidal anti-inflammatory drugs (NSAIDs) for pain management, physical therapy involving stretching and strengthening exercises, corticosteroid injections, hydrodilatation, and in severe cases, manipulation under anesthesia or surgery.
Physiotherapy is an important component of frozen shoulder treatment. It focuses on exercises to improve range of motion, stretching, strengthening, manual therapy techniques, and modalities for pain relief. Home exercise programs and education on proper posture and body mechanics are also provided.
While prevention of frozen shoulder is not always possible, maintaining shoulder mobility, avoiding prolonged immobilization, practicing good posture, gradually increasing activity levels, and managing underlying health conditions can help reduce the risk. Early treatment of shoulder injuries is also important.
Overall, a comprehensive approach involving medical management, physiotherapy, and lifestyle modifications can help alleviate symptoms, improve shoulder function, and enhance quality of life for individuals with frozen shoulder. It is important to consult with a healthcare professional for an accurate diagnosis and personalized treatment plan.
