Mouse shoulder

Mouse is become a common feature of our life's. It helps us while using the computers and makes it more simple to use. 

However, the use of mouse results in a lot of musculoskeletal disorders, few of them are:

Mouse shoulder

Mouse arm

Carpal tunnel syndrome

Trigger finger

Out of these mouse shoulder and carpal tunnel are commonly seen.

Mouse shoulder:

What is mouse shoulder?

It is collection of symptoms in neck and shoulder blade area noticed in people using computer for long periods.

Symptoms:

The symptoms may be just pain, or might be associated with burning and heaviness.

The pain is usually deep and worsens with use of mouse.

The pain is felt in shoulder blade, neck and sometimes even in the chest area.

How does it take place?

The shoulder and shoulder blade is attached to the ribcage and spinal column via muscles and soft tissues.

When we use the mouse without any support for the arm and forearm the muscles have to work more in order to maintain the position of the unsupported arm hence placing them under continuous stress. 

Treatment:

The pain usually subsides with rest during the initial stages, however in later stages even rest doesn't help.

1.Simple NSAIDs can help relieve pain.

2.Icing

3.Using support and taking frequent breaks

4.Physiotherapy:

    Tens, ultrasound,Dry needling, taping

    Exercises: scapular strengthening,                  pectoral stretching, ROM exercises along      with neck stretching and strengthening        exercises, postural exercises.

    Perform simple desk stretches at work.

5. Use of ergonomic mouse.

Hence, proper ergonomics and exercise can prevent you from developing any of the above symptoms and conditions.

The giant support of your body

Today we all exercise to be fit yet while doing so most of us forget to train one of the most important group of muscels in the body which is one of the major supporting system in our body- The Pelvic floor muscles or PFM or pelvic diaphragm.

What are pelvic floor muscles?

Pelvic floor muscles are group of muscles and ligaments which support the pelvic organs like bladder, bowel, uterus( in females) ,urethra in humans.

Structure of PFM:

It is a funnel shaped musculature which separates the pelvis from the genitals.

It comprises of the following:

1. Leavtor ani muscle which is the largest component and is divided into 3 parts- pubococcygeous,puborectalis, and iliococcygeous.

2. Coccygeous muscle

3. Fascia covering the muscles

Importance and function of PFM:

1. Provide support to abdominal viscera like bladder, intestine,uterus and bowel etc.
2. Resist the change in intra abdominal pressure while coughing or sneezing or lifting heavy objects.
3. Support and stabilize the spine.
4. Bowel and bladder control.

Pelvic floor disorders:

• Urinary incontinence or lack of urine control
• Fecal incontinence or lack of bowel control
• Pelvic organ prolapse
• Pelvic pain.

Causes of pelvic floor muscle disorder:

• Aging
• Obesity 
• Chronic constipation 
• Pregnancy and child birth
• Hormonal changes
• Incorrect lifting of heavy objects regularly

Symptoms:

• Increased frequency of urination and/or painful urination
• Low back ache with no other known cause
• Painful intercourse

Does pelvic floor disorder or dysfunction affect only females?

 This is a myth as the condition can affect both males as well females though is commonly seen in females specially post childbirth and menopause.

Treatment for pelvic floor disorder

Conservative treatment -

1. Physiotherapy-

Electrical stimulation for weak muscles, kegels exercise, core strengthening, biofeedback, vaginal cones( for females) are sone physiotherapy interventions.

                      The 4 steps of pelvic floor exercises are-Locate, squeeze, hold and release

          
             

.

      2. Coping strategies
   
      3. Pessaries.

If conservative treatment fails the last option would be surgical repair of the muscles.

Hence, exercise of pelvic floor muscles is important for both males and females particularly post the ages of 30 years. 
For futher guidance contact your physiotherapist.

                   

Dr. Pranjal 
BPT 

Balanced exercise

 

                 BALANCED EXERCISES

 

Exercise and fitness have become a very important part of our life's today.
Most of us exercise regularly and still face problems like back pain, knee pain , neck pain etc. If exercise is so important than why so people who are into fitness still face problems??
The reason for this is firstly improper exercise and secondly lack of balanced exercises. We all know that everyone's body is different from each other than how can same exercises have an effect on everyone. Hence the exercise plan should be according to the person's needs, body type and any physical problems if any.

                 

Secondly, lack of balanced exercises. This is one of the major points which we forget while exercising. When a person talks about diet there is always a balanced diet which has all the nutrients in it.

Similarly, when we talk about exercise and fitness we should include all the types of exercises i .e . Stretching, strengthening, endurance and power, balance and coordination etc . When we would include all these in our routine it shall give a better effect.

To understand this better imagine your muscles to be a rubber band, when you keep stretching it for long time it would loose its tensile strength. The same thing happens with muscles when u continuously do stretching exercises the muscles loose its tensile strength and thus result in pain and discomfort.
Most of the problems in our body occur cause of imbalances in the muscles. Some muscles go in for weakness and some go in for tightness. Thus, one needs to understand which muscle needs to stretched and which has to be strengthened.

 So next time when you start exercising include stretching, strengthening, endurance and power training.

Dr. Pranjal
P.T.

Neck is your voice

We all are aware that a bad posture affects us in many ways. It might give us back problems, neck pain, also affects our personality and confidence to carry ourselves.
However, what most of us don't know is that a bad neck posture affects the quality of your voice. It is indeed something that we never thought about.
How does the neck affect one's voice? What exactly happens?
The voice box which produces the voice is attached to the muscular and skeletal system of our body. Hence the way your body is positioned will affect the quality of voice produced. For example: excess tension on the larynx will produce a harsh, strained voice.
Also poor neck posture affects the breathing mechanism of the body which further hampers the voice production.

Rounded shoulders reduce the space for the thoracic cage to expand and relax for appropriate breathing which powers the voice thus altering the quality of voice produced.

Now imagine the head and neck dropped too forward what would happen?? The muscles in the head and neck get constrict and have to work hard to maintain the head and neck position. Moreover the area around the larynx is also compromised.
Not everyone notices the change in voice individuals who are into professions where they have to vocalise would understand it better for eg: voice over artists, vocalists, singers etc.

Specially voice over artists who have to speak before the microphone tend to go in for a forward neck posture thus affecting their voice over a period of time.

How should one deal with the problem??
Firstly being aware of the problem and diagnosing it correctly addresses the disorder half way.
One can do simple postural Correction exercises like stretching , strengthening exercises.

Breathing or pranayam also have great results in such cases.

Wallet sciatica

Wallet sciatica sounds funny right?? But isn't funny as the name. Wallet sciatica as the name suggests is pain caused due to wallet. It is also known as hip pocket syndrome and is commonly seen in males.
  The wallet consists of cards, licence, cash etc which makes it bulky and when you place it in the back pocket and sit on it causes discomfort and pain.

                       

  What exactly happens when you place the wallet in back pocket it pinches or presses against the sciatic nerve which lies just behind the hip joint thus eliciting pain or tingling in the area. The pain may be localised to the buttock region or sometimes may move down towards the leg or upwards towards the spine.                          The wallet not nly causes compression of the nerve but also affects the soft tissues like muscles and ligaments in the area.

                        

The other major complication of sitting on a wallet is change in the position of the pelvis.
The hip and the pelvis play a major role in maintaining the posture of an individual. When you sit over a wallet or a purse that side of the pelvis is placed slightly higher than the opposite one thus causing it to tilt to one side.

                             

The pelvis and hips are the foundation of the spine, everything that sits on that foundation will be affected by this wedge. If you wear your wallet in your back right pocket you will create a high right side and a slightly lower left side. The body will compensate for this by pulling the spine towards the side of the wallet (the right) to even out the imbalance, the head may also be pulled to one side to keep the eyes level with the floor.

The two halves of the pelvis can also rotate slightly due to a constant force being applied to one side and this may lead to sacroiliac joint dysfuntion .
If left untreated it shall lead to permanent changes on the spine n postural stress.

Not only carrying the wallet in the back pocket is a problem but also placing it in the front pocket while sitting or driving causes irritation and friction between the hip and torso thus further leading to other problems.
Hence always be aware that you are not sitting with a wallet or mobile or cards in any of your trouser pockets.
Also the symptoms of pain and restricted movement and decreased activity are common symptoms of a lot of other problems and hence proper diagnosis and treatment is necessary.

Are u suffering from Runners knee?

My knee is hurting whenever I climb down the stairs or run downhill said one of my patients who is a sports person and physically very active. He was worried as he thought he had some major knee problem, but on examining him he was diagnosed as having runners knee. Runners knee is very common now a days and hence I decided to write about it today.

What is runners knee??

Runners knee or patellofemoral joint syndrome is when the knee cap starts rubbing against the underlying bone causing improper movement of the quadriceps muscle leading to pain and restricted movement.
It is often Misdiagnosed as osteoarthritis of knee joint as the symptoms are some what the same.

Runners knee is common in young adults specially runners and hence the name. However it is also seen in individuals who play games like basket ball, volley ball or who tend to walk a lot.

 Causes:

1. Weak knee and hip muscles.
2. Tight calf and hamstring muscle
3. Improper training techniques
4. Biomechanical issues like flat feet
5. Weak gluteal muscles

Symptoms:

• Pain is the major symptom and is usually noticed on the front side of the knee and sometimes around the knee cap.
• Swelling may or may not be present
• Reduced joint of motion are some of the main symptoms.

Treatment:

• First line of treatment is to reduce the pain which can be done by medications like NSAIDs , pain killer
• Physiotherapy:
• Modalities like ultrasound, ift, tens can be used to reduce pain.
• Taping for any correction and pain relief
• Exercise therapy: strengthening of weak muscles and stretching of tight muscles along with gluteal muscles activation.
• Orthosis: arch support for flat feet, quadriceps tendon support.

Prevetion:

Proper technique and foot wear.

Warm up before any sport.

Use of any orthosis if required

These are just basic exercises but if you r having any problem you need to show it to the doctor.

Pain while eating or speaking??

Jaw pain and physiotherapy

Just last week I had almost 3 patients at my clinic complaining of pain near the jaw and inability to chew or eat anything hard. So I decided to write this blog about temperomadibular joint or the TMJ.
Let's just know what it is exactly first. The TMJ is the joint just front of your ears and is the one responsible for opening and closing of your mouth.
Symptoms of TMJ pain:

• Pain on opening and closing of mouth
• Clicking and/ or grinding
• Inability to fully open the mouth or clench the jaw.

Causes and contributing factors of TMJ pain:

• Prolonged mouth opening eg: dental procedure
• Stress
• Injury
• Poor neck posture
• Grinding of teeth 
• Improper biomechanics or asymmetric of the jaw.
• Muscle imbalances.

Diagnosis:

TMJ pain or dysfunction is usually diagnosed by assessment and if required x-ray or ct-scan may also be advised.

 

It is also important to note that the joint is linked with your neck and hence the pain may be secondary to it.

Physiotherapy treatment:

• For pain relief: ultrasound, taping , myofascial release of muscles and fascia. 
• Icing or hot fomentation can also be done according to the condition.
• Posture correction of cervical spine 
• Joint mobilisation
• Relaxation and lengthening exercises
• Strengthening and stabilisation exercises.
• If required a night guard is given to people who have a habit of grinding or clenching the teeth in sleep.

This is however just a general information about the TMJ pain, for proper treatment a d guidance visit your doctor or physical therapist.