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25.01.2022 IMPROVE YOUR HAND MOBILITY - FLEXTOR AND EXTENSOR EXERCISE Technique 1 Sit or stand upright. Flex the elbow at a 90-degree angle, and extend the wrist as ...far as possible. Point the fingers upward. With the right hand, push the fingers on the left hand toward the elbow. Technique 2 Sit or stand upright. Turn the left arm so that the palm faces up and flex the elbow to a 90-degree angle. Flex the wrist to a 90-degree angle, and flex the fingers so that they are pointed toward the elbow. Place the right hand on top of the fingers and press the fingers down toward the forearm. Technique 3 Squeeze against the ball for 1 second. Open & spread against the cord for 1 second. Repeat until comfortable fatigue. Let's stay pain free and share the knowledge!

23.01.2022 A couple of spots left for this week. Thursday at 3pm Friday at 2 or 2.30pm Saturday 9am and 1pm

23.01.2022 DELTOID STRAIN OR AC JOINT INJURY? DELTOID The deltoid muscle is a large muscle that encompasses the shoulder joint. The deltoid is divided into three differe...nt portions, or heads, the anterior (front), middle, and posterior (back) portions of the deltoid. The deltoid originates on the lateral aspect of the acromion and clavicle and then inserts on the lateral aspect of the humerus. Its major action is to abduct the arm (lift the arm out to the side of the body) as well as assist in forward elevation (lifting the arm out in front of the body). AC JOINT The shoulder joint is formed at the junction of three bones: the collarbone (clavicle), the shoulder blade (scapula), and the arm bone (humerus). The scapula and clavicle form the socket of the joint, and the humerus has a round head that fits within this socket. The end of the scapula is called the acromion, and the joint between this part of the scapula and clavicle is called the acromioclavicular joint. STRAIN OR SPRAIN? Strains are injuries to muscles or muscle tendon units. Sprains are injuries to ligaments. Because the deltoid is a muscle, it can be strained, but not sprained. IS IT THE MUSCLE OR JOINT INJURY? The signs and symptoms of muscle and joint pain differ since the origin differs. Though some symptoms could be same, the type of pain experienced and the associated symptoms are different. Let's take a look at the differences between these two pains. SYMPTOMS OF MUSCLE PAIN Muscle spasms Weakness in the localised area Coordination problems Paralysis in case of severe pain Stiffness SYMPTOMS OF JOINT PAIN Swelling in local areas surrounding joints A slight warmth and temperature rise in the area Tenderness in the muscles surrounding the joints. CAUSES OF MUSCLE PAIN Muscle Tension or Stress: Too much tension or stress causes severe muscle pain at times. The body creates toxins as a result of stress and tension and this leads to pain in muscle. However, its extent and severity will depend on the level of stress and tension that you are having. Over-activity: When you overuse your muscles by either exercising or by working too much for a long stretch, it is very likely that your muscles will start aching. Any physically demanding work that engages the muscles to take pressure mostly ends in muscle pain. Injuries: Sometimes, stressful physical practice or exercise or any other kind of physical work might cause major or minor muscle injuries. CAUSES OF JOINT PAIN Injuries on the joints or on the bursae, ligaments and tendons of the muscles surrounding the joints. Various kinds of diseases like avascular necrosis, gout, osteoarthritis, psoriatic arthritis, rheumatoid arthritis, bursitis, bone cancer, leukaemia, osteomalacia, rickets, tendinitis. CONCLUSION The very basic difference between joint pain and muscle pain is that joint pain is local, surrounds only the bruised and affected joints and whereas muscle pain can be widespread throughout the body. Muscle pain usually sores the area and the ache increases when pressure is applied on the affected muscle. When the muscle is stretched due to some physical activities the pain increases. However, the easiest way to identify muscle pain and differentiate it from joint pain is that the pain reduces when there is not much activity. The joint pain, on the other is deeper, intense and troubles every movement. In fact, joint pain, unlike muscle pain, can be felt even when there is absolutely no external activity taking place. When you are still, either sitting or laying down on bed, you might feel the joint pain in such an extent that you will not be able to move.

23.01.2022 IT MAY BE TERES MINOR PROBLEM NOT BURSITIS Muscular problems in the teres minor muscle can mimic and feel like bursitis in your shoulder. It is a small muscle... that teams up with three other muscles infraspinatus, supraspinatus, subscapularis to form the rotator cuff. ANATOMY FACTS ORIGIN Upper two-thirds of the lateral margin of the scapula INSERTION Greater tubercle of the humerus ACTION External rotation and adduction of the arm. Support of the infraspinatus with the outward rotation of the arm. Stabilisation of the shoulder joint during movement. This means it works to keep the head of the humerus in its socket. PAIN PATTERNS Trigger points in your teres minor can make it ache right at the location of these spots, but also send pain to other, more distant parts of your body. If your teres minor contains trigger points, it will mainly give you pain at the side of your shoulder. Beside that, pain can radiate slightly into the backside of your arm. Because of this, it can contribute to back of shoulder pain. In general, the movements that will cause pain or that may be impaired are the ones where you rotate your shoulder outwards and reach backwards like putting on your jacket. Problems in the teres minor rarely occur alone but rather in combination with other muscles of your shoulder joint that have similar functions. SELF-MASSAGE WITH A TENNIS BALL To massage the teres minor I recommend using a massage ball or a tennis ball. Place the ball on the muscle and on the outer edge/border of your shoulder blade, respectively. Then bend your knees and lean against a wall. Slowly roll over the muscle and search for tender muscle tissue. Massage each painful spot with a couple of rolling motions.

21.01.2022 SERRATUS POSTERIOR INFERIOR - OVERLOOKED CAUSE OF LOWER BACK PAIN You have a client who tells you this: 'I reached for something and suddenly I felt a sharp s...pasm in the lower part of my back, slightly to the side of the spine, at the bottom of the ribs, and when I breathe in really deep I can feel it'. Based on the above description you should suspect that you might be dealing with the Serratus Posterior Inferior muscle. Where is the Serratus Posterior Inferior muscle? The Serratus Posterior Inferior muscle connects the lower 4 ribs to four vertebrae (T11, T12, L1, L2) in the low back. What movements does the Serratus Posterior Inferior muscle control? Forced expiration (breathing out when breathing hard) Assists with twisting at the waist Assists with straightening the trunk (standing up straight) Activities that cause Serratus Posterior Inferior pain and symptoms: Twisting the body when lifting Overreaching overhead or to the side of the body Lifting something heavy using the back muscles instead of leg muscles Sleeping on a sagging or too soft mattress Trigger Points Trigger points in the Serratus Posterior Inferior may cause an uncommon local ache radiating over and around the muscle. This may extend across the back and over the lower ribs, even continuing through the chest to the front of the body. This discomfort is typically described by clients as a nagging ache. In many cases this pain remains after other trigger points have been inactivated. This should be a good indicator for the therapist to recheck the Serratus Posterior Inferior for undiscovered trigger points. Stretching for self-release of the Serratus Posterior Inferior Cross your forearms just above the wrist, at about chest height. Inhale deeply as you slowly raise them up until the area where the arms cross is level with your forehead. Now lower the arms as you exhale. Do this once or twice, allowing for a brief rest (a few breaths) before repeating. Do this exercise set several times a day.

21.01.2022 BODY WATER CONTENT Human beings are mostly water, ranging from about 75 percent of body mass in infants to about 5060 percent in adult men and women, to as l...ow as 45 percent in old age. The percent of body water changes with development, because the proportions of the body given over to each organ and to muscles, fat, bone, and other tissues change from infancy to adulthood. Your brain and kidneys have the highest proportions of water, which composes 8085 percent of their masses. In contrast, teeth have the lowest proportion of water, at 810 percent.

20.01.2022 SCIATICA WHAT IS SCIATICA? Sciatica is the result of a neurological problem in the back or an entrapped nerve in the pelvis or buttock. There are a set of n...eurological symptoms such as: Pain (intense pain in the buttock) Lumbosacral radicular leg pain Numbness Muscular weakness Gait dysfunction Sensory impairment Sensory disturbance Hot and cold or tinglings or burning sensations in the legs Reflex impairment Paresthesias or dysesthesias and oedema in the lower extremity that can be caused by the irritation of the sciatic nerves (the lumbar nerve L4 and L5 and the sacral nerves S1,S2 and S3) CAUSES OF PAIN Pain is a result of irritation of the sciatic nerve. it can be constant or intermittend. The pain may be worsened by certain movements like coughing or sneezing (these movements increase the intra abdominal pressure). Sitting, bending, prolonged standing or rising from a sitting position can aggravate or increase the pain. PAIN PATTERNS In regards to relief the pain, the supine position decreases the pressure on the herniated disc and will subsequently decrease pain. Pain is located along the distribution of the nerve and can be felt in the back, buttocks, knee and leg. It only radiates to one side of the leg and can result in reduced power, reflexes and sensation in the nerve root. Also gait dysfunction (toe walking, foot drop and knee buckling), paresthesias or dysesthesias are frequent neurological symptoms. SYMPTOMS BASED ON NERVE COMPRESSION Sciatica can be caused by the compression or irritation of nerve L4, L5, S1, S2 and S3. The sciatica symptoms depend on which nerve is compressed or irritated. L4: When the L4 nerve is compressed or irritated the patient feels pain, tingling and numbnessiIn the thigh. The patient also feels weak when straightening the leg and may have a diminished knee jerk reflex. L5: When the L5 nerve is compressed or irritated the pain, tingling and numbness may extend to the foot and big toes. S1: When the S1 nerve is compressed or irritated the patient feels pain, tingling and numbness on the outer part of the foot. The patient also experiences weakness when elevating the heel off the ground and standing on tiptoes. The ankle jerk reflex may be diminished. source: B.W Koes, M.W Van Tulder, W.C Peul. Diagnosis and treatment of sciatica. BMJ.

18.01.2022 QUADRATUS LUMBORUM - ANATOMY, FUNCTION AND RELEASE EXERCISE QL ANATOMY The Quadratus Lumborum Muscle which is present in the posterior abdominal wall situat...ed deep inside the abdomen. This muscle is present dorsally to the iliopsoas muscle. This muscle courses from the iliac crest and attaches itself to the 12th rib and the transverse processes of 1st to 4th lumbar vertebrae. The quadratus lumborum muscle is rectangular in shape. The muscle gets its blood supply from the subcostal nerve and branches of the lumbar plexus. The quadratus lumborum muscle lies quite close to many vital organs of the body in the abdomen like the kidneys and colon. QL FUNCTION The main function of the quadratus lumborum is to provide stability to the body along with movement of the spine and pelvis. Since this muscle is used frequently day in and day out hence it is prone to strains and injuries resulting in quadratus lumborum pain. Certain activities like repetitive heavy lifting, sporting activities like rowing, golfing can strain the quadratus lumborum muscle. Treatment for quadratus lumborum strain is conservative with a period of rest along with using hot and cold therapy and back brace. QL REFERRED PAIN When muscle knots form in the Ql or it goes into spasm due to overload or injury, then it can give you real grief! Often this is more one-sided than the other also, giving you a real lopsided feeling and can make it seem like you have one leg shorter than the other or that your pelvis is out (which can’t really happen). The QL refers pain elsewhere and isn’t always felt at the muscle. The referred pain is generally felt in the outer hip and in the glutes and is often described as a deep ache but can be a sharp pain when moving. The trouble is that this muscle is very hard to stretch but, it is quite easy to do a QL muscle release! QL MUSCLE RELEASE 1. Position Lie on your back and place a firm massage ball under your QL muscle, which you will find in-between the top of your pelvis and your bottom rib, off to each side of your spine. 2. Action: Bring the knee on the same side as the ball up towards your chest, which puts pressure on the ball. Once you feel like you have the right spot (you will feel it!), holding onto your knee you can either: 1. Rock your knee out to the side and then in again and repeat, OR 2. Repeatedly bend your knee up and down towards your chest. Slowly and gently work into it for 1-2 minutes on each side and feel free to move the ball up or down slightly to get the right spots. Do this great myofascial release once a day for two weeks. Tip: Help prevent this recurring and giving you ongoing trouble by strengthening your QL and the surrounding muscle so that they can handle everything that is asked of them!

17.01.2022 If you're suffering with shoulder pain & don't have any headaches, but the pain sometimes runs down your arm into your thumb & index finger, is it referred Trig...ger Point pain or is there some irritation to the nerves of the arm? Some easy neural assessments will give you a clearer picture of what may be the cause See more

16.01.2022 Have you read our article about the Akashic records yet? If not, here it is! https://www.qhhtofficial.com/self-d/akashic-records-reading

14.01.2022 SUPRASPINATUS TEAR A supraspinatus tear is a tear or rupture of the tendon of the supraspinatus muscle. The supraspinatus is part of the rotator cuff of the s...houlder. The rotator cuff consists of Supraspinatus, Infraspinatus, Subscapularis and Teres minor. Most of the time it is accompanied with another rotator cuff muscle tear. This tear can occur in 2 ways. Due to a trauma or due repeated micro-trauma. The supraspinatus tear can be partial or full thickness tear. A partial tear means that the soft tissue (the muscle fibers) will not be completely disrupted. A complete tear on the other hand means that all the muscle fibers are disrupted. It is common that disrupted tendons begin by fraying and when the damage progresses the partial tear evolves into a complete tear. Most of the time the tear occurs in the tendon or as an avulsion from the greater tuberosity. The supraspinatus muscle is responsible for the abduction of the upper limb. There are several factors that contribute to degenerative or chronic tears. Repetitive stress Lack of blood supply Bone spurs (bone overgrowth) RISK FACTORS Older than 40 years old have a greater risk Body Mass Index Height Repetitive Lifting Overhead Activities and other people who do overhead work have a greater risk: Tennis Players Baseball Pitchers Painters Carpenters Plumbers Traumatic Injury e.g. a fall, more common cause in younger individuals So we can conclude that rotator cuff tears are associated with older patients, a history of trauma and affected the dominant arm. Patients have also a reduced forward elevation, external rotation and abduction. The most common risk factors for a tear consist of a history of trauma, dominant arm and age. Some of the Symptoms of a Supraspinatus Rupture are: Excruciating pain in shoulders Severe pain in the shoulder with rotation of the arms Severe pain in the shoulders when moving the arms sideways TREATMENT FOR SUPRASPINATUS RUPTURE Supraspinatus Ruptures can be treated both surgically as well as conservatively. In cases if the rupture is pretty small, then conservative management with physical therapy is the best route to go. Physical therapy is also used for individuals with extremely large tears which cannot be repaired via surgery. Conservative option is best for people who want to prolong or even if possible avoid surgical procedure due to the prolonged recovery phase postprocedure. If conservative treatments fail to provide adequate relief of symptoms, then surgery is the route to go but the success of the surgery depends on the extent of the tear and the condition of the muscles. The surgical procedure is done using arthroscopic technique in which an arthroscope which is an instrument with a miniature camera attached to it is inserted in the shoulder via small incisions and the internal structures are observed to look for damage and once identified the damage is repaired. Postsurgery, the tendon will take up to four months to completely heal. To increase range of motion one can use stretching exercises of the ruptured muscle (not too soon in recovery since premature stretching might aggravate the injury), passive- and active range of motion exercises such as pendulum exercises and symptom limited active-assisted range of motion exercises. To increase control and strength the patient will also be prescribed strengthening exercises for the rotator cuff specifically the functions of the supraspinatus muscle (abduction and exorotation) and external rotation.

14.01.2022 MASSAGE THERAPY FOR EDEMA Edema is a condition where there is accumulation of fluid in the tissues resulting in swelling. Edema usually affects the dependent ...parts of the body such as extremities. The causes of edema are various medical conditions and massage therapy may not benefit in systemic causes of edema. However, massage therapy can be beneficial in local causes of edema. Massage should always be started after the patient has consulted with his/her health care provider. Patient should always get massage done by an experienced and qualified massage therapist, because if massage is done by an amateur or if done incorrectly, it can cause more harm than good. Lymphatic Massage involves a light touch massage therapy which helps in enhancing the functioning of the lymphatic system. It is also known as Lymphatic Drainage Massage or Manual Lymphatic Massage. If there is a problem in the functioning of the lymphatic system, then it leads to swelling, headaches, cramps, fluid retention, fatigue, lethargy, joint pain, and repeated cold and flu infections. The lymphatic massage technique involves stimulating the lymphatic drainage system. This helps in encouraging the drainage of accumulated fluids and helps in restoring the normal function of the lymphatic drainage system. Lymphatic massage technique involves gentle touch with the massage strokes directed towards the heart (direction of the lymphatic flow). Preferably one finger should be used to perform these massage strokes. The massage strokes should be short and in one direction beginning with the affected limb lying closest to the trunk. BENEFITS OF LYMPHATIC MASSAGE * Lymphatic massage therapy should be done by trained and professional massage therapists only. * Only light pressure with circular rhythmic movements should be used in order to stimulate the lymphatic system in improving its function. * Lymphatic massage, when done properly, helps in removing the blockages present in the lymphatic system. * Lymphatic massage helps in increasing the lymph flow in the body which in turn helps in removal of waste and toxins from the body and enhances metabolism and makes the immune system stronger. * Patient feels very rejuvenated, energetic and relaxed after a lymphatic massage. Patient may also feel thirsty and must drink lots of water.

09.01.2022 THE TRICK TO HAMSTRING REHAB After poring over decades of research, a team of scientists in Australia believes it has pinpointed the missing link in hamstring... injury rehabilitation: neuromuscular training. Neuromuscular training involves reactivating communication between neurons (nerve cells) and muscles. In the case of hamstring injuries, that can be done by performing heavy resistance training exercises like Nordic hamstring curls or stiff-leg deadlifts, according to Antony Shield, Ph.D., one of the paper’s authors and a professor at Queensland University of Technology, School of Exercise and Nutrition Sciences. The researchers were interested in hamstring injuries because of their frequent reoccurrence in sports that involve fast runningsoccer, football, rugby, cricket, and track and field. The review, published in the Journal of Electromyography and Kinesiology, didn’t include distance runners, but Shield believes that, while hamstring injuries in distance runners tend to be less frequent and less severe, the paper’s conclusion is applicable because the rehabilitation practices are the same. When the hamstring is strained, the normal signals between neurons and muscle shut down. This neuromuscular inhibition limits normal muscles’ function and the effectiveness of strength and stretching rehabilitation. Over time, the injured muscle atrophies, strength imbalances increase, and the angle of peak torque changes (i.e., the knee becomes less stable). These maladaptations are long-lasting and raise the risk of injuring the area again. We have evidence for reduced activation many months after return to sport, Shield told Runner’s World Newswire via email. We have more recent data (as yet unpublished) that athletes use their previously injured biceps femoris [a hamstring muscle] about half as much on the injured side as the uninjured side when doing a Nordic hamstring curl. This data is, on average, 10 months after injury, so the change appears pretty permanent. Physical therapists likely avoid exercises such as Nordic hamstring curls owing to the high forces generated by the move. But if athletes re-establish pathways between nerves and muscle, they may be better able to restore full muscle strength and function to the hamstring and reduce their chances of getting injured again, the researchers suggest. Shield notes that many injuries result in neuromuscular inhibition. The concept isn’t new or radical, he says, it just hasn’t been adequately addressed. Additionally, neuromuscular training isn’t a magic solution, writes Shield, but one of many factors athletes and physical therapists should consider. Source: Runner's world

08.01.2022 HIP LIGAMENTS AND MUSCLE IMBALANCE The hip joint is strengthen by three capsular ligaments: the iliofermoral ligament and the pubofemoral ligament are on the ...anterior aspect of the joint, while the ischiofemoral ligament is on the posterior aspect. As the hip is flexed, all three ligaments relax. However, in extension all three ligaments are tight, with the inferior band of the iliofemoral ligament being placed under greatest tension as it runs almost vertically. It is this ligamentous band which limits posterior tilt of the pelvis. During adduction, it is the turn of the superior band of the iliofemoral ligament to become tighter while the pubofemoral ligament and ischiofemoral ligament relax. In abduction the opposite occurs. In lateral rotation both the iliofemoral ligament and pubofermoral ligament are taut, while medial in rotation the ischiofemoral ligament tightens. SCREENING EXAMINATION Hip conditions may refer pain anywhere within the L3 dermatome, over the front of the thigh and down to the knee. Initial observation includes resting position, muscle wasting, leg length and gait. Functional activities may also be revealing. Lying in bed with the affected side uppermost (hip adduction and medial rotation) places a stretch over the iliotibial band (ITB) and lengthens the posterior portion of the gluteus medius. This may be a consideration in ITB syndrome and for muscle imbalance over the hip. MUSCLE IMBALANCE AROUND THE HIP In the hip region, the Thomas test and the Ober manoeuvre are used to assess for muscle tightness of the hip flexors (rectus fermoris and iliopsoas) and hip abductors (TFL and ITB). Inner range holding ability of the gluteus medius is assessed with side-lying hip abduction, and of the gluteus maximus with the prone-lying hip extension movement.

07.01.2022 When and How to treat trigger points in the psoas muscles - learn what's possible and what's not! Watch now - http://bit.ly/2X3jN7o

06.01.2022 POSSIBLE CAUSES OF KNEE PAIN

06.01.2022 HIP (GREATER TROCHANTERIC) BURSITIS In between tendons and bones all over the body, small sacs of fluids called bursae are present. These fluid sacs provide n...ecessary cushion to the tendons and protect them from sudden damage. The trochanteric bursa is one such fluid sac present in the back of the thigh separating the muscles and tendons of the thighs and buttock from the greater trochanter of the hip. The greater trochanter or great trochanter of femur is the part of the skeletal system of the femur that is irregular in shape, with coarse surface, but to some extent looks quadrilateral. Greater Trochanteric Pain Syndrome or GTPS is also known as Trochanteric Bursitis that is symptomized by a pain in the upper surface of the hip and thigh. What is Greater Trochanteric Pain Syndrome? Due to any injury to the greater trochanter or the adjoining parts and trochanteric bursa, pain on the upper surface of the upper thigh and the hip may occur, which is known as Greater Trochanteric Pain Syndrome. The main cause of the pain is the inflammation or injury to the trochanter bursa, which is why it is also called Trochanteric Bursitis. In the adjoining area of the Greater Trochanter, several other small fluid sacs are present, but trochanter bursa is the largest fluid sac in that part, and it faces the maximum damage during an injury. In contrary, some recent research shows that inflammation of the trochanter bursa is not the sole cause of the pain; minor damages to the adjoining muscles and tendons also add to that pain along with an inflamed trochanter bursa. So, these days, experts call the condition as greater trochanteric pain syndrome. Following are the most known symptoms of Greater Trochanteric Pain Syndrome: - Mild to severe hip and upper thigh pain. The pain may spread up to the knee area. The pain intensifies while walking, running, carrying heavy weights, and sitting cross legged. - Tenderness in the affected areas. - Painful walking or normal movements is also a symptom of Greater Trochanteric Pain Syndrome. - Swelling of the affected area, with a sensation of warmth. - In severe situations, the affected area may be discolored or look reddish. Causes of Greater Trochanteric Pain Syndrome The main causes of greater trochanteric pain syndrome include the following: - Sudden fall with the hip area facing the ground and the maximum body weight concentrates on the hip and upper thigh area mainly. - Excessive pressure on the hip and thigh muscles and bones for a long time for many days may also cause greater trochanteric pain syndrome. This is the main reason of occurrence of the condition in athletes, weight lifters, and bodybuilders. - Some other problems like osteoarthritis, leg gait disturbances, and problems in the spinal cord may also lead to greater trochanteric pain syndrome. - In some small number of cases, it is found that greater trochanter pain syndrome has been formed after an arthroscopic surgery on the hip. - Infection due to any other reason like tuberculosis may also cause inflammation in the trochanter bursa leading to greater trochanteric pain syndrome. Treatment and Management of Greater Trochanteric Pain Syndrome The treatment of Greater Trochanteric Pain Syndrome includes the following: - Application of ice pack can help relieve greater trochanteric pain syndrome - Giving rest to the legs - Application of corticosteroid injections - Administration of non-steroidal anti-inflammatory drugs (NSAID) - If required, application of local anesthetic - Physical Therapy Exercise Clamshell Exercise for Greater Trochanteric Pain Syndrome: The exercise is to be done in the below mentioned way: The patient needs to lie on one side with the head on the pillow and the hand in the lower side bent with the head resting on the palm. The two legs will remain one over the other. The feet will also touch one another. In this posture, the patient needs to lift his or her leg up as much as possible without separating the two feet. Remain in this position as long as possible and when tired bring down the leg to the normal position once again. This exercise is to be practiced for 30 minutes, at least two times a day. Can massage therapy help with hip bursitis? Stay tuned.

05.01.2022 INJURIES OF THE ACROMIOCLAVICULAR JOINT + SHEAR TEST A fall onto the shoulder or outstretched arm frequently causes dislocation of the acromioclavicular joint... and damage to the acromioclavicular ligaments. Ligament injury allows the lateral end of the clavicle to move independently of the scapula, causing it to appear upwardly displaced. The clavicle can be pushed down (with significant pain), but will spring back up when pressure is released (piano-key sign). Three grades of acromioclavicular separation can be distinguished clinically based on the degree of ligament damage (Toss classification). TOSSY I The acromioclavicular and coracoclavicular ligaments are stretched but still intact. TOSSY II The acromioclavicular ligament is ruptured, with subluxation of the joint. TOSSY III Ligaments are all disrupted, with complete dislocation of the acromioclavicular joint. Radiographs in different planes will show widening of the space in the acromioclavicular joint. Comparative-stress radiographs with the patient holding approximately 10kg weights in each hand will reveal the extent of upward displacement of the lateral end of the clavicle on the affected side. SHEAR TEST Purpose To test for acromioclavicular joint pathology or injury Technique Patient: sitting or standing with the arm dependent or in a neutral position on the lap. Clinician: standing adjacent to the patient. The heel of one hand is placed posteriorly over the spine of the scapula with the fingers pointing upwards; the other hand is positioned in a9 similar fashion anteriorly over the mid section of the clavicle. The fingers of both hands are then interlocked over the upper trapezius area of the shoulder. Action The hands are gradually squeezed together, imparting a shear stress through the ACJ created by the approximation of the clavicle and scapula. Positive test Localized pain over the ACJ or increased joint excursion are considered to be positive findings and are indicative of ACJ pathology or injury.

05.01.2022 As of today, until regulations change, QR code scan in is required at the clinic. Thank you for understanding its for your safety, not mine

04.01.2022 TIGHT MUSCLES THAT MAY BE THE CAUSE OF LATERAL PELVIC TILT There are several kinds of pelvis tilts that are unhealthy for our body: 1. There is the anterio...r pelvic tilt, where the front of the pelvis is tilted downwards. 2. There is also the posterior pelvic tilt, which is the opposite of the anterior pelvic tilt, where the front of the pelvis is tilted upwards. However, the lateral pelvic tilt is unique, in that the pelvis is tilted to the side where one side will be higher than the other. Symptoms of a Lateral Pelvic Tilt Other than one hip being higher than the other, the presence of a lateral pelvic tilt can have a drastic chain effect which reverberates not only from the pelvis downwards, but also up to the shoulders. Uneven Hips This is the obvious symptom. Now that we have briefly discussed what a lateral pelvic tilt, we now know that this is a tell-tale sign of its presence. Uneven Shoulders From the image above, you will see how the hip which is higher will usually result in the shoulder on the same side, being lower than the other side. This can cause someone to notice or think that they have uneven shoulders, when in fact it is a problem that stems from having a lateral pelvic tilt. Leg Length Differences Someone with a lateral pelvic tilt may think they have one leg longer than the other, or one leg shorter than the other. However, this is a myth as it is the tilt in the pelvis which makes it feel like the hip that is lower down is longer because the other leg doesn’t reach the ground when you stand. There are such things as true differences in leg length but most of the cases are misdiagnosed. The truth is that uneven hips creates this illusion. The best way to rule out a true leg length difference is to measure both legs. If you do have a true leg length discrepancy, then it is unlikely that these exercises I am about to discuss will be of use to you. Leg Rotation You can see from the diagram that the bones of the leg usually rotate internally as a result of a lateral pelvic tilt. What’s not to be ruled out, is that the internal rotation of all these bones could also be the cause of the lateral pelvic tilt. If it is the cause, then it starts all the way down at the foot. Typically, one foot will be pronated where the ankle is rolled inward, this could be a flat foot or a collapsed arch. When one foot becomes pronated, the shin bones and the femur rotate inward and the hip will drop. Causes of a Lateral pelvic tilt a) Muscular imbalances: (Sagittal plane) A Lateral pelvic tilt can result from an imbalance between the Quadratus Lumborum, Adductors and Glute medius muscle. Other muscles involved: Obliques, Tensor fascia latae b) Sub-optimal habits: Do you lean on one leg? Do you sit more on one butt cheek than other other? Do you always sleep on the same side? If you do, then you have postural habits that may encourage the tilting of the pelvis! c) Neurological conditions Any condition that impacts the nerves that supply the control of the pelvic musculature may result in a laterally tilted pelvis. (The superior gluteal nerve supplies the glute medius) How to Fix a Lateral Pelvic Tilt There are a couple of angles that can be taken to fix a lateral pelvic tilt. The first is to fix the flat feet (if you have them) and the other is to correct any muscle imbalances that may have developed that causes your body to hold onto the lateral pelvic tilt position - massage and proper exercise. The final step is to address the bad posture that causes the problem in the first place.

02.01.2022 IMPROVE YOUR HIP MOBILITY The hip joint is also known as a ball and a socket joint. It is where the top of the thigh meets the pelvis. There are certain healt...h conditions such as arthritis, limit the range of motion of the hip joint. Also, strenuous exercise, wearing high heels, and certain leg and back injuries can have a similar effect on this joint. All this affect the motility. However, certain exercises that can help loosen the soft tissue and improve the flexibility and mobility in the hip area are of great help. The following moves will mobilize the hip flexors, the hip extensors and the hip rotators, all of which contribute to pain-free function and improved athleticism. Try these exercises postworkout or pre-bedtime for better movement in and out of the gym. Hip-Flexor Stretch 1. Stand inside a doorway and turn to face the door frame on your right. 2. Step back with your left foot and place your knee and lower leg on the floor to the left of the wall behind you (place a pad under your left knee if necessary). 3. Slide your left leg backward along the wall until you feel a stretch in the front on your left hip. 4. Raise your chest and torso and extend your arms overhead. 5. Grab the doorjamb behind you and slide your arms as far overhead as possible. 6. Press your lower back toward the doorjamb and hold it there for the duration of the stretch. 7. Breathe deeply, hold for one to two minutes, and repeat on the other side. Flex-and-Rotate Hip Stretch 1. Stand facing a thigh-high table, desk, high bench, or the armrest of a couch. 2. Bend your right knee and raise your leg to rest your shin on the table, as if you’re doing a modified pigeon-pose stretch. 3. Bend your torso directly forward over your leg. 4. Press your elevated leg into the table for a five-count, then release for a 10-count, moving more deeply into the stretch. Contract and release five times. 5. Repeat the stretch with your torso rotated gently to the left, and again rotated to the right. Keep your back neutral and avoid rounding forward. 6. Slowly come out of the stretch. 7. Repeat the entire sequence with your left leg on the table. It is not necessary that everyone can pull up the exercise with ease. It will take time for some, while a few might experience pain and stiffness in the muscles in the beginning. In any case, if the pain persists for long do not delay getting an advice from the health professional. For those with known joint and muscle problems or previous injuries and pain, it is better to seek medical advice before beginning with any exercises.

02.01.2022 WHAT'S BEHIND YOUR KNEE? The popliteal fossa is a mostly fat-filled compartment of the lower limb. Superficially, when the knee is flexed, the popliteal foss...a is evident as a diamond-shaped depression posterior to the knee joint. The size of the gap between the hamstring and gastrocnemius muscles is misleading, however, in terms of the actual size and extent of the fossa. Deeply, it is much larger than the superficial depression indicates because the heads of the gastrocnemius forming the inferior boundary superficially form a roof over the inferior half of the deep part. When the knee is extended, the fat within the fossa protrudes through the gap between muscles, producing a rounded elevation flanked by shallow, longitudial grooves overlying the hamstring tendons.

01.01.2022 KNEE BURSITIS EXERCISES You can stretch your leg right away by doing the first 3 exercises. You may start doing the other exercises when your leg is less pain...ful. Hamstring stretch on wall: Lie on your back with your buttocks close to a doorway. Stretch your uninjured leg straight out in front of you on the floor through the doorway. Raise your injured leg and rest it against the wall next to the door frame. Keep your leg as straight as possible. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat 3 times. Standing calf stretch: Stand facing a wall with your hands on the wall at about eye level. Keep your injured leg back with your heel on the floor. Keep the other leg forward with the knee bent. Turn your back foot slightly inward (as if you were pigeon-toed). Slowly lean into the wall until you feel a stretch in the back of your calf. Hold the stretch for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Do this exercise several times each day. Quadriceps stretch: Stand at an arm's length away from the wall with your injured side farthest from the wall. Facing straight ahead, brace yourself by keeping one hand against the wall. With your other hand, grasp the ankle on your injured side and pull your heel toward your buttocks. Don't arch or twist your back. Keep your knees together. Hold this stretch for 15 to 30 seconds. Hip adductor stretch: Lie on your back. Bend your knees and put your feet flat on the floor. Gently spread your knees apart, stretching the muscles on the inside of your thighs. Hold the stretch for 15 to 30 seconds. Repeat 3 times. Quad sets: Sit on the floor with your injured leg straight and your other leg bent. Press the back of the knee of your injured leg against the floor by tightening the muscles on the top of your thigh. Hold this position 10 seconds. Relax. Do 2 sets of 15. Heel slide: Sit on a firm surface with your legs straight in front of you. Slowly slide the heel of the foot on your injured side toward your buttock by pulling your knee toward your chest as you slide the heel. Return to the starting position. Do 2 sets of 15. Straight leg raise: Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle on your injured side and lift your leg about 8 inches off the floor. Keep your leg straight and your thigh muscle tight. Slowly lower your leg back down to the floor. Do 2 sets of 15.

01.01.2022 WHAT DO YOUR FEET TELL YOU? The feet tell you a lot about what’s happening above them, at rest and during movement. The posture (position) your feet are ...in is the result of what’s happening upstream. Your foot position is intimately related to how well you control the position of your pelvis and how well your hips are able to function as a result of this. The stability, strength, and control of your hips and pelvic musculature determines whether you can maintain control of every joint beneath them, and therefore maintain the desired position of your joints at rest and during movement. It comes down to having control over your joints, and attaining/maintaining the desired joint positions as you move. The feet can grant your body a huge amount of stability IF they are in a good position. If you can use your hips and pelvic control to get your feet where you want them, then they have a huge amount of intrinsic muscles that can work to your advantage. But the feet need to be in a desirable position (posture) in order to work optimally. All of this can be worked on and changed. The body changes and adapts to what you expose it to. Learning to control your body requires attention and focus at the start, but is essential for overall musculoskeletal/joint health.

01.01.2022 ITB syndrome happens when your IT band rubs repeatedly against the lower end of your thigh bone as it joins your knee. This friction causes inflammation and pain - https://bit.ly/3bThDMu

01.01.2022 ABDOMINAL MASSAGE TO RELIEF CONSTIPATION Massage has been used for constipation since the nineteenth century: how effective is it? According to some research ...done by Doreen McClurg from University of Ulster, Belfast, Abdominal massage can relieve constipation of various physiological causes by stimulating peristalsis, decreasing colonic transit time and increasing the frequency of bowel movements. It reduces feelings of discomfort and pain, and induces a feeling of relaxation. It has also been found to improve patients’ quality of life, and no adverse side-effects have been reported. The researcher suggests abdominal massage may be of benefit to people with constipation, including those with comorbidities such as multiple sclerosis. The main drawback is the amount of time required to perform the massage, and the repeated nature of the intervention. However, abdominal massage is not a difficult technique to teach to patients and carers, and could undertaken by them if appropriate. MASSAGE TECHNIQUE Stroking: start at the small of the back and follow the dermatome of the vagus nerve, over the iliac crests, and down both sides of the pelvis towards the groin. Repeat it several times; Effleurage: Strokes should follow the direction of the ascending colon across the transverse colon and down the descending colon. This should be repeated several times with increased pressure to stimulate the austral and segmental contractions of the large intestine. The aim is to propel the faecal matter along the gut; Palmar kneading: This is the heart of the massage and tracks down the descending colon, up the ascending colon, and down the descending colon once again. Kneading helps to propel the faecal matter along the gut to load the rectum. Finger kneading may be required to break up faecal mass. This part of the massage may be uncomfortable because of the deep compression required. Vibration: Over the abdominal wall to relieve flatulence. This should conclude the massage session.