psLower LimbComments Off on Shin Splint (Medial Tibial Stress Syndrome)
What is Shin Splint (Medial Tibial Stress Syndrome)?
Shin Splints may develop in the muscles in the front and outer parts of the shin
Shin splint is the symptom of pain over the front of the tibial bone.
What are the Causes?
Shin splints are normally due to overuse. When the overuse causes irritation to the tendons and the attachment of these tendons to the bone, the condition is called medial tibial stress syndrome. It is commonly seen in athletes who suddenly increase their duration or intensity of training.
What are the Treatments?
The treatments are applying ice packs or perform ice massage for up to 20 minutes three times a day, take anti-inflammatory medication prescribed by a doctor, or perform rehabilitation exercises regularly e.g. swimming and cycling.
Scoliosis is a medical condition in which a person’s spine is curved from side to side, shaped like an “s” or “c”, and the spine may also be rotated.
How is scoliosis diagnosed?
A rib “hump” or a prominent shoulder blade caused by rotation of the ribcage in thoracic scoliosis can be detected on physical examination. It is more prominent when the patient is bent forward. A special X-ray film called a scoliosis film will confirm the diagnosis.
Causes of scoliosis
There is no definite cause but most are due to developmental problems.
Prevention of scoliosis
Regular exercise and a good diet. Scoliosis is more likely to occur to low body weight patients.
There is no way to prevent idiopathic scoliosis. Early detection and treatment, if necessary, helps to prevent it getting worse.
If you have a history of scoliosis in your family, children can be checked regularly for scoliosis from the age of nine throughout their teens.
Treatments for scoliosis
Treatments include monitoring with regular medical check up to look for worsening of the curvature, bracing to help moderate cases and surgery may be necessary for the severe cases.
psUpper LimbComments Off on Shoulder Pain Due to Rotator Cuff Injury
What is Shoulder Pain Due to Rotator Cuff Injury?
Rotator cuff injury is the damage to the rotator cuff. This condition is one of the most common causes of shoulder pain.
Rotator Cuff Tear
How is Shoulder Pain due to Rotator Cuff Injury Diagnosed?
Diagnosis is done through understanding the patient’s history of activities and symptoms of pain in the shoulder. Plain x-rays are also done to exclude bony injuries. The MRI scan is the best to delineate the tissues of the shoulder.
What are the Causes?
The rotator cuff can be injured due to degeneration associated with aging or inflammation of the shoulder. The rotator cuff is also commonly injured by trauma for example falling and injuring the shoulder or overuse during sports activities. Rotator cuff injury is particularly common in people who perform repetitive overhead motions that can stress the rotator cuff. These motions are frequently associated with muscle fatigue.
What are the Treatments?
Treatment of rotator cuff injury depends on the severity of the injury to the tendons of the rotator cuff and the underlying condition of the patient. Mild rotator cuff disease is treated with ice, rest, anti-inflammatory medications and gradual exercise rehabilitation. More severe rotator cuff injuries require surgical repair.
psLower LimbComments Off on Total Knee Replacement
There are several ways to treat the pain caused by arthritis. One way is total knee replacement surgery. The decision to have total knee replacementsurgery should be made very carefully after consulting your doctor and learning as much as you can about the knee joint, arthritis, and the surgery.
In total knee replacement surgery, the bone surfaces and cartilage that have been damaged by arthritis are removed and replaced with artificial surfaces made of metal and a plastic material. We call these artificial surfaces “implants”, or “prostheses”.
During Total Knee Replacement
The patient is first taken into the operating room and given anaesthesia. After the anaesthesia has taken effect, the skin around the knee is thoroughly scrubbed with an antiseptic liquid. The knee is flexed about 90 degrees and the lower portion of the leg, including the foot, is placed in a special device to securely hold it in place during the surgery. Usually a tourniquet is then applied to the upper portion of the leg to help slow the flow of blood during the surgery. An incision of appropriate size is then made.
Knee Flex at 90 degrees for preparation for surgery
Removing the Damaged Bone Surfaces
The damaged bone surfaces and cartilage are then removed by the surgeon. Precision instruments and guides are used to help make sure the cuts are made at the correct angles so the bones will align properly after the new surfaces (implants) are attached.
Small amounts of the bone surface are removed from the front, end, and back of the femur. This shapes the bone so the implants will fit properly. The amount of bone that is removed depends on the amount of bone that has been damaged by the arthritis.
A small portion of the top surface of the tibia is also removed, making the end of the bone flat.
The back surface of the patella (kneecap) is also removed.
Damaged Tibial Bone Surface
Attaching the Implants
An implant is attached to each of the three bones. These implants are designed so that the knee joint will move in a way that is very similar to the way the joint moved when it was healthy. The implants are attached using a special kind of cement for bones.
The implant that fits over the end of the femur is made of metal. Its surface is rounded and very smooth, covering the front and back of the bone as well as the end.
Femoral Implant Made of Metal
The implant that fits over the top of the tibia usually consists of two parts. A metal baseplate fits over the part of the bone that was cut flat. A durable plastic articular surface is then attached to the baseplate to serve as a spacer between the baseplate and the metal implant that covers the end of the femur.
Tibial Implant consists of two parts
The implant that covers the back of the patella is also made of a durable plastic.
Patellar Implant made of durable plastic
Artificial knee implants come in many designs. Some designs may have pegs, requiring small holes to be drilled into the bone after the damaged surfaces have been removed. Others may have central stems. In addition, some designs may allow screws to be used on the lower implant to provide added attachment security. The surgeon will choose the implant design that best meets the patient’s needs.
Implants with Pegged and Stemmed Design
Closing the Wound
If necessary, the surgeon may adjust the ligaments that surround the knee to achieve the best possible knee function.
When all of the implants are in place and the ligaments are properly adjusted, the surgeon sews the layers of tissue back into their proper position. A plastic tube may be inserted into the wound to allow liquids to drain from the site during the first few hours after surgery. The edges of the skin are then sewn together, and the knee is wrapped in a sterile bandage. The patient is then taken to the recovery room.
What Happens After the Total Knee Replacement
When you are back in your hospital room, you will begin in a rehabilitation program designed specially for you. This program will help you regain strength, balance, and get you back to the activities you enjoy. It may include a machine, called a continuous passive motion machine, that automatically moves your leg.
Your physical therapist will help you perform appropriate exercises. About 24 hours after surgery, you will probably be asked to stand. Within the next 24 hours, you will begin to walk a few steps with the help of a walker.
You will be discharged as soon as our surgeon determines that you have recovered sufficiently. You can expect to stay in the hospital for about three days after your surgery. Your bandages and sutures will usually be removed before you leave the hospital.
At home, you will need to continue your exercises. Your physical therapist will instruct you about proper home care, and may continue to work with you.
Within six weeks after surgery, most patients are able to walk with a cane. You will probably feel well enough to drive a car within seven to eight weeks after surgery.
In most cases, successful total knee replacement will relieve your pain and stiffness, and allow you to resume many of your normal daily activities.
The amount and type of food you eat has a major influence on your health. Eating a well-balanced diet can reduce your risk of various diseases as well as help you to maintain a healthy weight.
There are certain times when it can be particularly important to make sure you’re following a healthy diet – for instance, if you want to lose excess weight or if you’re watching what you eat because you’re pregnant. However, it’s important to eat a healthy diet throughout your life, no matter what age you are – there’s never a bad time to make some changes and improve your eating habits.
Why is healthy eating important?
A balanced diet
Getting the balance right
Improving your diet
Making changes
Why is healthy eating important?
There is good evidence that eating a healthy diet can reduce your risk of obesity and illnesses such as diabetes, heart disease, stroke, osteoporosis and some types of cancer.
The food you eat contains several different types of nutrients, which are all required for the many vital processes in your body. Key nutrients in your diet include the following.
Carbohydrates – these provide you with energy.
Proteins – these are another source of energy and essential for the growth and repair of all tissues in your body.
Fats – these are a very concentrated source of energy and also have a number of other roles, including helping to transport essential vitamins around your body.
Vitamins and minerals – there are many different vitamins and minerals, which are all important to keep your body healthy and functioning.
Another important element of your diet is fibre. Fibre isn’t classed as a nutrient, but it’s essential to keep your digestive system healthy and certain types of fibre can help to control your blood cholesterol levels.
A balanced diet
You need to eat a range of foods to get all of the nutrients and fibre your body needs. The five main food groups are:
starchy foods including bread, pasta, rice and potatoes
fruit and vegetables
milk and other dairy foods
meat, fish, eggs, beans and other non-dairy sources of protein
foods high in fat or sugar
Eating the right balance of foods from these groups will make sure your body gets all it needs to stay healthy.
The image below shows proportionately how much food you should eat from each of the different groups to enjoy a balanced and healthy diet. This includes everything you eat during the day, including snacks. You don’t have to give up the less healthy foods you like, just adjust the amount of them you eat in proportion to the amount of healthy foods in your diet.
Healthy Diet Pyramid
Getting the balance right
Starchy foods
Starchy foods contain energy in the form of carbohydrates, and release this energy slowly throughout the day. You should eat starchy foods as your main source of energy.
Starchy foods include bread, pasta, cereals, rice and potatoes. Choose wholegrain or wholemeal varieties where possible, and brown rice, as they are particularly high in fibre.
Fruit and vegetables
Fruit and vegetables are good sources of many nutrients, in particular vitamins, minerals and fibre. Aim to eat at least five portions of fruit and vegetables each day. Your five portions don’t all have to be fresh – dried, frozen, tinned, and juiced fruit and vegetables count too.
Milk and other dairy foods
Milk and dairy products such as cheese and yoghurt are important sources of protein, calcium and vitamins.
Choose lower-fat options such as semi-skimmed or skimmed milk and low-fat yogurts.
Some dairy foods, such as butter and cream, have a high fat content so you should eat these in much smaller amounts.
Meat, fish, eggs, beans and other non-dairy sources of protein
Meat, fish and alternatives, such as beans, pulses, eggs and nuts are all important non-dairy sources of protein.
Try to eat two portions of fish a week (one portion is about 140g). One of these portions should be oily fish, such as mackerel, salmon or pilchards. Oily fish is particularly rich in long chain omega 3 fatty acids, which can help prevent heart disease.
Some types of meat are high in fat, so always cut off any extra fat and skin. Grill, bake or poach meat and fish rather than fry it. Try to limit the amount of processed meat you eat (such as sausages and beef burgers) as these foods often contain a lot of fat and may increase your risk of bowel cancer.
Foods high in fat and sugar
Fat is an important part of your diet but you don’t need very much. Try to eat less fat overall, but remember that the type of fat you eat is also important. Try to replace foods that are high in saturated (bad) fats such as butter, pastries and cheese with foods that are rich in unsaturated (good) fats such as avocado and olive oil.
Sugary foods such as sweets and biscuits provide you with energy but not many nutrients. Eating sugary foods can cause tooth decay and gum disease, so try to limit the amount you eat.
Improving your diet
Aim to eat three balanced meals a day with healthy snacks in between if you need them. Breakfast is important so don’t skip it, especially if you’re trying to lose weight.
Generally, if you want to improve your diet there are certain foods you should aim to eat more of and others that you should eat less of. Some examples are listed below.
Eat more:
fruit and vegetables
foods high in fibre, such as wholegrain bread, beans, pulses, potatoes with the skins on
low-fat dairy products, such as semi-skimmed milk, low-fat cheese and yoghurt
starchy foods, such as wholemeal rice, pasta and bread
Eat less:
processed meat products, such as sausages, salami, meat pies and burgers – replace these with lean meat with the skin and fat removed
foods high in salt, such as crisps and processed foods such as ready meals and sauces
sugary foods and drinks, such as fizzy drinks, sweets and biscuits
high-fat foods, such as cream, butter, and cakes
Making changes
Changing your eating habits should be a gradual process. Don’t be tempted to make drastic changes overnight or fall into the trap of making common dieting mistakes. Small, day-to-day changes will have a much bigger and more long-lasting effect.
If you’re having trouble making changes to your diet or you’re worried that you’re not getting all of the nutrients you need, talk to your GP. He or she may be able to give you some practical advice or refer you to a dietitian who can help you further.