Q: I am a 33-year-old female and cannot move my wrist in an upward direction properly, I got an injection that was administered incorrectly. I have been experiencing the problem since then.

A: The condition is known as “Wrist Drop”, which is caused by damage to the Radial nerve. The nerve supplies the muscles that are responsible for moving the elbow, wrist, and fingers in extension. It also controls sensations of the arm, damage to the nerve can cause paralysis of the muscles, and there can be weakness, numbness, and sensory issues. A physical therapist conducts a detailed neurological examination for assessment of the condition, utilises stimulatory modalities (for facilitation), and plans exercises for rehabilitation.

Q: My daughter is 10 years old and the doctors have diagnosed her with scoliosis. Please describe the condition.

A: Scoliosis is the deviation of the spine to the side (lateral deviation). It is commonly diagnosed in childhood or adolescence. To measure scoliosis. Although lateral deviation is highlighted in scoliosis, the element of rotation also adds to it.

The signs of scoliosis include lateral or sideways deviation of the spine, a sideways posture, shoulders not aligned and one of them being higher than the other, muscles aching, and pulmonary issues (the concern in progressing scoliosis). In several cases, patients have back pain, though the diagnosis needs to be thoroughly confirmed.

There are three types of scoliosis, 1: Idiopathic: In most of the cases (about 80%) if no cause is identified the condition is said to be idiopathic. It can also occur in adults especially old adults due to degenerative changes of the spine, it is common in adolescents and is further divided into Infantile scoliosis (the child is 0-3 years old), Juvenile scoliosis (the child is 4-10 years old, if the condition is not properly and timely treated, it can lead to cardiopulmonary issues. If the curve is more than 30 degrees it can progress and even require surgical procedures, Adolescent scoliosis (11-18 years of age).

2: Congenital scoliosis means that the condition is by birth, It may be due to any faulty or slow development of the spine at a location during pregnancy. 3: Neuromuscular scoliosis: The condition can develop as a complication of any neuromuscular condition like cerebral palsy, spina bifida, or muscular dystrophy.

For the diagnosis of scoliosis, a physical examination, an x-ray, MRI, or CT scan. Cobb’s angle is used to measure the angle of scoliosis which will further define the severity and progression. An Adam’s forward bend test and sociometry are also used. An examination is required to check whether the scoliosis is structural (no plasticity is found generally and the pathology lies in the spine) or non-structural (caused by any other factor or structure than the spine itself e.g. leg length shortening on one side).

The treatment is divided into conservative and medical or surgical. Patients who just have mild lateral deviations do not need any kind of treatment, in children however regular checkups are recommended because of their growing age. The conservative management includes braces and physical therapy, if a child has mild scoliosis and wears a brace, it will keep the condition from progressing but will not work to reverse the deviation.

Severe conditions require surgical procedures like a spinal fusion of some vertebrae, hence they lose movement and get fixed. In some cases when scoliosis is continuously progressing, a rod is placed in the spine.

A physical therapist can help with muscular strengthening, coordination, equilibrium, respiratory education, ergonomics, etc, and plan an exercise program for the patient.

Q: Doctor I am a 24 years old male and have severe pain in the tendon near my heel. I am an active participant in sports. Please guide.

A: You are suffering from a condition known as “Achilles Tendinopathy”, which is diagnosed by a physical therapist after clinical assessment and differentiated by other conditions. The Achilles tendon is the tendon of the calf muscles. The condition is an overuse injury that affects the Achilles tendon. There can be chronic stress building over the tendon. Overuse leads to an initial inflammation and edema, the condition if not properly addressed can lead to adhesions and then degeneration. The condition may or may not be associated with a tear in Achilles Tendon. If there is less flexibility in the tendon, there is an increased chance of injury. Morning pain is a common symptom, the pain occurs in the tendon itself and the area that closely surrounds the tendon.