ASK A PHYSICAL THERAPIST

Q: Doctor my mother is 58 years old and has a curved upper back. What can a physiotherapist do in this regard?
A: Age-related hyperkyphosis affects 20-40% of older adults and can be described as an exaggerated anterior curvature of the thoracic spine that is associated with aging. General causes of age-related hyperkyphosis that have been reported are poor posture, dehydration of the intervertebral discs, and reduced back extensor muscle strength. Age-related hyperkyphosis may: Induce symptoms such as back soreness, neck pain, numbness of upper extremities or buttock, Low psychological well-being such as depression and low self-esteem, Lead to mobility impairments of the cage (connected to ) which can result in pulmonary difficulties, Increase biomechanical stress on the spine which can result in an increased risk of development of , Increase the risk of and fractures due to poor , Impaired Physical function has an impact on the basic functioning and daily living, which affects the . The main goals of physiotherapy are Increased strength, Increased spinal extension mobility, Improved postural awareness, Prevention of vertebral compression fractures, Maintaining or restoring physical function, and preventing further deterioration. The strategies include Postural correction training through and strengthening exercises to help reduce the hyperkyphotic curvature and prevent the condition from advancing. Breathing exercises help improve tolerance for physical activity by increasing lung capacity. , pain management using modalities such as , , and/or electrical stimulation such as transcutaneous electrical nerve stimulation (), l/soft tissue manual therapy (using hands-on techniques), and shoulder mobilization to help improve spinal flexibility, Specialized braces or therapeutic to help reduce the angle of the curve, Education to improve posture and activities of daily living and ease physical functioning. exercises and gait training to increase general fitness and reduce the risk of falls.

A physiotherapist can also guide postural awareness. Explain to the patient what the problematic posture is. Demonstrate correct posture, and explain every motion that should be made: Have the patient try this him/herself, the first time still going over every cue. Once the patient has practiced the posture a sufficient number of times to immediately be able to resume good posture on command, taping and random reminders (timer) can be used to ensure the posture is kept during the day.


Q: I am a 34-year-old housewife and have had pain on the outer side of my elbow for about three weeks. Kindly guide me about it.
A: Lateral Epicondylitis, also known as "Tennis Elbow", and lately proposed as Lateral Elbow (or Epicondyle) Tendinopathy (LET) is the most common overuse syndrome in the elbow. It occurs often in repetitive upper extremity activities such as computer use, heavy lifting, forceful forearm pronation and supination, and repetitive vibration. Despite the name, you will also commonly see this chronic condition in other sports such as squash, badminton, baseball, swimming, and field throwing events. People with repetitive one-sided movements in their jobs such as electricians, carpenters, gardeners, and desk-bound jobs also commonly present with this condition. General physiotherapy management methods for LET may include Education/Advice on pain control and/or modification of activities, modalities- ice, massage, ultrasound, transcutaneous electrical nerve stimulation (tens), laser, shockwave therapy. supervised exercises- strengthening and stretching. manual therapy. sport/occupation specific rehabilitation

Q: My sister is 38-year-old. she has a herniated disc in her lower back. Please guide me about physical therapy.
A: A herniated disc in the spine is a condition during which a nucleus pulposus is displaced from intervertebral space. It is a common cause of back pain. The patients who experience pain related to a herniated disc often remember an inciting event that caused their pain. Unlike mechanical back pain, herniated disc pain is often burning or stinging, and may radiate into the lower extremity. Furthermore, in more severe cases, there can be associated with weakness or sensation changes. In some instances, a herniated disc injury may compress the nerve or the spinal cord causing pain consistent with nerve compression or spinal cord dysfunction, however, the severity depends upon the type and cause of disc herniation.

Physical therapy often plays a major role in herniated disc recovery. Involving below key points, Ambulation and resumption of exercise, , and Education re maintaining healthy weight. Physical therapy programs are often recommended for the treatment of pain and restoration of functional and neurological deficits associated with symptomatic disc herniation. here are several programs for the treatment of symptomatic disc herniation e.g. activity (walking, cycling), directional preference ( approach), flexibility exercises ( and ), // (medicine ball and ), exercises, MCEs. In case of , programs start regularly 4-6 weeks post-surgery a physical therapist offers information about the rehabilitation program they will follow the next few weeks. The patients are instructed and accompanied in daily activities such as: coming out of bed, going to the bathroom, and clothing. patients have to pay attention to the ergonomics of the back.

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