ASK A PHYSICAL THERAPIST
- 25 Mar - 31 Mar, 2023
Q1: I am a 47-year-old female and have severe pain in my right arm. I am unable to lift it to the maximum and there is stiffness. I am unable to do my chores. I also have diabetes and blood pressure.
A: It seems that you have a condition known as Adhesive Capsulitis (Frozen shoulder). The diagnosis is confirmed after proper diagnosis. It has been divided into stages with initial pain and later stages of active and then the passive restriction of the shoulder joint. It is caused by inflammation of the joint. It may be idiopathic (no specific reason) or caused by factors like an injury, stroke, or surgery (altered patterns and hesitancy in shoulder joint movements can lead to the condition). There can be systemic causes like diabetes, extrinsic factors like cardiopulmonary diseases (blood pressure), and intrinsic factors like arthritis or tendinopathy. People 40 and older, particularly women, are more likely to have frozen shoulders. A physical therapist can help in any stage of Adhesive Capsulitis, addressing pain, joint stiffness, and muscle weakness utilizing various modalities, techniques, and exercises. Pain is often most severe during the freezing phase and patients in this phase would benefit from learning pain-relieving techniques. These exercises include gentle shoulder mobilization exercises within the tolerated range (e.g. pendulum exercise, passive supine forward elevation, passive external rotation, and actively assisted range of motion in extension, horizontal adduction, and internal rotation).
Q2: I am a 36-year-old female and cannot move my wrist in an upward direction properly, I got an injection that was administered incorrectly.
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 wrist in an upward direction, damage to the nerve can cause paralysis of the muscles. A physical therapist conducts a detailed neurological examination for assessment of the condition, utilizes stimulatory modalities (for facilitation), and plans exercises for rehabilitation. Initial treatment includes wrist splinting for support, as well as osteopathic medicine, physiotherapy, and occupational therapy. Surgical removal of bone spurs or other anatomical defects that may be impinging on the nerve may be necessary in some cases. If the injury was caused by pressure from using improperly fitted crutches for an extended period, the symptoms of wrist drop will most likely resolve spontaneously within 8-12 weeks.
Q3: I am a 30-year-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. It is an overuse injury that affects the Achilles tendon. Overuse leads to an initial inflammation and edema, the condition if not properly addressed can lead to adhesions and then degeneration. A physical therapist assesses muscle weakness, range, flexibility, etc, and utilizes modalities, techniques, and exercise plans for rehabilitation. Please take rest from sports for some time to avoid repeated trauma and make sure you have good footwear that supports the arch.
Q4: I am a 39-year-old male and have pain in my tailbone. I am unable to sit. I am an office worker.
A: The condition is known as “Coccygodynia / Coccydynia. There is pain at the tailbone/coccyx. It is difficult to sit or transition to standing by the patient. You are an office worker and proper ergonomic adjustment is required in this case. Make sure you use a firm seat and sit erect. Donut / circular cushions can be used. Take breaks during working hours. Taking an NSAID like ibuprofen to reduce pain and swelling. Taking a hot bath to relax muscles and ease pain. Use a wedge-shaped gel cushion or coccygeal cushion (a “donut” pillow) when sitting. A physical therapist can help you deal with the condition by using specialized techniques and modalities.
Q5: I am a housewife (28 years) and have had pain at the side of my right elbow for about two weeks. Please guide me about the condition.
A: You are probably suffering from “Lateral Epicondylitis” or Tennis Elbow. The diagnosis is confirmed by tests applied by a physical therapist. It is a commonly occurring overuse injury that is categorized by tendinopathy of the forearm muscles. There is pain on the outer side of the elbow. The causes include repetitive activities like computer use, forearm pronation and supination, heavy lifting, vibration, etc. It is seen in sportsmen (Tennis, Squash, Badminton, etc), electricians, gardeners, etc. A physical therapist deals with the condition by using modalities, specialized techniques, strengthening, and stretching. Make sure you do not perform any repetitive activity on the involved side. Stretching and strengthening the muscles of your lower back and pelvis. Applying hot or cold packs to your lower back. Apply for no longer than 20 to 30 minutes, several times a day. Wearing loose-fitting clothing. Rest the arm to decrease further injury. Elbow pain and inflammation can often be treated with medications such as ibuprofen, acetaminophen, or naproxen. There are a variety of braces and compression bands for people seeking treatment for elbow tendonitis. Finding the correct style and fit is somewhat a matter of personal choice, but an orthopedic specialist can also be of tremendous assistance in choosing the best device.