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Q: My son has been diagnosed with hip dysplasia, he is 4 months old, How can physical therapy help in this case.
A: Developmental dysplasia of the (DDH) generally refers to hip dysplasia of the infant or child. Presentation of hip dysplasia varies from minor hip instability to frank dislocation. The exact etiology is still elusive. Multifactorial in nature and mechanical factors plays a role.
In 88% of infants born with hip instabilty, hips become stable by 2 months of age If they do not progress to subluxation or complete dislocation. Hips dislocated at birth do not often reduce spontaneously. In hips showing subluxation, arthritic changes usually occur and with severity associated with degree of subluxation. With severe subluxation, symptoms can begin as early as after skeletal maturity.
Even though DHD is common and usually very well managed, it can be hard and overwhelming for new parents to deal with the dos and don’ts along with the other struggles of parenthood. With physiotherapy we can help the parents feel empowered and enable them to help their babies along the process of healing.
Appropriate massage, stretching and strengthening can help with the recovery of the hip while the child is in the brace. All these treatments can be performed by the parents at home once perfected by a visit to the physiotherapist every month.
A baby can exercise and strengthen the hip muscles by using their developmental milestones to their advantage. A physiotherapist should do a thorough assessment of the baby, go through the scans, follow the recommendations by the paediatrician and make a plan that suits the baby according to their age.
A baby with hip dysplasia needs to be kept in a certain position to give their hip a mechanical advantage. So if it is a baby who is six months old, the physiotherapist takes advantage of their current milestones and trains the hip muscles on a number of surfaces keeping the hip position in mind and challenge the hip muscles. This also avoids the chances of delayed milestones that can happen in babies with serial and prolonged periods of casting.
Therapy is important to correct poor posture, muscle weakness, poor joint awareness, and associated tendon inflammation. Therapy can improve all these factors including the strength of hip extensors and external rotators, gait re-education, and improving body awareness. Strong muscles will act like shock absorbers and provide greater support for the hip.
For grown up kids, Exercise: Regular, low- or non-impact exercise such as swimming, aquatic therapy or cycling train strength and range of motion. Weight loss: For those overweight can significantly reduce the stress on the hip and reduce pain. : A specialised therapy treatment strategy that uses a horse's movement to influence the patient/client in a various number of ways. During hippotherapy, functional riding skills are not taught; the client sits on the horseback and physically accommodates to the three-dimensional movements of the horse's walk. Hippotherapy is shown to motivate the child to engage in therapy, maintain the child's willingness to participate and provide a playful environment while facilitating pain free movement.
Q: Dear Doctor, I am a 34 years old female and have been diagnosed with Carpal Tunnel Syndrome, kindly guide about this condition and the physical therapy treatment.
A: Carpal tunnel syndrome (CTS) is an entrapment neuropathy caused by compression of the as it travels through the wrist's carpal tunnel. CTS is caused by repetitive movements, awkward postures, forceful exertions, vibration or compression (pressing against hard surfaces).
Early symptoms of carpal tunnel syndrome include pain, numbness, and paresthesias. Sensory changes and paresthesia can occur along the median nerve distribution in hand. Pain also can radiate up the affected arm. It may radiate into upper extremity, shoulder and neck. With further progression, night pain, hand weakness, decreased fine motor coordination, decreased grip strength, clumsiness, reduced wrist mobility and thenar atrophy can occur. Many patients will report an improvement of symptoms following shaking or flicking of their hand.
Patients with mild to moderate symptoms can be effectively treated in a primary care environment Physical therapists should give advice on modifications of activities and the workplace (ergonomic modifications), task modification, For example, taking sufficient rest and variation of movements.
Often simple obvious alterations to the working practice can be beneficial in controlling milder symptoms of CTS. techniques include of Soft tissue, Carpal bone, Median nerve.
Other modalities include: ultrasound and electromagnetic field therapy and. CTS symptoms typically escalate over a longer-term despite conservative treatment. Surgical interventions for appropriate patients have been shown to be safe and more effective than any conservative intervention, Clinicians should be aware that constant tingling or numbness is associated with significant compression of the median nerve. Prolonged duration of such symptoms may lead to irreversible changes in its internal structure, affecting the effectiveness of surgery and leaving individuals with chronic symptoms and muscle atrophy of thenar eminence.
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