Category: Physiotherapy

We are designed to move for survival and our wellbeing. Recent researchers have shown that regular movements act as a natural painkiller by releasing serotonin, dopamine, GABA, and endorphins. So if you or your loved one is in pain and looking for more substantial ways of managing it then read on.

What happens when we move?

FOR THE WHOLE BODY

Better general circulation

Easier lymphatic drainage so fewer chances of swelling of hands and feet.

Better muscular control and coordination.

Improved bone health.

Improved gut mobility so good appetite and easier bowel emptying.

Metabolic rate is improved so easier body weight control.

FOR THE HORMONES

Release of endorphins, dopamine, serotonin, and reduced secretion of cortisol ( stress hormone).

Reduction of free radicals and p substance so reduced pain and inflammation.

FOR BREATHING

Better diaphragmatic movement

Relaxed and even breathing

Parasympathetic activation

Lowers stress

Sample movement routine

In bed

Spinal twist– Lie on the back, arms by the side. Bend both the knees, drop them to one side and then another keeping the shoulders relaxed and on the bed. Repeat 3-5 times on each side.

 Belly breathing with arm raise-Lie on the back with the knees bent as much as possible. Breathe in through the nose and allow the belly to come out. Simultaneously interlace the fingers and take the arms upwards as much pain-free. Repeat 3 to 5 times.

 Pelvic Bridge

In-chair sitting

Seated figure of 4-Sit without back support and bend 1 knee such that that ankle is on the opposite knee in a figure of 4. Keep the chest up and hinge forward from the hip to a point where you feel the sensitivity in your butt region or the lower back. Stop at that point and breathe into that position for 3 to 5 breaths. Repeat it 3-5 times.

Seated cross leg stretch-Sit cross-legged as before. Gently pull one knee to the opposite shoulder, keeping both the sit bones in contact with the chair. Repeat as above.

In standing

Hip hinging -Stand with feet shoulder-width parallel. Keep the outer border of your feet parallel, keeping the heels out. Drop the knee caps. You will feel your glutes engaged. Keep the chest up and bend from the hips. Go to a where you feel a mild pull or stretch in the back of your thigh or even the low back. Stop, ease into it, and breathe. Repeat as above.

Hip hinging with knee bent-Repeat the same activity with your knees bent to 5 cms keeping the knee caps facing forward and parallel. Your weight must be on the heels. Repeat as above.

Hope these hacks help you to manage your pain and live pain free… Take care move more and better.

Covid 19 has been difficult for all of us. With the healthcare system already overworked this blog is to help you manage one of the most commonly faced problems at home and also identify when to seek professional help.

How does it feel?

It’s a painful stiffness in the back of the leg below the knee commonly called the calf muscle. You can feel a twitching in the calf or the knee. In severe cases, you will feel that the whole leg is frozen and you are unable to bear weight on that leg. Any position change like sitting to standing, walking, or even turning in the bed can aggravate the pain.

When should you see a Dr?

Pain is unchanged and moderate to severe for more than 3weeks.

Burning sensation in the sole or the leg.

Numbness or tingling in the foot or calf.

Worsening of the pain and reduced mobility due to it.

Visible swelling in one or both feet.

DIY relief techniques

Tennis ball roll-Roll lengthwise with gentle pressure along with the calf bulk for 1-2 min every 90 min.

Hot or cold application -Can do it for 2-3min every 2 hours.

Ankle pumps and circle-Can be done in sitting or lying down. Push the feet down with the heels lifting up, then push the heels down with the toes pointed up. Repeat it 5-8 times every hour. Roll the ankle clockwise and then counterclockwise direction keeping the knee relaxed. Repeat 5 to 8 times every hour.

Toe scrunching and splaying– Curl the toes gently to feel the calf tense be there for 1 or 2 breaths. Now release the toes and spread them out fully as much as possible keeping the heel on the ground and the knee relaxed. Repeat as above.

Stroll with heel-toe pattern -Stand with the feet hip-width distance. Press the heel into the ground. Keep the knee soft. Gently push off with the toes. Walk slowly indoors with this pattern for 2 min every hour.

Hope these suggestions help you to heal faster and be pain-free. Take care

Today’s blog is dedicated to one of the most commonly injured joints “The Ankle”. Research says that 1 in 4 people experience ankle injury or instability at some point in their lives. As a clinician can validate this as I see a similar presentation in my clinic.

Ankle though a small joint in size is biomechanically big in walking or any weight-bearing activity. The foot up and down activity at the ankle helps to clear the ground while walking and propel us forward by pushing the ground back. The tilting movements at the ankle or foot in and out helps to stabilize the foot and knee.

Being so functionally important it often gets overused and injured. Ankle injury presents compensation in standing and walking. A few compensations are as below

Limp and hop walk to avoid putting weight on the affected side.

Clawing and scrunching the toes.

Rolling the knee inwards causing a lot more push off from the inner border of the foot.

Reduced hip range of motion so the length of the step is shortened.

As with any compensation any of the above would make walking painful, inefficient, and injury-prone.Due to the pain, most patients start reducing or avoiding moving. Lack of movements reduces our balance system called Proprioception and makes the joint more unstable and injury-prone. A classic Pain – spasm – weakness cycle where I find most of my patients in. I am listing a few corrective movements which help us to get optimal balance and hence be pain-free.

1. Walk barefoot on as many surfaces as possible. You can try walking on a pebble way, sand, grass, or carpet.
2. Cushion walk- Put 3-5 cushions on a non-slip surface 5 cm apart. Stand on 1 cushion with feet hip-width distance. Take a step onto the cushion in the front without losing balance. Then you can move back to the starting cushion. Start with 2 cushions at a time and can move up to 3-5 cushions. You can repeat 2-3 times every hour.
3. The balance on 1 leg- Stand as above on a non-slip stable surface. Lift 1 leg up such that the hip and knee are bent to 90 degrees. Hold this position for 30 sec to 1 min each side and can repeat as above. 
4. You lift 1 leg to the side 5-6 coms from the midline of the body without tilting. Hold as above. Repeat as above.
5. Vrikshasana
6. Chair pose in yoga

The secret to a pain-free and strong ankle is good body balance. I hope all of these help you to improve the balance and be pain-free… Stay happy and healthy.

Hi, as a pain clinician I see patients who want reliable information to understand their pain. This blog is to help you know your pain better and overcome it.

What is pain?

Pain is a protective and useful sensation. It tells the brain about actual or impending tissue damage. The immune system is mobilized to that region to heal the damage. In short, pain is vital for our survival and safety.

Is pain always equal to tissue damage?

Not always.. when an injury happens for the first time there is actual tissue damage in that region. This is an acute injury. The immune system takes over and it’s healed in some time. Even after the healing is complete its memory is stored in the hippocampus (memory center). 

Next time when we move out repeat a similar movement pattern to the original injury the brain identifies it as a potential threat based on the past memory. To stop us from going further it releases pain substance and we feel the pain now even without any injury. This is an example of the brain being overprotective. When this happens multiple times inefficient compensatory movement patterns develop. This is the chronic pain-injury cycle. This is why we but just even when the injury has long healed.

Should I rest when in pain?

Not always. When the pain is more than 70% of your capacity,  it is good to protect and rest the part. The application of ice and heat helps in pain relief. Once the pain is down to 50 percent you can start moving slowly indoors making sure that you don’t do the aggravating movement. You can move the part in all pain-free zones. Belly breathing can help greatly to stabilize the core and decrease the pain. When the pain is stable at 50 percent for 24 to 48 hours or even less start with posture corrective exercises, core stability activity like simple tummy tuck in along with belly breathing. You can try bending from the hips instead of from the waist to bend forward.

A few things that help

While standing or sitting keep the outer borders of the feet parallel to each other and at hip-width distance.

Drop the knee caps while standing.

Wear comfortable clothing that allows the belly to move out with each breath.

Drop the shoulders down.

Belly breathe every 2 to 3 times every 60 min.

Pain though an uncomfortable feeling can be controlled and overcome. I want to leave this takeaway The biggest influencer of your pain is you… Stay happy and healthy.

Hello and welcome to my new blog on living pain-free and moving with ease. As a pain clinician, I am asked this question frequently by patients on how to live pain-free and move with ease so this blog is all about it. Here are a few things which have helped me and my patients and I hope they help you too.

Move regularly

Research shows that moving regularly throughout the day has significantly more benefits than packing all your movement in an exercises session of an hour or more. This is because we have movement maps in the brain and these maps get activated and sharpened as we move regularly. These maps make our moments smooth coordinated and efficient. So whatever your goal is whether it is to lose weight or to be pain-free move regularly. An ideal would be to move for 2 to 5 minutes every 60 minutes throughout the day. Your movement could be quick push-ups or an on spot jog or even a walk around the block.

Move with the purpose

Purposeful movements like walking to and fro to get groceries has more benefit than just walking as an exercise or on a treadmill this is because our brain activates centres of memory on previous experiences of movement, so there is better neuromuscular coordination and efficiency. this creates a state of balance and generates feel-good hormones like Serotonin, Dopamine, and Endorphins which help us remain pain-free.

Breathe

Belly breathing is the best natural painkiller as it stimulates the parasympathetic system. When we push the belly out while breathing-in, we allow the diaphragm which is the respiratory muscle to come down. This gives more space for the lungs to fill with air. When we breathe out gently talking the belly in we allow the diaphragm to go back to its resting position and make the exhalation full and better. This is a safe movement for a brain which is in a state of overdrive trying to fight pain.  It also makes breathing efficient and generates feel good hormones. To belly breathe; start in a comfortable position like lying or sitting. Keep your shoulders relaxed. Breathe in through the nose such that the belly moves forward and breathe out gently while talking your belly in. Make sure to have movement in your belly rathan than your chest. You can also add a count to your inhalation and exhalation of about 4 seconds.

Vary your Movements

Put in a variety of movements in your day. You can sit, stand or even walk differently to add variety for e.g. Cross-leg sitting, side-sitting or long-sitting can be variations to regular floor sitting. you can also try walking in a figure of eight or heel to toe touch pattern. Stand with the outer border of your feet parallel to each other. Make a note of the movements which you don’t typically do and try to add them slowly during the day. By adding movement variety we use different motor patterns and many more muscles to complete tasks. This makes the movement patterns efficient and helps us to be pain-free.

Balance work

Put in at least 10 minutes of balance work in the day these are whole-body movements and they greatly improve our movement quality and coordination.

 Some of them are  Stand on one leg  without support of the wall or furniture and without leaning to any side for at least 30 seconds to a minute switch sides and repeat three to five times

 In the same way you can raise 1 leg to the side  about 5 to 10 cms from the ground. Hold and repeat as above.

  You can raise one leg  to the back and repeat as above.

 Try to walk on your heels or toes for a change for 3 to 5 min.

I hope these hacks help you be pain-free and be what you have always wanted to be.