Knee pain

The knee joint is a largest hinge synovial joint consisting of 4 bones and is also a major weight bearing joint of the body. The 4 bones are femur (thigh bone on the top), the tibia (shin bone below), fibula (outer shin bone), and patella (knee cap in front). Knee injuries are most common during sports.

Causes:

• Knee pain may occur due to Knee injury, Fractures, Inflammation of lateral/medial ligament of knee, Twisting injuries to knee, Bursitis, Ligament sprains, Repetitive strain injury, Overuse syndrome, Osteoarthritis, Rheumatoid arthritis, Patellar fracture, Excessive jumping, Muscle strain, Tendonitis, Meniscus tears.

Symptoms:

• Pain, Swelling, Stiffness, Weakness, Redness and Warmth on the knee.

• Pooping/Crunching sounds in the knee while movement.

• Pain /Inability to straighten the knee or Locking while straightening the knee.

• Painful knee movements and Difficulty while walking. Any deformity/ Unusual symptoms of knee.

Diagnosis:

• X ray, MRI (magnetic resonance imaging), Menisci tear can be diagnosed through arthroscopy, arthrography.

Treatment:

NOTE: The treatment to the fractures, severe pain and post-operative cases should be followed by the advice of the doctor.

• R I C E treatment program is to be followed for pain reduction.

  1. Rest the knee. Using of knee caps while walking gives stability.

  2. Ice application to the painful knee area is to be done for 15-20 min with certain gap.

  3. Elevation of the knee joint helps reduce swelling and induce healing.

• Analgesics, Anti-inflammatory drugs, Cortisone injections given under doctor’s supervision.

• Joint mobilization, Soft tissue massage, Electrotherapy modalities done by the physiotherapist.

• Strengthening exercises

  1. Quadriceps

     - Sit in a chair comfortably at its edge. Slowly lift the feet off the floor keeping knee extended and straight along with tightening of thigh muscles. Hold and relax.

     - Lie on the back bending one (left) knee to 90 degrees and foot flat on the floor. Keeping another leg (right) straight, slowly lift it up to a certain height. Hold and relax.

     - Sit/Lie on the floor/bed. Keep your leg straight and place a rolled towel underneath your thigh. Then slowly raise your foot off the floor pressing the towel with the thigh. Hold and relax.

  2. Hamstrings

    - Sit/ Lie on your back. Bend one of your knees to 45 degrees keeping only toes off the floor. Then slowly pull your heel back towards your buttock as if sliding/ digging the heel into the floor. Hold at a point and relax.

    - Lie on your stomach. Slowly lift one foot off the floor tightening the back thigh muscles. Hold and relax.

    - Place left foot on the heel of the right foot. Then slowly try to lift your right heel towards your buttocks with the resistance of the left one (press the left foot to the right heel against each other to resist).

    - Backward walking also strengthens hamstrings resulting in giving less strain to your knees.

  3. Hip adductors (inner quadriceps)

  4. Hip abductors

• Stretching exercises

1.    Quadriceps stretch              2. Hamstrings stretch

• Balancing exercises

Stand straight and take support of the chair. Stand with one leg for one minute and switch to other side. Slightly increase your balance removing the chair support.

Calcium rich food

Calcium is needed for growth and bone development. Deficiency of calcium leads to osteoporosis. Osteoporosis makes the bones thin. It is more common in women.

 More calcium is required during pregnancy, lactation. Even children and elderly require more amounts of calcium.

 Milk, curd, nuts, milk products, green leafy vegetables and ragi are some of the sources of calcium. Doing exercise reduces calcium loss from bones.

Root Canal Treatment

Root canal treatment is a method to clean roots by gaining access from the tooth with the help of Dental instruments and specific equipments. When the carious lesion reaches pulp (where all blood vessels are present), then the only option left is RCT. Sometimes carious lesion even extend from root to apex (where root ends), then extraction is advisable as RCT will have poor prognosis in this case.

Time taken or sittings involved during RCT depends upon the extent of infection in tooth. 

Steps involved in RCT are as follows:

Gaining Access to Root canals: Access from the surface of the tooth(crown) is gained with the help of Drilling instrument . Normally there are 3 canals in molars, 2 canals in premolars and 1 canal in Incisors and canine. Number of root canals can vary in tooth from person to person, it is never fixed.

Cleaning and Shaping of Root canals: 

Once the access is gained, then with the help of instrument known as files as shown in figure, Canals are cleaned. To avoid friction and proper cleaning disinfectant solution known as sodium hypochlorite is used. It removes all the debris and infection from the canals and makes them sterile. It usually takes 2 sittings, but if infection is less than it can be completed in 1 sitting also. After the thorough cleaning, temporary filling is placed in tooth and patient is asked to come after 2 days.

Filling of Root canals: 

Once the canals are cleaned, and then canals are properly dried with the help of paper points and filled. Canals are filled tightly with Gutta percha points (GP points). After filling of root canals, Permanent filling is placed in tooth; normally permanent filling does not last long. Always Crown is mandatory after RCT as tooth becomes weak from inside. To avoid further fracture of tooth, crown is mandatory.

Celiac disease

Celiac disease: In celiac disease one cannot digest gluten properly. It is an autoimmune disorder of small intestine. Symptoms of celiac disease include diarrhea and fatigue. In celiac disease absorption of all the macronutrients is reduced.

Dietary guidelines:

• Iron deficiency anemia is common with celiac disease. optimize dietary sources with iron.
• The gluten free diet are low in iron, calcium, zinc, magnesium , vitamin b12 and fiber. Hence daily vitamin and mineral supplementation is necessary.
• Eat sprouted nuts and seeds.
• Add omega 3 rich foods in your diet.

Foods to eat:

• Rice
• Rice bran
• Arrowroot
• Flax seeds
• Soy
• Legumes
• Potato
• Corn
• Sago
• Sorghum
• Amaranth
• Tapioca
• Millets
• Malt vinegar

FENUGREEK

Fenugreek has been associated with number of health benefits. It is a common herb and used as a condiment for seasoning in Indian homes. This seed when used in cooking imparts a characteristic flavor and tang to food. Fenugreek leaves are well known for their high nutrient content of minerals and vitamins like potassium, calcium, magnesium, selenium, Iron and vitamin C, riboflavin, folate, vitamin B6. These leaves also have high fiber content and also Vitamin C.  Fenugreek seeds are a rich source of fiber. It contains mucilaginous fiber and total fiber to the extent of 20% and 50% respectively. This mucilaginous fiber is recognized medically for its anti-inflammatory properties. Fenugreek seeds have many medicinal values. These include in the treatment of digestive problems, diabetes, kidney problems, wounds, cellulites, tuberculosis. A PASTE OF Fenugreek leaves or seeds , applied on face prevents pimples, dryness of skin, blackheads and it also have anti aging factors. The Fenugreek seeds contain “Diosgenin” which is more of a raw material substance used in medical steroids by pharmaceutical industries.

• Fenugreek seeds aids in proper digestion: It maintains good metabolism and prevents constipation. The soluble fiber found in Fenugreek seed extract may help slow digestion and absorption of food. It also helps to treat colon disorders. It also increases appetite.
• Fenugreek seeds are effective in treatment of skin disorders: It relieve skin inflammation. It is also used in the treatment of eczema, gout, boils and burns.
• Fenugreek seeds reduce fever: Fenugreek seeds with lemon and honey help to reduce fever and weakness .In fever it is beneficial to consume tea added with fenugreek seeds that helps to lower the intensity of temperature rising.
• Fenugreek eases menopause symptoms: It is effective in treating the menopause symptoms including anxiety, hot flashes and insomnia this is because of its natural estrogen.
• Fenugreek may help in preventing cancer: It is an effective antioxidant. It also have anti carcinogenic properties some studies have shown that this may be due to presence of Diosgenin.
• Fenugreek also acts as a natural blood purifier and helps to prevent acne. Its also very effective in curing of oily skin.
• Fenugreek can also be used for excessive hair fall. It is believed to enhance hair growth both in men and women. Fenugreek powder mixed with curd helps in controlling your dandruff problem.
• These seeds help in lowering the risks of heart diseases.
• Fenugreek seeds help to increase production of milk in lactating mothers. The seeds contain a chemical known as Diosgenin which acts as similar to estrogen and hence promote milk production during breastfeeding.
• It is also used in the treatment of arthritis and asthma.
• Fenugreek seeds help in management of Diabetes: The powder of seeds in the diet reduces blood sugar and urine sugar with improvement in glucose tolerance and diabetic symptoms in both insulin and non-insulin dependent patients. It also lowers the levels of serum lipids such as cholesterol and triglyceride. Depending upon the severity of diabetes the quantity of fenugreek seeds to be taken varies from 25g to 50g.The Fenugreek seeds powder can be incorporated in food preparations such as vegetable curries, roti and dhal etc. Seeds can also be taken as such after overnight soaking in water.

MASSAGE AND HOT STONE MASSAGE THEREPY

Massage is one of the oldest healing arts practiced in all cultures and regions in the world. It is the procedure of systematic placing the hands on the body and applying techniques to treat the body and the person to relieve ailments and stress.

Massage has been a part of Ayurveda and Indian traditional medicine system since ages. It was practiced and taught by Vedic Rishis, who led the foundation of the Vedic civilization in India. Today massage is widely recognized as a cost effective preventive medicine and therapy. 

Massage therapy has been attested by billions in relieving stress and tension in everyday life. Being accepted in many physical rehabilitation programs, massage therapy has also proven beneficial for many chronic conditions like low back pain, arthritis, fatigue, diabetes, immunity suppression, depression, etc.     

Massage therapy involves the following:

• The application of physical touch to affect the various systems of the body, e.g., muscular, circulatory.

• The manipulation of the soft tissues of the body with the hands for therapeutic, pleasing, relaxing and healing effects.

•  Expression of the caring through the hands.

Massage and body work treatments can

• Alleviate low back pain

• Ease medication dependence

• Enhance the immunity of the body

• Improves the condition of the skin- body’s largest organ

• Increase joint flexibility

• Lessen depression and anxiety

• Promotes tissue regeneration and reduces scar marks and stretch marks

• Improves the circulation of fluids inside the body

• Reduces spasms and cramps

• Relax and softens injured, tired and overused muscles

• Relieves migraine pain.

There is no denying the fact that the massage or the bodywork has got immense power. It has got immense healing relieving properties. Massage therapy can be a powerful in every individual’s healthcare regime. 

Massage isn’t a pointless indulgence in sensory experience. It is an assurance keeping you in touch with your body. 

Another therepy of best massage is hot stone massage therepy 

 Hot Stone Massage

Hot stone massage is a variation on classic massage therapy. Heated smooth, flat stones are placed on key points on the body. The massage therapist may also hold the stones and use them to massage certain areas of the body.

The use of hot stones for healing dates back to ancient times, but it wasn't until Arizona massage therapist Mary Nelson introduced her hot stone massage technique, called LaStone Therapy, that the use of hot stones for massage caught on.

Nelson conducts workshops to train other massage therapists in LaStone. While LaStone continues to be popular, massage therapists and spas have also developed their own versions of the hot stone massage using heated, smooth rocks.

How Does Hot Stone Massage Work?

The hot stones are usually made of basalt, a type of rock that is rich in iron, so they retain heat. River rocks are normally used because they are so smooth - they have been smoothed over time by the river's current.

The stones are immersed in water and heated in an electric heating device until they are within a certain temperature range. The stones may be placed at specific points on the back, in the palms of the hand, or between the toes.

The heat warms and relaxes the muscles, which allows the therapist to apply deeper pressure, if desired.

The warmth of the hot stones improves circulation and calms the nervous system.

Some massage therapists place stones on points that are thought to be energy centers of the body to rebalance the body and mind.

 People should Get Hot Stone Massage because

Many people find the warmth of the hot stones to be comforting and get it for relaxation.

Hot stone massage is suited to people who tend to feel chilly or who have cold feet. It's also suited for people who have muscle tension but prefer a lighter massage. The heat relaxes muscles, allowing the therapist to work the muscles without using deep pressure.

People also get hot stone massage for a variety of health conditions:

Back pain and aches

Poor circulation

Osteoarthritis and arthritis pain

Stress, anxiety and tension

Insomnia

Depression

Feeling of Hot Stones ?

The hot stones are never rough. They are always flat and smooth. The hot stones used on the back are about the size of a large egg, only flat.

The stones are heated in an electrical heating unit that either provides a temperature reading or has an adjustable thermostat control.

The massage therapist always holds the stones first before touching them to your body, which ensures that the temperature will not be too hot. Everyone, however, has their own comfort range. Be sure to speak up if the stones are too hot for you.

Cool marble stones are occasionally used during a treatment, particularly if there is inflammation.

 Expections During  Hot Stone Massage

The massage therapist often begins by applying oil to the body, which allows the hot stones to glide smoothly along the muscles. You are lying face down, and the massage therapist often then uses the hot stones to massage the back.

After the hot stones have relaxed the muscles, the massage therapist may put down the stones and use his or her hands to directly massage the skin.

The hot stones may then be placed back on to the body and left for a short period of time.

You are then asked to turn over onto your back. The massage therapist may place small hot stones between your toes or in the palm of your hand and repeats the sequence.

A typical hot stone massage is between 60 and 90 minutes long .

Precautions to take

Massage is not recommended for certain people:

People with infectious skin disease, rash, or open wounds

Immediately after surgery

Immediately after chemotherapy or radiation, unless recommended by your doctor

People prone to blood clots. There is a risk of blood clots being dislodged. If you have heart disease, check with your doctor before having a massage

Pregnant women should check with their doctor first if they are considering getting a massage. Massage in pregnant women should be done by massage therapists who are certified in pregnancy massage.

Massage should not be done directly over bruises, inflamed skin, unhealed wounds, tumors, abdominal hernia, or areas of recent fractures.

Some Additional Hot Stone Massage Tips

Don't eat a heavy meal before the massage

If it's your first time at the clinic or spa, arrive at least 10 minutes early to complete the necessary forms. Otherwise, arrive 5 minutes early so you can have a few minutes to rest and relax before starting the massage.