Whiplash Video

December 30, 2009

Following our previous articles on whiplash injuries, here is a video that shows the mechanism of whiplash.

Written by chyetuan.chng · Filed Under Cervical, Featured Video, Spinal Conditions, Video | View Comments

What to do when your back hurts so much that you can’t get out of bed?

December 28, 2009

Source: Flickr erikogan

If your back suddenly hurts so much even to move up into a sitting position to get out of bed, it is likely that your spinal joints are severely inflamed and your back muscles are spasm-ing (twitching).

What you NEED to do

Reduce the inflammation:
- Either take an anti-inflammatory medication (tablet or injection). GP prescription may be required.
- If it is too painful even to go see the GP,
  - Apply a COLD press to the sore/painful area.
  - Take an over-the-counter anti-inflammatory (e.g. Voltaren Gel / Tablet). This is a weaker form of anti-inflammatory medication than what you will get from your GP.
Rest to let your body heal and reduce the inflammation naturally.

What NOT to do

Apply Heat (either through a hot pack or some of heat rub) You will further aggravate the inflammation.
Massage the sore area.

See your physiotherapist only after it doesn't feel so sore or painful the day after.

Written by Sylvia Ho · Filed Under Treatment Options | View Comments

Osteoarthritis Knee

December 25, 2009

Osteoarthritis (OA) of the knee is a degenerative condition where the cartilages of the knee wear away. Pain, stiffness and swelling are common symptoms of an OA knee. In this article, we look at the three factors that lead to the development of OA knee – Aging, Physical Attributes and Muscular Causes. Of which two of these factors, Physical Attributes and Muscular Causes, can be addressed with physiotherapy management. We will focus more in detail on the exercises and treatment for OA knee in a follow-up article.

Aging

OA Knee

OA knee usually afflicts the older population as our cartilage thin naturally as we age. If you have a past history of knee injury or long history of activities that overloads the knee joint, degeneration may set in much earlier. Unfortunately, these events are irreversible, so it is important that we look after our knees during our early adult life.

Physical Attributes

The three key physical attributes are:

Obesity - A heavier person will load their knee joints more, wearing out their cartilages faster than a lighter person.
Knee alignment – A bow legged or knock-knee appearance will cause an uneven compression of the knee. Either the outer or inner compartment knee respectively will take up most of the load upon weight bearing and cause more wear and tear.
Foot type -
- People with flat feet or whose feet over pronate tend to roll their knee inwards upon weight bearing similar to a knock-knee above.
- A person with high foot arch or whose feet under-pronate absorbs less impact with each foot fall. More impact goes up through the leg and the knee will have to work harder to cushion the impact.

Muscular Causes

When the muscles around the knee do not contract strong and fast enough in a coordinated fashion to absorb the impact of walking or running, the knee joint takes up the remaining forces of the impact.

Tight muscles pull joints closer to each other.In an OA knee where the joint space is already reduced, tight muscles will increase the compression of the joint space. Muscles with reduced flexibility are also less coordinated and slower in reaction time. The muscles that tend to be tight are the quadriceps, hamstrings and calves.
Weak muscles. The quadriceps muscles is the main muscle group that help to support the weight of the body and off loads the knee joint. It is very common for this muscle to atrophy because of disuse. The knee pain deters the patient from loading the knee and this will gradually lead to weakness of the knee which will affect the ability to cushion the impact. This pain, disuse, weakness cycle will continue without treatment.
Weak gluteus medius muscle can aggravate the degeneration of knee cartilage because its function is to keep the hip joint stable, especially in walking. This is often seen as a waddling gait where the hip sway with big movements side to side. The thigh muscle have to work a lot harder to stabilise the wobbly hip and if they are unstable, the knee joints will have to bear the weight.

The management of these factors are summarised in the following table. In our upcoming article, we will further discuss the specific exercises and treatment for OA knee.

Physical Attributes	Management
Weight	Weight loss programme
knee alignment	- training of muscles – orthotics
foot type	- orthotics

Muscular Causes	Management
Tightness	Stretch Quadriceps, Hamstring and Calves
Weak	Strengthen Quadriceps and Gluteus Medius

Written by chyetuan.chng · Filed Under Knee, Knee (NonSport), Running | View Comments

Waking up with neck pain? Try this.

December 25, 2009

How often do we wake up in the morning with stiffness and pain in the neck? You are not alone. This is one of the most common complain of most people but most people just think it’s just a sign of ageing and that they have to live with it. However, this is not true. You need not have to wake up every morning with this pain and stiffness.

Written by MCR · Filed Under Ergonomics, Spinal Conditions | View Comments

Train Proprioception to Prevent Sprains

December 17, 2009

Hi, I hear from my personal trainer that i need to train my proprioception because of my ankle sprains. What is proprioception and how is it relevant to my ankle problem? – John Koh

What is Proprioception? Read more

Written by lenia.teo · Filed Under Ankle and Foot, Have A Question?, Injury Management, Injury Prevention, Sports Injury | View Comments

Newly Discovered Sensory System in the Skin May Explain Fibromyalgia

December 14, 2009

A newly discovered sensory system hidden in a network located throughout our blood vessels and sweat glands, separate from the usual nerves that gives us the ability to touch and feel, may explain difficult to treat pain conditions like Fibromyalgia Read more

Written by chyetuan.chng · Filed Under Latest Research Findings | View Comments

Carpal Tunnel Syndrome

December 8, 2009

You’re going about doing your everyday work when you notice yourself shaking your hand to get rid of the tingling in it. It’s starting to really bother you because you’ve had the tingling at night too. You’re probably wondering if it’ll go away on its own. Does this sound like you? You might have Carpal Tunnel Syndrome. Read more

Written by MCR · Filed Under Hand & Wrist (NonSport), Workplace Health | View Comments

Elderly Balance Better After Foot Massages

December 4, 2009

Researchers found that elderly people were able to balance on their feet better with foot massages.

Jacques Valiant and his group of fellow researchers from Grenoble, France and Geneve, Switzerland found that a session of plantar massage and joint mobilisation of the feet and ankles with clinical balance performance tests in elderly people.

Dividing 28 subjects, aged between 65-95 years, into two groups:

1. An intervention group had a 20 minute session of massage and mobilisation to the feet and ankle,

2. A placebo group that was given an application of three demagnetized magnets in the region of the fifth metatarsal for 20 minutes.

The subjects were tested on their One Leg Balance (OLB), Timed Up and Go (TUG) and Lateral Reach performance. Results were compared between the two groups before and after the massage and application of the magnets.

The group who had massages and mobilisations showed significant improvements in performance of OLB and TUG after one session of intervention.

Reference:

Massage and mobilisation of the feet and ankles in elderly adults: Effect on clinical balance performance, J Vaillant et al., Manual Therapy 2009;14:661-664

Written by lenia.teo · Filed Under Latest Research Findings | View Comments