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28/09/2022

🔈THORACIC OUTLET SYNDROME

Thoracic outlet syndrome is a disorder characterized by pain and paresthesias in a hand, the neck, a shoulder, or an arm.
Pathogenesis often involves compression of the lower trunk of the brachial plexus (and perhaps the subclavian vessels) as these structures traverse the thoracic outlet below the scalene muscles and over the 1st rib, before they enter the axilla.

Compression may be caused by:
• A cervical rib
• An abnormal 1st thoracic rib
• Abnormal insertion or position of the scalene muscles
• A malunited clavicle fracture
• Thoracic outlet syndromes are more common among women and usually develop between age 35 and 55.

Symptoms and Signs of TOS
Pain and paresthesias usually begin in the neck or shoulder and extend to the medial aspect of the arm and hand and sometimes to the adjacent anterior chest wall. Many patients have mild to moderate sensory impairment in the C8 to T1 distribution on the painful side; a few have prominent vascular-autonomic changes in the hand (e.g., cyanosis, swelling). In even fewer, the entire affected hand is weak.

Rare complications of thoracic outlet compression syndromes include Raynaud syndrome localized to the affected arm and distal gangrene.

Exercise:
• Pectoralis stretch: Stand in a doorway or corner with both arms on the wall slightly above your head. Slowly lean forward until you feel a stretch in the front of your shoulders. Hold 15 to 30 seconds. Repeat 3 times.

• Thoracic extension: While sitting in a chair, clasp both arms behind your head. Gently arch backward and look up toward the ceiling. Repeat 10 times. Do this several times per day.

• Arm slide on wall: Sit or stand with your back against a wall and your elbows and wrists against the wall. Slowly slide your arms upward as high as you can while keeping your elbows and wrists against the wall. Do 3 sets of 10.

• Rowing exercise: Tie a piece of elastic tubing around an immovable object and grasp the ends in each hand. Keep your forearms vertical and your elbows at shoulder level and bent to 90 degrees. Pull backward on the band and squeeze your shoulder blades together. Repeat 10 times. Do 3 sets.

18/07/2022

🔈 INFLAMMATION: TISSUE RESPONSE TO INJURY

The inflammatory response is a natural defence mechanism that is triggered whenever body tissues are damaged in any way. Most of the body defence elements are located in the blood and inflammation is the means by which body defence cells and defence chemicals leave the blood and enter the tissue around the injured or infected site. Inflammation occurs in response to physical trauma, intense heat and irritating chemicals, as well as to infection by viruses and bacteria.

The inflammatory response:

1. prevents the spread of damaging agents to nearby tissues
2. disposes of cell debris and pathogens
3. sets the stage for the repair process.

The four cardinal signs of inflammation are redness, heat, swelling and pain. Many experts consider impairment of function to be the fifth cardinal sign of inflammation.

The inflammatory process begins with chemical “alarms” a series of inflammatory chemicals that are released in the extracellular fluid. Injured tissue cells, phagocytes, lymphocytes, mast cells and blood proteins are all sources of inflammatory mediators, the most important of which are histamine, kinins, prostaglandins, complement, and lymphokines.

Though some of these mediators have individual inflammatory roles as well, they all promote dilation of the small blood vessels in the vicinity of the injury. As more blood flows into the area local hyperemia (congestion with blood) occurs which accounts for the redness and the heat of the inflamed area.

These chemicals also increase the permeability of local capillaries. Consequently, exudates, fluid containing proteins such as clotting factors and antibodies, seeps from the bloodstream into the tissue spaces.

This exudate is the cause of the local oedema or swelling that in turn, presses on adjacent nerve endings, contributing to a sensation of pain. Pain also results from the release of bacterial toxins, lack of nutrition to the cells in the area, and the sensitising effects of released prostaglandins and kinins. If the swollen and painful area is a joint, normal movement may be inhibited temporarily in order for proper healing and repair to occur.

Although at first, oedema may seem to be detrimental to the body, it isn’t. The entry of protein-rich fluids into the tissue spaces helps to dilute harmful substances, which may be present, brings in large quantities of oxygen and nutrients necessary for the repair process, and allows the entry of clotting proteins which form a gel like fibrin mesh in the tissue space that effectively isolates the injured area and prevents the spread of bacteria and other harmful agents into the adjacent tissues. It also forms a scaffolding for permanent repair.

17/07/2022

🔈THE SIX TYPES OF SYNOVIAL JOINTS

Synovial joints are classified according to the shape of their articulating surfaces and/or the type of movement they permit.

1. Plane joints permit gliding or sliding movements in the plane of the articular surfaces. The opposed surfaces of the bones are flat or almost flat, with movement limited by their tight joint capsules. Plane joints are numerous and are nearly always small. An example is the acromioclavicular joint between the acromion of the scapula and the clavicle.

2. Hinge joints permit flexion and extension only, movements that occur in one plane (sagittal) around a single axis that runs transversely; thus, hinge joints are uniaxial joints. The joint capsule of these joints is thin and lax anteriorly and posteriorly where movement occurs; however, the bones are joined by strong, laterally placed collateral ligaments. The elbow joint is a hinge joint.

3. Saddle joints permit abduction and adduction as well as flexion and extension, movements occurring around two axes at right angles to each other; thus, saddle joints are biaxial joints that allow movement in two planes, sagittal and frontal. The performance of these movements in a circular sequence (circumduction) is also possible. The opposing articular surfaces are shaped like a saddle (i.e., they are reciprocally concave and convex). The carpometacarpal joint at the base of the 1st digit (thumb) is a saddle joint.
4. Condyloid joints permit flexion and extension as well as abduction and adduction; thus, condyloid joints are also biaxial. However, movement in one plane (sagittal) is usually greater (freer) than in the other. Circumduction, more restricted than that of saddle joints, is also possible. The metacarpophalangeal joints (knuckle joints) are condyloid joints.

5. Ball and socket joints allow movement in multiple axes and planes: flexion and extension, abduction and adduction, medial and lateral rotation, and circumduction; thus, ball and socket joints are multiaxial joints. In these highly mobile joints, the spheroidal surface of one bone moves within the socket of another. The hip joint is a ball and socket joint in which the spherical head of the femur rotates within the socket formed by the acetabulum of the hip bone.

6. Pivot joints permit rotation around a central axis; thus, they are uniaxial. In these joints, a rounded process of bone rotates within a sleeve or ring. The median atlanto-axial joint is a pivot joint in which the atlas (C1 vertebra) rotates around a finger-like process, the dens of the axis (C2 vertebra), during rotation of the head.

11/07/2022

🔊 FROZEN SHOULDER - CAN MASSAGE AND EXERCISE HELP?

Frozen shoulder is a condition where an individual will experience pain and stiffness in the shoulder and is not able to lift the arm over the head. Frozen shoulder causes stiffness and restricted range of movement in the shoulder. This condition is medically known as "adhesive capsulitis." However, the adhesive capsulitis is a specific condition where there is a slow onset of stiffness and pain in one shoulder due to inflammation and tightening of the joint capsule. Usually the terms frozen shoulder and adhesive capsulitis are used alternately.

💡 PHASES

Clinical presentation is typically in three overlapping
phases:

🔁 Phase 1 – lasting 2 months to 9 months. Painful
phase, with progressive and increasing pain on
movement. Pain tends to be constant and diagnosis
in the early stages before movement is lost can be
difficult.

🔁 Phase 2 – lasting 4 months to 12 months. Stiffening
or freezing, where there is gradual reduction of pain
but stiffness persists with considerable restriction in
range of motion. Pain pattern changes from constant
to end range pain of reduced intensity.

🔁 Phase 3 – lasting 12 months to 42 months.
Resolution or thawing phase, where there is
improvement in range of motion with resolution of stiffness. End range pain may persist until full
resolution.

💡 TREATMENT

In most of the cases adhesive capsulitis resolves on its own over a period of a year to year-and-a-half. Treatment for adhesive capsulitis basically focuses on alleviating pain and trying to preserve as much range of motion as possible in the affected shoulder.

➡️ EXERCISE

Stretching exercises are usually the cornerstone of treating frozen shoulder. Here are just a few.

1. Cross-body arm stretch
2. Pendulum stretch
3. Arm circles
4. Towel stretch

➡️ MASSAGE

Massage therapy is very beneficial in treating frozen shoulder as it increases the blood circulation to the injured region and also reduces the formation of scar tissue. Regular massage should be done to reduce the muscle stiffness. The pain and stiffness usually gets relieved after several massage treatments.

There are various combinations of techniques done by a professional massage therapist, which provide relief from shoulder pain and help in the recovery stage.

▪️DEEP TISSUE MASSAGE

One of the common techniques used to treat frozen shoulder is deep-tissue massage. In this technique, the massage therapist applies constant pressure to the muscles in order to release the scar tissue or adhesions, which may be causing the shoulder pain.
Shiatsu is a Japanese form of deep-tissue massage, which involves deep pressure on certain regions of the body. These are called acupressure points and helps in controlling the energy flow ("Ki" in Japanese) across the body and thus results in decrease in pain. Deep-tissue massage techniques should not be done in case of acute shoulder pain, swelling or inflammation, as it may aggravate the condition.

▪️TRIGGER POINT THERAPY

Trigger point therapy is another massage technique, which benefits the frozen shoulder. In this technique, a steady pressure is applied on certain targeted points within the muscles. This helps in relieving the muscle spasms.

▪️HEAT THERAPY

Heat therapy is also very helpful in treating the frozen shoulder. It can be applied before or after a massage. Heat therapy can be also done for trigger point massage for frozen shoulder. It helps in relaxing the muscles and decreasing pain. Mild heat can be applied for multiple times daily using pads, which are heated an hour before application.

source: Harvard Medical School, British Orthopaedic Association.

29/09/2021

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28/05/2021

And for the lazy persons guide; get a massage 💆‍♀️

If you have excess fluid, especially in your legs, you might need to drain your lymphatic system. Here's how to do it and tips to keep it clear.

15/12/2020

Posted • This Christmas we’re wishing for a food system where everybody, regardless of income, status or background, will have access to non-toxic food - food that is medicine. A food system that doesn’t compromise planetary health but rebuilds a resilient and biodiverse world for generations to come. ⠀⠀⠀⠀⠀⠀
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