What is Physiotherapy?



Ways to Ease a Muscle Cramp

Cramps are unpleasant, often painful sensations caused by muscle contraction or over shortening. Common causes of skeletal muscle cramps is-

  1. Muscle fatigue
  2. Cold Temperatures
  3. Not enough Warm up before exercising or playing a sport
  4. Dehydration
  5. Electrolyte imbalance

Ways to relax your Muscles & avoid Cramping:

  1. Hydrate Yourself- Dehydration is one of the biggest culprits of muscle cramps. When you feel your muscles tensing into a cramp, it could be a sign that your body is dehydrated. Immediately drink water before the pain becomes too bad.
  2. Massage It- The minute you get a cramp, gently massage the muscle that is cramping. Rub the knots that have formed in the muscle to ease the sharp pain. Make sure you rub in the natural direction of the muscle.
  3. Warm Bath- Warmth eases tension in the muscles. If you’ve been struck by a cramp, hop in for a long, warm shower. It will relieve pain, relax the cramped muscle & make you comfortable. And you will feel much fresher afterwards too!!
  4. Stretch- Stretching helps ease muscle cramps too. For example, if you have a calf cramp, stretch your leg out with toes pointing upwards & towards your head. Hold for 30sec. It also works for cramps in your thighs.
  5. Magnesium Oil- Magnesium oil is hard to find, but its a really good remedy for muscle cramps. It is a natural muscle relaxant. All you have to do is massage the oil into the cramp in order for it to be relieved within minutes.
  6. Go Ayurvedic- There are several Ayurvedic solutions for easing cramps, including mustard seeds. Saturate a tub of hot water with a homemade tea bag of brown/black mustard seeds. When you have a cramp, immerse your feet in the tub for around 20min & your muscle cramp should be relieved.
  7. Ice Pack- If you have a really bad cramp, rubbing an ice pack over it can help the pain. Rub the ice pack over your muscle till your skin becomes reddish. The redness is an indication that blood is flowing back into the muscle & the cramp should ease.
  8. Cover Up- The minute you feel a cramp coming on pr when your struck by one, cover yourself with a blanket/switch off the air conditioner if your indoors. The warmth will get rid of the muscle tension & cramp.
  9. Electrolyte Supplements- Make sure you take supplements that you need daily. Also, while suffering from a cramp, something salt heavy such as an electoral can help ease the pain.
  10. Apple Cider Vinegar- Drinking a mixture of apple cider vinegar everyday will help keep muscle cramps away as it is a source rich in potassium. However, if you suddenly get a cramp, drink some with a teaspoon of honey in some warm water will give your cramps instant relief.

If you have another method you use to relieve your muscle cramps, we’d love to know. Comment here to let us know!

Psoas: ‘The’ Core Muscle

This mighty muscle, lying at the very core of your physical body, has a profound influence upon our well-being.

The psoas is the most important muscle in the body for 3 reasons:

  1. It brought us up to stand. The lumbar curve was created when we came to stand upright by the psoas.
  2. The walking muscle.  It is the muscle responsible for propelling you forward.  There are a lot of muscles helping it, but essentially walking is falling, and falling is all about your psoas. A healthy psoas provides a suspension bridge between trunk and legs. The psoas responds to every movement of the spine. Ideally the psoas guides rather than bears the transfer of weight from the one (trunk) into the two (legs).
  3. It’s a muscle of trauma.  This is the muscle in your body wherein you’re storing your emotions. When feeling threatened it is your psoas muscle that propels you into fleeing or fighting or curls you into a protective ball.

Everything from the chairs we sit in to the shoes we wear can curtail the natural movement of the psoas. Having a constricted psoas might be traced back to your first shoe. Wearing a shoe that shapes the foot, stops bones from rolling, limits ankle mobility, drops the heel behind or shifts the weight onto the toes can and does affect skeletal balance. It can stifle the vitality of your psoas.

Premature standing and walking (before the bones are fully formed and weight bearing) teaches a child to rely on their psoas muscle for structural support. Playpens and walkers encourage early standing and limits crawling, which is so important for kinaesthetic maturation. Plastic baby holders restrain and limit natural movement, rhythm and the protective give and take of a mother’s supple body.

The Effects/Symptoms of a Shortened Psoas

  • Pain with prolonged standing, or standing while leaning forward (doing dishes), pain on rising to stand after sitting, especially when you are leaning forward (computer use or bleacher sitting), and lying flat on your back with the legs flat
  • Constricted organs
  • Impinged nerves
  • Impaired diaphragmatic breathing
  • Putting pressure on the uterus, a tense or short psoas can cause cramping
  • Pushing the oesophagus forwards, a tight upper psoas can cause digestive problems
  • A short psoas can interfere with the diaphragm fully descending through the abdominal core

Psoas as ‘The’ Core Muscle


See the Psoas as a support.  It is the length and vitality of the psoas that helps to maintain volume in the core. Providing a diagonal muscular shelf, the psoas moves through the core supporting the abdominal organs. A major ganglion of nerves is located on top, around and imbedded through the psoas. Together with the diaphragm, the action of the psoas works like a hydraulic pump to massage the organs and viscera while stimulating the flow of fluids throughout the body.

The keystone of skeletal alignment, it is the balanced pelvis that provides a base of support for the spine, ribcage, neck and head. It is the aligned pelvis that transfers weight down through the hip sockets, legs, knees and feet. If the bones do not support and transfer weight properly, it is the psoas muscle that is called upon to provide structural support, making it tight & weak.

In addition to the psoas being tight, it is also typically weak at the same time. This creates dysfunction in the muscle. Our brain has trouble controlling the muscle because it has been in a shortened position for so long, thinking the psoas always needs to be flexed.

True core strength then, depends upon core integrity. Unlike other muscles, the Psoas does not need strengthening, but rather nourishing. The ‘weak’ Psoas muscle is really a dry, exhausted, Psoas; abused, over-used and too often misused.

Test your Psoas

  • constructive-rest-positionConstructive Rest is an easy position for releasing tension in your psoas muscle. After work and before your evening meal take 10 – 20 minutes to rest in constructive rest and feel the benefits.  Begin by resting on your back. Knees bent and feet placed parallel to each other, the width apart of the front of your hip sockets. Place your heels approximately 12-16 inches away from your buttocks. Keep the trunk and head parallel with the floor. If not parallel place a folded, flat towel under your head. DO NOT push your lower back to the floor or tuck your pelvis under in an attempt to flatten the spine. For best results keep the arms below the shoulder height letting them rest over the ribcage, to the sides of your body or on your belly. There is nothing to do; constructive rest is a BEING position. In this simple position gravity releases the psoas and you’ll feel more at peace with your self and the world.
  • Psoas Strength Test  hip-flexor-strength-test-226x300
    (Modified Sahrmann’s Test (3))
    Here is a general way to determine if your psoas is weak:

    1. Standing, grab and pull your knee to your chest as high as you can without leaning backward. You will need to get your thigh well past 90° (in relation to your supporting leg).
    2. Once your knee is close to your chest, release your hands and attempt to keep your leg above 90 degrees for 15 seconds.
    3. Start timing when you release your hands and stop when your thigh drops below 90° (make sure to use a clock on the wall).

    If you fail before 15 seconds then you have a weak psoas muscle. Any major body shifts, leans, cramping, or loss of control in the allotted time also results in a failed test.  Failure far before 15 seconds shows further weakness. For best accuracy have a fitness professional conduct your test.

For more on Psoas muscle & its conditioning, check out:

Thus working with the Psoas challenges the standard precept of core strength. To really achieve core strength you must first regain a supple, responsive and fluid core so that rich bio-intelligent messages from the central nervous system can foster healthy neuromuscular and skeletal relationships.


Total Hip Replacement – Precautions

Total Hip Replacement(T.H.R) is a surgical procedure of removing the diseased hip joint and replacing it with an artificial one.

Usually the patients considered for T.H.R are

  1. Young patient
  2. Osteoarthritis of hip joint
  3. Rheumatoid Arthritis
  4. Avascular Necrosis
  5. Septicemia

There is a progressive increase in chronic pain and difficulty in walking, stair climbing and rising froma chair.

Usually there are two types of prosthesis which are commonly used for the surgery: Cemented and Uncemented Prosthesis.

Difference of cemented and uncemented prosthesis:

Cemented prosthesis is usually used in older patients who are less active and have less bone moneral density.

Uncemented Prosthesis is used in younger and more active individuals.

The primary disadvantage of uncemented rposthesis is the extended recovery periof. Because it takes long time for natural bone to grow and attach to prosthesis, hence the person has to limit his activitties for upto 3 months to protect hip.

Your hospital stay my last for a week. If you go home you will need help for several weeks.

The following steps can make your home coming easier:

  • In kitchen as well as other rooms, place items of daily use within reach so you dont have to reach up or bend down.
  • Rearrange furniture you can walk easily with walker or stick.
  • Get a good chair that is firm and higher than average seat.
  • Remove rugs or area rugs that could make you slip.
  • Securely fasten electrical cords around perimeter of the room
  • Install a shower chair grab bar and raised toilet.
  • Use assistive devices such as long handle sponge and grabbing tool or reacher to avoid bending too far.

Once you get home, stay active.The key is not to overdo it while you expect some good and some bad days, you should notice gradual improvement over time.

WEIGHT BEARINGDiscuss with your physical therapist regarding the weight bearing of operated leg as the rehabilitation protocol will be different for cemented and uncemented prosthesis.

STANDING: Move your operated leg first and pushoff the armrest of chair to stand up.

SLEEPING POSITIONS: Sleep on your back with legs slightly apart on your side with abduction pillow.Be sure to use the pillow atleast 6 weeks or untill your doctor tells you to use. Sleeping on stomach is alright.

SITTING: For atleast 3 months donot cross your legs at knees. Make sure the seat height is good so as to avoid bending of hip beyond 90 degreesGet up and move around possibly every 1 hour.

SEX: Some sex positions can be safely resumed 4-6 weeks after surgery. Ask your doctor regarding the same.

CLIMBING: Stair climbing should be limited if possible untill the wound is healed.

Following pattern of stair climbing should be followed.


  • the unaffected leg should step up first
  • then bring affected leg to same step
  • then bring the cane


  •  put the cane first
  • next bring the affected leg down the step
  • finally step down with unaffected leg.

DRIVING: You can begin driving an automatic car 4 to 8 weeks after consulting your doctor and symptoms after surgery.

SITTING INTO CAR: Be sure the passenger seat is pushed all the back.Recline the seat as far as possible.with the walker in front of you slowly back up the car seat.Swing your legs into the car.Lean back if you need to avoid the hip more than 90 degrees.

GETTING OUT OF THE CAR: Push the seat all the way back.recline the seat and lift your legs out.lean back if you need to.place walker up in front of you and stand up on unaffected leg.

RETURN TO WORK: Depending on the type of activities you eprform it may take as long as 3 months to 6 months to return to work.

OTHER ACTIVITIES: Walk as much as you like once doctor gives you permission, but remember donot substitute walking to exercise.Swimming is recommended once suture are removed and wound is healed.Acceptable activities are dancing, golfing with spike less shoes and cart,bicycling on level road.Avoid activities that involve impact or stress on joints such as tennis, badminton or contact sports like baseball, football,squash, jumping or jogging, Lifting weights is not a problem but carrying heavy and awkward objects that cause to stagger is not advised especially if you must go up and down stairs or slopes.

Do’s and Dont’s

The do’s and dont’s vary depending on orthopaedic surgeons apporach.Your doctor and Physical therapist will provide you with a list of the same to remember with your new hip.The precautions will help you to prevent the new joint from dislocation and ensure proper healing.

 The Dont’s

  • Donot cross legs at knee for atleast 8 weeks
  • donot bring knee up higher han your hip
  • donot lean forward while sitting or as you sit down
  • donot try to pick up something on the floor while ou are sitting
  • donot turn your feet excessively inwards or outwards
  • donot reach down to pull your blanket when lying down
  • donot bend at waist beyond 90 degrees
  • donot use pain as a only guide for what you may or may not do

The Do’s

  • Keep skin dry and clean
  • Notify doctor if wound drains
  • Swelling is normal for first 3-6 months. Elevate leg slightly <30 degrees on pillow and put ice packs for 15-20 min
  • If you get calf pain , chest pain and shortness of breath notify doctor immediately
  • Do exercises prescribed daily.
  • A balanced diet is very important.
  • Maintain an active lifestyle after surgery.

DISCLAIMER: Kindly refer your doctor and Physical therapist for the instructions depending on your surgery procedure.

Trigger Finger: What you can DO

Trigger finger, often experienced by the elderly or by people diagnosed with conditions like rheumatoid arthritis, causes the fingers to pop or get stuck when you try to extend them. Diagnosis is often made by a physical examination & manipulation of the finger by your doctor. Exercises & physical therapy treatments for a trigger finger are suggested before more serious treatment options such as surgery are recommended. 


Trigger finger is a bone & joint condition caused by a contraction of the flexor tendons lining the inside of the finger. The flexor tendons are secured to the ligaments and bones of your fingers with sheaths. If your finger flexor tendons become thickened or develop small nodules due to age, wear or tear, you’re often unable to extend a finger or a thumb. This causes your finger to bend into a fixed position as you try to extend, much the way you’d hold your finger to pull a trigger, hence its name.

As with all disorders of the upper extremity, proximal segments must be screened.  Also, because posture can contribute to distal problems, it should be addressed to provide the patient with optimal outcomes. It is important to commence Physiotherapy soon after diagnosis to prevent the condition from getting worse & to get back to your normal level of functioning.

Physiotherapy treatment will help to reduce swelling, relieve pain and stiffness & regain functional movement of the finger. Physiotherapy treatment may include:

  • Ultrasound: Reduce swelling & accelerate healing
  • Soft tissue massage
  • Joint mobilisation
  • Passive stretching
  • Supervised hand & finger exercise program to regain strength, dexterity & flexibility
  • Splinting or Taping

Patient Education

Since trigger finger is observed as an overuse injury, education is very important. Education should be given on:

  • Rest
  • Modifications of activities
  • Specialized tools
  • Splinting
  • Modalities
  • Posture

Modalities such as heat/ice, ultrasound, electric stimulation, massage, stretching, & joint motion (active & passive) can have some positive effects on trigger finger. Following heat with stretching can provide more extensibility with plastic deformation. Joint movement & mobilizations increase joint & soft tissue mobility via a slow, passive therapeutic traction & translational gliding.


Tendon Exercises

  • Perform a series of tendon gliding exercises.
  • Start with your fingers extended outward and your thumb pointing away from and perpendicular to the palm. Flex your fingers toward your thumb, as if you’re making the shape of a duck’s beak. Your finger and thumb should be approximately 1/2 inch apart. From this position, curl your fingers into your palm, placing your thumb along the outside of the index finger. Curl your fingers more and make a fist; this time, curl your thumb over the outside of your knuckles.
  • Slowly open your hand and lift the fingers, knuckles bent, into a upright position, your thumb again extended away from your palm. Repeat the sequence several times.

Soft Tissue Mobilization

  • Massage or soft tissue mobilization may help reduce the severity of your trigger finger or thumb constriction.
  • Massage manipulates muscle, tendon & ligament tissues & floods the affected area with blood & nutrients.
  • Massage also helps relax tightened muscles, which may facilitate other trigger finger exercises for greater efficacy and benefits.
  • One method of massaging a sore trigger finger is friction massage, which a physical therapist can do or you can do yourself. Stroke the affected finger in a downward motion toward the palm or upward toward the tip of the finger. This may help relieve pain and stiffness caused by nodules & lengthen the finger muscles and tendons.

Palm Presses

  • Hand & finger exercises that contract & extend the muscles & tendons of the fingers may provide relief & greater range of motion of the finger & thumb.
  • Pick up small items & place them in your palm, squeezing tightly for several seconds. Release, opening your fingers wide, & then repeat as instructed by your physical therapist.
  • Regular exercise and movement may help lengthen the flexor tendons, relieving symptoms of trigger finger.
  • Avoid activities which involve a sustained grip. Hold off on the use of grip strengthening devices or exercises involving repetitive squeezing – these put stress on the irritated tendon.

If fingers bend & lock during the night and are painful to straighten in the morning, it may be helpful to wear a splint to keep them straight while sleeping.

A first step in treatment is to stop doing activities that aggravate the condition. Splinting is one of the best ways to limit motion. There are various ways to splint a patient but, ultimately, it will depend on what provides the patient with the most relief. Splints are usually worn for 6-10 weeks. It should be noted that splinting yields lower success rates in patients with severe triggering or longstanding duration of symptoms.Two major types of splinting most recently studied:

  • Splinting at the DIP joint.  This showed to have resolution in 50% of the patient’s symptoms.
  • Splinting at the MCP joint with 15 degrees of flexion.  This showed to have resolution of the patient’s symptoms at both 65% and 92.9%, which is consistent with current literature.




Taping Technique (Click for video on Taping)

DISCLAIMER: Please consult your medical professional before beginning exercises.

Physiotherapy to Treat Pelvic Organ Prolapse (Guest Post by DrugWatch.com)

Women diagnosed with Pelvic Organ Prolapse (POP) may feel confused about what the diagnosis means, and what treatments are available. It is important that women become educated on the subject since approximately 50 percent will be diagnosed with it. POP occurs when a weakened pelvic floor allows pelvic organs to fall, or drop, placing pressure on the vagina.

The good news is that many cases of POP, especially cases with very mild to moderate symptoms, can be treated using physiotherapy — physical therapy — rather than surgery. Some surgical procedures, especially those using transvaginal mesh, have been linked to serious and irreversible health complications. Physiotherapy can often reverse the symptoms of POP, allowing women to skip risky surgical treatment altogether.

Can Pelvic Organ Prolapse be Avoided?

One of the most natural ways to avoid POP is to do physiotherapy-based exercises before POP sets in. POP is usually diagnosed in women between the ages of 50 and 79 because menopause is a time when estrogen levels decrease and pelvic tissues become thin and weak.

Pregnancy and childbirth are leading causes of POP. Additional factors include smoking and obesity. Women can be proactive about their pelvic health by leading a healthy lifestyle and doing daily exercises, such as Kegels, to keep pelvic muscles healthy and strong.

Physiotherapy Options for Treating Pelvic Organ Prolapse

Once POP has been diagnosed, there are several safe and effective methods for treating it. Women will want to discuss these options with their doctor before agreeing to surgery.

Pelvic Floor Exercises: Pelvic floor exercises like Kegels, Yoga and Pilates can help to strengthen the pelvic floor and core muscles. This can often reverse mild symptoms and protect organs from prolapsing further.

Pelvic Physiotherapy: There are physical therapists who specialize in pelvic health. A doctor can recommend a pelvic physical therapist who will instruct and guide women through a series of exercises that focus on pelvic muscles to reverse the symptoms of POP. Women with a family history of POP may want to start these exercises when they are young to help prevent POP.

Electrical Stimulation: Doctors can use electrical stimulation to manually strengthen pelvic floor muscles, if Kegel exercises aren’t enough. They also have biofeedback machines that can demonstrate whether a woman is doing pelvic exercises effectively. If the feedback indicates the muscles aren’t being stimulated, a doctor can work to instruct the patient on how to do the exercises more effectively.

Not only is pelvic physiotherapy beneficial for women with POP, it can also help women who experience incontinence. In fact, research demonstrates that women who perform proper Kegel exercises on a daily basis during pregnancy are much less likely to develop incontinence during their third trimester. Continued use of these exercises can prevent incontinence altogether.

Other Non-Invasive Treatments

The American Congress of Obstetricians and Gynecologists has recommended that women with mild to moderate POP opt for more conservative treatments, as opposed to surgical treatments. The organization has also stressed the importance of taking preventative actions against the development of POP.

   Healthy Lifestyle: POP can be prevented. Many of the symptoms of POP are worsened by unhealthy lifestyles, such as smoking and chronic straining, such as with constipation, and obesity. By maintaining a healthy and active lifestyle and weight, the risk of POP can be minimized.

   Vaginal pessary: A pessary is a removable device placed into the vagina, designed to support prolapsed organs. Pessaries hold organs in the correct place before it becomes enlarged and protrudes through the vagina. The pessary is fitted as to not cause discomfort. Symptoms of POP usually improve or go away after pessary use. Risks include wearing of vaginal wall and bleeding; but can be prevented by insuring the device fits correctly.

Working with doctors, and implementing physiotherapy when necessary, can prevent the development of POP and can often reverse existing symptoms of the condition. Transvaginal mesh, a common surgical device used to treat POP, has been determined risky by the Food and Drug Administration.  Thousands of women who are suffering from its use have filed vaginal mesh lawsuits against the manufacturers. Now, it is more important than ever that women do all they can to prevent the need for risky surgical procedures.

For further updates on this condition and its treatments, stay tuned to Fitnesspedia.