World Physiotherapy Day 2022 | Exercises for the Prevention and Management of Osteoarthritis

Every year World Physiotherapy Day is observed on the 8th of September. This day is celebrated to recognize the importance of physiotherapy in our lives. Physiotherapy plays an important role in keeping our bodies healthy and fit. Several diseases can be cured with the help of Physiotherapy. The physiotherapist can treat the injuries and deformities in a patient and make their damaged body part functional. The Theme for World Physiotherapy Day 2022 is Prevention and Management of Osteoarthritis (the most common form of arthritis). The day focuses on raising awareness about the crucial role of physiotherapists in the prevention of Osteoarthritis and the way through which the condition can be managed. Mentioned below are a few exercises which can be done by individuals suffering from osteoarthritis.

 

Initially, get started with simple strengthening exercises without resistance and then progress by using flexible tubing, weights up to 1 or 2 pounds 12 to 15 times in 2 or 3 sets.

 

Shoulder Stretches:

• Sit with forearms in front of the body.
• Bring the elbows back to the "hands up" position, with palms facing forward.
• Stretch the arms overhead as far as possible, but keep the elbows in line with the side of the body.

 

Forward arm reaches:

• Sit or stand with arms at the side, elbows bent and thumbs pointed back toward the shoulders.
• Stretch arms overhead.
• If one of the arms is weak, then help it by placing the hand under the elbow and assisting the arm to the overhead position.
• Finally, lower the arms slowly and bring them to the starting position.

 

Finger walk thumb circles:

• Sit with hands on the table and fingers pointing ahead.
• Slide thumbs toward each other.
• Then slide each finger towards the thumb, one by one.
• After the little finger has completed the "walk", lift the hands and put them down straight. Then, move the fingers toward the thumb. Then rotate the thumbs.

 

Biceps curls:

• Start with elbows bent by the sides.
• Keep the upper arm at the side, and bring one dumbbell up to the shoulder.
• Lower to the starting position and repeat the same exercise with the opposite arm.
• Continue to alternate between sides.

 

Triceps extensions:

• Hold the weight overhead by using both hands.
• Keeping the elbows pointed upward, lower the weight behind the head. (Make sure not to hit the back of the neck).
• Raise weight overhead again.
• Return and repeat.

 

Side lateral raises:

• With arms down at the sides, raise arms (slightly bent) to shoulder height.
• Lower and repeat.

 

Wall push-up:

• Stand 12 inches (with feet) away from the wall.
• Place both hands a little wider than the shoulders.
• Lower the chest to the wall, then push back to the starting position.

 

Knee raise:

• Sit on the edge of a chair or stool with the back straight.
• Lift the knee as high as possible without bending the back.
• Bring the knee higher with the hands if necessary.
• Keeping the abdominals tight, slowly lower the leg back to the starting position.

 

Heel/ toe lift:

• Sit forward on a chair with feet flat on the floor.
• Lift heels, place toes on the floor, then lift toes.
• Hold for 3 seconds and then return to feet flat position.

 

Leg lift/ ankle movement:

• Sit upright with your back supported.
• Slowly straighten the knee. With the knee slightly bent, bend the ankle, pointing the toes ahead.
• Then reverse to point the toes toward the ceiling, and repeat.

 

Exercising has often been seen to be effective in helping, but the nature of the condition often impedes the implementation of such therapy. Motion hurts, but motion is shown to be among the best treatments, as exercises keep the joint mobile it helps to reduce the constant inflammation and pain associated with it.

 Top 10 Strengthening Exercises for Frozen Shoulder in Diabetic Patients

The global prevalence of diabetes has risen dramatically in the last few decades, and currently affects millions of people around the world. Diabetics require to control the blood sugar level in their body otherwise, it can lead to long-term complications, like heart problems, muscle cramps, arteriosclerosis (blocked arteries), etc. Regular exercises help to keep the heart healthy and maintain the cholesterol level in the body. Diabetics have high glucose levels in their blood because, either their body doesn't produce enough insulin to process glucose, or their body doesn't use insulin properly. This leads to the development of various joint disorders associated with diabetes, and among them, shoulder issues like the frozen shoulder are observed quite commonly in diabetic patients. Frozen shoulder is characterized by pain, thick adhesions, and significant loss of its range of motion in all directions. And exercises are generally helpful in restoring shoulder joint movement. In this blog, we have mentioned a few exercises for frozen shoulder.

 

Frozen shoulder

Frozen shoulder or adhesive capsulitis, is painful with loss of shoulder motion, which typically occurs in phases. It starts with pain and stiffness, that lasts for 2-6 months. Then it evolves into a less painful, but stiff with complete loss of certain movements. Usually, after months to years of the onset, there is spontaneous improvement in the range of motion. Physiotherapy treatment focuses on decreasing pain, inflammation, and increasing the range of motion.

 

Exercise for Frozen Shoulder

Before doing these exercises do warm up by taking a warm shower or bath for 10 -15 minutes.

Flexion Extension Exercises:

• Sit or stand and use an exercise rod or band.
• Gently bend the arm and shoulder muscles.
• Lift the rod or band over the head and behind the back.

 Pendulum Stretch:

• Relax the shoulders.
• Stand and lean slightly forward, so that the affected arm hangs down,
• Swing the arm in a small circle in clockwise and anti-clockwise directions about a foot in diameter.

 Towel Stretch:

• Hold one end of a towel behind the back and grab the opposite end with the other hand.
• Hold the towel in a horizontal position. Use the unaffected arm to pull the affected arm upward so that stretch is felt.

 Finger Walk:

• Face a wall at arm's length.
• Reach the wall at waist level with the fingertips of the affected arm. Bend the elbow slightly, slowly walk the fingers up the wall, till the arm is raised as far as comfortable.
• Do not involve the shoulder muscles.

 Cross-body Reach:

• Sit or stand and use the good arm to lift the affected arm at the elbow, and bring it up and across the body, exerting gentle pressure to stretch the shoulder.
• Hold the stretch for 20 seconds.

 Armpit Stretch:

• Use the unaffected arm to lift the affected arm onto a shelf about breast height.
• Slowly bend the knees and open up the armpit.
• Deepen the knee bend slightly, gently stretch the armpit, and then straighten.
• Stretch a little further with each knee bend, without forcing it.

 Outward Rotation:

• Hold an exercise band between the hands with the elbows at a 90-degree angle close to the sides.
• Rotate the lower part of the affected arm outward two or three inches and hold for 5 secs.

 Inward Rotation:

• Stand next to a closed door, and hook one end of an exercise band around the doorknob.
• Hold the other end with the hand of the affected arm, while holding the elbow at a 90-degree angle.
• Pull the band toward the body 2-3 inches and hold for 5 seconds.

 Hand-behind-back Stretch

• Stand and place the affected arm behind the back.
• Use the opposite hand to take hold of this wrist.
• Stretch the affected arm by moving it towards the opposite buttock.
• Slowly move it as far up as possible.
• Hold this position for a few seconds.

 Umbrella Push

• Sit in a chair with the elbows alongside the body.
• To hold an umbrella in front, use an overhand grip.
• Use the unaffected arm to push the affected arm over to the side.
• Keep the elbow of the affected arm drawn in at the side.
• Return to the starting position.

While performing these exercises, do them gradually and hold the arm at the endpoint of the range of motion for a few seconds. Slowly release the stretch and repeat. Do not perform forceful movements because they can elicit pain.

 Fibromyalgia: Management of Chronic Pain and Fatigue By Physiotherapy

Fibromyalgia (FM) is a medical condition that affects millions of people around the world. It is a syndrome characterized by generalized chronic musculoskeletal pain for more than 3 months duration. The patient with fibromyalgia suffers from hyperalgesia in specific points (tender points), fatigue, sleep disturbances, depression, cognitive dysfunction, and gastrointestinal disorders. These symptoms cause a reduction in functional capacity and consequently, reduce the patient’s quality of life.  The treatment strategy entails a comprehensive multidisciplinary approach that consists of pharmacologic measures and physiotherapy and other complementary approaches. Physiotherapy is the most strongly indicated non-pharmacological therapy that allows a person with fibromyalgia to work closely with a trained professional who can design a fibromyalgia-specific treatment program. In this blog, we have summarized the main physiotherapy interventions used to treat fibromyalgia patients.

 

Patients with fibromyalgia should include cold therapy, heat therapy, massage therapy, hydrotherapy, electrical therapy, and exercise therapy. The physiotherapist monitors the treatment and documents the progress. The patient learns the specific treatments and exercises and then does them daily at home.

 

Ice Therapy:

Cryotherapy or cold compresses reduce the pain and may give relief to fibromyalgia's chronic muscle pain or trigger point pain. Physiotherapists may use a combination of physical therapy techniques to ease the pain and other fibromyalgia symptoms.

 

Heat Therapy:

Heat deeply or thermotherapy relaxes the muscles and causes the blood to flow to the painful area faster. This therapy can be used with a dry, hot towel or moist heat like a moist, warm cloth. Heat is recommended for a few minutes before and after stretching or doing resistance exercises. As it makes the exercise less painful and more effective. Moist heat is used to decrease fibromyalgia pain, it can be tried twice daily, about 15 minutes each time. For best benefits alternate the ice compresses with the moist heat.

 

Hydrotherapy:

Hydrotherapy uses water to stimulate the body's healing force. Hydrotherapy provides short-term relief to fibromyalgia pain. The patient can sit on a stool or stand and hit the painful area on the body with warm water to relieve pain and muscle stiffness.  Hydrodynamic properties of water, such as buoyancy, hydrostatic pressure, density, and viscosity, provide resistance to movement, which leads to muscle strengthening and causes muscle relaxation, low joint impact, and better venous return.

 

Massage Therapy:

Massage therapy like deep tissue massage, connective tissue massage, manual lymphatic drainage, and myofascial release uses pressure to decrease muscle tension and muscle spasms.

 

Transcutaneous electrical nerve stimulation (TENS):

TENS decreases fibromyalgia-related pain by blocking pain signals from reaching the spinal cord. It also reduces muscle spasms and triggers the release of endorphins natural pain killers produced by the brain.

 

Ultrasound:

Therapeutic ultrasound produces sound waves, it produces a gentle heat that enhances blood flow to deep tissues. This therapy can help decrease pain, inflammation, stiffness, and muscle spasms.

 

Low-impact aerobic exercise:

These exercises are gentle yet highly effective e.g. water aerobics.

 

Strengthening and flexibility Exercises:

These exercises help build muscle strength and improve the range of motion. Stretching exercises are indicated to relieve muscle tension and increase muscle length and consequently range of motion.

 

Exercises should be done slowly and not overdone. Mild soreness is usually experienced after a physiotherapy session, if soreness or pain lasts longer than a few days, then the physiotherapist should be immediately consulted.

 10 Benefits of Physiotherapy for Geriatric                                    People

As we grow old, our body undergoes many physical as well as mental changes. These changes include a decrease in bone density, reduced muscle strength, and increased body fat. Elderly individuals may also experience poor coordination and stiff joints that affect their mobility and balance, making them more likely to fall. These deficiencies can have a big impact on their daily lives and independence. To reduce this impact, one should consult a physiotherapist. The physiotherapist helps geriatric individuals to maintain their health, well-being, functional ability, and independence. Physiotherapy treatment techniques are well-suited for the challenges that accompany aging. In this blog, we have discussed various factors that prevent people from being active and independent, and also find ways of overcoming them. 

 

Benefits of Physiotherapy

The physiotherapist starts by carrying out a detailed assessment to determine the specific areas that may be having an impact. This assessment would typically include looking at the strength, range of movement, balance, and walking. The physiotherapist then uses this information to address the areas that are deficient and designs a tailor-made program.

These include treating diagnosed age-related illnesses, as well as the general annoyances experienced as we age. Here's how physiotherapy can help to improve the overall health of elderly patients.

 

Decreases Pain Level:

The physiotherapist can treat illnesses, such as pain, joint problems, and stiffness and adopt a delicate and sensitive approach during physiotherapy. Pain is decreased by using different electrical modalities like cryotherapy (ice packs are used for 15-to-20-minute sessions), and thermotherapy (which relaxes the muscles, improves circulation and loosens stiff joints. Transcutaneous electrical stimulations, Ultrasound, and laser therapy are also used by physiotherapists to alleviate pain, and muscle spasms and relax the muscles.

 

Improves Mobility and Strength:

Physiotherapists can provide advice on how to safely exercise so that older people can realize the benefits of exercising. The hands-on technique of physiotherapy allows therapists to customize each treatment, for example, regarding the amount of pressure applied. Massage is given for relaxation, improving circulation, and pain relief, it can also include mobilization (i.e. helps loosen tight joints, and increases flexibility), manipulation (fast, forceful movements used to relieve pain and realign bones and joints). Studies have shown that older adults who engage in regular physical activity gain many benefits like preventing joint, reducing high blood pressure, and obesity. Daily exercises and practicing activities like back or side leg raises, wall sits, regular calf stretch, marching in place, wrapping up, wiggling hands and fingers, rocking the boat, and walking heel to toe are proven to be effective for older people, these exercises include strengthening and stretching exercise programs and balance training.

 

Treating Musculoskeletal Conditions:

Medical conditions like osteoporosis, arthritis, fractures, and joint replacement, are commonly associated with old age. The physiotherapist can help restore mobility, and fitness by restoring the function of muscles, bones, joints, tendons, and ligaments.

 

Treating Cardiopulmonary Conditions:

Cardiopulmonary conditions associated with the elderly are heart attack, myocardial infarction, and pulmonary conditions like chronic obstructive pulmonary disease (COPD), etc. The conditions can be treated and prevented by physiotherapy by increasing endurance and functional independence.

 

Treating Neurological Conditions:

Neurological conditions like Parkinson's disease, Alzheimer's disease, brain injury, or stroke are common in elderly people. Through physiotherapy, these patients are taught to adapt to impairments in vision, mobility, balance, and muscle loss so that the patient completes the activities of daily living more easily.

 

Prevents Falls:

A safe and supportive environment like handrails near stairs, non-slippery floors, and spacious areas without hurdles, more light near stairs, coloring the steps with alternating color patterns can prevent falls. Walking aids are also provided for people with foot drop, spinal injury, stroke, and other health issues which hinder mobility. These aids make them as quick and steady on their feet as they used to be and improve their ability to be independent. Environmental adaptations have to incorporate the principles of work simplification and safety, e.g., toilet signs on washroom doors, putting the cup sign on the cupboard, replacing the buttons of dresses with velcro fasteners for activities of daily living independence. For elderly who require support for walking are also provided with types of equipment such as walking aids to facilitate independent living.

 

Better Mental and Emotional health:

Exercises have also been shown to improve the mental and emotional health of elderly individuals. Physiotherapy aims to improve the overall well-being of each person being treated. Issues like social difficulties sleep problems and even just the challenges of day-to-day life can be lessened through physiotherapy services. During the assessment, the physiotherapist needs to understand the cognitive impairment (memory, attention, learning, concentration, language, thinking, the cause of dementia, and depression. Functional training is given where the activity is broken down into simple components, repetition along with kinaesthetic cueing is an effective technique for teaching proper functional movement patterns. For the elderly having dementia, sensory stimulation has improved their quality of life as they are able to interact with other people in a meaningful way. Stimulations like activity by giving cues occasionally (e.g. Does this picture remind you of something? Does this surface feel smooth or rough), is provided to enhance independence and self-esteem. For depression, the individual is advised to spend at least one hour outdoors every day, like sitting in a park or going for a walk where the person gets to interact with other people which helps to improve mental health.

 

Less dependence on medication:

Older people are more susceptible to illnesses like high blood pressure, high cholesterol, heart disease, stroke, lung diseases, diabetes, arthritis, etc. Physiotherapy is a great alternative to harsh medications, especially for older adults suffering from digestive or immune system intolerance or serious side effects. Even for incontinence Kegel exercises are ideal to strengthen the pelvic floor muscles.

 

Prevents Obesity:

Obesity is one of the main risk factors for the elderly, doing exercises daily helps with weight control and also reduces the risk of suffering from various conditions related to obesity.

 

Improves quality of Life:

Physiotherapy includes specialized techniques that can improve the quality of life of older individuals. Exercises are taught that increase mobility and flexibility, and when done regularly, boost overall health levels and reduce the effects of aging on the body. It helps lower the risks of a fall or the damage caused by one.

 

Therefore, physiotherapist provides professional services combined with a healing touch and promotes comfort and care for elderly patients, this has an impact on the patient's physical recovery as well as also has a positive influence on their emotional wellbeing.


This Article was first Published at CB Physiotherapy