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Physiotherapy Yoga Exercises

Each position should be held for 5-10 seconds at maximum point of movement/bending
Then back to neutral position with relaxation for 10 seconds
Again the next position or counter movement/reverse movement at maximum bend position /or till pain is tolerable for 5-10 seconds

Each movement should be done very slowly like yoga
Any hurried/speed movement could lead to more injury
Slow movements relax and stretch the muscles, ligaments and tendons, thus helping in recovery.

Each set of exercise should be repeated 3-5 times, and upto 2-4 times daily. 
Hence 15-20 times for each exercise per day.
In severe pain exercises are done slowly to the tolerance of pain and 5-10 times per day.
Overdoing the exercise can aggravate the pain and worsen the problems
Also more than 5 times in each sitting should be avoided as it can increase the pain and discomfort.

Pls note:Exercises prescribed are for illustrative purposes only. Please consult your doctor & physiotherapist before starting the exercise program. 

Physiotherapist – Dr Vinod (Chief Physiotherapist)– 9392486771, 9393486771

                             Dr Dhananjay – 9908145859

                             Dr Wazir  - 9394897296

                      Physiotherapy and it's role

As well as exercises, therapists can use a range of other physiotherapy treatments.

It's good to know a little about each treatment before you have it done, so you can feel comfortable the whole time. I'll go through the following physiotherapy treatments:

  • Massage
  • Joint Manipulation And Taping
  • Heat Therapy And Cryotherapy
  • Electrotherapy (including Ultrasound)
  • Hydrotherapy
  • Acupuncture

    Massage

    Anybody can "massage" anybody else. But massage done by a physiotherapist is based on science. It is very specific to the needs of the patient, i.e. you!

    The benefits of different types of massage are seen in 3 body systems:

    Mechanical..

  • mobilisation of soft tissues (muscles, tendons, ligaments)
  • stretching and mobilisation of scar tissue
  • removing dead skin cells
  • helping lymphatic drainage (the system of tubes or vessels in your body that helps drain fluid back to the blood and helps fight infection).

    Physiological..

  • circulatory - increased blow flow, stimulation of the healing process
  • neurological - can be either relaxing or stimulating.

    Psychological..

  • pain and stress relief
  • preparation for physical activity.

    There are different types of massage, each designed to get the specific benefits above. The 4 main types of massage are:

  • Stroking - this is a gliding movement performed in any direction. Soothing stroking has slow, rhythmical movements designed to have a sedative affect. Stimulating stroking has brisk, invigorating strokes in any one direction designed to simulate.
  • Effleurage - this is a rhythmical, superficial or deep gliding movement in the direction of flow of veins and lymphatics. This helps to reduce swelling following injury, stretch scar tissue, relax muscles, and is used as a connecting massage stroke.
  • Petrissage - this is used to help reduce swelling following injury, mobilise scar tissue, reduce muscle spasm and help circulation. There are 4 types of these pressure techniques:
    Kneading - muscles and superficial tissues are compressed, squeezed and relaxed. The hands move rhythmically in a circular way.
    Picking up - muscles are lifted and squeezed in one or two hands.
    Wringing - lifting, squeezing and wringing of muscles.
    Skin rolling - two hands are used to hold and roll skin between fingers.
  • Frictions - this a cross (transverse) movement over the affected area (ligaments, tendons and muscles). This helps in the healing process or is used to break down scar tissue. Deep friction massage therapy is a more vigorous form of this.



    Joint Manipulation And Taping

    Physiotherapists are trained to perform movements on you, where the therapist moves the limb/joint whilst you keep your muscles relaxed.

    Mobilisation and manipulation techniques are commonly used when you have pain and stiffness around a joint or muscle. Rest assured that the therapist is within the control of yourself so that the movement can be stopped if you so wish.

    Mobilisation is where the therapist uses smooth movements of 2 or 3 seconds of small or large force anywhere within the range of movement of the joint.

    Manipulation is the next step from mobilisation, where the therapist applies a thrust of small force on the joint at the end of its range of movement.

    Therapists have a grading system for identifying the level of stiffness and pain, and then using that, they devise your treatment. Pain and stiffness have specific relationships with each other, and physios are experts in treating these. If you hear any clicks or pops then don't be worried as these are natural and safe, as long as the treatment is done by a fully qualified professional.

    Taping is a technique used by physios and sports professionals. Special tape is used, taping around muscles and joints for support. In cases after injury, you can use taping to restrict the movement of a joint to protect it from further injury.



    Heat Therapy And Cryotherapy

    These physiotherapy treatments are quite straight forward, used for muscle injuries. Your therapist will still take all precautions necessary, as there are certain conditions where these treatments may not be suitable for you.

    Heat therapy consists of a hot pack or heat bath. Cryotherapy consists of an ice pack or ice bath. They are usually applied for up to 20 minutes, where you would have to remain still. Your therapist will remain with you throughout the treatment and will monitor the temperature of your affected muscle.

    The danger of both these sets of treatments is burning due to extreme heat or cold. Your feedback along with the therapists own observations should ensure this doesn't happen.



    Electrotherapy (including Ultrasound)

    There are different types of electrotherapy, varying by using heat, sound waves or electrical stimulation. These are good for treating pain in muscles and joints, swelling, and to help the healing process. The different types of these physiotherapy treatments are:

  • Infrared.. an infrared lamp is placed parallel to your joint, with your skin uncovered and examined prior to treatment. Heat from the infrared rays warms your specific muscles. You may feel a mild gentle warmth, anything hotter then this feeling should be reported.
  • Ultrasound.. for parts of your body that are relatively flat, the gel is applied on to your skin, and the applicator is moved over the surface of your skin. For parts that have irregular surfaces, it is placed in a bath of warm water. The head of the applicator is placed in the bath and moved around next to the part to be treated. You should feel no sensation at all either way.
  • TENS.. Transcutaneous Electrical Nerve Stimulation (TENS) is normally used to treat pain. The electrodes are placed on your skin and the intensity gradually increased. Depending on the frequency, you should either feel a slow tickling sensation, or a continuous buzzing sensation. You will be able to feel which frequency is best for your pain. The intensity should never be strong or painful.



    Hydrotherapy

    This is done in a hydrotherapy pool with water temperatures of 33-38 degrees Celsius. There are so many advantages of physiotherapy treatments in water, the main one being the feeling of weightlessness. This is called buoyancy and it provides support for activities not possible on land.

    Even without any equipment at all, working against buoyancy will help with strengthening, and working with buoyancy will help with mobilising. Adding floats can provide further resistance or support, depending on your needs.

    Some other benefits of hydrotherapy include:

  • Pain relief - the warmth has a sedative effect on your nerve endings on your skin, and can help to relax muscle spasm.
  • Increases confidence - the weightlessness gives you a feeling of safety, takes the pressure off your body especially your spine, if you have severe movement problems then you could achieve more movement in water.
  • It's fun!

    Hydrotherapy from a physiotherapist's view, is more commonly used if you have arthritis, cerebral palsy with learning difficulties, chronic lower back pain and spinal cord injuries. It can also be used for many other things, such as stress related problems, ultimately it's up to your therapist to decide your best course of treatment.



    Acupuncture

    This is not strictly a part of the main physiotherapy treatments, but many physios have trained to practice it. It is basically known as "sticking needles into you". Well I'm sure there are a few people you'd like to do that to!! But acupuncture is a very old Chinese therapy, based on energy flow within your body.

    Your therapist will insert a very thin needle (so thin that it won't break your skin i.e. no blood, so it's nothing like getting an injection) into very specific parts of your body. The needle will free any block of energy flow in that part of your body, helping it get back to it's normal state, e.g. pain free.

    You will usually need a course of acupuncture treatment, although some people see results after the first treatment. Acupuncture is a great treatment to try, if your other physiotherapy treatments have not helped you much.

    Even if you have a fear of needles, I would recommend you go with a friend or relative for support, and get that first treatment done. You'll see how it doesn't hurt and the needles are so thin, once they're in, you hardly notice them at all!

    Types of exercise

  • Exercises are generally grouped into three types depending on the overall effect they have on the human body:

     Categories of physical exercise

    Sometimes the terms 'dynamic' and 'static' are used. 'Dynamic' exercises such as steady running , tend to produce a lowering of the diastolic blood pressure during exercise, due to the improved blood flow. Conversely, static exercise (such as weight-lifting) can cause the systolic pressure to rise significantly (during the exercise).

    Stretching is a form of physical exercise in which a specific skeletal muscle (or muscle group) is deliberately elongated to its fullest length (often by abduction from the torso) in order to improve the muscle's felt elasticity and reaffirm comfortable muscle tone.[1] The result is a feeling of increased muscle control, flexibility and range of motion. Stretching is also used therapeutically to alleviate cramps

    benefits of stretching:

    1. may improve ROM
    2. reduce risk of injury during activity
    3. prevent post-exercise muscle soreness
    4. slow delayed-onset muscle soreness (DOMS)

    How often and how long should I exercise?

    There are three ways to measure your exercise: frequency, duration, and intensity.

    • Frequency: This is how often you exercise. Try to get aerobic exercise at least 3 times a week, although 5 to 6 times a week is even better. Do anaerobic exercise 2 or 3 times a week.
    • Duration: This is how long you exercise. The goal is to have each exercise workout last 30 to 60 minutes. You may need to work up to this gradually.
    • Intensity: This is how hard you are working when you exercise. While you are doing aerobic exercise, you should keep your heart rate up. To make sure you are benefiting from your exercise, you need to check your heart rate (pulse) during your workout. You need to set a target heart rate for yourself so that you can make sure you are exercising hard enough to help your heart, yet easy enough so you can complete the exercise safely. The goal is to maintain your target heart rate during your exercise for at least 30 minutes. You can also use your target heart rate to check your progress over time.

    After a few weeks of training, you can continue improving your level of fitness by increasing the frequency, duration, or intensity of your exercise.

    How do I calculate my target heart rate?

    To figure out your target heart rate, you first need to figure out your maximum heart rate (MHR). Your maximum heart rate is calculated by subtracting your age from 220.

    220 - Age = MHR

    For example, if you are 40 years old, your MHR would be 180 beats per minute.

    220 - 40 (years old) = 180 beats per minute

    Next you need to figure out your target heart rate. Your target heart rate is based on a percentage of your MHR For aerobic activity, you need to try to keep your heart rate between 60% and 85% of your MHR. For example, if you are 40 years old your target heart rate range should be 108 to 153 beats per minute.

    180 (MHR) X 0.6 (60%) = 108 beats per minute

    180 (MHR) X .85 (85%) = 153 beats per minute

    During your exercise, you should check your pulse from time to time to see if you are within your target heart rate range. You do this by finding your pulse on the thumb side of your wrist or in your neck to the side of your Adam's apple. Using a clock or watch with a secondhand, count the number of heartbeats in 10 seconds. Multiply that number by 6 to get the number of heartbeats per minute. Some exercise machines will measure your heart rate for you when you put your hands on special sensors.

    If your heart rate is too fast (over your 85% mark) then slow down. If your heart rate is below your 60% mark then you need to pick up your pace.

    What about warming up and cooling down?

    You should include warm-up and cool-down exercises before and after exercise. Muscles that have not been used are cool. Stretching or walking slowly for 5 to 10 minutes before beginning your workout warms your muscles, making them more flexible and less prone to injury.

    Right after exercise, allow your heart rate to return slowly to normal. Walking slowly, for example, will let you cool down and let your heart and breathing to return to normal levels. You should also stretch the muscles you used during your exercise. After stretching, your muscles will be more flexible and less stiff. Devote a total of 5 to 10 minutes to cooling down.             

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