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exercise for scitica and lumber disc

som dissease and treatment

cellulitis

🔴 Causes of Ankle pain

🔹Ankle is an intricate network of bones, ligaments, tendons and muscles.

🔹The lower leg bones (tibia and fibula) come together to meet the foot bone (talus) to form the ankle.

🔹It is strong enough to bear the body weight and enable to move.

🔹Injury to any of the ankle bones, ligaments or tendons and several types of arthritis can cause ankle pain. Common causes of ankle pain include:

1️⃣ : Fluid-filled sacs called bursaecushion the bones when they move. Bursitis happens when these sacs become irritated and inflamed.

2️⃣ : An accident or injury can cause bones to break (fracture). Ankle fractures range from mild to severe. Broken ankles can involve bones in any part of the ankle joint. A broken ankle causes ankle swelling and pain.

3️⃣ : Sprained ankles are a common cause of ankle pain. An ankle sprain happens when ligaments stretch or tear. Sprained or twisted ankles happen when the ankle rolls forcefully out of its normal position.

4️⃣ : Irritated, inflamed tendons are a soft-tissue injury called tendonitis. Tendons connect muscles to bones. Sometimes, a tendon can tear (such as an Achilles tendon rupture). A torn tendon may need surgical repair.

5⃣ : Pain and stiffness in the ankle joint can result from ankle arthritis. Arthritis happens when cartilage (tissue in joints that cushions bones) breaks down. The breakdown causes bones to rub together. Injuries and overuse can lead to arthritis, and it’s more common in people over 65. Several types of arthritis can affect the ankles. Common types include rheumatoid arthritis and osteoarthritis.

6⃣ : A very low arch (or no arch at all) can cause pain and swelling in the ankles and feet. Sometimes, kids’ arches don’t develop normally as they grow up, resulting in the condition.

7️⃣ : A type of arthritis, gout results from a buildup of uric acid throughout the body. Typically, uric acid leaves the body in urine. Excess uric acid creates crystals that settle in the joints. Gout in the ankle can be very painful.

8⃣ : Several types of infection, including cellulitis, can cause swelling and pain in the ankle joint. A bone infection called osteomyelitis can result from a staph infection.

Other causes of ankle pain:

▪️ Osteochondritis dissecans
▪️ Plantar fasciitis
▪️ Pseudogout
▪️ Tarsal tunnel syndrome

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cystitis

🔴Calf Strain or Tear🔴

▪️ A calf strain, commonly called a ‘pulled’ muscle, is caused by overstretching or tearing of either of the 2 calf muscles – the soleus and the gastrocnemius.

🔴Symptoms

▪️ Sudden pain in the back of the lower leg
▪️ A pop, snap or tearing sensation may be felt.
▪️ Occasionally, with a severe tear, it may feel like you have been shot in the back of the leg.
▪️ Afterwards, the calf may swell and it will be difficult to rise up onto the toes.
▪️ The calf will be painful and tender and will feel weak and stiff.
▪️ Bruising usually occurs within a day or 2 of the injury.

🔴 Causes

Calf strain occurs during activities that involve pushing off on the toes, such as running or jumping, or sports that require explosive muscle contractions, such as tennis, squash or football.

🔹🔹Other Causes of calf muscle's pain🔹🔹

1️⃣ Muscle cramp:
Calf muscle cramps are usually temporary but can cause significant pain and discomfort. Commonly seen in those who exercise frequently.

Causes of calf muscle cramps include:
▪️ Dehydration
▪️ Loss of electrolytes through sweating
▪️ Lack of stretching
▪️ Prolonged physical activity
▪️ Weak muscles

2️⃣ Arterial claudication
▪️ A person may experience calf pain due to narrowing or blockages in the arteries that supply blood flow to the legs. This is known as arterial claudication.
▪️ Arterial claudication may cause pain while walking, as this movement requires blood to flow to the lower legs.
▪️ A person with arterial claudication will experience no discomfort at rest, but pain after a few minutes of walking.

3️⃣ Neurogenic claudication
Neurogenic claudication occurs when the nerves that go to the legs are pinched, affecting their ability to communicate with the lower legs.
Sciatica is one example of neurogenic claudication.
In addition to calf pain, neurogenic claudication symptoms include:
▪️ pain while walking
▪️ pain after prolonged standing
▪️ pain that also occurs in the thighs, lower back, or buttocks
▪️ pain that usually improves when a person leans forward at the waist
A person may also experience calf pain from Neurogenic claudication when at rest.

4️⃣ Achilles tendinitis:

▪️ The Achilles tendon is a tough, fibrous band that connects the calf muscle to the heel bone.
If a person’s calf muscles are especially tight, this may put extra pressure on the Achilles tendon. As a result, a person can experience calf pain.

Other less common causes of calf muscles pain are
5⃣ Compartment syndrome
6️⃣ Diabetic neuropathy
7⃣ Plantar fasciitis
8⃣ Varicose veins
9⃣ Deep vein thrombosis

🔴Management

Treatment for calf pain will depend on the underlying cause.

✅ Initial treatment of calf strain / tear is:
PRICE method. This stands for:

▪️ Protection: Apply a cloth bandage, splint, or immobilizer to the foot, ankle, or calf to protect the injury and allow the muscles to rest.
▪️ Rest: Avoid using the calf muscle more than necessary.
▪️ Ice: Apply ice pack for 10 to 15 minutes at a time to help reduce inflammation.
▪️ Compression: Wrap the calf in a stretchy, tight bandage or wear a compression stocking to reduce swelling.
▪️ Elevation: Elevate the leg on pillows to help promote circulation and reduce swelling.

👉 After 48 hours, stretching and strengthening exercises should be started. Heel raises and calf stretches form the basis of these exercises and should be gradually progressed in number of repetitions and load before returning to sport.

🔹🔹Other causes of calf pain may be treated with Physical therapy (pain management, stretching and soft tissue mobilization) and medications depending on the underlying cause.🔹🔹

Physical therapy includes

1️⃣ Pain management by Cold packs/hot packs, Ultra sound TENS etc
2️⃣ Stretching exercises.
3️⃣ Soft tissue mobilization.
4️⃣ Theraputic massage

🔴🔴When ti seek emergency help or treatment? 🔴🔴

⚠️ Symptoms of DVT include pain swelling, and warmth in one leg.

Other signs a person should seek emergency treatment for calf pain include:
⚠️ fever that is greater than 100°F
⚠️ swollen leg that is pale or cool to the touch
⚠️ sudden extreme swelling in the legs

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🔴 Cervical Radiculopathy 🔴

▪️ Cervical radiculopathy, commonly called a "pinched nerve," occurs when a nerve in the neck is compressed or irritated where it branches away from the spinal cord.

▪️ This may cause pain that radiates into the shoulder and/or arm, as well as muscle weakness and numbness.

✔️Causes

1️⃣ Damage to a disk in the cervical spine due to some acute injury kr trauma. The damaged disk may then press on nearby nerve roots.
2️⃣ Degeneration from wear and tear, and aging. This can lead to narrowing (stenosis) of the openings between the vertebrae. The narrowed openings press on nerve roots as they leave the spinal canal.
3️⃣ An unstable spine. This is when a vertebra slips forward. It can then press on a nerve root.
4️⃣ There are other, less common causes of pressure on nerves in the neck. These include infection, cysts, and tumors.

✔️ Signs and Symptoms

▪️ Neck pain
▪️ Radiating or shooting pain down to the Arms
▪️ Numbness or tingling or weakness in arms or in hands.
▪️ Increased pain when using arms, reaching over head, or turning the neck
▪️ Stiff neck. Loss of neck movement, Soreness and difficulty moving the neck, especially when trying to turn the head from side to side.
▪️ Muscle spasms
▪️ Trouble with gripping or lifting objects. This problem can happen if numbness or weakness goes into the arm or fingers.
▪️ Headaches. Sometimes an irritation in the neck can affect muscles and nerves connected to the head. Some examples include tension headache, cervicogenic headache, and occipital neuralgia.

✔️ Diagnosis

▪️ Spurlings Test
▪️ Upper limb tension-1
▪️ Distraction test
▪️ Involved side cervical rotation range of motion less than 60 degrees.

When all 4 of these clinical features are present, the post test probability of cervical radiculopathy is 90%, Where only 3 of the 4 tests are positive the probability decreases to 65%.

✔️Management

1️⃣ Pain medicines. These help relieve pain and swelling.
2️⃣ Cold packs/hot packs, These help reduce pain.
3️⃣ Resting. This involves avoiding positions and activities that increase pain.
4️⃣ Neck brace (cervical collar). This can help relieve inflammation and pain.

✔️Physical therapy Management

1️⃣ Education and advice

⛔Avoid Smoking
To***co smoking causes constriction of the vascular network surrounding the intevertebral disc (IVD), reducing the indirect exchange of nutrients and anabolic agents from the blood vessels to the disc.

✅Adopt a correct posture

2️⃣ Manual Therapy

✅ PAIVMs (Passive Assessory Intervertebral Movements) / PPIVMs (Passive Physiological Intervertebral Movements)
✅NAGs (Natural Apophyseal Glides) / SNAGs (Sustained Natural Apophyseal Glides)
✅ Muscle Energy Techniques
▪️ Post isometric relaxation
▪️ Reciprocal inhibition
▪️ Eccentric Contraction
▪️ Concentric Contraction
✅Neurodynamics - Gliding and Sliding/Tensioning
✅ PNF Stretching
▪️ Hold Relax
▪️ Contract Relax
▪️ Hold Relax with agonist Contraction

3️⃣ Exercise Therapy - AROM, stretching and strengthening

▪️ Chin Tucks
▪️ Upper trapezius stretch
▪️Shoulder ROM
▪️ Active neck side bend
▪️ Active neck rotation
▪️ Neck forward and backward bending
▪️ Shoulder shrugging
▪️ Scapular retraction against resistance using elastic bands or pulleys can
▪️ Scapular-strengthening exercises including prone horizontal abduction, sidelying forward flexion, prone extension of each shoulder, as well as prone push-ups with emphasis on shoulder protraction.

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