Monthly Archives: August 2022


Physiotherapy in the Dislocation of the Patella

The patellar luxation is a disease of the locomotor system which generally occurs toward the lateral side of the knee, resulting in breakage of the medial patellofemoral ligament (LPFM) in approximately 90-100% of cases.

Although several risk factors have been identified that cause patellofemoral instability after patellar dislocation, appropriate therapy remains a controversial issue.

In this article, we will only talk about the conservative treatment of this lesion.

What is kneecap dislocation?

Label dislocation is defined as the complete loss of contact between the articular surfaces of the patellofemoral joint and in which to restore the normality of the joint a dislocation reduction by a professional with the appropriate knowledge is required, although in In certain cases this reduction occurs spontaneously through a complete extension of the knee.

Types of patellar dislocation: We found three types of patellar dislocation;

  • Congenital laxation, which occurs during birth.
  • Recurrent dislocation, which tends to recur. A dislocation is considered recurrent when it occurs two or more times.
  • Traumatic dislocation, in which there is a loss of contact between articular surfaces in an acute or traumatic way as a result of trauma or forced movement.

The elements involved in the extensor apparatus of the knee are the patella, the femoral trochlea, the quadriceps muscle, the patellar tendon, and the patellofemoral retinaculum.

In the medial retinaculum is the most important ligament in this lesion, the medial patellofemoral ligament (LPFM). This ligament consists of a transverse and an oblique portion and both portions are fused with the vast middle of the quadriceps to be inserted into the patella. This ligament is the main passive stabilizer before the dislocation of the patella during flexion from 0 to 30º.

  • The quadriceps angle (angle Q) is a measure of alignment between the femur and the tibia that is measured by drawing an imaginary line that connects the center of the label with the ESIA and a second line that is drawn following the direction of the patellar tendon, from the center of the label to the anterior tibial tuberosity Where these lines intersect, angle Q is formed.

This angle is important since its increase affects the patellofemoral stability and the path of the patella in the trochlea during knee flexion and extension.

  • The main risk factors are anatomical, and they are patellar dysplasia, the syndrome of the high patella and the increased distance between the anterior tuberosity of the tibia and the intertrochlear groove (TAT-SIT distance). However, there are other anatomical features that favor patellar dislocation such as ligament hyperlaxity, increased Q angle or atrophy or imbalance of the vast middle of the quadriceps with respect to the vast lateral and a shortened iliotibial waistband.
  • The mechanism of injury can be direct, when it is caused by trauma to the medial part of the patella or indirectly when it is caused by a knee flexion movement along with with a knee valgus and internal rotation adduction of the femur, while the tibia abducts and rotates externally.

The indirect mechanism represents 93% of the cases of the dislocated patella.

  • For the evaluation and diagnosis of the lesion, in addition to imaging tests such as nuclear magnetic resonance imaging (MRI), radiography or computed tomography (CT), a physical examination must be performed that includes functional tests of the knee (meniscal, varus-valgus, anteroposterior stability, range of motion, etc.) and emphasizing the patellofemoral joint. For this, we will analyze if the sign of the J occurs, which occurs when during the full knee extension, the label moves excessively to the side. In addition, we will perform the patellar apprehension test; With the knee in full extension, we apply a force on the patella directed towards the side and ask the patient to try to flex the knee. If the patient feels pain or dislocation sensation, the test will be positive, indicating femoropatellar instability.

In addition, we will perform a gait analysis to check for possible wrong patterns.

  • For the physiotherapeutic treatment of the dislocation of the patella, physiotherapist in Dwarka will begin with immobilization by means of orthotic devices that allow the mobility of the knee, allowing some exercises and a progressive increase in mobility over time. Controlled mobilization reverses the harmful effects of immobilization by stimulating the synthesis and correct alignment of healing tissues so it is important to recover the joint range as soon as possible.
  • Treatment of inflammation with cryotherapy, neuromuscular bandage, compression bandage, electrotherapy, soft tissue massage (manual lymphatic drainage), active movement, drugs, and limb elevation.
  • Functional or neuromuscular bandage to reduce excessive contact forces in the patellofemoral joint or possible hypermobility of the patella.
  • In the early stages of treatment, we can use muscle electrostimulation in addition to an active contraction by the patient to balance the function of the vast middle and the vast lateral quadriceps.
  • We must work on the flexibility of soft tissues, especially those that are located in the lateral compartment that, due to their stiffness, can cause instability in the knee; The flexibility of the tensor fascia lata and the iliotibial belt, the vast quadriceps, and the knee flexors should be worked on.
  • Balance training and coordination, that is, proprioception exercises, is very important. These exercises cause changes in the nervous system through tasks that seek awareness, sensitization, and enhancement of joint, muscle, tendon and bone structures.
  • The most important part of the physiotherapy in Dwarka in the dislocation of the patella is the rehabilitation plan through physical exercise. Once there is a good balance in the extensor mechanism of the knee we will begin a functional training with a gradual increase of the load exercises in the knee.

We will divide the treatment bread into 4 phases:

  1. First phase: Reduce pain, swelling, and inflammation.
  2. The second phase: Improve the balance between the vast quadriceps, improve the flexibility of the muscles, re-educate the gait and decrease the excess load in the patellofemoral joint.
  3. Third phase: Strengthening of the femoral quadriceps and hip muscles and improving coordination and balance in the lower limb achieving a good knee function.
  4. Fourth phase: Recover the physical and sports level prior to the injury.

Low Back Pain in Women

The physiotherapist in Dwarka, recalls that “back pain affects men and women in the same way, but some female particularities may favor its onset. So women need to be aware and take extra care to avoid low back pain. ”

For example, the physiotherapist in Janakpuri explains that “when the body undergoes a sudden change – such as a pregnancy or a breast implant – the body’s balance and center of gravity change. This requires the patient to be well oriented to observe her posture to avoid pain in the cervical, thoracic and lumbar spine. ”

Some of the specific risk factors for women include:

1. Pregnancy

During pregnancy, there is weight gain and increased lordosis, which causes discomfort from overload and likely low back pain. Symptoms usually regress after delivery.

2. Osteoporosis

Osteoporosis weakens bones, especially in women after menopause. It increases the propensity for fractures of the lumbar vertebrae, which may have low back pain as an important sequel.

3. Bulky Breasts

Women with large breasts should be aware that weight causes the spine to constantly bend forward. Appropriate bras are available today, and in cases that compromise health the most, breast reduction surgeries can be used.

4. Accessories

High heels of more than 4 centimeters and worn daily can cause calf shortening and back pain due to poor posture. Heavy bags, when carried on a single shoulder, overload the spine, easing contractures, and may even lead to herniated discs.

Live without pain. Yes, you can.

Science has made remarkable advances in creating new treatments for low back pain patients, offering them a better quality of life. Among them, for example, are the creation of drugs that act on the nervous system in different places and the emergence of minimally invasive surgical procedures. Also new is the administration of physical therapies as a way to start treatment, with less exposure of the patient to the risk of injury: massage, acupuncture, motor control exercises, spinal manipulation, surface warming, progressive relaxation, RPG, electromyography. , among others.

If back pain is common, it does not mean that suffering from it is normal or acceptable. Living without pain – or at least reducing it as much as possible – improves the quality of life, increases productivity and allows the focus of life to be on what you want to be and have, not on the pain you want to avoid. Seek a health professional.

back pain

Low Back Pain: 8 Simple Care To Avoid Back Pain And Live Better

Have you ever had back pain? According to WHO (World Health Organization) data, 8 out of 10 people will experience this pain at least once in their lifetime. Low back pain is the second most common pain in the world, second only to the headache.

Low back pain – also called lumbago, lower back pain or simply back pain – is the pain in the lower, lower back, near the pelvis, and may extend to the buttocks and back (back) of the back. thighs. When left untreated, it can be very detrimental to one’s quality of life.

Why do I have back pain?

Fortunately, most people experience back pain because of posture rather than more serious factors. These are erroneous, continuous habits that affect posture, such as working all day bent over the computer keyboard, incorrect sleeping, sitting, driving, and so on.

Low back pain of muscular origin can also arise from sudden movements, twisting, distension of the muscles or ligaments of the back and sedentary lifestyle, due to lack of exercise.

Common causes also include orthopedic and rheumatic diseases (such as herniated disc and sciatic nerve problems), aging, intervertebral disc infection, etc. In addition, psychological factors such as exhaustion, tension, and stress, so common in modern times, can also exacerbate back pain considerably.

Fortunately, low back pain is hardly the result of serious diseases such as cancer, degenerative diseases of the intervertebral discs, among others.

What are the most common symptoms of low back pain?

The main symptom of low back pain is a non-stop pain located in the lower back. The pain can range from simple discomfort to severe and disabling pain. Tingling and numbness can also be observed, as well as cases where the person feels a strong muscle contraction, which makes it impossible even to perform common movements, such as walking, driving, sitting, etc.

Is there a way to prevent low back pain?

Yes, there is. The physiotherapist in Dwarka, highlights “it is important to promote lifestyle change, through the implementation of a specific exercise program and posture care. These exercises are called isometric strengthening and should be practiced to develop the muscles of the entire lower back and abdomen, which form a belt of muscles called the “lumbar stabilizer muscles” that support and protect the spine.

Physiotherapy doctor in Dwarka warns, however, that “muscle-building exercises need to be done correctly so as not to cause injury and further worsen the condition.” It is therefore imperative that the practice takes place under the guidance of a physical therapist or practitioner. of physical education.

Are there differences between low back pain?

Yes. There are different ways to classify low back pain. The first way is regarding the duration of pain:

Acute Low Back Pain – When pain duration is less than 6 weeks

Subacute Low Back Pain – When pain duration is between 6 and 12 weeks

Chronic low back pain – When pain duration is 3 months or more

Low back pain is also classified according to its origin:

Does not specify – It represents 90% of all patients with low back pain. It has no clear cause. Its diagnosis is made by exclusion after other pathologies have been ruled out.

Specific – Caused by some pathology, such as herniated disc with nerve root involvement, inflammatory disorders, infections, osteoporosis, rheumatoid arthritis, fractures or tumors.

8 Tips to Avoid Back Pain in Everyday Life

1. Control your weight

Try to stay within your ideal weight. Obesity greatly damages the spine.

2. Do physical exercises

Do physical activities at least 3 times a week for 30 minutes.

3. Don’t carry too much weight

Avoid carrying too much weight or overweight. If you need to lift some weight, bend your knees and try to keep your spine upright.

4. Search for the best sleeping position

Try to sleep on your side with a pillow between your legs, or on your back with a pillow under your knees. Avoid sleeping on your stomach.

5. Careful when lifting

Get out of bed always on your side. Support yourself and take your time. Avoid getting forward too sharply.

6. Sit down correctly

If you spend many hours sitting, use an armchair that does not recline. Your feet should be flat against the floor.

7. Screen at eye level

If you work with a computer (or spend hours on your smartphone), remember that the screen should be at eye level

8. Observe your posture also while driving

Maintain good posture and try to place support or cushion behind your lower back – especially if you spend a lot of time in traffic.


What is the recommended treatment for low back pain?

It is essential to seek the opinion of an orthopedist or physiotherapist in Dwarka to get the correct diagnosis and the best treatment for low back pain.

There are several possible treatments, including the use of pain relief drugs, muscle relaxants, acupuncture, infiltration sessions, a multidisciplinary rehabilitation program, supervised physical activities, etc.

Many physical therapists work using RPG (Global Postural Reeducation) techniques, which focus on stretching the muscles responsible for postural change due to shortening, which leads to loss of flexibility.

In addition, the physiotherapist in Janakpuri may also resort to the use of pain-relieving apparatus and stretching, relaxing therapeutic massages for tense muscles, and postural correction through exercise.


Cerebral Vascular Attack – Stroke

Stroke is an infarction of the brain, in which ischemia or hemorrhage leads to interruption of function. It is characterized by a localized neurological deficit (hemiparesis, hemiplegia), suddenly installed. It is little known that it is possible to experience a stroke without the patient knowing it. Stroke can occur during sleep, and a lack of severity and minor symptoms will not interfere with it. At the time of awakening, however, the patient may present a confused state, the inability to express himself correctly, difficulties in using afoot, the feeling of weakness in the arm, double or partial vision.


The morning symptoms depend largely on the degree of severity and the part of the brain affected by stroke. The symptoms of stroke can occur as a result of interest:

  1. anterior cerebral circulation comprising:
    • the carotid artery and its main branches
    • anterior and middle cerebral arteries
  1. posterior cerebral circulation comprising:
    • vertebrobasilar arteries
    • posterior cerebral arteries

Knowing the symptoms of a stroke (even in the case of a minor stroke) is essential in preventing the spread of brain damage. Specialized medical care is critical, especially when the stroke is caused by a blood clot.

Almost 80% of strokes occur in the carotid distribution territory and consist of decreased muscle strength of one part of the body, affecting the face, arm or leg in any combination. Stroke that occurs in the territory of the posterior circulation (stroke at the base of the brain) is the result of thrombosis and occlusion of small penetrating arterioles that detach directly from the vertebrobasilar arteries. The clinical picture of this stroke is more complex, due to important neurophysiological structures arranged compactly at the base of the brain compared to the cerebral hemispheres.

Types of Strokes

Etiologically, stroke is divided into four broad categories (the first two are more frequent and the others rarer):

  1. cerebral ischemia
  2. intracranial hemorrhages
  3. cerebral vascular malformations
  4. cerebral thrombophlebitis


Stroke recovery involves using:

  • compensatory techniques for mobility (physiotherapy, massage)
  • daily activities / ADL (Activities of Daily Living)
  • communication

The recovery of the hospitalized patient is a sample that allows the patient to demonstrate his candidacy for immediate recovery after acute stroke. The limited prognosis of a stroke to recover is conferred by the following elements:

  • severe memory problems
  • inability to understand orders
  • medical/surgical instability
  • Stroke in the background
  • urinary incontinence / fecal matter
  • visual space deficits

Stroke is a common occurrence, and recovery is a complex process. Even if the functional deficiencies appear to be identical the patients react individually. As a result, the recovery program is tailored to the case. More important than the motor deficits are the cognitive aspects, affected by stroke. The recovery of patients after the stroke starts in the acute phase of the care given to them.

The therapeutic intervention performed in a timely manner presents the following advantages:

  • increases the recovery potential
  • prevents problems due to immobilization

Have you noticed Back Pain lately?

There are many people who suffer from back pain during the day or at the end of it. This may be due to some pathology or due to bad gestures and postures in the activities that are carried out daily at work or during sport.

We have suffered back pain at some point and many times we do not know what causes it. The two most frequent types of pain are mechanical and inflammatory.

The data does not lie, and according to statistics, 80% of people have suffered or will suffer this pain at some time in their life, becoming in many cases chronic.

What are the causes of back pain?

There are many factors that affect and make back pain appear, from poor posture or improper choice of footwear to even psychological and emotional causes.

Despite this, it is almost always related to a vertebral or articular lesion due to spinal wear or osteoporosis. When a vertebral scoliosis occurs (the spine is curved sideways), very painful muscle contractures can arise.

Types of back pain that exist

Mechanical back pain: it is the most frequent pain, usually described as a throbbing pain, worsens with movement and is relieved by rest. Its cause is mostly a muscle strain or trauma, however, it is best to receive an accurate diagnosis by your traumatologist as soon as possible.

Some of its features are:

  • It can happen at any age
  • It is not usually accompanied by morning stiffness and if it does not exceed 30 minutes
  • Its most common cause is usually a trauma

Inflammatory back pain:  About 1 in 20 people with chronic back pain is usually of inflammatory origin. There are various diseases that can cause this inflammation and therefore the appearance of pain, some of them being quite complicated to diagnose.

It is very important to see a doctor as soon as this pain persists for a long time.

Some characteristics of inflammatory pain:

  • Appears before age 40
  • It has a gradual beginning
  • Pain improves with physical activity
  • The pain does not improve with rest
  • It usually makes you wake up at night
  • Morning stiffness of more than 30 minutes
  • Continued pain for more than 3 months
  • Alternation of pain in the buttocks

The importance of treating back pain on time

The most important thing to keep in mind to treat back ailments is to see a specialist as soon as possible, since, if it takes a long time to treat, the discomforts usually increase over time and once they are established they are difficult to reverse.

When acute back pain appears, it is usually treated first through analgesics and muscle relaxants.

Later, when the muscles have relaxed, physiotherapy treatment in Dwarka is applied to reduce pain and relieve discomfort. It is also recommended to exercise periodically to avoid the risk of pain.

home physiotherapy in dwarka

Do you know the advantages of physiotherapy?

Do you know what are all the advantages of physiotherapy in Dwarka? This technique brings a lot of benefits to the body, especially those patients who are in the process of recovering from an injury or illness. It also serves those who need additional assistance with regard to the mobility of the affected members and even if they suffer from a disability.

Another of its main benefits is that physiotherapy is able to improve the development of children since when they receive some physiotherapy treatment from an early age, it helps improve muscle tone and correct physical problems that may occur.

This technique is indicated for pediatric care, pregnancy and postpartum, with pelvic floor exercises being the most popular for its simplicity and the improvements it produces.

At Dr. Sarwar Physiotherapy Centre in Dwarka, we tell you all the advantages offered by physiotherapeutic treatments:

What are the advantages of physiotherapy?

  • With physiotherapy, greater flexibility is achieved.
  • It improves muscle power and mobility.
  • Physical deterioration is prevented and controlled.
  • They improve the basic functions of the organism.
  • Get pain relief.
  • One of the greatest benefits of physiotherapy is achieved in the treatment of tendinitis. Knee or meniscus ligaments, fibrillary ruptures and ankle sprains.
  • Physical therapy helps us achieve a greater sense of well-being.
  • Prevents injuries when practicing a sport regularly.

The union of the different techniques that we perform in our clinic, facilitate the improvement of health and pain in a short period of time.

Our clinics seek to become the most innovative centers in the province by applying the highest technology in the hands of the best professionals, so we implement this technique to our facilities to achieve better results in the rehabilitation of our patients.

back pain treatment

Back Pain: Take Care of Your Back According to the Seasons

For a large part of the population, each season brings its share of tasks to maintain, including, his house and his land.

Even though these physical activities seem commonplace, they can cause various muscle problems and cause back pain that could affect the performance of daily tasks.

Back pain according to the seasons: what are the risks of injury?

According to physiotherapist in Dwarka there are likely, during the year, times when the back is more solicited.

Take, for example, the winter period, when the appearance of patches of ice and snow coincides with an increase in injuries. In the fall, it is rather the collection of leaves that puts the muscles of the back to the test. During the spring and summer, activities associated with yard preparation, such as gardening or do-it-yourself, can involve adverse movements to the spine. 

The most common causes of injury are:

  • inadequate sitting postures;
  • the lifting of objects in full flexion;
  • repetitive efforts;
  • physical efforts poorly executed.

Taking care of your back: simple actions to prevent injuries

As trivial as they may seem, your physical efforts deserve special attention. Remember these tips:

Exercise preparation: simple actions to prevent back injuries

  • Give yourself a long time. Divide the work over a few days or even weeks.
  • Split the effort and diversify your tasks: work in small sections to combine several short works.
  • Take several breaks during and between jobs.
  • Do not overestimate your body. Avoid heavy loads and sudden movements.
  • Use the right tools with sleeves long enough not to work bent.
  • Flex your hips and knees and take supports when necessary.

Physical activity in general and healthy lifestyle habits help a lot to prevent injuries. Physiotherapy can also help prevent them by teaching ergonomic strategies for posture and proper lifting of loads.

How does the physiotherapist treat back injuries?

Even if you are extremely cautious and work properly, there is always the risk of injury. Thus, the physiotherapist’s main role in the event of a back injury is:

  • to decrease inflammation;
  • to shorten the period of incapacity;
  • improve muscle strength, flexibility, and endurance;
  • reduce the risk of reoffending;
  • perform muscle reprogramming by teaching proper movement patterns and ergonomics.

The physiotherapist in Janakpuri will offer, among other things, a series of dynamic exercises to change the way muscles coordinate in this area of ​​the body. He will accompany the patient in this process while teaching him the importance of his own collaboration to maintain the gains achieved in treatment.


Most frequent shoulder sports injuries

Understanding by shoulder the set of joints that combine tendons and muscles that give the movement of the arm, we find several injuries among athletes in this area of ​​the body.

All injuries of the shoulder joint complex can be grouped into 4 categories: fracture, osteoarthritis, instability, and inflammation of the tendon. Among these large groups, the most frequent injuries among people who practice sports either amateur or professional are:

  • Shoulder tendinitis. For an involvement of the infraspinatus and supraspinatus tendon, which may be due to overexertion or trauma. The main symptom that appears is a loss of mobility along with acute pain.
  • Swimmer ‘s shoulder. It is due to subacromial impingement syndrome, it is mainly related to the practice of crol. Its causes are due to high training frequencies, poor technique, repetitive movements, among others.
  • Rotator cuff tear. As the name implies, it occurs when a tendon or more of those that form the rotator cuff suffer a rupture, either partial or total. Its symptoms are similar to shoulder tendinopathy, suffering from weakness in the arm, deep pain and hindering tasks that cause movement of the shoulder.
  • Broken collarbone. This injury is usually caused by a fall in sports such as snowboarding, skateboarding, cycling …

In order to treat these injuries, it is important to apply ice to the area, perform a rest period that will be different depending on the person and the type of injury and perform a compression with a bandage. After the rest period, it will be very important to perform light exercise to start returning to the sports routine.

The sports physiotherapist in Dwarka can help in the diagnosis and treatment of these types of injuries and can also reduce the risk of suffering them.