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Back in Harmony, shop 4, 23 Wyong Road, Long Jetty (2026)

13/06/2023

LOW BACK PAIN OR KIDNEY PAIN?

Every disease or ill health condition has certain characteristics which are specialized only to that particular condition or illness. Knowing the symptoms, characteristics, causes and triggers, etc about the diseases will help one take effective step in treating the same. In this current article we will be talking about the differences between the back pain and the kidney pain, taking into consideration some of the most important factors.

Differences Between Back Pain And Kidney Pain Based On The Location/Area Showing The Pain Symptoms:
Back pain can be experienced anywhere in the lower back or in the buttocks.

While, Kidney pain usually occurs in the portion between the ribs and hips (also known as flanks) and also may be experienced in the upper abdomen.

Differences Between Back Pain And Kidney Pain Based On Characteristics Of The Pain:
In case of the back pain, the pain usually changes from time to time and is not constant.

However in case of the kidney pain there is usually a constant pain until the last, it maybe a sharp pain (in kidney stones) or maybe dull pain (in kidney infection)

Difference Between Back Pain And Kidney Pain Based On The Types:
Taking the back pain into account first, it can be divided into neck pain, upper back pain and lower back pain. They can also be categorized as acute back pain, where the pain exist for 4 weeks, sub acute back pain, pain for 4 weeks to 12 weeks, and any back pain beyond 12 weeks is termed to be chronic back pain.

However in case of the kidney pain, the pain can be either kidney stone or that of the pain of kidney infection. Usually kidney pain due to kidney stones is very much severe, while the pain due to kidney infection might be mild. However both the type of kidney pains are associated with symptoms like vomiting, nausea and fever.

Difference Between The Back Pain And Kidney Pain Based On Causes:
Now, coming to the causes we can also differentiated between the back pain and the kidney pain in the following ways.

Back pain can be caused due to many factors including sciatica, backbone fractures (Vertebral body fracture), fracture of pedicle, fracture of lamina, disc bulge, disc herniation, spinal stenosis, osteoporosis, metastatic vertebral cancer and paravertebral muscle spasm.

However kidney pain occurs with kidney stones, kidney infection (pyelonephritis), glomerulonephritis, kidney cancer and renal infarction.

Difference Between Back Pain And Kidney Pain Based On The Triggers:
There are triggers for back pain and also kidney pain which might initiate the pain signs and symptoms.

Most common triggers for back pain include prolonged sitting in one posture, long time standing, moving etc.

On the other hand, kidney pain is mainly triggered by excessive intake of fluids, i.e. in case of ureteropelvic junction obstruction. Though moving is not included in the list of triggers for kidney pain.

Difference Between Back Pain And Kidney Pain Based On The Area Of Its Spreading:
Now when we look for the differences between back pain and kidney pain based on the area of their spreading, we can say back pain spreads to back of the thigh, buttock, calf, foot and also the toes in one or both the feet. While kidney pain usually spreads to the lower abdomen, inner thigh etc.

09/06/2023

Overpronation of Foot: Mechanism of Injury, Diagnosis, Treatment- Gait Analysis, Orthotics

Overpronation is a condition where there is excessive pronation of foot or where there is flattening or inward rolling of foot. Pronation occur when subtalar joint moves into eversion, which means the sole turns outwards, dorsiflexion which means toes pointing upwards, and abduction which means toes pointing to sides. While standing, there is pronation when the foot rolls in the inward direction and foot arch is flattened. Pronation is normal with gait cycle. It acts as a shock absorber. Supination is opposite of pronation. Supination is also normal with gait cycle and if done excessively then it is known as oversupination, which also causes problems.

Overpronation is a condition where there is excessive pronation and this leads to problems. It is actually quite common in athletes and leads to many injuries, especially in sprinters. Overpronation commonly results in overuse type of injuries. Runners are more frequently affected with this condition. During walking or running, a normal foot pronates and lower leg, knee, and thigh all rotate medially and if an athlete who has an overpronated foot starts running it results in excessive rotation movement. This excessive stress placed on the medial surface of foot due to overpronation causes injury and pain in foot and ankle. Repetitive rotational forces in shin, knee, and thigh causes added stress on muscles, tendons and ligaments of lower leg.

Treatment of Overpronation of Foot

▪️Getting a gait analysis done by podiatrists, physiotherapists or sports therapists of your running style helps in distinguishing between overpronation, oversupination and neutral gait.

▪️If you suffer from overpronation, then having extra support in shoes helps. Running shoes with a firm material on inside of midsole help in supporting inside of foot and prevent it from overpronating.

▪️In severe cases of overpronation, orthotic devices can be fitted. Most of the times patients can use the orthotic insoles that can be bought from the market but some patients may require custom made orthotic devices which can be prescribed by a sports injury therapist or a podiatrist.

06/06/2023

🔈 TIGHT INTERCOSTAL MUSCLES AND SHORTNESS OF BREATH OR DYSPNEA

Chest wall or Rib Pain is an annoying pain, which is quite common following intercostal muscle spasm or muscle sprain. An individual can sprain any muscle of the body, including those in the chest area resulting in severe pain. Intercostal muscle sprain results in severe spasmodic shooting pain.

Intercostal Muscles facilitate breathing. The muscles between the ribs are known as intercostal Muscles. Intercostal Muscles have a very vital role to play when it comes to movement of the ribs like while breathing.

The 11 groups of intercostal muscles lie on right and left side. Three layers of intercostal muscles are attached to upper and lower rib known as intercostal space. The three layers of intercostal muscles are outer layer known as external oblique, middle layer known as transverse intercostal muscles and inner layer known as internal oblique intercostal muscles. The function of the Intercostal Muscle is to stabilize the structure of the chest wall. The Intercostal Muscles also join the ribs together. The external and internal intercostal muscles fibers run in opposite oblique direction. Middle muscle layer runs in horizontal direction.

🔒 CAUSES OF INTERCOSTAL MUSCLE SPRAIN

* Upper Body Twist
* Forceful Twist Of Upper Body
* Forceful Swing Of The Arm
* Direct Chest Wall Impact

🔒 SYMPTOMS OF INTERCOSTAL MUSCLE SPRAIN

Sudden Acute Intense Pain
* Pain is localized over the sprained muscles.
* Pain intensity is severe, sharp and intense pain.
* Pain is associated with tenderness. Patient feels severe pain with palpation or examination of the area of the chest with sprain intercostal muscles.
* The main symptom of an Intercostal Muscle sprain is severe and constant pain in the chest wall area.
* If left untreated, after some time the pain may start occurring with movement or activities like breathing, coughing, sneezing etc.
* It is a self-limiting medical condition and usually resolves on its own after a few days.

🔒 SWELLING AND TENDERNESS

* Swelling is observed over the sprained intercostal muscles.
* Swelling is secondary to subcutaneous hematoma or inflammation of the muscles.

🔒 SHORTNESS OF BREATH OR DYSPNEA

* Patient complaints of shortness of breath also known as dyspnea.
* Shortness of breath is secondary to increase of pain intensity during inhalation.
* Patient stops taking deep breath when pain become severe and act of breathing results in short of completing of inspiration.

🔒 CHEST WALL STIFFNESS

* Patient complaints of chest wall stiffness.
* Patient prefers to take shallow breath.
* Stiffness is localized around the tender chest wall area.

🔒 TREATMENT FOR INTERCOSTAL MUSCLE SPRAIN

As stated above, Intercostal Muscle Sprain is a self-limiting medical condition and resolves itself within a few weeks. There may be steps taken to calm down the pain and inflammation that a person experiences with Intercostal Muscle sprain. Conservative treatment helps a long way in relieving symptoms and may include:

* Adequate rest
* Applying ice to the affected area
* Cold compresses
* Limited stretching exercises
* Physical therapy and/or massage therapy

25/04/2023

🔈 SYNOVIAL SHEATHS AND TENDONS OF HAND

A. Observe that the six synovial tendon sheaths (purple) occupy six osseofibrous tunnels formed by attachments of the extensor retinaculum to the ulna and especially the radius, which give passage to 12 tendons of nine extensor muscles. The tendon of the extensor digitorum to the little finger is shared between the ring finger and continues to the little finger via an intertendinous connection. It then receives additional fibers from the tendon of the extensor digiti minimi. Such variations are common. Numbers refer to the labeled osseofibrous tunnels shown in part B.

B. This slightly oblique transverse section of the distal end of the forearm shows the extensor tendons traversing the six osseofibrous tunnels deep to the extensor retinaculum.

24/04/2023

🔈 KNEE BURSITIS EXERCISES

You can stretch your leg right away by doing the first 3 exercises. You may start doing the other exercises when your leg is less painful.

🔎 Hamstring stretch on wall: Lie on your back with your buttocks close to a doorway. Stretch your uninjured leg straight out in front of you on the floor through the doorway. Raise your injured leg and rest it against the wall next to the door frame. Keep your leg as straight as possible. You should feel a stretch in the back of your thigh. Hold this position for 15 to 30 seconds. Repeat 3 times.

🔎 Standing calf stretch: Stand facing a wall with your hands on the wall at about eye level. Keep your injured leg back with your heel on the floor. Keep the other leg forward with the knee bent. Turn your back foot slightly inward (as if you were pigeon-toed). Slowly lean into the wall until you feel a stretch in the back of your calf. Hold the stretch for 15 to 30 seconds. Return to the starting position. Repeat 3 times. Do this exercise several times each day.

🔎 Quadriceps stretch: Stand at an arm's length away from the wall with your injured side farthest from the wall. Facing straight ahead, brace yourself by keeping one hand against the wall. With your other hand, grasp the ankle on your injured side and pull your heel toward your buttocks. Don't arch or twist your back. Keep your knees together. Hold this stretch for 15 to 30 seconds.

🔎 Hip adductor stretch: Lie on your back. Bend your knees and put your feet flat on the floor. Gently spread your knees apart, stretching the muscles on the inside of your thighs. Hold the stretch for 15 to 30 seconds. Repeat 3 times.

🔎 Quad sets: Sit on the floor with your injured leg straight and your other leg bent. Press the back of the knee of your injured leg against the floor by tightening the muscles on the top of your thigh. Hold this position 10 seconds. Relax. Do 2 sets of 15.

🔎 Heel slide: Sit on a firm surface with your legs straight in front of you. Slowly slide the heel of the foot on your injured side toward your buttock by pulling your knee toward your chest as you slide the heel. Return to the starting position. Do 2 sets of 15.

🔎 Straight leg raise: Lie on your back with your legs straight out in front of you. Bend the knee on your uninjured side and place the foot flat on the floor. Tighten the thigh muscle on your injured side and lift your leg about 8 inches off the floor. Keep your leg straight and your thigh muscle tight. Slowly lower your leg back down to the floor. Do 2 sets of 15.

22/03/2023

Weak inner thighs are a major problem for large swaths of the population.

16/03/2023

🔊 SCIATICA

WHAT IS SCIATICA?

💡 Sciatica is the result of a neurological problem in the back or an entrapped nerve in the pelvis or buttock. There are a set of neurological symptoms such as:

➡️ Pain (intense pain in the buttock)
➡️ Lumbosacral radicular leg pain
➡️ Numbness
➡️ Muscular weakness
➡️ Gait dysfunction
➡️ Sensory impairment
➡️ Sensory disturbance
➡️ Hot and cold or tinglings or burning sensations in the legs
➡️ Reflex impairment
➡️ Paresthesias or dysesthesias and oedema in the lower extremity that can be caused by the irritation of the sciatic nerves (the lumbar nerve L4 and L5 and the sacral nerves S1,S2 and S3)

CAUSES OF PAIN

💡 Pain is a result of irritation of the sciatic nerve. it can be constant or intermittend. The pain may be worsened by certain movements like coughing or sneezing (these movements increase the intra abdominal pressure). Sitting, bending, prolonged standing or rising from a sitting position can aggravate or increase the pain.

PAIN PATTERNS

💡 In regards to relief the pain, the supine position decreases the pressure on the herniated disc and will subsequently decrease pain. Pain is located along the distribution of the nerve and can be felt in the back, buttocks, knee and leg. It only radiates to one side of the leg and can result in reduced power, reflexes and sensation in the nerve root. Also gait dysfunction (toe walking, foot drop and knee buckling), paresthesias or dysesthesias are frequent neurological symptoms.

SYMPTOMS BASED ON NERVE COMPRESSION

💡 Sciatica can be caused by the compression or irritation of nerve L4, L5, S1, S2 and S3. The sciatica symptoms depend on which nerve is compressed or irritated.

◾ L4: When the L4 nerve is compressed or irritated the patient feels pain, tingling and numbnessiIn the thigh. The patient also feels weak when straightening the leg and may have a diminished knee jerk reflex.

◾ L5: When the L5 nerve is compressed or irritated the pain, tingling and numbness may extend to the foot and big toes.

◾ S1: When the S1 nerve is compressed or irritated the patient feels pain, tingling and numbness on the outer part of the foot. The patient also experiences weakness when elevating the heel off the ground and standing on tiptoes. The ankle jerk reflex may be diminished.

source: B.W Koes, M.W Van Tulder, W.C Peul. Diagnosis and treatment of sciatica. BMJ.

14/03/2023

Stress in the re**us femoris tendon creates an environment that increases the likelihood of getting piriformis syndrome.

14/03/2023

🔊 HOW DOES LYMPHATIC DRAINAGE WORK? - TREATMENT FOR LYMPHEDEMA

Manual lymph drainage (MLD) is a gentle manual treatment technique based on four basic strokes, which were initially developed in the 1930’s by Dr. Emil Vodder, a PhD from Denmark. These basic strokes known as the “stationary circle”, “pump”, rotary” and “scoop” techniques are designed to manipulate lymph nodes and lymphatic vessels with the goal of increasing their activity and promote the flow of lymph.

The common denominator of all strokes is the resting and working phase. In the working phase of the stroke lymphatic structures located in subcutaneous tissues are stretched, resulting in an increase of their activity (lymphangiomotoricity). In addition to increased lymphatic activity, the light directional pressure in the working phase of the strokes causes lymphatic fluid to move in the desired direction, thus contributing to the reduction of the swelling.

Certain MLD strokes are designed to manipulate lymph vessels located in the subcutaneous tissues of larger body surfaces, such as the trunk, other techniques are better suited to be applied on contoured surfaces, such as the extremities.

Stationary circle: This technique consists of an oval-shaped stretching of the skin with the palmar surfaces of the fingers or the entire hand. Stationary circles can be applied with one hand, or bimanually and are used on the entire surface of the body, but mainly on lymph node groups (axilla and groin), the neck and the face.

Pump technique: The entire palm and the proximal (upper) phalanges are used to apply a circle-shaped pressure on the skin, operating within almost the full range of motion in the wrist. Pumps are primarily used to manipulate lymph vessels located in the extremities and can be applied with one hand or bimanually.

Rotary technique: This stroke is used on large body surface areas, such as the trunk. The entire surface of the hand and fingers are used in an elliptical movement during the working phase. Like the scoop technique, rotaries are applied dynamically, meaning the working hand moves over the surface of the treated body part in a continuous fashion. If applied bimanually, the techniques are alternating.

Scoop technique: Scoops are applied mainly on the lower parts of extremities and consist of a spiral-shaped movement. During the working phase, which can be applied with one or both hands, the palmar surface of the hand moves dynamically over the skin. The hand movement is facilitated by transitional movement in the wrist, combined with forearm pronation and supination.

Compared to traditional massage, the pressure applied with manual lymph drainage is much lower in intensity. The goal of these techniques is to manipulate the lymphatic structures located in the subcutaneous tissues. In order to achieve the desired effect, the pressure in the working phase should be sufficient enough to stretch the subcutaneous tissues against the fascia (a structure separating the skin from the muscle layer) located underneath, but not to manipulate the underlying muscle tissue. The amount of pressure needed in MLD is sometimes described as the pressure applied stroking a newborn’s head.

In the resting phase of the stroke the pressure is released, which supports the absorption of lymph fluid into lymph vessels. To achieve the maximum effect with each technique, the working phase with every stroke should last about one second and should be repeated five to seven times.

The overall goal of MLD in the treatment of lymphedema is to re-route the flow of stagnated lymphatic fluid around blocked areas into more centrally located healthy lymphatic vessels, which eventually drain into the venous system.

In the case of upper extremity (Fig. 1) lymphedema caused by breast cancer surgery, it is necessary to re-route the flow of stagnated lymph in the subcutaneous tissues of the arm around the blocked axillary area towards and into the axillary lymph nodes on the opposite side and the inguinal lymph nodes on the same side the surgery was performed. These groups of lymph nodes represent the drainage areas for the stagnant lymph fluid located in the affected upper extremity and need to be manipulated prior to initiating the treatment of the arm itself.

In the case of lower extremity (Fig. 2) lymphedema the stagnated lymphatic fluid is generally re-routed around the blocked inguinal (groin) area towards and into the inguinal lymph nodes of the opposite side and the axillary lymph nodes on the same side of blockage. As with lymphedema affecting the upper extremity, these groups of lymph nodes represent the drainage area for the stagnated lymph fluid and need to be manipulated prior to starting treatment of the leg.

The manipulation of these drainage areas with MLD strokes creates a “suction effect” in the healthy lymph vessels located in the drainage areas, which enables accumulated lymph fluid to move from a region with insufficient lymphatic drainage into an area with normal lymphatic drainage, and eventually back into the venous system.

Following this preparation, the extremity itself is treated in segments; the proximal (upper) aspect of the affected extremity is decongested prior to expanding the treatment to the more distal (lower) aspect of the arm or leg. This segmented approach ensures that lymph vessels located in more proximal areas of the extremity are properly prepared to handle incoming lymphatic fluid from areas located more distally.

In order to prevent reaccumulation of the fluid evacuated from the extremity, it is necessary that the MLD treatment is followed up with compression, which depending on the stage of treatment, is applied either with specialized padded bandages or compression garments.

Manual lymph drainage presents a unique opportunity for health care professionals to specialize and opens the door to treat and manipulate a variety of conditions associated with dysfunctions of the lymphatic system. However, the unique techniques of manual lymph drainage deviate considerably from traditional manual techniques and therefore require specialized training.

Credit: Joachim Zuther, Lymphedema Specialist

13/03/2023

🔈 INFLAMMATION: TISSUE RESPONSE TO INJURY

The inflammatory response is a natural defence mechanism that is triggered whenever body tissues are damaged in any way. Most of the body defence elements are located in the blood and inflammation is the means by which body defence cells and defence chemicals leave the blood and enter the tissue around the injured or infected site. Inflammation occurs in response to physical trauma, intense heat and irritating chemicals, as well as to infection by viruses and bacteria.

The inflammatory response:

1. prevents the spread of damaging agents to nearby tissues
2. disposes of cell debris and pathogens
3. sets the stage for the repair process.

The four cardinal signs of inflammation are redness, heat, swelling and pain. Many experts consider impairment of function to be the fifth cardinal sign of inflammation.

The inflammatory process begins with chemical “alarms” a series of inflammatory chemicals that are released in the extracellular fluid. Injured tissue cells, phagocytes, lymphocytes, mast cells and blood proteins are all sources of inflammatory mediators, the most important of which are histamine, kinins, prostaglandins, complement, and lymphokines.

Though some of these mediators have individual inflammatory roles as well, they all promote dilation of the small blood vessels in the vicinity of the injury. As more blood flows into the area local hyperemia (congestion with blood) occurs which accounts for the redness and the heat of the inflamed area.

These chemicals also increase the permeability of local capillaries. Consequently, exudates, fluid containing proteins such as clotting factors and antibodies, seeps from the bloodstream into the tissue spaces.

This exudate is the cause of the local oedema or swelling that in turn, presses on adjacent nerve endings, contributing to a sensation of pain. Pain also results from the release of bacterial toxins, lack of nutrition to the cells in the area, and the sensitising effects of released prostaglandins and kinins. If the swollen and painful area is a joint, normal movement may be inhibited temporarily in order for proper healing and repair to occur.

Although at first, oedema may seem to be detrimental to the body, it isn’t. The entry of protein-rich fluids into the tissue spaces helps to dilute harmful substances, which may be present, brings in large quantities of oxygen and nutrients necessary for the repair process, and allows the entry of clotting proteins which form a gel like fibrin mesh in the tissue space that effectively isolates the injured area and prevents the spread of bacteria and other harmful agents into the adjacent tissues. It also forms a scaffolding for permanent repair.

10/03/2023

The retinaculum, part of the fascial system, are strong connective tissue found only in certain parts of the body.

08/02/2023

🔈 ANATOMY OF SCAPULA AND SCAPULAR REGION

The clavicle is the boundary demarcating the root of the neck from the thorax. It also indicates the “divide” between the deep cervical and axillary “lymph sheds” (like a mountain range dividing watershed areas): Lymph from structures superior to the clavicles drain via the deep cervical nodes, and lymph from structures inferior to the clavicles, as far inferiorly as the umbilicus, drain via the axillary lymph nodes.

The infraclavicular fossa is the depressed area just inferior to the lateral part of the clavicle. This depression overlies the clavipectoral (deltopectoral) triangle - bounded by the clavicle superiorly, the pectoralis major medially, and the deltoid laterally - which may be evident in the fossa in lean individuals. The cephalic vein, ascending from the upper limb, enters the clavipectoral triangle and pierces the clavipectoral fascia to enter the axillary vein.The coracoid process of the scapula is not subcutaneous; it is covered by the anterior border of the deltoid; however, the tip of the process can be felt on deep palpation on the lateral aspect of the clavipectoral triangle. The coracoid process is used as a bony landmark when performing a brachial plexus block, and its position is of importance in diagnosing shoulder dislocations.

While lifting a weight, palpate the anterior sloping border of the trapezius and where its superior fibers attach to the lateral third of the clavicle. When the arm is abducted and then adducted against resistance, the sternocostal part of the pectoralis major can be seen and palpated. If the anterior axillary fold bounding the axilla is grasped between the fingers and thumb, the inferior border of the sternocostal head of the pectoralis major can be felt. Several digitations of the serratus anterior are visible inferior to the anterior axillary fold. The posterior axillary fold is composed of skin and muscular tissue (latissimus dorsi and teres major) bounding the axilla posteriorly.

The lateral border of the acromion may be followed posteriorly with the fingers until it ends at the acromial angle. Clinically, the length of the arm is measured from the acromial angle to the lateral condyle of the humerus. The spine of the scapula is subcutaneous throughout and is easily palpated as it extends medially and slightly inferiorly from the acromion. The root of the scapular spine (medial end) is located opposite the tip of the T3 spinous process when the arm is adducted. The medial border of the scapula may be palpated inferior to the root of the spine as it crosses ribs 3–7. It may be visible in some people, especially thin people. The inferior angle of the scapula is easily palpated and is usually visible. Grasp the inferior scapular angle with the thumb and fingers and move the scapula up and down. When the arm is adducted, the inferior scapular angle is opposite the tip of the T7 spinous process and lies over the 7th rib or intercostal space.

Back in Harmony

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Monday	9:30am - 7pm
Tuesday	9:30am - 7pm
Wednesday	9:30am - 7pm
Thursday	9:30am - 7pm
Friday	9:30am - 2:30pm