Dr Satyajit Mohanty blogs

Traction can be used 1. as an adjunct 2. as a independent modality to treat Traction as an adjunct treatment Gentle forcing at almost any joint is tolerated well if the move¬ment is carried out during traction. However, traction as an adjuvant therapy can affect in the following ways 1. An attempt to reduce an intra-articular dis¬placement is much more likely to succeed if the bone-ends are brought apart as far as possible. This is because the loose fragment is now given room to move. 2. If the intra-articular dis¬placement projects beyond the articular edge, the tautening of the ligaments joining the bones during the traction exerts beneficial centripetal force on he fragment. 3. Distraction produces a suction which also exerts beneficial centripetal force on the fragment. 4. If the joint is held at mid-range during traction i.e. in a position that ensures that every ligament is lax, the bones are pulled apart and pressure on the displacement ceases. Pain is thus rel

Why a musculoskeletal physiotherapist should become familiar with assessment of the respiratory muscles? (Adpoted from the original source: Thorax 1995;50:1131-1135) 1. Firstly, because dyspnoea in patients in whom no pulmonary cause can be detected may be due to respiratory muscle weakness. Even moderately severe muscle weakness may be difficult to detect clinically and, indeed, it is possible to have total paralysis of the diaphragm without life threatening consequences. 2. Secondly, because patients with clearly documented generalised neuromuscular disease usually also have respiratory muscle weakness and, for selected cases, treatment in the form of non-invasive ventilation is indicated. 3. Finally, there has recently been increased awareness that respiratory muscle weakness can be a compounding factor in other disease processes such as malnutrition and steroid therapy. For most patients the suspicion of clinically important respiratory muscle weakness may be confirmed or

Several findings provide support for the proposed relationship between diaphragm EMG and postural control of trunk stability. Anatomy of Diaphragm: The diaphragmatic musculature and its fasciae imparts crucial function of respiration & postural control. The diaphragm is divided into 3 parts on the basis of these muscle fiber origins: 1. Sternal part: two muscular slips from the back of the xiphoid process. 2. Costal part: the inner surfaces of the cartilages and adjacent portions of the lower six ribs on either side, interdigitating with the Transversus abdominis. 3. Lumbar part: aponeurotic arches, named the lumbocostal arches, and from the lumbar vertebrae by two pillars or crura. There are two lumbocostal arches, a medial and a lateral, on either side. The diaphragm is innervated by the phrenic nerve. It's a branch of C3,C4,and C5. Crura and central tendon: At their origins the crura are tendinous in structure, and blend with the anterior longitudinal ligament of the vert

In my opinion the entire medical fraternity is to be blamed for it. Speaking generally, it may be said that the "bone-setter" flourishes not because people suffer injury, but on account of the treatment they receive. A traditional bone setter’s friends & foes: 1. The doctrine of fixation, rest and splintage is his (traditional bone setter) great ally. 2. His (traditional bone setter) enemy is the treatment of recent injury by mobilisation. How far traditional bone setters will sustain? According to Dr.Mannell - until the time the old teaching of absolute and prolonged rest after injury is replaced with combination of justified rest with early mobilisation, the type of disability which fills the "bone-setter's" rooms will never decrease and hence they will flourish.

Ankle joint = tibio-talar joint, permits DF & PF Dorsiflexion (DF) is performed by the tibialis anterior , EHL,EDL,and peroneus tertius. DF limited by the tension of the tendocalcaneus , the posterior fibers of the medial ligament and the calcaneofibular ligament. During dorsiflexion the wider anterior part of the articular surface of the talus is forced between the medial & lateral malleolus, causing them to separate slightly & tighten the ligaments of the distal tibiofibular joint. This arrangement increases the stability of the ankle joint when the foot is in the initial position for major thrusting movements in running , jumping and walk . Plantar flexion is performed by the gastrocnemius, soleus,plantaris, peroneus longus & brevis , tibialis posterior, flexor digitorum longus and flexor hallucis longus It is limited by the tension of the opposing muscles , the anterior fibers of the medial ligament and the anterior talofibular ligament . When the ankle is full

Bony Anatomy • Curved trochlear surface of talus produces a cone-shaped articulation whose apex is directed medially; thus the fan-shaped deltoid is all that is needed for support medially • A larger area of movement and the subtalar joint articulation laterally dictates more soft tissue involvement to produce stability, thus, more commonly injured Anatomy of Ligaments • The lateral ligaments should include not only the ATFL, CFL, and PTFL of the tibiotalar joint, but should also include the subtalar joint which is supported by the CFL, inferior extensor retinaculum, the lateral talocalcaneal ligament, the cervical ligament, and the interosseous talocalcaneal ligament • Note: the CFL is included in both these joints and is crucial to the proper biomechanics of both joints • ATFL - originates at the distal anterior fibula and inserts on the body of the talus just anterior to the articular facet (not unto the talar neck). ATFL - Makes an angle of approximately 75° with the

1. In the absence of relaxation the movement of the joint is forced, and therefore strain is placed upon it. The result is that any synovitis or other pathological condition is perpetuated or increased. 2. There is great danger of inflicting further injury on the already damaged structures, so that adhesions of greater density and strength will ultimately form. 3. Repair is retarded owing to undue strain on the structures that are undergoing repair. 4. The muscles are strained, and possibly even torn, in their vain attempt to resist the movement. 5. The circulation of the venous blood and of the lymph may be assisted, but extravasation will be increased; and 6. The disorganisation of the vaso-motor system is increased as the result of repetition of trauma, and so oedema increases in proportion as repair decreases. 7. The joint-sense is outraged by repeated trauma, and all power of co-ordination is thereby destroyed.

A. In Massage of the Limbs. Massage is a form of surface stimulation that can produce a muscular contraction by reflex; antagonistically it can also secure muscle relaxation. We invoke instinctively the aid of massage for its mechanical effect in day to day activity, for example rub our eyes hard to reduce intra-ocular tension, or press upon temple or forehead after a day of great fatigue. B. In Massage for Diseases of the Nervous System -In the treatment of an irritable neurasthenic, the victim of insomnia. C. In Abdominal Massage- According to Kleen mechanical stimulation of abdomen does not produce chemical stimulation in producing, secretion of active digestive juices. It is possible that by mechanical means we can help empty a dilated stomach, and we can certainly assist in the softening and molding of scybala, in those very exceptional cases where they are palpable, and therefore amenable to manipulation. In this event we can also assist their passage along the bowel. However dur

An introduction to Mannel Dr.James Mannell’s name is associated among the pioneers of physical therapeutics applied in modern medicine. James Mannell was a qualified medicine specialist & physician. First book of Mannell’s concept emerged in 1920 as a result of twelve years' experience of massage and its allied arts, and effects of treatment of six thousand medical cases of fracture. The book was named massage-its principles and practice which was forwarded by Dr. Robert Jones, then the major general of army medical services of United Kingdom. The early experiences of James mannell was modified by following findings: 1. Positive out comes of effects of "early movement" on post-immobilization stiffness. 2. Effect of simple manual handling providing distraction at a particular joint (that was stiff post-fracture-immobilization) which seemed like a massage can attend joint mobility painlessly and without any attempt at force that are attained by the exercise of considera

Chiropractic was invented by a non-medico named DD palmer of USA. The literal meaning of chiropractic is "by hand". Hence treatment by hand is called chiropractic. treatment We in India never got to know what is chiropractic treatment? Yesterday i was preparing to teach my students "history of manual therapy", i happen to come across the following in classic encyclopedia(1911) & Wikipedia. Read it & wonder (also feel for simon singh, UK who was sued for defaming chiropractic) Rule of Nerves by DD Palmer Palmer hypothesized that vertebral joint misalignments, which he termed vertebral subluxations ( his type of subluxations can not be seen on X-rays or such investigations) interfered with the body's function and its inborn (innate) ability to heal itself. D.D. Palmer repudiated his earlier theory that vertebral subluxations caused pinched nerves in the intervertebral spaces in favor of subluxations causing altered nerve vibration, either too tense or

The Rule of Artery by AT still Early osteopathy teaches that 1. Structural derangement (SD) of the body is the predisposing cause of disease 2. SD causes functional distortion (FD) of the vascular and nervous systems 3. Which further leads to a. Weakening the nutritional processes and lowering the powers of resistance of the body b. Production of congestion, either general or local, active or passive further depriving tissues of an adequate blood and lymph supply c. impairs the rebuilding of cells and retards the elimination of waste products through body drainage 4. As drainage & elimination are affected, body is unable to withstand climatic changes or unhygienic and unsanitary surroundings, and offering a open medium for the invasion and propagation of pathogenic germs. Dr. Still, the founder of osteopathy, said, "A disturbed artery marks the beginning to the hour and minute when disease begins to sow its seeds of destruction in the human body. The rule