Dr Satyajit Mohanty blogs

Introduction: Planter heel pain & posterior heel pain: Plantar heel pain is a symptom commonly encountered by clinicians. A variety of soft tissue, osseous, and systemic disorders can cause heel pain. Tendonitis also may cause heel pain. Achilles tendonitis is associated with posterior heel pain. Bursae adjacent to the Achilles tendon insertion may become inflamed and cause pain. HPT (heel pain triad): Labib et al described the heel pain triad (HPT). HPT is a combination of plantar fasciitis, posterior tibial tendon dysfunction and tarsal tunnel syndrome. They hypothesized that failure of the static (plantar fascia) and dynamic (posterior tibial tendon) support of the longitudinal arch of the foot has resulted in traction injury to the posterior tibial nerve, i.e., tarsal tunnel syndrome. When such a situation is present then all abnormalities i.e. plantar fasciitis, posterior tibial tendon dysfunction and tarsal tunnel syndrome must be recognized and treated. Classification of ...

Pelvic floor dysfunction is a disorder predominantly affecting females. It is common and undermines the quality of lives of at least one-third of adult women and is a growing component of women's health care needs (2). The reported prevalence rates of pain within the pelvis range from 3.8% to 24% in women aged 15 to 73 years (3). Pelvic floor dysfunction affects women of all ages and is associated with functional problems of the pelvic floor. Pelvic floor dysfunction describes a wide range of clinical problems that rarely occur in isolation (2). Functional pelvic floor problems are perceived to have low priority compared with other health disorders, and treatment remains sub-optimal. Inherent in achieving and promoting better health care services for women is the need for better collaborative approaches to care(2,3). There is a need to identify and develop comprehensive interdisciplinary, multi-professional strategies that improve the assessment and treatment of pelvic floor dysfun...

The pelvic floor is a highly complex structure made up of skeletal and striated muscles, support and suspensory ligaments, fascial coverings and an intricate neural network. Its dual role is to provide support for the pelvic viscera (bladder, bowel and uterus) and maintain functional integrity of these organs (4). So the pelvic floor represents the neuromuscular unit that provides support and functional control for the pelvic viscera. Its integrity, both anatomic and functional, is the key in some of the basic functions of life (1): a. Storage of urine and feces b. Evacuation of urine and feces c. Support of pelvic organs, and d. Sexual function In pelvic floor dysfunction the aetiology is inevitably multi-factorial, and seldom as a consequence of a single aetiological factor (4). However, the problems that are encountered with pelvic floor can be broadly grouped into due to hypotonic or hypertonic status. The hypotonic condition leads to: stress incontinence, fecal inconti...

According to modern imaging techniques and surgical techniques the classical concepts concerning the subdivision of the pelvic connective tissue and muscles need to be revised (3). A compartmental clinical model basing on clinical requirements subdivides the pelvic cavity into anterior, posterior, and middle compartments which is feasible (3). Further the pelvic structures can be divided in three groups: the hollow organs, the endopelvic fascia and the muscles (1). Let us review how the pelvic floor is organised A. The pelvic floor & it’s important parts: The pelvic floor is the support of the pelvic visceras. Important pats of pelvic floor are 1. The levator ani muscle 2. Perineum & it’s myofascial structures 3. Pelvic fascia & it’s reinforcements The M. levator ani is the muscle of the pelvic diaphragm. Its parts were given different names depending on their function or localization (1). The levator ani muscle (LA) with its two bundles (pubo- and ilio-coccygeus) ...