Dr Satyajit Mohanty blogs

Shoulder elevation mechanics in impingement syndrome: Both glenohumeral and scapulothoracic kinematics are altered during impingement syndrome. Normal & altered mechanics during shoulder elevation is discussed below. Normal mechanics: Functions of Trapezius muscle: Upper trapezius produces clavicular elevation and retraction. The middle trapezius is primarily a medial stabilizer of the scapula. The lower trapezius assists in medial stabilization and upward rotation of the scapula. Functions of serratus anterior muscles: The middle and lower serratus anterior muscles produce scapular upward rotation, posterior tilting, and external rotation. Pectoralis minor: The pectoralis minor is aligned to resist normal rotations of the scapula during arm elevation. Rotator cuff: The rotator cuff is critical to stabilization and prevention of excess superior translation of the humeral head, as well as production of glenohumeral external rotation during arm elevation. Alterations of shoulder musc...

Tate AR et al recently tried to define the dosage and specific techniques of manual therapy and exercise for rehabilitation for patients with subacromial impingement syndrome in a case series. 10 patients (age range, 19-70 years ware treated with a standardized protocol for 10 visits over 6 to 8 weeks. More about this program: 1. Strengthening rotator cuff and scapular muscles (3-phase progressive strengthening program) 2. Manual stretching 3. Manual therapy aimed at thoracic spine (Both thrust and nonthrust manipulation) 4. Manual therapy aimed at and the posterior and inferior soft-tissue structures of the glenohumeral joint (Both soft & bony. Bony manipulation: Both thrust and nonthrust manipulation) 5. Other components of this program: Activity modification and a daily home exercise program of stretching and strengthening. Result of this program: This case series describes a comprehensive impairment-based treatment which resulted in symptomatic and functional im...

What is Condensing osteitis of clavicle? Osteitis condensans of the sternoclavicular joint was first described by Brower et al in 1974 (5). Till 1989 only 16 cases ware reported in world medical literature (6). Definition: Condensing osteitis of the clavicle is a benign idiopathic entity that is probably degenerative or mechanical in etiology manifesting by variably painful and tender swelling over the medial end of the clavicle. There is no clinical or laboratory evidence of infection in all cases of Condensing osteitis. Where else Condensing osteitis is also marked? Condensing osteitis is also marked at ilium, and pubis (4). The etiopathogenesis of this rare benign clinico-radiologic entity remains unknown (7). However Berthelot et al have proposed a pathogenic hypothesis for condensing osteitis of the clavicle, ilium, and pubis. According to their observation joint aspects spared by the sclerosis are covered with hyaline cartilage but occurs in bone overlaid by fibrocartilage. Clin...

What is a dynia? The "dynias" are a group of chronic, focal pain syndromes with a predilection for the orocervical and urogenital regions. They include glossodynia, carotidynia, vulvodynia, orchidynia, prostatodynia, coccygodynia, and proctodynia. In some cases, the dynias occur secondarily, but more often, despite an exhaustive evaluation, no etiology is found and in these remaining cases, the cause of the pain remains enigmatic. The controversy that surrounds this group of disorders, which ranges from questioning their existence to suggesting that they are purely psychosomatic, is counterbalanced by an extensive literature attesting to their organicity (1). What is coccygodynia? & Causes of coccygodynia: The three most common functional disorders causing anorectal and perineal pain are levator ani syndrome, coccygodynia and proctalgia fugax. However, Alcock's canal syndrome is also responsible for pain in these areas (3). A review of Mayo clinic records Physical Med...

1. Excessive lateral pelvic tilt (Trendelenburg): Areas that may be affected due to compensation: Lumbar spine, sacroiliac joint (SIJ), greater trochanter bursa, insertion of muscle on greater trochanter, overactivity of piriformis and tensor fascia lata (TFL) . 2. Medial knee drift: Areas that may be affected due to compensation: Lateral tibiofemoral compartment (via compression), patellofemoral joint, patella tendon and fat pad, pes anserinus, iliotibial band (ITB) 3. Lateral knee drift: Areas that may be affected due to compensation: Medial tibiofemoral compartment (via compression), ITB, posterolateral compartment, popliteus 4. Same-sided shift of trunk (lateral flexion of trunk): Areas that may be affected due to compensation: Lumbar spine (increased disc and facet joint compression), SIJ (increased shear)