Musculoskeletal Conditions

Leg Length Discrepancies

Do you know that many of us have some sort of leg length difference?

While most of us generally have no issues with that, (due to our wonderful ability to adapt and accommodate) some of us develop musculoskeletal pains because of the unequal load and stress we place on the legs over time.

This is even more apparent in people who do sports such as running and racket games because of the impact we place on our knee and ankle joints.

Common causes of leg length differences are due to structural problems like scoliosis (unnatural curvature in the spine), operation done to the legs as well as being flat footed on one side.

LLD

The picture above shows a shorter left leg when we do clinical measurements in the clinic.

If it’s found to be a major cause for your pain, you can approach a physio to correct the muscle imbalance that comes along with this condition.

Physios can also work with podiatrists to correct your running and walking technique to reduce the stress in the affected joint.

Of course, if the length difference is too big, insoles can also be customised and prescribed by the podiatrists to offer support and correction.

Heels & Pain

Are you a frequent user of high heel shoes?
Are you experiencing foot pain or back pain?
What’s the association between those beautiful heels and your pain?

Heels & Pain 1

Here’s some of the reasons:

Firstly, as the height of the heel increases, the amount of load increases exponentially at the forefoot. This makes the muscles in the ankle and foot work harder and can result in overuse injuries/ arch pain. Besides, the calf muscles also develop tightness and affect the way you walk, thereby causing you to adopt bad postures.

Secondly, we will be focusing on the selection of heels so that you need not give up your favourite footwear and continue to look beautiful as ever.

Heels & Pain 1

Pay attention to the “slope” or “pitch” of the heel when purchasing your next pair. A pair of stilettos as seen in the photo can provide excessive trauma to the balls of the foot as well as tightening the heel tendon. This can result in heel pain and other overuse foot injuries.

In general, shoes with wedged heels has a more gradual slope while giving you the same elevation as a pair of stilettos. This gradual slope will help to better distribute weight along the foot and helps reduce strain in the arch and heel.

Help maintain your own foot health by choosing a gentler heel to wear the next time.

Lastly, we will be looking at some simple exercises to help prevent or relieve foot associated problems arising from wearing heels.

One of the most common causes of foot problems is the presence of tight calf muscles in individuals who have been wearing heels for a prolonged period of time.

As we all know, wearing heels basically put our feet in a ‘tip-toe’/’heel raise’ position. This position generally places the calf muscles in a constantly contracted and shortened state. Over time, muscle shortening takes place and this has a pronounced effect on the overall function of the foot and ankle.

Shortened calf muscles generally alter the walking pattern and places more stress on the middle and balls of the feet. Therefore, one must continually stretch her calf muscles if she wants to wear those beautiful heels for a long time to come.

The picture below shows the muscles involved and how you can stretch them. The dosages and duration illustrated here are just a guide. One should consult a physiotherapist if any injuries are present before doing these exercises.
Gastroc Stretching in Standing
Stand, right foot behind, heel on floor and leg straight, forward leg bent. Keeping arms straight, push pelvis forward until stretch is felt in calf. Hold 20 seconds.
Repeat 3 times per session. Do 2 sessions per day.

Soleus Stretch in Standing
Stand, right foot behind, heel on floor with toes pointing to the front. Lower hips and bend knees. Hold 20 seconds.
Repeat 3 times per session. Do 2 sessions per day.

Heels & Pain 3

 

 

Frozen Shoulder

Adhesive Capsulitis/ Frozen Shoulder as it’s commonly known, is a clinical condition described as a gradual loss of shoulder movement due to pain and stiffness.

The condition comes in 3 stages, namely freezing, frozen and thawing stage:

Frozen Shoulder

Freezing- Diffused ache/Sharp pain with shoulder movement. (Duration of 0 to 3 months)

Frozen- Pain at end of range and increasing stiffness. Pain intensifies with movement. (Duration 3 to 9 months)

Thawing- Improving pain and progressive improvement of range. Stiffness at end range. (Duration 9 to 18 months)

Typical risk factors include:

– Female gender

– Above 40 years old

– Diabetic

– History of frozen shoulder on the other side and post trauma to the shoulder.

*Treatment and management will depend on the stage of the condition.

Freezing stage- Anti inflammatory drugs, education on resting positions, posture education to prevent aggravating symptoms.

Frozen stage- Soft tissue release of tight neck and shoulder muscles. Shoulder blade muscles strengthening to correct muscle imbalance at the shoulder region due to pain.

Thawing stage- Manual therapy to loosen the joints and regain range. Exercise rehabilitation.

When in doubt, always consult a doctor/ a physio if you suspect you are developing such symptoms.

About Trigger Points

Trigger points are tight knots/ taut bands in muscles that either produce pain locally or in a referred pattern. Compression of such points usually brings about a short period of soreness and discomfort and sometimes even elicit pain in areas away from the point of compression. This is usually accompanied by a twitch of the muscle and some patients tend to describe it as a ‘good pain’ or something which they felt is needed to bring about a relief.

Causes of trigger points may include repetitive microtrauma due to overuse of the muscles and poor posture. Some studies have shown an increase in level of inflammatory marker and chemicals such as cytokines around areas of trigger points and this could possibly be a reaction to the overload and microtrauma that has been taking place.

Treatment pain caused by trigger points include trigger point release which involves applying firm pressure on them for a period of time and then followed up by stretching exercises. Other treatment may include postural education as well as strengthening under utilised muscles to help minimise the demand on the painful muscles.

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