Saturday, August 12, 2017

EXERCISE SPECIAL..... Protect your joints

Protect your joints


Strengthen your wrists, elbows, knees and ankles and keep these injury-prone spots in healthy working order with these exercises

The global prevalence of MSDs (musculoskeletal diseases) ranges from 14 per cent to as high as 42 per cent,“ writes Dr V M Katoch in his foreword to a 2012 Indian Council of Medical Research (ICMR) report on the epidemiology of musculoskeletal conditions in India. He goes to explain that while conditions like cardiovascular diseases, cancer and neurological diseases are widely considered to be fatal and therefore given due importance, problems of the musculoskeletal system tend to be treated with a more lackadaisical attitude as they're generally thought of as a natural consequence of ageing.
In fact, aside from age, numerous factors like the shoes you wear, sudden injuries or force applied to the area, the physical activity you participate in and your daily routine -like if you engage in a lot of housework at a stretch, for instance -may all contribute to MSD. The term refers to injuries or pain in the musculoskeletal system. Prevention, boils down to the identification of risk factors and the intervention methods you employ. Top physiotherapists suggest starting by working on at least these regions.

Knees
The most common injury in this area is the patellofemoral syndrome. It is seen in those who stand or walk for long hours without doing adequate strengthening exercises. In this case, the person experiences a pain below or behind the knee cap. “The knee is a weight-bearing joint. So, there is wear and tear of the cartilage. Strengthening and stretching of the knee muscles is very important. You must also ensure that you wear proper footwear,“ advises Dr Rakhi Vinay Darne, Physiotherapist, Sports Medicine, Dr L H Hiranandani Hospital.
According to Christopher Pedra, Consultant, Sports Medicine at Kokilaben Dhirubhai Ambani Hospital, patellar tendonitis (an overuse injury affecting your knee), fat pad impingement (the fat pad is a soft tissue that lies beneath the kneecap which can get impinged, causing knee pain), meniscus degeneration and osteo arthritis can be aggravated if the person doing activities such as walking or running isn't strong enough to carry them out effectively. “Weekend warriors (people who play a sport just for leisure once a week) are less conditioned than a professional athletes and are prone to suffer from osteoarthritis in their knees. But, we wouldn't advise them to stop playing sports or exercising. For instance, if a 60-year-old woman who walks regularly complains of knee pain and we analyse that she suffers from osteoarthritis, we may advise her to opt for swimming instead of walking,“ says Pedra. He recommends alternating lunges, and the following exercises.

Glute bridges
Lie on your back and cross your hands on your chest. With knees bent at 90 degrees, feet shoulder width apart, lift your hips and spine off the floor starting with your tailbone and progressing up to your shoulders, `curling' your spine up off the floor segment by segment. Gradually, bring your body down. Take a break of a minute between each set. Do three sets of 10 reps daily.

Wall squats
Stand with your feet shoulder width apart, with your back resting against a wall. Take a step forward so your feet are about a foot away from the wall.
Slide down, bend your knees to 90 degrees and then gradually push up to stand again. It's important to maintain a good neutral trunk posture. Do three sets of 10 reps daily.
This builds your isometric strength and endurance.

Wrists
According to Dr Darne, most wrist injuries are caused by extensive use of computers and mobile phones.“De Quervain syndrome (inflammation of the tendon) is quite common. It usually occurs when people type a lot. Carpal tunnel syndrome is another common problem that working professionals experience. The carpal tunnel at the wrist gets inflamed and the arteries and nerves in that area get compressed, causing a tingling sensation in the hand.“
People who play cricket or any racquet sports often suffer from Triangular fibrocartilage complex (TFCC) where the triangular fibrocartilage tissue (a cartilage around the wrist joint) gets injured. “One can avoid these injuries by stretching and strengthening their wrist muscles and forearm muscles,“ says Darne. Darne recommends two sets of 15 each reps of each of these exercises, eventually increasing to three sets.

Wrist extensions
Sit in an erect posture on an armchair.Support only your forearm on the armrest, not your wrist. Use a resistance band -keep one end of it under your feet and wrap the rest of the band around your fingers. Ensure that the band is held tightly between your fingers and leg. Tighten your fist while holding the band; ensure that your palms are facing down towards the ground. Pull the band up and down.

Ulnar deviation
Keep the band wrapped around your fingers. Pull out the part of the band under your feet, fold this and hold it in the opposite hand. The portion near the little finger is called ulnar. Make a thumbs-up gesture with the fingers around which the band is wrapped. Your little finger should be facing down.Push your wrist down in such a way that the little finger moves towards the wrist. This exerts pressure on the wrist and works on the surrounding muscles.

Ankles
Ankle sprains and inflammation of the plantar fasciitis (a fibrous tissue at the sole of the foot) are most common. “These occur if you walk a lot or use the wrong footwear. The most obvious symptom is pain in the heels,“ says Dr Darne.
Pedra observes that it's essential to work on one's balance and strength. He says, “Common injuries around the ankles involve overusing the muscle such as tendinopathy, tendon injury, chronic ligament pain and neuropathy. Most of these develop due to the biomechanical institution of the foot. The mechanism of the foot includes the muscles, tendon, ligaments and its structure including the lower leg and knee, right till the hip, which affect all the movements of the ankle. So, if you are overexerting the hip, knee, ankle or the foot, you end up overworking some tendons or muscles. This can result in Achilles tendonitis in the heel, which is caused due to excessive walking or exercise, tendinopathies around the foot, or impingement of the tendon (where two bones squeeze on to a tendon if the foot is not strong enough to hold a certain posture).You may also suffer muscle fatigue or spasms.“ Pedra recommends:

Walking on toes
Stand upright, with hands on your hips and feet shoulder width apart. Raise your toes and ensure that your heel doesn't touch the floor. Your body weight should be on your toes. Walk 5 metres forwards, 5 metres sideways, both ways and 5 metres backwards. In this exercise too, your trunk and pelvic posture is important.

Calf lifts
This exercise can be done on the staircase or a stool whose height is equivalent to that of a step. Stand at the edge of the stairs. Only the front portion of your foot should be on the stairs while the heel should be out. Stand on your toes, gradually lifting the heels up; then lower them. Three sets of 10 will strengthen your calf muscles well.

Elbows
Lateral epicondylitis, popular known as tennis elbow, is usually seen in those who type a lot, drive for long hours or do household chores like rolling chapattis, wringing clothes, washing utensils and carrying heavy bags. “The extensor carpiradialis brevis is a muscle in the forearm that acts to extend and abduct the wrist. In tennis elbow, this muscle or tension is inflamed and the person experiences shooting pains on the outer portion of the elbow. Sometimes, they might experience pain in the forearm too,“ adds Dr Darne.
To avoid this, ensure that you do not overdo the tasks, and spread them out. “Also, while carrying heavy bags, ensure that you distribute the weight equally and carry it close to your body with both your hands. Stretching your forearm muscles will help you ease the tension and relax the elbows.“ Dr Darne recommends the following exercises.
Eccentric strengthening
Sit on an armchair. Take a dumb bell of 1 or 2 kg weight. Hold it in your hand and do a wrist extension. Your palm should face downwards. Lift your wrist up with the support of the other hand; then, slowly bring it down. Do three sets of 15 reps, twice a day.

Extensor stretch
While standing, arms parallel to the ground, open your palms and move your wrist down. Support the hand with your other hand and stretch your muscles. This will flex your extensor muscles which are on the top of the forearm. Hold for 15-20 seconds and then relax. Then, do a flexor stretch. Open your palms, support the fingers with your other hand. Move your wrist up and stretch the flexor muscles. Hold for 15-20 seconds and then relax. Do five or six reps of each, twice or thrice a day.
Rinky Kumar

MM3AUG17 

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