Functional Dizziness or Vertigo?

 

What exactly is functional dizziness?

Recurrent attacks of vertigo or prolonged vertigo, other balance system disorders give rise to functional dizziness.

Eg. I have dizziness on looking at moving cars or traffic

I have dizziness on looking at moving lights

I have dizziness on looking down or bending to pick something up

How is vertigo different from functional dizziness?

Vertigo is a sudden attack of dizziness with imbalance caused due to specific position of head.

Eg. Having dizziness on turning on left side and getting up. It usually goes away within a minute. If I close my eyes, the nausea reduces. I feel like surrounding moves. I feel imbalance while walking.

So what does this mean?

This implies that everytime I have dizziness, the cause is may not be vertigo. It should be properly diagnosed by a Physiotherapist or a Doctor. You should not take medication without proper advice because you maybe taking medication to cure something which is not the cause.

Then why does functional dizziness happen?

The brain receives inputs from eyes, balance system in the ear and joint position sensors and then it matches all 3 inputs. Eg. If you tilt your head to the right and walk, inputs will be given by eyes, ear and neck joint sensors that everything is tilted. Each input will be matched with each other and then the brain will give command to body to balance itself, otherwise you would go sideways to the right and fall

In prolonged vertigo, this mismatch between all these 3 systems happens repeatedly and you become used to interpreting everything wrong. Hence, moving cars, moving visuals, etc. give you dizziness. Any psychogenic disorders like anxiety, depression are know to provoke functional dizziness.

What can we do about it?

There is definitely a solution for this! Vestibular rehabilitation along with exercises which train your visual and ear balance system inputs are given to improve the mismatch.

There is a variety of exercises which can be given depending on personal symptoms and requirements. The treatment needs to be customised and cannot be generalized. Since there is a psychogenic factor to functional dizziness, Cognitive Behavioural Therapy (CBT) helps as well.  CBT is a gradual process that helps a person take incremental steps toward a behaviour change.

Combination of vestibular rehabilitation with CBT can help patients escape a cycle of maladaptive balance control, recalibrate vestibular systems, and regain independence in everyday life.

For details about vertigo and its physiotherapy treatment, please refer to our previous blog on vertigo: https://rehabstationpune.blogspot.com/2022/02/blog-post.html

Dr. Sukanya Dandekar (PT)

Neuro Physiotherapist

Rehab Station, Pune

Is Parkinson's Disease a Death Sentence?

To answer in the very first sentence: NO!

Parkinson's Disease is a progressive condition which means that the disease severity increases with time.There are a lot of misconceptions about Parkinson's Disease and no one really knows what it is!

To save you the time and efforts of googling, we will answer some of the questions you ask on google:

1. How does a person get Parkinson's Disease?

Combination of genes, environment and lifestyle. 

 
2. What happens to a person with Parkinson's disease? 

- muscle stiffness

- tremors

- difficulty maintaining balance and walking

- forward bent posture

- loss of facial expressions

- loss of recent memory

- trouble talking and swallowing

3.  What are the early warning signs of Parkinson's disease?

- tremors of fingers and thumb

- handwriting becomes smaller as you write more words

- taking small steps

- trouble walking immediately after getting up

- swaying forwards or backwards while doing activities

- soft or low voice

4. Can you prevent Parkinson's Disease?

Unfortunately, no, you cannot prevent Parkinson's Disease. However, physiotherapy and medicines together can help you maintain near normal functional life.

5. What is the best treatment for Parkinson's Disease?

As mentioned above, Physiotherapy and Medicines will have a combined effect. Only medicines or only physiotherapy will not give you the desired results. Doing Physiotherapy after you have taken medications is the best treatment.

Another helpful solution is stress management and prevent social isolation. Encourage them to take part in all social activities so that they don't feel lonely!

Dr. Sukanya Dandekar (PT)

Neuro Physiotherapist
Rehab Station, Pune

All you need to know about Post pregnancy physiotherapy

Postnatal Care (PNC) and Physiotherapy

 

Life for new moms can get hectic between changing diapers and feeding. With everything else on your plate, it can be difficult to take out even a few minutes for yourself. Many mothers neglect their health and avoid going to a physiotherapist. Some mothers don't even know that there are Physiotherapists who can look after their problems.

 

During pregnancy every woman goes through physical and emotional changes. Several physical changes which occur during pregnancy persist even after it. All these factors are interlinked and have a carryover effect after pregnancy. Even after giving birth, the mother might need proper attention to these problems, which range from low back pain to incontinence.

 

Many mothers ignore symptoms like pain and assume that it would go on its own, but that's not the case. There are other factors that also come into picture, like-

          1. Postpartum pelvic pain

          2. Low back pain

          3. Pelvic floor weakness

          4. Abdominal weakness

          5. Incontinence

          6. Ligament laxity

Here, Physiotherapy comes into picture. It plays an important role in managing the above mentioned problems and involves:

   1. Pain management

   2. Strengthening of pelvic floor & Abdominal muscles

   3. Proper Breast-feeding techniques

   4. Ergonomic advice

   5. Weight reduction

With physiotherapy, mothers can improve flexibility, strength, scar tissue mobility as well as incontinence. It helps mothers return to their pre-pregnancy fitness & their daily activities.

So, when to visit a Physiotherapist?

One can visit a Physiotherapist within or after first 6 months post-delivery. According to ACOG guidelines, women can safely perform low impact activities 2-3 weeks after vaginal delivery & 6-9 weeks after a caesarean delivery.

 

 Give your motherhood the fitness it deserves!

 

  

 

व्हर्टिगो: काही समज व गैरसमज

 व्हर्टिगो हा एक सामान्य त्रास झाला आहे पण व्हर्टिगो म्हणजे नक्की काय हे सर्वांना माहित नाही . उंच ठिकाणावरून खाली पाहिल्यावर जी चक्कर येते किंवा गाडीतून प्रवास करताना चक्कर येते त्याला सगळे व्हर्टिगो म्हणतात. पण तसे नसून व्हर्टिगो ची लक्षणे हि वेगळे व ठराविक आहेत. 

व्हर्टिगो ची लक्षणे:

१. आपण हालत नसताना हल्ल्यासारखे वाटणे 

२. चक्कर आल्यावर आपण फिरत आहोत  किंवा आपल्या आजूबाजूचे सगळे फिरत आहे  असे वाटणे 

३. एका बाजूला मान वाळवल्यावर चक्कर येणे व त्या दिशेने तोल जाऊन पडणे 

४. चक्कर आल्यावर मळमळणे किंवा उलटी होणे 

५. कानात आवाज येणे किंवा कमी ऐकू येणे 

व्हर्टिगोची चक्कर १-२ मिनिटे राहते व त्याचा त्रास पुढील २-३ तास किंवा दिवसभर होतो. 

                                           Credits: Southern ENT Associates

हा आजार कशामुळे होतो?

कानातल्या बॅलन्सच्या यंत्रणेतील हा एक बिघाड आहे. तो नक्की कशामुळे होतो याचे काही प्रमुख कारण नाही. खालील काही कारणांमूळे व्हर्टिगो होऊ शकतो:

१. मधुमेह 

२. कानाचे इन्फेक्शन किंवा सर्जरी 

३. बी पी चा त्रास

४. डोक्याच्या इन्जुरीज 

५. मायग्रेन

व्हर्टिगोवर इलाज काय?

पोसिशनल व्हर्टिगो वर फिजिओथेरपीने कायमचा उपचार होतो. कानातल्या बॅलन्स सिस्टीम मध्ये कॅल्शिअमचे कण सुटून बाहेर येतात व ते सिस्टीम मध्ये फिरतात. त्यामुळे मेंदूला चुकीची माहिती मिळते व आपल्याला चक्कर येते आणि तोल जातो. मानेच्या विशिष्ठ हालचालींनी ते कण आत घालवता येतात व चक्कर लगेच जाते. 

ते कण जर का आत गेले नाहीत तर कुठेतरी ते अडकून राहतात व काही दिवसांनी किंवा वर्षांनी चक्कर परत येत राहते व आपली रोजची कामे करण्याचा किंवा बाहेर जाण्याचा आत्मविश्वास ढळतो. म्हातारपणात व्हर्टिगोमुळे पडले तर फ्रॅक्चर होऊ शकते किंवा डोक्याला मार लागू शकतो. 

व्हर्टिगो वर फिजिओथेरपी मध्ये चाचणी व उपचार दोन्ही आहेत. औषध न घेता तुम्ही या त्रासावर लवकर उपचार करू शकता!

डॉ. सुकन्या दांडेकर (पी . टी.)

न्युरोफिजिओथेरपीस्ट 

रिहॅब स्टेशन, पुणे 

 

YOUR FRACTURE MAY HAVE HEALED, BUT HAVE YOU??

Fractures are very common and we all know someone who has had a fracture some time in their life. Fractures are generally treated by putting a cast or in some cases with surgery. Bone healing is a long process and so any person with a fracture needs to be very patient.

Bone healing is only half of the problems faced due to a fracture. Cast or surgery for the fracture does not target any soft tissue or muscle that may have been damaged due to the fracture. Also, if your joints have been immobilized in a cast for several weeks they get really stiff and movements become difficult. Many patients complain of pain, stiffness, reduced joint movement, difficulty in certain activities even after the fractured bone has completely healed. In such cases people tend to avoid even simple activities like climbing stairs or walking on uneven roads. When even simple activities seem difficult; no need to imagine how much activities like dance, sport, and travel might be affected…

An important part of full and functional recovery from fracture is Physiotherapy. To make sure that you do not face above problems and regain full confidence after a fracture; a proper physiotherapy rehab is absolutely essential.

Physiotherapy is advised by most doctors when the fractured bone is aligned. Physiotherapy is generally started immediately after cast removal or after your fracture fixation surgery.

This is how physiotherapy helps at this stage-

Early physiotherapy is very beneficial as it restores all normal movements and reduces unnecessary fear of movement which may be present after fractures. Some fractures do not unite or heal properly if appropriate movement is not done; in such cases a person may land up with a deformity, which is almost impossible to correct later. If you have been operated to fix the fracture; re-training the muscle and helping bone healing depends entirely upon how well you move!  

Most people complete this part of physiotherapy rehabilitation; they get back to their normal routines and the fracture is almost completely forgotten!

Many patients notice that their old, well-treated fracture starts to create difficulties when they try a new activity or when they resume activities they were doing easily before. As physios, we see a lot of patients who feel that their joint pain or muscle pain is due to a fracture they had some years ago. We commonly hear statements like- ‘I haven’t been able to take my hand behind my back after I had a shoulder fracture’, ‘I get pain if I lift something heavy because my wrist fracture has not healed’, ‘I cannot walk fast because my leg was fractured’ and so on.

Such statements indicate that many people are unable to return to their previous level of activity even after proper bone healing has taken place.

A huge factor for this is inadequate physiotherapy. Patients most commonly stop physiotherapy after basic movements are restored and hence functional strengthening of the injured hand/leg takes a backseat.

But here’s some good news!! Such complaints can be reduced with physiotherapy at any stage! Physiotherapy may not correct your old deformity; but it will definitely help make painful activities easier. Strengthening of muscles required for these activities can be properly done with your physiotherapist’s guidance.

On the occasion of World Physiotherapy Day, we at Rehab Station are organizing a camp just for you! Get your old fractures re-assessed by the expert physiotherapists at Rehab Station and we will help you get back to your normal routines!

-Dr Shriya Joshi (PT)

Musculoskeletal Physiotherapist at Rehab Station, Pune

COMMON MYTHS ABOUT YOGA!

 21^st June is celebrated as International Yoga day and was started in 2015 to spread awareness about the numerous benefits of Yogic practice on health and well-being. The major benefit that is most relevant to our current lives during the pandemic, is that Yoga minimizes the impact of stress on our bodies. It is not a miracle but a science that works beautifully to reduce the impact of stress and its delirious effects it has on our bodies.

Let’s dive into the most common myths regarding Yoga!     

Yoga belongs to Hinduism

Yoga does not belong to any religion. Although Yoga did evolve around Hinduism, one does not have to be a follower of Hinduism to perform Yoga. It is a tool which teaches us how to lead our lives to the ultimate goal. In earlier times, Yoga was taught to children a part of their education, regardless of their religion. It is a source when used correctly, can lead to physical and emotional well-being.

Yoga is all about stretching and flexibility

Yoga is not only about flexibility but more about mindful movement control which requires strength, flexibility, and balance. It is a holistic form of exercise which has numerous effects like reducing stress, improving posture and balance, and improving breathing control to name a few.

Yes, we are trying to say that Yoga is not merely a stretching workout. There are eight limbs, what we call as Ashtanga Yoga-

Yama – attitude to the environment
Niyama- attitude to yourself
Asana- physical postures
Pranayama- control over breathing
Pratyahara- withdrawal of the senses
Dharana- concentration
Dhyana- meditation
Samadhi- integration of all

Asanas are only one component of Yoga practise. Hence Yoga is not about twisting and turning into weird positions. It is much more than that!

I don’t have a Yoga body. I need to be thin to do Yoga

There is nothing such as a ‘Yoga body’ Every-body can become a Yoga body. Yoga does not discriminate between thin, fat, old, young etc. You also don’t have to be at the peak of your physical ability to perform Yoga. No matter where you are, you can start your Yoga journey.

Yoga is too feminine for me. I prefer going to the gym.

Yoga is practised solely by women is a big misconception in today’s youth. Yoga and working out at the gym or cross-fit training cannot be compared. Most types of exercises are competitive. Yoga although non competitive nevertheless incredibly challenging and requires mindful performing of asanas.

                                                Credits: B.K. S. Iyengar (yogavastu.com)

              

I cannot do Yoga as I am not flexible

You do not have to be flexible to do Yoga, but in fact practising Yoga will make you flexible. If you find others more flexible than you, remember you must perform better than only yourself.  The only prerequisite to start your Yoga journey is to have a body and a willing mind. Consistency in practise will bring strength and flexibility in the body and in the mind as well.

 

My Yoga routine is safe on days of my periods.

Some Yoga asanas like for example inverted postures like headstands, handstand, should be avoided on days of menstruation. One must be educated and aware of what to do and what not to do when on your periods! Even some variations of pranayama are contraindicated then. Doing all asanas just because you can even on the 2^nd day, is not an achievement. You may be doing harm to your body than helping it.

                                                    Credits: Verywell health  

I have health issues and that is why I cannot do Yoga

Suffering from hypertension i.e. high blood pressure for past few years should not stop you from performing Yoga, A lot of research has shown how Yoga helps in various health conditions, the top most being high and low blood pressure, diabetes, osteoarthritis and anorexia. But this requires deep understanding of basic anatomy and physiology of our body and the correct methods to help us out with some diseases. Getting help from an educated professional in this field in highly recommended.

Yoga gives me back pain

Yoga is supposed to help your body and not cause harm to it. If you are having back pain, knee pain, shoulder pain etc., please do consult with your physiotherapist. Some things can be resolved easily but need timely intervention form an expert. Do not continue doing the same routine which might aggravate your condition rather than solving it!

Yoga can be made simple with the use of props and deeper understanding of one self. Don't be afraid to start your Yoga journey! You will be amazed at what your body can do... 

-Dr. Neha Gogate (PT)

Team Rehab Station 

Footballers: 5 tips to kick off your knee injuries!

Knee Injuries: How serious can they be?

The knee is a complex joint. It moves like a door hinge, allowing a person to bend and straighten their legs so they can sit, squat, jump and run. The knee is made up of four components: bones, cartilage, ligaments, tendons. There are many different types of knee injuries that may occur. 

Most common knee injuries are ligament injuries of which ACL injury is the most common, Fractures, Meniscal injuries, Knee bursitis, Patellar tendinitis, etc. 

Current and a relatable example can be of Sergio Aguero one of the major stars in English Premier League of Manchester City Football Club suffered with a devastating knee injury against Burnley, which was later revealed as a meniscus injury. 

 

The injury-  

The menisci are dual crescent shaped pieces of cartilage that sit between the femur(thigh bone) and tibia(shin bone) within the knee joint to absorb force, distribute load and reduce friction.

The surgery-

Based on reports it is very likely that the City Star underwent partial menisectomy in which the damaged piece of tissue is removed via arthroscopic surgery using tiny instruments inserted through portals in the knee. 

This injury side lined the Argentinian International for more than 8 months. This was a devastating blow to not only the player but also the the club he was playing for Manchester City, as he was their highest goal scorer in the previous season. 

Aguero underwent surgery a few days later after his injury. The major question for the player and the team is now whether he can make it back to the most important league in club football the UEFA Champion's League.The medical staff and physiotherapist are currently working with the player to get him back on the field to his utmost potential. 

TIPS TO AVOID KNEE INJURIES:

1. Regular warm up and cool down for 20 mins.

2. Focus on strengthening exercises of hip and knee muscles. 

3. Regular stretching of hamstring and quadriceps muscles. 

4. Wear good shoes that fit well and are appropriate for the sport like football or exercise that you are doing.

5. Maintain a healthy weight to reduce stress on your knees.

Knee injuries are a common phenomenon in football, visiting a physiotherapist can reduce the recurrence as certain strengthening and conditioning programs can be recommended which would in turn increase tolerance of excessive pressure while playing. 

Any injury creates a huge set back in the sports career of a footballer. It affects performance and has a negative impact on his/her physical, emotional and mental health. In addition, a previous injury can increase the chances of a re-injury or a new injury. Thus, complete recovery from an injury under an experienced physiotherapist is critical for effective return to sport. 

The rehabilitation program at REHAB STATION is customized according to the footballer's injury for a powerful comeback.