Tag Archives: Active Physical therapy

Tips for Safe and Healthy Spring Cleaning

Spring is always a welcome change after cold and lethargic winters. The blue skies and warm temperatures also bring open windows, fresh air, blossoming flowers and above all the spring cleaning.  Spring cleaning can be as hard and difficult as full-body workout as it involves good dusting, mowing of lawns; clearing gutters and many more. But the statistics show that great many numbers of people injure themselves during this annual cleaning. Active Physical Therapy suggests you to be cautious and observe the following measures to avoid any harm or injury to your body:

  • Do not perform similar motions repeatedly as this can result into sprains, strains or low back pain.
  • Keep your spine in line i.e. maintain a good posture and keep a wide base of support.
  • Avoid too much twisting or bending while lifting objects. Lift the objects properly by getting closer to them i.e. use your legs instead of your back.
  • Use long-handled tools, kneeling pad and stools while doing yard work and gardening as well.
  • Keep your properly hydrated throughout the cleaning session.
  • Wear skid resistant shoes to ensure proper footing on uneven surfaces.
  • Take regular breaks, in order to relax your tense muscles.
  • Use correct height ladder to minimize the risk of falls during cleaning your windows. Also make sure that ladder is placed on a levelled surface.
  • Move your feet and body while vacuuming, instead of reaching forward and sideways with your arms and trunk.
  • Use extension cords carefully. Do not drape them across the spans of crossing walkways to avoid tripping or falling.
  • Avoid twisting while bending, raking or thatching; instead use your legs to shift your weight from side to side.
  • To avoid slips and falls, always work in the yard wherever it is dry. Do not overfill bags or tarps as it can put pressure on your spine.
  • Do not over-exert yourself. Listen to your body and if you notice any symptoms like light-headedness, shortness of breath, sudden or severe headache, excess sweating, chest or stomach pain after or during cleaning, Contact Your Doctor immediately.

Prevention is always better than cure. Poor Physical posture, lack of exercise or warm-up, poor Physical condition can lead to injury or pain. So always do your best and follow good practices to save yourself form all such hazards.

Active Physical Therapy will be glad to help you with more spring cleaning tips or with any injuries or pain you experience during cleaning. Our diligent and expert physical therapists use state of art techniques to treat any of your musculoskeletal pains or injuries.

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Elbow Pain: Causes, Symptoms And Treatment

Elbow Pain: Causes, Symptoms And Treatment

Use of the upper limb in sport demands a well functioning elbow. In addition, injuries in this region may interfere with the patient’s everyday activities. The clinical approach to elbow pain is considered under the following headings:

  • Lateral Elbow Pain, with a particular focus on
  • Extensor Tendinopathy
  • Medial Elbow Pain
  • Posterior Elbow Pain
  • Acute Elbow Injuries
  • Forearm Pain
  • Upper Arm Pain.

Lateral Elbow Pain

Lateral elbow pain is an extremely common presentation among sportspeople and manual workers. The most common cause is an overuse syndrome related to excessive wrist extension. This condition has traditionally been known as ‘tennis elbow’. This is an unsatisfactory term as it gives little indication of the pathological processes involved. In fact, the condition is more common in non-tennis players than in tennis players. It has also been referred to as ‘lateral epicondylitis’. This is also inappropriate as the site of the abnormality is usually just below the lateral epicondyle and the primary pathology is due to collagen disarray rather than inflammation.

The primary pathological process involved in this condition is tendinosis of the extensor carpiradials brevis (ECRB) tendon, usually within 1-2 cm of its attachment to the common extensor origin at the lateral epicondyle. This condition will be referred to as extensor tendinopathy.

Other conditions that may cause lateral elbow pain include synovitis of the radio humeral joint, radiohumeralbursitis and entrapment of the posterior interosseous branch of the radial nerve (radial tunnel syndrome). These conditions may exist by themselves or in conjunction with extensor tendinopathy.

There is often a contribution to lateral elbow pain from the cervical and upper thoracic spines and neural structures. This may be a relatively minor contribution or, in some cases, the main cause of the patients elbow pain. A full assessment of the cervical spine and neural structures is essential in examination of the patient with lateral elbow pain.


The characteristics of the patients lateral elbow pain should be elicited. The diffuse pain of extensor tendinopathy typically radiates from the lateral epicondyle into the proximal forearm extensor muscle mass. Occasionally the pain may be more localized. The onset of pain may be either acute or insidious. There may have been recent changes in training or technique, note-taking or equipment used in sport or work.

The severity of pain ranges from relatively trivial pain to an almost incapacitating pain that may keep the patient awake at night. It is important to note whether the pain is aggravated by relatively minor everyday activities, such as picking up a cup, or whether it requires repeated activity, such as playing tennis or bricklaying, to become painful.

Pain may radiate into the lateral aspect of the forearm. This may be consistent with posterior interosseous nerve entrapment or irritation of other neural structures. If pain is closely related to the activity level, it is more likely to be of a mechanical origin. If pain is persistent, unpredictable or related to posture, referred pain should be considered.

Certain movements, usually those involving wrist extension or gripping, will aggravate mechanical pain. Referred pain is affected by prolonged posture, such as lengthy periods seated at a desk or in a car. Associated sensory symptoms, such as pins and needles, may indicate a neural component. Presence of neck, upper thoracic or shoulder pain should also be noted.

Often by the time the patient presents to the sports medicine clinician, he or she will already have undergone a variety of treatments. It is important to note the response to each of these treatments.

An activity history should also be taken, noting any recent change in the level of activity. In tennis players, note any change in racquet size, grip size or string tension and whether or not any comment has been made regarding his or her technique.


Examination involves:

1. Observation from the front

2. Active movements

  • elbow flexion/extension
  • supination/pronation
  • wrist flexion (forearm pronated)
  • wrist extension

3. Passive movements

  • as above

4. Resisted movements

  • wrist extension
  • extension at the third metacarpophalangaI-joint
  • grip test

5. Palpation

  • lateral epicondyle
  • extensor muscles

6. Special tests

  • neural tension
  • cervical spine examination
  • thoracic spine examination
  • periscapular soft tissues


Investigations are usually not performed in the straightforward case of lateral elbow pain. However, in longstanding cases, plain X-ray (AP and lateral views) of the elbow may show osteochondritis dissecans, degenerative joint changes or evidence of heterotopic calcification.

Ultrasound examination may prove to be a useful diagnostic tool in the investigation of patients with lateral elbow pain. Ultrasound may demonstrate the degree of tendon damage as well as the presence of a bursa.

Extensor tendinopathy

For this major sports medicine condition, we review the pathology, outline the clinical presentation, and then discuss evidence based and clinically founded treatment.

Clinical Features

Extensor tendinopathy occurs in association with any activity involving repeated wrist extension against resistance. This includes sporting activities, such as tennis ,squash and badminton, as well as occupational and leisure activities, such as carpentry, bricklaying, sewing and knitting. Computer use has been shown to be associated with the development of this condition. The peak incidence is between the ages of 40 and 50 years but this condition may affect any age group.

There are two distinct clinical presentations of this condition. The most common is an insidious onset of pain, which occurs 24-72 hours after unaccustomed activity involving repeated wrist extension. This occurs typically after a person spends the weekend laying bricks or using a screwdriver. It is also seen after prolonged sewing or knitting .In the tennis player, it may occur after the use of a new racquet, playing with wet, heavy balls or over hitting, especially hitting into the wind. It also occurs when the player is hitting ‘late’(getting the position slowly), so that body weight is not transferred correctly and the player relies on the forearm muscles exclusively for power.


No single treatment has proven to be totally effective in the treatment of this condition. A combination of the different treatments mentioned below will result in resolution of the symptoms in nearly all cases.

The basic principles of treatment of soft tissues injuries apply. There must be control of pain, encouragement of the healing process, restoration of flexibility and strength, treatment of associated factors (e.g. increased neural tension, referred pain),gradual return to activity with added support and correction of the predisposing factors.

Control of Pain

It remains unclear as to how much pain is ideal in the treatment of tendinopathies. Clinical experience suggests that a low level of pain, which does not worsen with training, is likely to not be harmful for tendon healing. However, some patients require relative rest, application of ice and analgesia for comfort.

Active Physical Therapy Treatments for Degenerative Disc Disease

Physical Therapy for Degenerative Disc Disease

Physical therapy includes both passive and active treatments. Passive treatments help to relax you and your body. They’re called passive because you don’t have to actively participate. If you’re experiencing acute pain, you’ll most likely start with passive treatments as your body heals and/or adjusts to the pain. But the goal of physical therapy is to get into active treatments. These are therapeutic exercises that strengthen your body so that your spine has better support.

Passive Physical Therapy Treatments for Degenerative Disc Disease

Your physical therapist may give you one of the passive treatments below.

Deep tissue massage: This technique targets spasms and chronic muscle tension that perhaps builds up through daily life stress. You could also have spasms or muscle tension because of strains or sprains. The therapist uses direct pressure and friction to try to release the tension in your soft tissues (ligaments, tendons, muscles).

Hot and cold therapies: Your physical therapist will alternate between hot and cold therapies. By using heat, the physical therapist seeks to get more blood to the target area because an increased blood flow brings more oxygen and nutrients to that area. Blood is also needed to remove waste byproducts created by muscle spasms, and it also helps healing.

Cold therapy, also called cryotherapy, slows circulation, helping to reduce inflammation, muscle spasms, and pain. You may have a cold pack placed upon the target area, or even be given an ice massage. Another cryotherapy option is a spray called fluoromethane that cools the tissues. After cold therapy, your therapist may work with you to stretch the affected muscles.

Spinal traction: By stretching the back, spinal traction works to alleviate pain caused by muscle tightness or compressed nerves. The therapist can do that manually (by using his or her own body) or mechanically (with special machines). Especially if your nerve is being pinched by the foramen—the area where the nerve exits the spinal canal—your therapist may try traction. It’s thought to widen the foramen by stretching the spine to readjust the vertebrae.

Active Physical Therapy Treatments for Degenerative Disc Disease

In the active part of physical therapy, your therapist will teach you various exercises to improve your flexibility, strength, core stability, and range of motion (how easily your joints move). Your physical therapy program is individualized, taking into consideration your health and history. Your exercises may not be suitable for another person with DDD.

Degenerative disc disease won’t ever entirely “go away”—once your discs start to degenerate, you can’t reverse that process—and because of that, your physical therapist will help you learn how to work around it and how to limit the pain. You’ll learn about body mechanics and how to avoid positions that cause pain.

If needed, you will learn how to correct your posture and incorporate ergonomic principles into your daily activities.

If needed, you will learn how to correct your posture and incorporate ergonomic principles into your daily activities. This is all part of the “self-care” or “self-treatment” aspect of physical therapy: Through physical therapy, you learn good habits and principles that enable you to take better care of your body.

Your physical therapist may also suggest a personalized exercise program for you. The goals may include: strengthening abdominal and back muscles, increasing muscle endurance (so that your stronger muscles can work harder longer), and getting your body to carry your weight more efficiently. An exercise program comes with another bonus—it may help you lose weight. Extra weight can exacerbate pain from DDD, so if you need to lose weight, your physical therapist can work with you to set goals and then follow through.


Exercises for Strong Bones

According to the Medical Researchers people with low bone density are at the higher risk of developing Osteoporosis. National Institutes of Health National Resource Center states that bone mass peaks during the third decade of life and after that we begin to lose bone. But this bone loss can be prevented with regular exercise. If you continue to exercise into middle age and beyond; risk of developing osteoporosis decreases undoubtedly. You can start a bone-healthy exercise program even if you are diagnosed with osteoporosis.

National Osteoporosis Foundation (NOF) suggests that as the people age, they should take the charge of their bone health. Along with diet and regular check-ups, a healthy and regular exercise regimen can help to slow down the aging effects while allowing you to maintain quality of life through activity and independence. A customized and regular exercise program may help to prevent falls and fall related fractures which quite so often result into disability and pre-mature death.

Which exercises can benefit bone health?

Exercises which can be beneficial for bone health and as well strengthen bones and muscles and improvise balance, co-ordination and flexibility can be categorized as follow :-

  • High-Impact Weight-bearing Exercises: Activities like dancing, hiking, jogging, stair climbing, tennis which make you move against gravity are grouped under this exercise regime.
  • Low-Impact Weight-bearing Exercises: Such activities help you to make bones strong while being a safer alternative to high-impact exercises. These include activities like; using elliptical training machine, using stair-step machines or moving fast on a treadmill or outside.
  • Posture Exercises: Such exercises help to improve posture and reduce risk of developing ‘sloped’ shoulders and bone fracture as well.
  • Hip and Back Strengthening Exercises: These include activities which are helpful in strengthening the muscles in the back and hips.
  • Balance Exercises: These exercises strengthen your legs and as well evaluate or test your balance while reducing the risk of falling.
  • Functional Exercises: These include activities for elder adults and specifically for those with limited movements. Such exercises improve how will you move and reduce the chances of falling and breaking a bone.

But it is to be kept in mind that before beginning any exercise regime, you should undergo a through medical examination in order to determine a safer exercise regime. Based on medical evaluation of the following factors a customized exercise regime is set up:

  • Fracture Risk
  • Balanced and Gait
  • Muscle Strength
  • Range of Motion
  • Physical Activity Level
  • Fitness

Your physical therapist would also consider your chronic medical conditions like; obesity, high blood pressure and heart disease. And thereafter, a customized program is designed based on the movement, limitation, personalized goal and health consideration of the clients.

Contact Active Physical Therapy for the state-of-art treatment of any of your musculoskeletal disease. Our treatment modules are planned and coordinated according to the needs, requirements and urgencies of our patients. The treatment modules co-ordinated by us will not only cure your current ailment but also pose a check on the further ones.


COVID -19 is a short name for the disease known as novel coronavirus 2019. Coronaviruses are a large group of similar viruses; some are known to infect humans. There are many different COVID -19 vaccines developed worldwide. You may be wondering how long after the second dose you have full immunity. The COVID -19 vaccine being so new and it studied so less, so questions are highly predictable. All the countries are still healing from the second wave of COVID -19 and undergoing strengthening of healthy immunity. Light fever and weakness are common after vaccines and these are normal to build immunity. First of all COVID -19 vaccines work depending on our body, that is how our body fights against illness. A strong immune system includes several tools to fight against infection. The vaccine contains inactive parts of particular antigens and newer vaccines contain the blueprint for producing antigens to oppose and fight the specific disease-causing virus. Inside the virus, genetic material called RNA is made up of genes, genes carry the information to make more copies of the virus. COVID -19 vaccine given with the needle triggers the immune response of the body. Influenza vaccines can trigger an immune response by mimicking viral infection. Vaccines are a product of science and train the body’s immune system to create a memory. When a pathogen again infects in the future, the body will rapidly prevent disease by remembering the threat. First Corona virus vaccine can prevent more than 90% of people from getting COVID -19; there are around a dozen vaccines in the final stages of testing.

Nations around the globe are racing to vaccinate people against the COVID - 19 virus. The scientific studies suggest that taking two doses of vaccine is significant for achieving the antibody response that provides overall protection and creates lasting immunity. The second dose activates the immune system much more quickly within a week of dose two. The second dose increases immunity tenfold and offers much stronger and long-lasting protection from the injection. COVID - 19 vaccines are safe and effective against severe disease and death from variants of the virus that causes COVID - 19. Two weeks after full vaccination like Pfizer and Modern vaccines are fully approved to protect, but after a single dose vaccine, you still need to follow the prevention methods such as wearing a mask and social distancing. COVID - 19 vaccines approved by WHO continue to be monitored to have a high efficacy rate of 50% or above. Immunity does not happen immediately after vaccination, because of this you can still become sick during this time frame.

Types of Immunity and Vaccines

Natural Immunity- Natural Immunity is the body’s actual immune response to produce antibodies against infection.

Vaccine-Induced Immunity- Vaccination starts producing antibodies to protect from diseases in the future.

Different Vaccines have different time periods to give a positive response.

· Pfizer- after Pfizer vaccine immunity starts developing about 12 days after the first jab.

Full immunity reached about 7 days after the second dose.

Pfizer is 92% effective after the first dose and 95% after the second dose. · Modern- Immunity starts developing from the 14th day after the first shot. Full immunity starts developing after 14 days of the second dose. The vaccine has an 80% efficacy rate after the first & 94% after the second dose. · Johnson & Johnson- Partial immunity starts developing after 2 weeks of shot. Full immunity develops after 28 days of the second shot.

Vaccines are 66% effective after full vaccination. 

 How Long Will Immunity Last?

Natural Immunity- Three types of white blood cells protect the immune system Macrophages, B- Cells, and T- Cells.

  • Macrophages- Macrophages are white blood cells produced in bone- marrow, get matured and released into the bloodstream. The role of macrophages is to ingest and destroy bacteria, viruses, clean up debris and other harmful particles. That means macrophages will attack and break the viruses and bacteria when we are sick or shortly after the vaccine.
  • B- Cells- B- Cells are key players in the body’s adaptive immune response. B Cells play a crucial role to produce antibodies that recognize unique parts of invading viruses, B- Cells fight bacteria and viruses. That means if the same infection gets into the body again, B- Cells will make unique antibodies and kill the infection right away.
  • T- Cells- T- Cells have two types- Helper T- Cells and Killer T- Cells. T- Cells take care of B- Cells. T- Cells are slightly modified throughout the human lifetime. T Cells kill the damaged cells and the infection inside of them.

Vaccine-Induced Immunity- The same process after a vaccine is followed by the body to develop immunity. B- Cells, T- Cells, and Macrophages play the same role. Vaccines help the body to develop T- Cells and B- Cells that will remember how to fight the virus in the future.

Protection After Vaccine- Scientists have seen that vaccines will protect most people for the first few months after getting the second dose and no one really knows how long immune response and how many years from now COVID - 19. Vaccination has long-term protection and Key things to know about COVID - 19 vaccines.

Effectiveness- COVID - 19 vaccines are effective, they can keep you from getting and spreading the virus, you may resume many activities you did before the pandemic. Get vaccination regardless of whether you already have COVID - 19. For non- non-vaccinated communities, COVID is still a threat, even for those who did not have symptoms. Vaccines are not experimental but went through all required stages of clinical trials. Vaccines teach our immune system to recognize and fight the virus causes COVID - 19.

Mild – Reaction- after COVID -19 vaccination, you may have some side effects. The side effects from COVID - 19 vaccination such as tiredness, headache, or chills may affect your ability to do a daily activity but will go away in a few days. Vaccines are designed to give you immunity without the dangers of getting the disease. These mild effects after getting the vaccination signs that your body is building protection. Serious allergic reactions to the COVID -19 vaccines are rare. These minor symptoms usually happened after the second dose rather than the first.

Take Precautions- The far most essential precaution after taking the COVID vaccine is to continue wearing a mask after both doses. In fact, double mask protection Is still recommended. Vaccination allows you to stay unmasked, but it does not mean you should stop practicing precautions such as masking, social distancing, and hand hygiene.

Do & Don’ts after COVID - 19 Vaccination to Boost Immunity

 1. Do’s – 

  • Drink plenty of water, and a hydrated body will reduce the symptoms you may face, preventing you from feeling sick.
  • Eating a well-established diet such as green vegetables, turmeric, and garlic helps to boost immunity. Vitamin –C-rich fruits also fight the vaccine side effects.
  • In case a person has allergies to medication or drugs, it is important to get an all-clear from medical practitioners such as people on steroids and diabetes.
  • Vaccinated lactating mothers should continue breastfeeding as babies can get through milk.

2. Don’ts- 

  •  Don’t be afraid after vaccination, some feel unpleasant, dizzy, and feel strong pain. Don’t worry about the post-effects of Vaccination. These effects give signs that your body is naturally reacting to the vaccine.
  • It all depends on your body to handle the effects of the vaccine. Your body needs to rest as much as possible. Don’t do such strenuous activities within the first 24 hours. Start light exercise after 24 hours of the COVID vaccine.
  •  Do not consume alcohol or smoke, Avoid tobacco also. Alcohol affects the body’s immune system negatively and there is a chance that the immune response to the vaccine may not be as effective.
  • Do not miss other necessary vaccines, and do not stop taking precautions. A person could still get infected by COVID -19 in a few days immediately following the vaccination because the person would not have had enough time to develop immunity.

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