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Physio Masud, Dhaka (2026)

02/12/2025

2018

29/11/2025

Head of Femur

28/11/2025

Overtightness of the quadratus femoris can lead to sciatica, we find out the quad fem overworking and the hamstrings underworking

27/11/2025

Differential Diagnosis of Dizziness & vertigo

24/11/2025

Best Knee Strengthening Exercises for Osteoarthritis

1️⃣ Quadriceps Setting (Quad Set)

Gentle but powerful activation of the VMO for knee stability.

2️⃣ Straight Leg Raise (SLR)

Strengthens quads without bending the knee — ideal for painful OA.

3️⃣ Short Arc Quads (SAQ)

Targets quads with controlled knee extension.

4️⃣ Terminal Knee Extension (TKE)

Strengthens quadriceps + improves knee locking mechanism.

5️⃣ Wall Sit (Isometric Hold)

Builds endurance in quads & glutes.

6️⃣ Mini Squats

Functional movement training with minimal joint stress.

7️⃣ Step-Up Exercise

Improves knee stability, hip strength & walking capacity.

8️⃣ Heel Slide (Active ROM)

Maintains joint mobility + lubricates knee joint.

9️⃣ Glute Bridge

Strengthens glutes → reduces load on knee joint.

🔟 Clamshell Exercise

Targets hip abductors → reduces knee valgus collapse.

1️⃣1️⃣ Hamstring Curls (Standing or Prone)

Balances knee musculature & reduces posterior stiffness.

1️⃣2️⃣ Calf Raises

Improves ankle-knee alignment & weight-bearing mechanics.

✅Physio Masud

23/11/2025

⭐ Clinical Problems Caused by Side-Lean Walk

❗ Lumbar compression
❗ Facet joint stress
❗ Disc pressure
❗ Pelvic asymmetry
❗ Gait imbalance
❗ Further back or leg pain

23/11/2025

🔥 Chondromalacia Patella – The Pain Behind Your Knee Cap! 🦵

💡 What is it?
Chondromalacia Patella (also called Runner’s Knee) is a painful condition where the cartilage under the kneecap (patella) gets soft, weak, or damaged. This leads to pain when bending, squatting, climbing stairs, or sitting too long.

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📜 Name Origin & History
The word Chondro = cartilage, Malacia = softening.
So, Chondromalacia = softening of cartilage under the patella. 🧩

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♨️ Causes / Risk Factors⤵️

👉 Overuse injuries (runners, athletes )
👉 Misalignment of the patella
👉 Weak thigh muscles (quadriceps imbalance)
👉 Trauma / direct blow to the knee
👉 Flat feet or abnormal gait
👉 Arthritis or degenerative changes

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♨️ Signs & Symptoms ⤵️

❌ Dull, aching pain under or around kneecap
❌ Pain during stairs, squats, running, or sitting long time
❌ Grinding or clicking sensation 🛠️
❌ Swelling or puffiness around knee

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🔍 Physical Examination & Clinical Tests ⤵️
✔️ Patellar Grind / Clarke’s Test
✔️ Observation of patellar tracking
✔️ Check for muscle weakness & tightness

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🖼️ Radiological Findings ⤵️
🔹 X-Ray – May show patellar misalignment
🔹 MRI – Detects cartilage softening or damage

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💊 Conservative Treatment⤵️
✅ Rest & Activity modification
✅ Ice packs
✅ NSAIDs (pain relief medicine)
✅ Knee support / Bracing

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♨️ Physiotherapy Management⤵️
✔️ Strengthening quadriceps, hamstrings, hip abductors
✔️ Stretching tight muscles (IT band, hamstrings)
✔️ Patellar mobilization techniques
✔️ Balance & proprioception training
✔️ Electrotherapy (TENS, Ultrasound for pain relief)
✔️ Taping / Kinesiotaping for patellar tracking

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🌿 Alternative Approaches
✨ Acupuncture – for pain modulation
✨ Orthosis – patellar stabilizing brace

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🏡 Home Advice ⤵️
🥦 Maintain healthy weight (reduce stress on knee)
👟 Wear supportive shoes
🚶‍♂️ Avoid prolonged sitting with bent knees
🧘 Practice regular stretching & low-impact exercises (cycling, swimming)

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💖 Key Message:
Chondromalacia Patella is common but very manageable with proper care, exercises, and physiotherapy. Don’t ignore knee pain – early treatment saves your joint!

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✍️ Physio Masud

22/11/2025

💥 “Scottie Dog Sign 🐕
– A Key Radiological Clue in Lumbar Spine!”

🩻 What is the Scottie Dog Sign?
In an oblique lumbar spine X-ray, the vertebra appears in the shape of a Scottie dog. This classic radiological sign helps identify abnormalities in the pars interarticularis.

🔍 What Does It Show?

🐕 The vertebra resembles a Scottie dog

💔 A “break in the neck” of the dog indicates pars fracture / spondylolysis

🦴 Most commonly observed at the L5 vertebra

⚕️ Why Is It Important?

✔️ Helps in early diagnosis of low back pain conditions

✔️ Early detection → better treatment planning

✔️ Useful for assessing risks of spondylolysis and spondylolisthesis

🧠 Clinical Value for Physiotherapists:

🔹 Must be considered in extension-based low back pain

🔹 Helps guide rehab: core stabilization, hip mobility, posture correction

🔹 Very important for athletes or adolescents with back pain

-✅--Physio Masud

18/11/2025

🧠 Neuron — Deep but Clear Explanation

A neuron isn’t just a cell—it’s a communication machine designed for speed, precision, and insane coordination. Everything you feel, think, remember, or move… starts with these guys firing.

Let’s take it layer by layer.

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🔍 1. Structure in More Detail

🟦 Dendrites

Highly branched — more branches = better communication.

Covered with dendritic spines that help form synapses.

They handle graded potentials (small incoming signals).

🟦 Cell Body (Soma)

Contains organelles: nucleus, mitochondria, ribosomes.

Integrates all incoming signals and decides
“Should I fire an impulse or not?”

🟦 Axon Hillock

The “decision point.”

If the combined signal crosses threshold, an action potential starts here.

🟦 Axon

Can be 1 mm or up to 1 meter long (like in the sciatic nerve!).

Transmits action potential — an all-or-none electrical impulse.

🟦 Myelin Sheath

Increases conduction speed from 2 m/s → 120 m/s.

Diseases like multiple sclerosis damage myelin → slow or blocked signals.

🟦 Nodes of Ranvier

Areas without myelin.

Sodium channels concentrated here.

Impulse jumps node to node → saltatory conduction.

🟦 Axon Terminals (Synaptic K***s)

Contain vesicles storing neurotransmitters.

Release chemicals into the synaptic cleft.

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⚡ 2. How a Neuron Sends Messages (Detailed Mechanism)

Step 1: Resting Membrane Potential (-70 mV)

Inside is negative compared to outside.

Maintained by Na⁺/K⁺ pump.

Step 2: Depolarization

Sodium channels open → Na⁺ rushes inside.

Membrane becomes positive (+30 mV).

Step 3: Repolarization

Potassium channels open → K⁺ moves out.

Step 4: Hyperpolarization

Membrane becomes slightly more negative than resting.

Step 5: Refractory Period

Neuron cannot fire again immediately.

Prevents backward flow of impulse.

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🔗 3. Synapses — How Neurons Communicate

There are two types:

🟡 Chemical Synapse (most common)

Uses neurotransmitters.

Slower but more flexible.

🟢 Electrical Synapse

Direct ion flow through gap junctions.

Very fast (found in retina, heart, brainstem).

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🎨 4. Types of Neurons (More Detailed)

By structure:

Multipolar → 1 axon + many dendrites (most common)

Bipolar → 1 axon + 1 dendrite (eye retina, olfactory epithelium)

Unipolar (pseudo-unipolar) → sensory neurons

By function:

Sensory (afferent)

Motor (efferent)

Interneurons

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🧪 5. Neurotransmitters (Quick Overview)

Just a few you should know:

Neurotransmitter Function

Acetylcholine Muscle contraction, memory
Dopamine Reward, movement
Serotonin Mood, sleep
GABA Inhibitory, calming
Glutamate Major excitatory NT
Norepinephrine Alertness, focus

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🧩 6. Neuron Functions in Real Life

Touch something hot → sensory neuron sends message

Spinal cord → interneuron processes

Motor neuron → tells muscle to pull hand away

All this happens in milliseconds

18/11/2025

Release Gluteus Minimus then Activated Hip Flexors, Gluteus Maximus

16/11/2025

💥LATISSIMUS DORSI💥
Language orgin = Latin
🔑latissimus means =widest .
🔑dorsi means =of the back.
The latissimus dorsi muscle is often called the "lats" . The lats are superficially located, which means they are clearly visible.

🛑SHAPE: it is a large, flat triangular muscle

🛑ORGIN
🎈Spinous processes T6-T12 vertebrae
🎈 Spinous processes of all lumber vertebrae
🎈9th-12th ribs
🎈Thoracolumbar fascia
🎈 Inferior angle of the scapula
🎈 Posterior part of lliac crest
🎈Crest of sacrum

🛑 INSERTION:
📍Twists to insert into the intertubercular sulcus
(bicipital groove) of humerus, justbelow the shoulder joint

🛑NERVE SUPPLY:
Thoracodorsal nerve, C6, 7, 8, from the posterior cord of the brachial plexus.

🛑BLOOD SUPPLY:
Thoracordosal Artery from the axillary artery

Function
💡Adduct of Shoulder
💡Arm extension
💡Internal rotation of arm at the shoulder
💡Assists in forced inspiration by raising lower ribs.
💡Assists with lateral flexion of the trunk

☘️EFFECTS OF TIGHTNESS OF THE LATISSIMUS DORSI :
The latissimus dorsi is an important muscle in swimming and is very strong and perhaps overdeveloped in competitive swimmers. Tightness of the latissimus dorsi limits shoulder ROM in flexion, lateral rotation, and perhaps abduction. Attached to the pelvis and lumbar spine posteriorly and to the anterior aspect of the humerus, the latissimus dorsi crosses from the posterior to the anterior surface of the trunk. Consequently, tightness of the latissimus dorsi also may contribute to flexion of the upper thoracic spine

⁉️TRIGGER POINT ACTIVATING CAUSES:
🌠Golf 🏌️
🌠Racquet sports,
🌠Swimming🏊
🌠Baseball⚾
🌠Cricket🏏
🌠Rowing,
🌠Heavy lifting,
🌠Gym related🏋️
🌠Gardening,
🌠Poorfitting bra👙

⁉️DIFFERENTIAL DIAGNOSIS:
📌C7 neuropathy.
📌Ulnar neuropathy.
📌Subscapular nerve entrapment. 📌Axillary neuropathy.
📌Thoracic outletsyndrome.
📌Cardiopulmonary diseases.

🛑 ASSESSMENT
👌 Flexibility & musle length test
👌Musle strength test

🛑TREATMENT
📍Myofascial Release
📍Stretching
📍Strengthening
📍Musle Energy technique
📍IASTM
📍Dry Needling
📍Wet Needling

🛑 PREVENTION
🔖Using proper form during sports and exercise
🔖Avoiding overuse of the muscle
🔖Applying a heating pad to the area before exercising
🔖Warming up and cooling down before and after a workout
🔖Stretching gently after warming up and before cooling down
🔖Staying hydrated
🔖Getting occasional massages

✍️Written by
Physio Masud Rana

15/11/2025

🔥 Post-Operative Low Back Pain & Leg Burning Sensation After PLID
👉 Why it happens & how physiotherapy helps
🩺 Why Pain Still Occurs After PLID Surgery?
Even after removing the disc fragment, some symptoms may continue for weeks due to:
✔️ Nerve root inflammation
✔️ Residual nerve compression from swelling
✔️ Scar tissue formation around the nerve
✔️ Weak core & lumbar stabilizers
✔️ Abnormal movement pattern due to fear & guarding
✔️ Poor post-operative posture

🔥 Why Burning Sensation in the Leg?
🔥 Burning, tingling, or electric pain means the nerve is healing but still irritated.
👉 After PLID the nerve root needs time (4–12 weeks) to recover.
👉 Scar tissue or local inflammation can irritate the nerve → causing burning pain down the leg.
👉 Weak glutes & core increase lumbar shear → nerve gets re-sensitized.

🧘‍♂️ Most Effective Physiotherapy Approach
1️⃣ Pain & Nerve Inflammation Control
✔️ McKenzie Extension protocols (as tolerated)
✔️ Neural mobilization (Sliders → Gliders)
✔️ Modalities: IFT / TENS / laser (if needed)
✔️ Pelvic tilting for lumbar decompression
2️⃣ Re-activate Deep Core
✔️ Transverse abdominis activation
✔️ Multifidus retraining
✔️ Diaphragm + pelvic floor synergy breathing
3️⃣ Hip & Glute Strengthening
✔️ Glute bridge (gentle → advanced)
✔️ Hip abduction isometric
✔️ Clamshell variation
👉 Strong hips reduce nerve load on lumbar spine.
4️⃣ Movement Correction
✔️ Avoid forward flexion in early stage
✔️ Log roll technique for bed mobility
✔️ Lumbar-neutral sitting & walking
✔️ Gradual return to activity (no heavy lifting early)
5️⃣ Scar Tissue Management
✔️ Nerve flossing
✔️ Soft tissue mobilization around incision (when allowed)
✔️ Gradual stretching of hamstring & piriformis

⚠️ When to Worry?
Seek urgent medical review if:
❌ Progressive leg weakness
❌ Severe night pain
❌ Loss of bowel/bladder control
❌ Pain increases day by day without relief

💡 Key Message
Post-operative burning pain does NOT always mean the surgery failed.
Most cases improve with proper guided physiotherapy, nerve healing time, and core strengthening.

PHYYSIO MASUD

Physio Masud

02/12/2025

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