https://www.facebook.com/592517463954963/

Nirmal The Bone Doc, Madurai (2026)

01/03/2026

Doc, is it cancer?” 🛑

This is often the first question I get when a patient hears the word “tumor.” As an orthopedic surgeon, treating bone tumors is a big part of what we do—and the good news is, many of them are completely benign!

However, even benign bumps can cause major problems if they press on your nerves or joints. Removing them isn’t always straightforward.

In our latest publication in the Journal of Orthopaedic Reports, we detailed 6 cases where tumors were hiding deep in the thigh. We used a rare, high-stakes surgical technique to safely get them out and get our patients back on their feet safely.

Swipe to learn how we do it, and hit save if you found this helpful! 📌 Link to the full paper in my stories/bio.

27/02/2026

You’ve swiped through the post and seen the magic of how your living bone actively heals around a surgical plate. But what happens after you’re fully healed?

If you are rocking new plates and screws, you probably have a few practical questions about your new “hardware.” Here are three things to know about living with orthopedic metal:

1. Will it set off airport metal detectors? ✈️
Most modern fracture plates and screws are made of highly biocompatible titanium or surgical stainless steel. While massive joint replacements might trigger the security wand, standard plates and screws usually fly right under the radar!

2. Does it ache when it gets cold? 🌧️
This isn’t just a myth! Changes in barometric pressure (like when a storm rolls in) can cause the tissues around the bone to expand and contract. Because metal and bone respond to temperature and pressure at slightly different rates, it can pull on sensitive nerve endings, causing a deep, dull ache on chilly days.

3. Do you eventually have to get the metal removed? 🔩
Usually, no! Once your bone heals, the hardware just sits there quietly. Unless a plate is sitting directly under the skin (like on a collarbone or ankle) and rubbing uncomfortably against your backpack or shoes, surgeons prefer to leave it right where it is. A second surgery is rarely necessary.

👇 Are you currently part-cyborg? What’s the most surprising part about having hardware in your body? Let me know in the comments!

25/02/2026

Got an MRI report saying “Disc Bulge”? Don’t panic! 🛑👇

In today’s reel, we look at Ramesh and Rajesh—both have a disc bulge, but only one needs surgery. Why? Because we treat the PATIENT, not just the SCAN.

The truth is, 90% of disc bulges can be managed perfectly with medications, physiotherapy, and time.

So, when IS surgery actually required? We look for these “Red Flag” signs:

🚩 Severe leg weakness (like foot drop)
🚩 Loss of bowel or bladder control (Cauda Equina Syndrome)
🚩 Unbearable pain that doesn’t improve after weeks of proper non-surgical treatment

The good news? When surgery is needed, we can now do it using advanced Microscopic Keyhole (tubular) techniques for faster recovery and minimal scarring. 🔬

I recently published a detailed research paper on this exact surgical technique in the Journal of Orthopaedic Surgery and Research.

👇 Comment “ARTICLE” below, and I’ll instantly DM you the link to my published paper!

22/02/2026

Ever wonder how elite athletes achieve such incredible mobility? They don’t just hold a stretch and hope for the best—they use advanced techniques like PNF stretching to unlock new ranges of motion and keep their joints healthy. 🚀

PNF (Proprioceptive Neuromuscular Facilitation) might sound complicated, but it’s essentially a bio-hack for your flexibility. Instead of just passively pulling on a tight hamstring, PNF uses your own nervous system to “trick” your muscles into relaxing and letting go of stubborn tension.

Here is exactly how to perform the Contract-Relax PNF technique for tight hamstrings:

1️⃣ The Setup: Lie flat on your back and loop a towel, yoga strap, or resistance band around the arch of one foot. Keep your resting leg flat on the floor.

2️⃣ The Initial Stretch: With your leg straight, gently pull it up toward the ceiling using the towel until you feel a mild, comfortable stretch in the back of your thigh. Hold this passive stretch for about 10 seconds.

3️⃣ The Contraction: Here is the magic step. Push your foot hard against the towel, trying to drive your heel back down to the floor. Do not let your leg actually move—resist the push with your hands. Hold this isometric contraction at about 20-30% of your maximum effort for 6 seconds.

4️⃣ The Release: Stop pushing, take a deep exhale, and completely relax the leg muscle.

5️⃣ The Deepen: Immediately (but gently) pull the leg a little further toward you. Because of the previous contraction, your nervous system will allow the hamstring to stretch noticeably further! Hold this new, deeper position for 20-30 seconds.

Repeat this cycle 2 to 3 times per leg. Remember to breathe deeply and never push into sharp pain. Try adding this to your routine 2-3 times a week and watch your flexibility skyrocket! 📈

Save this post to guide you through your next mobility session! 👇

20/02/2026

4 LIES you’ve been told about Knee Replacements 🛑🦵

“Doctor, my neighbor said if I get the surgery, I’ll be bedridden for 6 months.”

As an orthopedic surgeon, I spend half my OPD time just busting myths! Fear is the number one reason patients suffer with severe knee osteoarthritis for years longer than they need to.

Let’s set the record straight:

❌ You are NOT automatically too old.
❌ You will NOT be stuck in bed.
❌ The implant does NOT expire in 5 years.
❌ You MIGHT still be able to sit cross-legged.

Swipe 👉 to read the actual facts about modern Total Knee Replacement (TKR).

Surgery has evolved massively in the last decade. Less pain, faster recovery, and implants that last.

Send this Carousel to your parents, grandparents, or that one uncle who is terrified of fixing his knees! Let’s get them moving again. 💪

Drop your biggest fear about knee surgery in the comments, and I’ll answer it! 👇

18/02/2026

That “locking” sensation you feel is called Trigger Finger (or Stenosing Tenosynovitis). It happens when the pulley at the base of your finger becomes too thick or the tendon swells, making it hard to glide through the tunnel.

⚠️ So, why does this happen?

While it can happen to anyone, you are at higher risk if:

1. Medical Conditions: People with Diabetes or Rheumatoid Arthritis are significantly more prone to this.

2. Repetitive Gripping: Jobs or hobbies that involve heavy repetitive hand use (like gardening, using power tools, or even musical instruments).

3. Gender & Age: It is more common in women and individuals between 40 and 60 years old.

💡 The Good News:

As mentioned in the reel, the release procedure is quick (just 10 mins!) and done under local anesthesia. You walk out with a free-moving finger immediately.

Got questions about hand pain? Drop them in the comments! 👇

15/02/2026

Ever felt that sharp pain near your thumb or tingling in your fingers after a long day?

Most patients just tell me, “Doctor, my wrist hurts.” But as an Ortho Surgeon, I need to know: Is it a trapped nerve, or is it an inflamed tendon?

Because the treatment for them is completely different! 🚫💊

Swipe through ➡️ to learn the difference between Carpal Tunnel Syndrome (CTS) and De Quervain’s Tenosynovitis—and take the 2 simple self-tests I use in the clinic.

👨‍⚕️ Real Talk:

I see De Quervain’s (Slide 6) constantly in two specific groups:

1. New Parents: Lifting babies repetitively strains the thumb tendons.
2. Heavy Phone Users: Constant scrolling and texting.

On the other hand, Carpal Tunnel (Slide 5) loves my IT professionals and anyone typing away at a keyboard all day. 💻
So, let’s test it out:

Check Slide 5 and Slide 6. Did you feel the “⚡️” (Tingling) or the “🔥” (Burning)?

👇 Tag a hard-working Developer or a New Mom who needs to take a 60-second break and do this test!

14/02/2026

Whether it’s a Reel or a Research Paper, the mission is the same: Education. 🏥📚

You know me for breaking down complex orthopedic topics right here on Instagram. But recently, I took that same passion for visual teaching from the feed to the academic world.

I am honored to announce that my original research is now published in the Journal of Orthopaedic Surgery and Research (Springer Nature)!

The Study: Microscopic Tubular Unilateral Laminotomy.

Just like my content here, this paper focuses heavily on the “How-To.” We included detailed surgical illustrations to teach surgeons exactly how to perform this minimally invasive technique for bilateral decompression.

Serving as the First Author in this International Q1 Journal is a huge milestone. It proves that clear, visual education isn’t just for social media—it changes how we practice medicine.

A massive thank you to my mentor Dr. Scott Chacko John and Dr. A. V. Arsha for the support in bringing this vision to life.

If you want to see the surgical illustrations and read the full technique, check the Link in Bio (It’s Open Access & Free)! 🔗

12/02/2026

Context is the key 🔑 especially when it comes to healing soft tissue injuries like ligament sprains or tendon issues.

For decades, the standard advice was to “Just Rest” 🛌 whenever we got hurt. But in modern orthopedics, we have shifted gears. Why? Because of Davis’ Law.

Here is the science simply put:

Your body heals soft tissue by laying down new Collagen fibers.

❌ If you Rest completely: That collagen forms a messy, tangled web (think of a bird’s nest). The tissue heals, but it’s weak, stiff, and prone to re-injury.

✅ If you Move (Early Mobilization): The tension from controlled movement forces that collagen to align in straight, strong lines. This makes the healed tissue flexible and resilient.

Movement isn’t just exercise; it is the blueprint for how your body rebuilds itself. 🏗️

Disclaimer: Early mobilization means controlled rehab exercises, not running a marathon on a sprained ankle! Always follow your doctor’s protocol.

Share this with someone who is still “resting” a 3-week-old sprain! 🚀

10/02/2026

Is it a Slipped Disc... or just a Fat Wallet? 🍑💥

In clinical practice, we often see patients fearing a disc herniation when they actually suffer from Piriformis Syndrome—colloquially known as “Wallet Sciatica” or “Hip Pocket Neuropathy.”

Here is the biomechanics behind the pain:

1️⃣ Pelvic Obliquity (The Tilt): Sitting on a 2-3 cm thick wallet creates an artificial elevation on one side. This forces your pelvis to tilt unlevel, causing a compensatory curve in your lumbar spine (functional scoliosis) to keep your eyes level.

2️⃣ Nerve Entrapment: The Sciatic Nerve runs directly underneath (or sometimes through) the Piriformis muscle in your gluteal region. The constant pressure from the wallet acts as a mechanical irritant, causing the muscle to spasm and compress the nerve.

3️⃣ The Result: This mimics classic sciatica symptoms—radiating pain, numbness (paresthesia), and tingling down the back of the leg—without any actual disc pathology in the spine.

The Prescription? A “Wallet-ectomy” 🛑

Before we talk about MRIs or injections, the first line of treatment is simple mechanics:
✅ Remove the wallet while driving or sitting.
✅ Switch to a front-pocket slim wallet.
✅ Perform Piriformis stretching (Figure-4 stretch).

Pathology isn’t always in the bone; sometimes, it’s purely strictly lifestyle.

Tag a friend who sits on a “brick” and needs to read this! 👇

09/02/2026

“Doctor, I saw my X-ray and the gap is completely gone! Should I get admitted for surgery today?”

I hear this almost every week in the OPD.

Here is the truth: As an Orthopedic surgeon, I treat YOU, not your X-ray.

I have seen patients with terrible-looking X-rays who can still walk 2km comfortably. I have also seen patients with “mild” X-ray changes who are in severe, crippling pain.

So, when do we actually decide on a Total Knee Replacement (TKR)? It’s not just about the bone; it’s about your Quality of Life.

Swipe through to see the “Checklist” I use to help patients decide. 👉
✅ The Walking Distance Test
✅ The Night Pain Test
✅ The Painkiller Dependency
✅ The Deformity Check

If you tick “YES” to most of these, then it is time to have a serious conversation about TKR. It’s about adding life to your years, not just years to your life.

Have questions about Knee Replacement? Drop them in the comments below! 👇

07/02/2026

If you have Knee Pain, that “10k Steps” goal might be making it worse. 🛑

Why? It’s simple physics. When you walk, your knee takes a load of 3-4x your body weight.

For a 70kg person, that is roughly 250kg (A Quarter Tonne!) slamming your knee with every step. 📉

Why Cycling Wins for Knees:
✅ The weight goes through the SEAT, not the knee.
✅ It is “Zero Impact” (Closed Chain Exercise).
✅ You burn nearly DOUBLE the calories compared to walking!

⚠️ IMPORTANT TIP:
Make sure your cycle seat is HIGH enough!
If the seat is too low, you will hurt your kneecap. Your leg should be almost straight at the bottom pedal stroke (slight 25-degree bend).

Share this with someone who has knee pain! 🔄

Nirmal The Bone Doc

01/03/2026

27/02/2026

25/02/2026

22/02/2026

20/02/2026

18/02/2026

15/02/2026

14/02/2026

12/02/2026

10/02/2026

09/02/2026

07/02/2026

Address

Website

Alerts

Shortcuts

Share

Category