Dr Tajmuhammad

09/07/2023

(Upper-Limb) Handmade Notes!

09/07/2023

Lower limb anatomy

05/06/2023

All About Osteoporosis!

12/03/2023

𝘾𝙡𝙞𝙣𝙞𝙘𝙖𝙡 𝙘𝙖𝙨𝙚 𝙨𝙩𝙪𝙙𝙮 #1

••NON-UNION FRACTURE -CLAVICLE

Subject- 27 Years / Male

•C/o. inability to lift the right arm above shoulder - 3 months

•History

->History of fall on outstretched hand on right side - 3 months ago

->History of indigenous treatment present (+) - Duration (2 months)

-> History of fall on point of shoulder (or) History of direct trauma to clavicle

•Inspection

-> Attitude : Arm adducted, elbow slightly flexed, forearm and wrist in neutral position

-> Swelling over the medial 2/3'd and lateral 1/3'd right clavicle present Deformity visibly seen

-> Depression of skin over deformity seen

•Palpation

->No swelling palpable but a gap is felt

->No tenderness

->Abnormal mobility + both in antero posterior plane and when asking the patient to abduct his right shoulder

•Movement of Right Shoulder

Flexion 40 — 80 degree
Abduction possible O — 100 degree; further 10 degree passively
Extension O — 40 degree
Ext. / Internal rotation 0 — 45 degree further 5 degree passively possible

•Measurement

-> I cm. Shortening of right clavicle compared to Left

•Investigation

-> X-ray right shoulder with clavicle :- Nonunion Fracture clavicle

•Important Points

1. Nonunion of fractures of clavicle is rare except in cases of middle 1/3 fractures.

2. Patients may have symptoms of pain on movement of shoulder or a grating sensation, though some patients have absolutely no symptoms.

3. Only those patients with sufficient symptoms should be considered for surgery.

4. Treatment would be plate fixation and bone grafting

11/03/2023

𝘾𝙡𝙞𝙣𝙞𝙘𝙖𝙡 𝙘𝙖𝙨𝙚 𝙨𝙩𝙪𝙙𝙮 #20

ACROMIOCLAVICULAR JOINT DISLOCATION

𝙎𝙪𝙗𝙟𝙚𝙘𝙩- 28 Years/Male

𝘾𝙡𝙤.
•difficulty in raising the right upper arm - 4 months History

𝙃/𝙤.
•fall of a weight on the point of the right shoulder - 4months ago
•treatment with adhesive strapping+

𝙄𝙣𝙨𝙥𝙚𝙘𝙩𝙞𝙤𝙣
•Prominent swelling at the outer end of right clavicle
•Skin over the swelling is stretched but not shiny

𝙋𝙖𝙡𝙥𝙖𝙩𝙞𝙤𝙣
•Outer end of Right clavicle displaced upwards and mild thickening and irregularity present
•Acromion process displaced downwards
•Palpable step present between the two

𝙈𝙤𝙫𝙚𝙢𝙚𝙣𝙮 𝙤𝙛 𝙍𝙞𝙜𝙝𝙩 𝙎𝙝𝙤𝙪𝙡𝙙𝙚𝙧
•Flexion 0-90 degree possible
•Abduction 0-30 degree possible further restricted with pain
•Internal rotation 0-45 degree •External rotation 0-45degree
•No distal neurovascular deficit

𝙄𝙣𝙫𝙚𝙨𝙩𝙞𝙜𝙖𝙩𝙞𝙤𝙣
•X-ray (R) shoulder with clavicle- Acromio clavicular joint dislocation is evident

𝙏𝙮𝙥𝙚𝙨 𝙤𝙛 𝙍𝙚𝙘𝙤𝙣𝙨𝙩𝙧𝙪𝙘𝙩𝙞𝙤𝙣
a) Reconstruction of superior acromio clavicular ligament
b) Transfer of coracoid to clavicle
c) Transfer of coraco acromial ligament

𝙄𝙢𝙥𝙤𝙧𝙩𝙖𝙣𝙩 𝙋𝙤𝙞𝙣𝙩𝙨
1. Same classification is used for both old unreduced and acute dislocations of the acromio clavicular joint
2. In symptomatic type of unreduced dislocations, where the coraco clavicular ligaments are intact, resection of the distal end of the clavicle is done (Mumford procedure)
3. In types II, IV or V chronic unreduced acromio-clavicular dislocations the coraco clavicular ligaments should be reconstructed

10/03/2023

Trigeminal neuralgia is a chronic pain disorder that affects the trigeminal nerve, which is responsible for sending sensory information from the face to the brain. The pain is usually sudden, intense, and often described as sharp, stabbing, or electric shock-like.

The condition is more common in women than men, and it typically affects people over the age of 50.

Trigeminal neuralgia can be caused by a variety of factors, including pressure on the nerve from a blood vessel or tumor, nerve damage from multiple sclerosis or other conditions, and idiopathic causes (meaning the cause is unknown).

Treatment options for trigeminal neuralgia include medications such as anticonvulsants and muscle relaxants, as well as surgical procedures like microvascular decompression (MVD), which involves moving the blood vessel that is compressing the nerve, and stereotactic radiosurgery, which uses focused radiation to damage the nerve and prevent it from transmitting pain signals.

Additionally, physiotherapy can be beneficial for individuals who have undergone surgical procedures such as microvascular decompression, as it can help to improve mobility and function after the procedure.

It's important to note that physiotherapy alone may not be sufficient for individuals with trigeminal neuralgia, and a multidisciplinary approach that includes medication management and other treatments may be necessary.

06/03/2023

THAT PINCH IN THE FRONT OF YOUR SHOULDER

Shoulder impingement is the most commonly seen shoulder condition and is responsible for 45% to 65% of all 💊 doctor's visits for shoulder pain. It occurs when the space between the acromion process and humeral head becomes ➡⬅ narrowed, entrapping the structure in between.

There are multiple reasons impingement can occur. Some of the most common ones we see are structural changes, postural dysfunction, scapular dyskinesis, and rotator cuff weakness.

Symptoms include pain when raising the arm overhead, especially between 60° and 120° of abduction. This is known as the 💥 "painful arc" and is a classic finding.

Good news is, there's a lot we can do to help. 🙌 I have a lot of good stuff to share with you guys on this one so let's start fixing those shoulders!

The first thing we look at with a shoulder impingement case is where the scapula sits. For most people, it will be tilted forward ↷ like the classic upper cross posture. This closes down the subacromial space and can irritate your impingement.

When we see this this type of posture, we immediately 💡 think the pecs must be tight. While this can be the case, a lot of times it can be a compensation for a lack of internal rotation. The humerus should be able to 🔄 rotate freely on the scapula. If it can't, they become one big complex, and the scapula rides up into an anterior tilt to give you that range of motion.

Over time, that pattern sets in and the scapula stays there. We see this a ton in people that stretch their pecs but can't ever seem to get rid of their rounded shoulders.

04/03/2023

Gait

02/03/2023

𝘾𝙡𝙞𝙣𝙞𝙘𝙖𝙡 𝙘𝙖𝙨𝙚 𝙨𝙩𝙪𝙙𝙮 #17

BICIPITAL TENDINITIS

𝙎𝙪𝙗𝙟𝙚𝙘𝙩- 40 years/Male

𝘾𝙡𝙤.
•pain right shoulder - 1 week •inability to use right shoulder 1 week

𝙃𝙞𝙨𝙩𝙤𝙧𝙮
•Pain right shoulder for 1 week duration following lifting of heavy weights
•Inability to use the right shoulder freely
•No swelling/constitutional symptoms

𝙄𝙣𝙨𝙥𝙚𝙘𝙩𝙞𝙤𝙣 𝙤𝙛 𝙍𝙞𝙜𝙝𝙩 𝙎𝙝𝙤𝙪𝙡𝙙𝙚𝙧
•No significant abnormality

𝙋𝙖𝙡𝙥𝙖𝙩𝙞𝙤𝙣
•Tenderness sharply localized to the bicipital groove
•Speed's test (+ve) :- Resisted flexion with elbow straight and forearm supinated causes pain
•Yergason's test +ve:- Resisted supination of the forearm with the elbow bent causes pain
•No distal neuro vascular deficit

𝙈𝙤𝙫𝙚𝙢𝙚𝙣𝙩
Right Shoulder--> Active--> Passive

•Flexion--> 0-90 degree--> further 20 degree
•Abduction--> 0-90 degree--> further 20 degree
•External rotation--> 0-20 deg -->further 10 deg
•Internal rotation--> 0-20 deg--> further 10 deg
•Extension: possible

𝙈𝙚𝙖𝙨𝙪𝙧𝙚𝙢𝙚𝙣𝙩
•No limb length discrepancy

𝙄𝙣𝙫𝙚𝙨𝙩𝙞𝙜𝙖𝙩𝙞𝙤𝙣
•X-ray right shoulder - No abnormality detected

𝙄𝙢𝙥𝙤𝙧𝙩𝙖𝙣𝙩 𝙋𝙤𝙞𝙣𝙩𝙨
1. The long tendon of biceps is a very intimate component of the articular capsule of the shoulder joint and therefore is frequently involved by the inflammatory processes which affect this joint, particularly capsulitis
2. Therefore it occurs together with rotator cuff impingement
3. Rarely it presents as an isolated problem in young people after unaccustomed
shoulder strain
4. Rest, local heat and deep transverse friction usually bring relief
5. If recovery is delayed, a cortico steroid injection will help. For refractory cases anterior acromio plasty is indicated

28/02/2023

24/02/2023

𝘾𝙡𝙞𝙣𝙞𝙘𝙖𝙡 𝙘𝙖𝙨𝙚 𝙨𝙩𝙪𝙙𝙮 #18

DELTOID FIBROSIS OF SHOULDER

𝙎𝙪𝙗𝙟𝙚𝙘𝙩- 10 Years/Male

𝘾/𝙤.
•deformity over the (R) upper arm 4 months

𝙃𝙞𝙨𝙩𝙤𝙧𝙮
•Deformity - insidious onset, slowly progressive. Associated with pain in the (R) Shoulder with restriction of movements
•H/O multiple injections into the arm several times for puimonary tuberculosis

𝙄𝙣𝙨𝙥𝙚𝙘𝙩𝙞𝙤𝙣
•Shoulder in abduction / elbow in flexion /wrist in neutral
•Obvious wasting of (R) deltoid present
•Winging of scapula present
On sitting posture -
1. acromion process prominently seen
2. vertebral border of scapula prominent

𝙋𝙖𝙡𝙥𝙖𝙩𝙞𝙤𝙣
•No warmth, No tenderness
•Deltoid over the (R) arm is taut, contracted and fibrosed (especially middle fibres)

𝙈𝙤𝙫𝙚𝙢𝙚𝙣𝙩 𝙤𝙛 𝙍𝙞𝙜𝙝𝙩 𝙎𝙝𝙤𝙪𝙡𝙙𝙚𝙧
•Fixed abduction deformity of (R) shoulder - 30 degree, trying to adduct the arm produces winging of the scapula

𝘿𝙚𝙛𝙤𝙧𝙢𝙞𝙩𝙮
•Flexion--> 0-100 degree
•Abduction--> 30-130 degree
•Ext. Rotation--> 0- 45 degree
•Int. Rotation--> 0 - 60 degree
•No distal neurovascular defict

𝙄𝙣𝙫𝙚𝙨𝙩𝙞𝙜𝙖𝙩𝙞𝙤𝙣𝙨
X-Ray (R) Shoulder - AP view: No bony abnormality

𝙄𝙢𝙥𝙤𝙧𝙩𝙖𝙣𝙩 𝙋𝙤𝙞𝙣𝙩𝙨
1. Contracture of the deltoid muscle can occur after repeated intra-muscular injections
2. Severe contractures can lead to significant pain around the neck and shoulder girdle, dimpling of the skin, winging of the scapula and an abduction contracture of the shoulder
3. MRI typically shows a fibrotic cord within the deltoid muscle, which extends from the superior acromial surface to the deltoid tuberosity
4. Surgical treatment for deltoid contractures should be reserved for patients with significant deformity and pain who have not responded to a lengthy rehabilitation programme

23/12/2022

𝐏𝐡𝐲𝐬𝐢𝐨𝐭𝐡𝐞𝐫𝐚𝐩𝐢𝐬𝐭
فزیوتھراپسٹ کسے کہتے ہیں؟
فزیوتھراپسٹ ایسے اسپیشلسٹ ڈاکٹر ہوتے ہیں جو ہر عمر کے لوگوں کی صحت کو برقرار رکھنے, مزید بہتر کرنے، درد سے آرام، بیماری کو روکنے، معذور افراد کی بحالی، اسپیشل بچوں کی بحالی، آپریشن کے بعد کی بحالی اور مختلف مریضوں کے معیار زندگی کو بہتر کرنے کا علاج بغیر میڈیسن و سرجری، اسپیشل ٹیکنیک، ورزشوں اور مشینوں کے ذریعے کرتے ہیں۔

فزیوتھراپسٹ کن بیماریوں کا علاج کرتے ہیں؟
فیزیوتھراپسٹ وسیع پیمانے پر بیماریوں کی تشخیص، علاج اور انتظام کرتے ہیں ان میں چند ایک بیماریوں کی تفصیل یہاں ہم آپ کو بتاتے ہیں۔

𝐒𝐩𝐢𝐧𝐞 𝐏𝐚𝐢𝐧
گردن، کمر کے اوپر والے یا نیچے والے حصے میں درد، پٹھوں کا کھچاؤ اور اکڑاؤ

𝐃𝐢𝐬𝐜 𝐒𝐥𝐢𝐩
مہروں میں موجود ڈسک کا اپنی جگہ سے ہٹ جانا

𝐒𝐜𝐢𝐚𝐭𝐢𝐜𝐚
مہروں میں موجود ڈسک کا اپنی جگہ سے ہلنے کے بعد قریبی اعصاب پر دباؤ ڈالنا جس کی وجہ سے درد کمر سے ہوتی ہوئی کولہے اور ٹانگ میں جاتی ہے

𝐀𝐧𝐤𝐲𝐥𝐨𝐬𝐢𝐧𝐠 𝐒𝐩𝐨𝐧𝐝𝐲𝐥𝐢𝐭𝐢𝐬
ریڑھ کی ہڈی کا گنٹھیا: گردن، کمر کا درد اور اکڑاؤ، کمر کی لچک کا کم ہو جانا

𝐊𝐲𝐩𝐡𝐨𝐬𝐢𝐬 / 𝐒𝐜𝐨𝐥𝐢𝐨𝐬𝐢𝐬
ریڑھ کی ہڈی کا ٹیڑھا پن، جس کی وجہ سے کمر میں درد اور پٹھوں میں کھچاؤ رہتا ہے

𝐅𝐫𝐨𝐳𝐞𝐧 𝐒𝐡𝐨𝐮𝐥𝐝𝐞𝐫
کندھے کی حرکت کا جا م ہو جانا

𝐅𝐢𝐛𝐫𝐨𝐦𝐲𝐚𝐥𝐠𝐢𝐚
پورے جسم کے پٹھوں کا کھچاؤ, سوئیاں چبھنا اور مختلف پوائنٹ میں درد ہونا

𝐒𝐭𝐫𝐨𝐤𝐞
فالج

𝐅𝐚𝐜𝐢𝐚𝐥 𝐏𝐚𝐥𝐬𝐲
لقوہ

𝐏𝐨𝐬𝐭 𝐒𝐮𝐫𝐠𝐢𝐜𝐚𝐥 𝐑𝐞𝐡𝐚𝐛𝐢𝐥𝐢𝐭𝐚𝐭𝐢𝐨𝐧
کولہے یا گھٹنے کے جوڑ کی تبدیلی، فریکچر کے آپریشن کے بعد حرکت میں دشواری اور نارمل زندگی کی بحالی کے لیے فزیو تھراپسٹ مخصوص پلان مہیا کرتا ہے تاکہ مریض اپنی نارمل زندگی کی طرف لوٹ سکے

𝐂𝐏 𝐂𝐡𝐢𝐥𝐝
اسپیشل اور معذور بچوں کی بحالی

𝐏𝐨𝐥𝐢𝐨𝐦𝐲𝐞𝐥𝐢𝐭𝐢𝐬
بچپن میں پولیو وائرس کی وجہ سے جسم کے دوسرے اعصاب کے پٹھوں میں کمزوری اور حرکت میں کمی

𝐏𝐚𝐫𝐤𝐢𝐧𝐬𝐨𝐧 رعشہ
ایسی بیماری جو اعصابی نظام کو متاثر کرتی ہے

𝐃𝐢𝐬𝐚𝐛𝐥𝐞𝐝 𝐩𝐞𝐫𝐬𝐨𝐧
معذور افراد کی بحالی

𝐎𝐬𝐭𝐞𝐨𝐚𝐫𝐭𝐡𝐫𝐢𝐭𝐢𝐬
مریضوں کے گھٹنوں کی گھساوٹ کی مطابق اسپیشل انسول (𝐈𝐧𝐬𝐨𝐥𝐞𝐬) تیار کئے جاتے ہیں۔

بروقت تشخیص سے ان بیماریوں کا بہت بہتر علاج ممکن ہے بروقت تشخیص اور علاج نہ ہونے کی وجہ سے ان میں سے کچھ بیماریاں مستقل معذوری میں مبتلا کر سکتی ہیں۔
اگر آپ یا آپ کا کوئی عزیز ان بیماریوں کی ابتدائی علامات میں مبتلا ہے تو فوری طور پر تجربہ کار فزیو تھراپسٹ سے رابطہ کریں۔03452907210
اللہ تعالی ہم سب کو صحت مند زندگی عطا کرے۔ آمین