UPPER-CROSSED SYNDROME

UPPER-CROSSED SYNDROME - Upper-Crossed Syndrome (UCS) is also referred to as proximal or shoulder girdle crossed syndrome. In UCS, tightness of the upper trapezius and levator scapula on the dorsal side crosses with tightness of the pectoralis major and minor. Weakness of the deep cervical flexors ventrally crosses with weakness of the middle and lower trapezius. This pattern of imbalance creates joint dysfunction, particularly at the atlanto-occipital joint, C4-C5 segment, cervicothoracic joint, glenohumeral joint, and T4-T5 segment. Specific postural changes are seen in UCS, including forward head posture, increased cervical lordosis and thoracic kyphosis, elevated and protracted shoulders, and rotation or abduction and winging of the scapulae.

The “crossed” in upper crossed syndrome refers to the crossing pattern of the overactive muscles with the countercrossing of the underactive muscles. When viewed from the side, an X pattern can be drawn for these two sets of muscles. The overactive muscles form a diagonal pattern from the posterior neck with the upper trapezius and levators down and across to the anterior neck and shoulder with the sternocleidomastoid (SCM) and pectoralis major. The other side of the X now depicts the underactive muscles, with the deep cervical flexors down toward the mid/lower trapezius, rhomboids and serratus anterior. As we continually assume the seated, forward head postures driven by electronic devices or poor exercise selection and technique, this X pattern of muscle imbalances will increase.

URINARY INCONTINENCE

#URINARY INCONTINENCE - Urinary incontinence — the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time. Though it occurs more often as people get older, urinary incontinence isn't an inevitable consequence of aging. If urinary incontinence affects your daily activities, don't hesitate to see your doctor.

Types of urinary incontinence include:#Stress incontinence. - Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.#Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more-severe condition such as a neurologic disorder or diabetes.#Overflow incontinence. - You experience frequent or constant dribbling of urine due to a bladder that doesn't empty completely.#Functional incontinence. - A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.#Mixed incontinence. - You experience more than one type of urinary incontinence.

SPINAL CURVATURE CHANGES ARE INCREASING IN CHILDREN BY CARRYING HEAVY SCHOOL BAGS

SCOLIOSIS (CHANGE IN CURVATURE) PROBLEM INCREASING IN CHILDREN BY CARRYING HEAVY SCHOOL BAGS

School children are at risk of developing back problems because of burdensome backpacks. Growing numbers of children are developing irreversible back deformities because of the weight of the bags they carry to school. Half of all children suffer back pain by the age of 10-14 and doctors are reporting a rise in cases of spinal abnormalities in pupils, including disfiguring curvatures known as scoliosis. Many are carrying their bags on one shoulder or are increasingly carrying them on the crook of their elbow, so are placing a great strain on the spine. Parents should insist that their children pack their bags only with what they need for the next day and ensure that they are worn on both shoulders. To carry a heavy bag, the child has to lean forward. This leads to developing a bad posture. The spine is a stack of bones called the vertebral column with the bones separated by a cartilage called the inter vertebral disk and held upright by the muscles and ligaments around it. The excess weight puts undue stress on the muscles, ligaments and disk thus damaging them. The alignment of the column is also disturbed causing it to bend, mostly forward or sideways.

CERVICAL RADICULOPATHY

CERVICAL RADICULOPATHY - Cervical radiculopathy is the clinical description of pain and/or neurological symptoms resulting from any type of condition that irritates a nerve in the cervical spine. Cervical nerve roots, named C1 through C8, exit the cervical spine above the designated vertebral level at all levels except the last one. These cervical nerves then branch out to supply muscles that enable functioning of the shoulders, arms, hands, and fingers. They also carry sensory fibers to the skin that provide sensation.When any nerve root in the cervical spine is irritated through compression or inflammation, symptoms of pain, tingling, numbness, and/or weakness can radiate anywhere along that nerve's pathway into the shoulder, arm, and/or hand.

Cervical radiculopathy symptoms differ depending on which nerve is affected.

• C5 radiculopathy can cause pain and/or weakness in the shoulders and upper arms. It especially may cause discomfort around the shoulder blades but rarely causes numbness or tingling.
• C6 radiculopathy causes pain and/or weakness along the length of the arm, including the biceps, wrists, and the thumb and index finger.
• C7 radiculopathy causes pain and/or weakness from the neck to the hand and can include the triceps and the middle finger.
• C8 radiculopathy causes pain from the neck to the hand. Patients may experience weakness in hand grip, and pain and numbness can radiate along the inner side of the arm, ring, and little fingers.

MUSCLE WEAKNESS

MUSCLE WEAKNESS - Muscle weakness happens when your full effort doesn’t produce a normal muscle contraction or movement. It’s sometimes called reduced muscle strength, muscular weakness, or weak muscles. Whether you are ill or simply need rest, short-term muscle weakness happens to nearly everyone at some point. A tough workout, for instance, will exhaust your muscles until you’ve given them a chance to recover with rest.
Many health conditions can cause muscle weakness. Examples include:
- chronic fatigue syndrome
- muscular dystrophies
- hypotonia, a lack of muscle tone that’s usually present at birth
- myasthenia gravis, an autoimmune and muscular disorder
- peripheral neuropathy, a type of nerve damage
- neuralgia, or sharp burning or pain in one or more of your nerves
- polymyositis, or chronic muscle inflammation
- stroke
- polio
- Graves disease
- Guillain-Barre syndrome
- Lou Gehrig’s disease
- hypothyroidism
- hypercalcemia, or elevated calcium in your blood
- rheumatic fever
- West Nile virus
- botulism, a rare and serious illness caused by Clostridium botulinum bacteria
- prolonged bed rest or immobilization

TMJ DISLOCATION

TMJ DISLOCATION -#Temporomandibular joint (TMJ) dislocation is an uncommon but debilitating condition of the facial skeleton. The condition may be acute or chronic. Acute #TMJ dislocation is common in clinical practice and can be managed easily with manual reduction. Chronic recurrent TMJ dislocation is a challenging situation to manage. #Dislocation of the temporomandibular joint is a painful condition that occurs when the mandibular condyle becomes fixed in the anterosuperior aspect of the articular eminence. More commonly, dislocation occurs bilaterally, resulting in a mandible that is fixed in a symmetrically open position so that only the most posterior teeth may be contacting. Infrequently, unilateral dislocation occurs with resultant deviation of the jaw to the unaffected side. 

It is a very #painful clinical condition, but easy to manage. The conservative methods in its management include symptomatic pain #relief with analgesics and manual reduction.

KYPHOSCOLIOSIS

Kyphoscoliosis is a musculoskeletal disorder, which is a combination of kyphosis and scoliosis where there is abnormal posterior and sideways curvature of the spine in both the coronal as well as the sagittal planes. Kyphoscoliosis commonly causes other problems, such as pulmonary hypertension, under-ventilation of lungs, psychological problems, such as anxiety, difficulty in doing activities of daily living. Kyphoscoliosis can also occur in other medical conditions, such as syringomyelia and Duchenne muscular dystrophy because of asymmetric weakening in the paraspinal muscles. Kyphoscoliosis occurring during the growth period without any obvious cause is termed as Idiopathic Kyphoscoliosis. Diseases of the spinal muscles and vertebrae can also cause Kyphoscoliosis. Causes of Kyphosis include nutritional deficiencies, congenital, post-traumatic and osteoporosis induced.

SACROILIAC JOINT DYSFUNCTION

SACROILIAC JOINT DYSFUNCTION - Dysfunction in the sacroiliac joint, or SI joint, is thought to cause low back and/or leg pain. The leg pain can be particularly difficult, and may feel similar to sciatica or pain caused by a lumbar disc herniation. Sacroiliac dysfunction and instability, generally refers to pain in the sacroiliac joint region that is caused by abnormal motion in the sacroiliac joint, either too much motion or too little motion. It typically results in inflammation of the sacroiliac joint, and can be debilitating.

Common symptoms include 
1) lower back pain, 
2) buttocks pain, 
3) sciatic leg pain, 
4) groin pain, 
5) hip pain, 
6) urinary frequency, 
7) transient numbness, 
8) prickling, or tingling. 

Pain can range from dull aching to sharp and stabbing and increases with physical activity. Symptoms also worsen with prolonged or sustained positions. Bending forward, stair climbing, hill climbing, and rising from a seated position can also provoke pain. Pain is reported to increase during menstruation in women. Patients with severe and disabling sacroiliac joint dysfunction can suffer from insomnia and depression.

PERTHES DISEASE

PERTHES DISEASE - Perthes disease is a rare childhood condition that affects the hip. It occurs when the blood supply to the rounded head of the femur (thighbone) is temporarily disrupted. Without an adequate blood supply, the bone cells die, a process called avascular necrosis.

Although the term "disease" is still used, Perthes is really a complex process of stages that can last several years. As the condition progresses, the weakened bone of the head of the femur, gradually begins to break apart. Over time, the blood supply to the head of the femur returns and the bone begins to grow back.

Perthes disease also known as Legg-Calve-Perthes, named for the three individual doctors who first described the condition — typically occurs in children who are between 4 and 10 years old. It is five times more common in boys than in girls, however, it is more likely to cause extensive damage to the bone in girls. In 10% to 15% of all cases, both hips are affected.

Symptoms - 

One of the earliest signs of Perthes is a change in the way your child walks and runs. This is often most apparent during sports activities. Your child may limp, have limited motion, or develop a peculiar running style. Other common symptoms include:

• Pain in the hip or groin, or in other parts of the leg, such as the thigh or knee (called "referred pain.").
• Pain that worsens with activity and is relieved with rest.
• Painful muscle spasms that may be caused by irritation around the hip.

Depending upon your child's activity level, symptoms may come and go over a period of weeks or even months before a doctor visit is considered.