Articles on manual therapy

Sex Therapy

Dr. Ramesh Maheshwari, Sexologist
Sex therapy is based on behavior therapy. It is a type of re-educative therapy. The fundamental of behavior therapy is that all the behaviors are learned, even the maladaptive behaviors. The behavior therapist helps the client to unlearn the unadaptive behavior and replaces it with newly learned adaptive behavior. The aims of behavior therapy are primarily educational and techniques facilitate improved self control.From amongst several techniques that are used in behavior therapy, ‘systematic desensitization technique’ is used in sex therapy. Prior to 1970, sexual dysfunctions were managed by psychiatrists. After  1970, the masters and Johnson model of sex therapy made it possible to treat sexual dysfunction by psychologists, social workers, nurses, counsellors, and medical doctors.Their approach included :Instead of treating the affected individual, the couple is treated. It is the relationship that is affected. This strategy provides an opportunity to gain  the co-operation and understanding of both the partners in overcoming the problem.Two therapist-a man and a woman work together as a team. This gives each partner a same sex therapist to whom he or she can relate more easily.Masters and Jonson recognized that it was important to identify organic conditions that might require medical or surgical treatment instead of sex therapy.They also found that explanining the anatomy and physiology of sexual response to the clients often had important therapeutic benefits.To individualize the therapy so as to meet the specific needs of each couple.The therapist must avoid imposing his own values on the client.The fear of performance and ‘spectatoring’ are often central to the cases of sexual dysfunction. The pressure of performance is removed initially by banning sexual contact. Couples are then helped to rediscover the sensual pleasures of touching and being touched without the goal of particular sexual response (Sensate Focus Exercise).Blaming each other for the sexual problem is discouraged.When a couple’s relationship improves outside the bedroom, it is apt to have positive results in the bedroom too.Basis : Sexual response is the function of Autonomic nervous system and is a physiological change when effective sexual stimuli are present , and a person is psychologically prepared to respond to them. All the sense organs are to be used to create a situation conducive to sexual response . (touch is most important).Systematic Desensitization : A mode of psychotherapy where all the anxiety provoking stimuli are arranged in an ascending level, and the client is exposed to, one by one, both the partners are to be involvedRelaxation: Deep breathing, deep muscle relaxation and plesant imagery are incorporated.Reassurance.Stages :Sensate focusWoman superior positionLateral positionMen superior positionFormat: No rigid format Variations in time, frequency and structure depending upon the dysfunction, the patient and the therapist.Results: Not as definite as in pharmacotherapy.As you shall sow and water, so you shall reap: A skilled and knowledgeable therapist is like a good seed. Client’s receptive mind is like fertile soil. Compliance and co-operation by wife is like watering by gardner. When all the three factors combine, the results are good. When sex therapy works, it does wonders and results are unparalleled for that particular couple.Contraindications:Severe DepressionActive psychopathologySubstance abuseIIInessHostility in couple-interaction


Mr. V Ravichandran, Physiotherapist
Variation of Treatments in PhysiotherapyManual TherapyIt is a clinical approach utilizing skilled, specific hands-on techniques which helps to reduce soft tissue inflammation and increases range of motion (ROM).Other Benefit:-Manipulation/mobilization to diagnose and treat soft tissues/joint structures for the purpose of modulating pain.Reducing or eliminating soft tissue inflammationInducing relaxationImproving contractile and non-contractile tissue repair, extensibility and/or stability.Facilitating movement and improvement functionUltrasoundIt is a method of stimulating the tissue beneath the skin’s surface using very high frequency sound waves.Primary Benefit:-Speeds up the healing process from the increase in blood flow in the treated area.Decrease in pain from the reduction of inflammation and oedema.Provides a gentle massage of muscles, tendons and/or ligaments in the treated area as there is no strainadded and any scar tissue is softened.Interferential (IFT)IFT is one of various types of physical therapy equipment. It uses a mid-frequency signal to treat muscular spasms and strains. The current produces a massaging effect over the affected area at periodic intervals and this therefore stimulates the secretion of endorphins, which is the body’s natural pain relievers. This will relax strained muscles and promotes soft tissue healing. IFT is used in 4 clinical applications to:Relieve painStimulate musclesIncrease local blood flowIce Stone Therapy (Cryotherapy)Cryotherapy is the local or general use of low temperatures in medical therapy. When cryotherapy is applied to the affected area, it will decrease the cells’ metabolism activity and decrease the permeability of tissues surrounding the wounded area so as to minimise any tissue debris that may enter the affected area. This therefore will then increase cell survivability, decrease pain and spasm and promote vasoconstriction. The result of it is a decrease in inflammation.Mechanical TractionIt is a term that describes the relief of pressure on one or many spinal discs and pinched nerves (neural impingement) of the spinal column. Spinal traction (cervical/lumbar) can be achieved non-surgically and is used to treat conditions that results in chronic back pain such as disc bulge, slipped disc, sciatica, degenerative spondylolisthesis and many more. Spinal traction is achieved through the use of a mechanical traction device, which reduces the body’s natural propensity to resist external force and/or generate muscle spasm. The results of spinal traction include pain relief, proper spinal alignment, and decompressed joints. Spinal traction stretches the muscles and bones in the back to combat the effects of gravity.Aqua JoggingAqua jogging is a good exercise method for elderly people and overweight people because of its low impact to the muscles and it helps to burn more calories due to the water resistance. This combination avoids muscle soreness, stress fractures and aching joints. To start aqua jogging, an individual need only swimming wear and an aqua jogging belt. The  aqua belt helps with maintaining the proper upright position and support the individual in the water. The purpose of aqua belt is to balance ourself in the water.TapingTaping is good, as it still allows for the range of motion, not much as it may inure the individual again. It provides a continuous amount of stabilization to the affected area and gives muscles/ligaments a chance to rebuild and restore by taking the pressure off those areas that have been worked manually. Taping can also be used to help with alignment. If an individual has an area of the body that is not properly aligned, taping can bring the body back into alignment. Having the correct alignment can decrease pain and help the joints recover efficiently.

Foot Massage and Sleep!

Dr. Sita S Bhatt, Homeopath
Reflexology believes that the entire human body and its organs have representations on the soles of our feet! Regularly doing a nice foot massage relaxes, rejuvenates and recharges the body and the mind and helps in good health! A simple daily routine of do-it- yourself foot massage could help you to relax the body and get a really good nights sleep! First wash the feet after soaking them in Epsom salts (2tsp) or rock salt (4 tsp) and warm water in a tub for 10 minutes . See that you are in bed and all your chores done and it's the last thing before you sleep. Keep the lights dim and the surroundings peaceful for this one! No gadgets! Use a nice thick oil with some aroma essential oil ( I give lavender oil to help one relax ) Starting from the arch of the foot, using the thumb, rub the foot in circular motions. Do it from the arch and progress to the entire foot while slowly increasing the pressure. Do 15 repetitions on each sole. Wear a pair of cotton socks to keep the feet warm. A couple of minutes of this ensures that the night's sleep is deep and refreshing!Added benefits of regular and specific foot acupressure and reflexological massage: 1. Relieves aches and pains 2. Helps in digestion 3. Improves metabolism and stamina to exercise 4. Improves circulation 5. Helps in muscle stretches 6. Used in treatment of restless leg syndrome 7. Reduces lactic acid related muscle pain 8. In children, boosts growth and immunity !

Managing Neck and Back Pain Through Physiotherapy

Dr. Biju Nirmal Jacob, Physiotherapist
One of the commonest cause of people consulting a physician is neck or back pain. Many of them try to live with the pain until it stops them from working. The common cause of neck and back pain is poor posture, muscle imbalance, repeated tasks involving the area or localized degenerative changes in the vertebrae. This causes reduced range of motion of the part, reduced strength and increased pain. POOR POSTURE: Forward headed posture or exaggerated lumbar lordosis can cause increased pressure on the surrounding structures of the vertebra this ultimately lead to segmental instability of the spine. In order to keep the part intact the muscles and other structures will adjust themselves, this will happen in a course of time. Whenever the person uses the part for a prolonged period or activity his pain and other symptoms will increase. MUSCLE IMBALANCE : If you closely examine yourself your posture you may observe that your shoulders are round, your head is forward protruding, abdomen is week, if you stand with both the leg together and eyes closed you may feel like you are swinging and loosing the balance. These features are pointing towards your muscle weakness. Major muscle that may get weakened are neck flexor muscles, inter scapular muscles, abdomen and buttock muscles. Major muscles that may get tightened are neck extensors, chest muscles, lower back muscles and hip flexors. Proper training of these muscles will help in reduction of neck and back discomfort. PHYSIOTHERAPY MANAGEMENT EVALUATION: A thorough evaluation of the patient is required before stating the physiotherapy treatment, which include a detailed history of the patient, explanations regarding the site of pain, onset, previous history, lifestyle of the patient, sleep, nature of pain, assessment of strength, range of motion, swelling, warmth, functional performances, clinical investigations like X-ray, MRI, Lab report to wipeout red flags. EXPLANATION TO THE PATIENT: Once the assessment is over the therapist will explain the treatment method to the patient, about the condition, the procedures, precautions, duration of session, total number of sessions etc. Once the patient is convinced the therapist will start the treatment after signing an informed consent. TREATMENT: After marking the location of pain initial the treatment is given to the soft tissues around that area using techniques like deep pressure soft tissue massage to reduce muscle tightness, trigger point release therapy followed by myofascial release. Once the pain is reduced we may follow muscle energy techniques to release muscle tightness and to take the muscle to a new length. Once the muscle pain is reduced we will mobilize the corresponding joints to correct the joint dysfuntions this will help in proper working of the joint in correct muscle length. We teach patients self stretching exercises and progressive strengthening exercises so that they can maintain the length and strength of the structures. We may tape the part using either dynamic stretch taping (kinesiology) or static non-stretch taping (zinc oxide), which will help in holding the structure in good length and position. We also use pain releasing modalities ultrasound therapy, interferential therapy, TENS & moist heat etc. to reduce the pain and increase the localized circulation. We also advise patients to do heat fermentation to reduce the tenderness. Once the pain and discomforts are reduced we put patients on further stretching and strength training program like self myofascial release techniques, stretch band and weight cuff exercises with increasing the resistance. Upon secondary evaluations we may also perform nerve mobilizations and other articular mobilizations to relieve other discomforts. We also start postural awareness training programs and core stabilization exercises to strengthen the weak muscles. Aerobic training programs like treadmill walking, static cycling, virtual reality based games are also included in the final stage to improve the overall fitness of the patients. This helps in prevention of recurrence of pain and other discomforts. We suggests our patients to visit us once a month for the next 3 months to make sure that they are following the exercises and also to modify the exercises if required. Thus a tailor-made treatment physiotherapy program will help in the management of neck & back pain than a conventional treatment methods. This includes a team work of many people including the patient itself. 

Ayurvedic Leech Therapy

Dr. Phanindra V V, Ayurveda
Leeches are used in the medical practice since ancient times to treat many diseases. It is a method in which localized impure blood is let out to heal the tissue. Leech therapy is Para-surgical treatment modality according to Ayurveda. Due to its therapeutic effects, this is successful even today. The description of using leech for therapy can be found in Sushruta Samhita written by Acharya Sushruta. He has described the nature of leeches, their habitat, the method of application, diseases indicated like Visarpa (Herpes), Skin diseases etc., in detail. Though there are hundreds leech species, only 15 are used for therapy. In the medieval ages, this was very popular. According to Ayurveda, Leech only sucks impure blood. Leech is used to relieve venous congestion and to improve blood circulation.Indications: Skin diseases, Vascular Problems, Varicose Veins, Acne, Non-healing Ulcers, Diabetic wounds, Boils and abscess, Herpes, Thrombosis, Arthritis, Sciatica, Dermatitis, Psoriasis, Alopecia, etc..Steps for application of LeechSnehana and swedana to the patient.Leech activation.Patient’s skin is cleaned.The leeches are applied.Cover the leech with wet cotton.Remove the leech once it has finished sucking the blood.Remove the blood from leech by inducing vomiting to the leech and then put back in fresh water container.The area should be cleaned and bandaged.Mode of Action: Leech have many distinct enzymes in its saliva, through which they act. The enzymes enter the blood through the place the leech sucks the blood. The most important is the Hirudin, which acts as an anti-coagulant. This leech enzymes also has the ability to stay in the blood and do vasodilation and further facilitate the blood supply to the surrounding tissue and prevent necrosis and healing. Some anti allergic factors ensure reduction in the lesions.

Back & Neck Pain - Mckenzie's Approach

Dr. David Kirubakaran, Physiotherapist
Back pain and neck pain are very common in this computer era because of our sedentary life style.  Even youngsters and mid age people are not spared from spinal issues because of their poor exercise habits and nature of jobs.Robin McKenzie, a reputed Physiotherapist from New Zealand classifies the cause of spinal problems into three types. 1) Derangement –Pain caused due to changes in the position and fluid imbalance in the spinal discs.2) Dysfunction -Pain and restriction of movement caused by tightening of the soft tissues around the spine. 3) Postural syndromes– Incorrect postures that induces stress on soft tissues leading to pain  Back pain lasting more than 3- 5 days,or if the pain radiates down the back of thighs and legs, needs immediate intervention. Also, prolonged neck pain may radiate down the arms and hands,finally leading to numbness. Surgery was the only option for these types of spinal problems in the past. Hot, cold and electrical modalities can provide a temporary pain relief. But modern physiotherapy which includes manipulation of spinal joints can replace the surgical option. Manipulation is a “hands on technique”where the physiotherapist treats the affected part of the spine gently manipulating the transverse process (part of the spinal bone).  McKenzie Approach is the widely used technique in the western world. This type of approach requires active participation of patients along with the guidance of a physiotherapist.  Active participation mainly includes spinal extension type of exercises (backward bending) and sustaining in that position for a while.                                               The main goals of this type of manual approach program are: To rule out the cause of radiating pain down the legs or other areas.To bring the spine to its normal position.To avoid re-occurrence rate.Reduce the frequency of visits to clinic and the expense.Carry out the exercise program by patients themselves and obtain a pain free lifestyle.Manipulation along with McKenzie exercise regimen can effectively cure the patient’s spinal problems.

5 Priceless Benefits of Salt Therapy for All Your Respiratory Troubles!

Mrs. Anju Chandna, Yoga and Naturopathy
Salt therapy is fast catching everyone’s attention. A therapy that was born within the confines of natural salt caves in the Eastern European countries like Poland and Romania around 150 years ago is now on its way to become one of the most revolutionary treatments of all time for all respiratory allergies like Asthma, Bronchitis,Sinusitis, Allergic cough, Dry cough, COPD and many others. A lot can be attributed to the fact that the treatment is natural.So let me give you a 5 point count as to what makes this therapy different from the conventional methods of treatment that we’ve known all these years. Salt therapy is a 100% natural treatment. The main ingredient that does all the trick is salt. The salt room has around 3-4 tons of salt on the walls, the ceiling, the floor and the aerosol that you inhale while sitting inside this artificial salt cave is also pharma-grade salt. Old age wisdom says that consuming too much salt is not good for our body but what needs to be understood is that this salt does not enter your digestive tract. So any side effect could arise of consuming salt directly is absent here. This salt aerosol enters only the respiratory tract through the nasal passage and goes directly into your lungs. It cleanses the mucous along its way and reaches the smallest bronchioles of the lungs. All naturally with no medicines.Salt therapy is absolutely safe for infants, the elderly and pregnant women. Since there is no medicine involved in the treatment, everyone from a 6 month old baby to an 80 year old adult can take the therapy without bothering about any negative fallout. Even pregnant women who are otherwise not advised medication can take this therapy and get relief from any allergy arising during their pregnancy. Salt therapy has no side effects. There is nothing entering your digestive tract that can possibly cause any side effect. Salt enters the lungs, reacts with the mucous present there and comes out of the body along with that mucous.  Presence of tons of salt in the salt room makes the environment absolutely clean and no allergens can find their way into it. People with respiratory disorders need such a clean atmosphere so that a one hour salt room session helps to cleanse their system and not irritate it. That is the reason why people with very chronic allergic cough can also endure the salt spray and benefit from it.Salt therapy offers long term relief. The basic function of salt therapy is to cleanse your lungs. So once your treatment is complete and your lungs get cleansed, the chances that they will remain that way are very high. But here we cannot ignore the fact that we are living in one of the most polluted regions of the world and you are constant being exposed to allergens. One might need maintenance sessions once every 3 months to keep your lungs clean and healthy.  Salt therapy de-stresses and calms the mind. Salt is inherently negatively ionized. Nature has made it this way.Negative ions are considered to be ‘cleansers of the air’ and salt has the property of negative ionization. Negative ionization of the air relieves stress, so spending an hour inside the salt room not just cleanses your lungs but also relieves your mind of stress. De-stressing the mind is considered to be an important step towards treating any kind of respiratory problem.So what are you waiting for? Come to the salt room and soak in the benefits of this miracle mineral!

Occupational Therapy a Solution for Osteoarthritis

Dr. Chaitanya Ulhas Mantri, Occupational Therapist
First, let us understand what is Osteoarthritis ...    OA is a degenerative disease of joints that affects all of the weight-bearing components of the joint:Articular CartilageMenisciBoneAbout OSTEOARTHRITIS [OA]:Most common joint disease Most common form of arthritis Most OA patients > age 45  Women> menMost often appears at the ends of the fingers, thumbs, neck, lower back, knees, and hips.Joints affected by Osteoarthritis[OA]OA-RiskFactors:Age:Strongest risk factorOA can start in young adulthood but risk increases with ageGender:Affects more in women than menMore common in men before age 45, women after age 45OA of the hand particularly common in womenJoint injury/Overuse from physical labor or sports:Trauma to any joint increases risk of OA Ligament or meniscus tearsRepeated movements in certain jobs increase risk Obesity:Joint overload is among strongest risks for knee OAObesity a risk to Knee OAOA–Symptoms:Gradual onset PainStiffnessSwelling or tenderness in one or more joints Crunching feeling or sound of bone rubbing on bone (called crepitus) when the joint is usedRadiographic Diagnosis:Asymmetrical joint space narrowing from loss of articular cartilageHow to Manage OA ???Goals in Managing OA :Decreasing painIncrease range of motionIncrease Muscle strengthOccupational therapy for Osteoarthritis: It would involvePain management through use of Physical Agent Modalities, Exercises to improve and maintain Range of Motion of the jointExercises to Strengthen Muscles of the jointUse of Energy Conservative and Work Simplification Techniques to help in doing the activity with easeUse of Joint Protection Technique while using the jointErgonomic Modification in Work & Home environment

Physiotherapy Plus Ergonomics - for Total Wellness!

Dr. Aditi Kulkarni(P.T), Physiotherapist
Do you need an advice on injury prevention or other aspects of musculoskeletal or neurological conditions? Do you wish to improve your physical performance for sports? Are you planning to return to routine exercises following prolong period of inactivity or injury? Or planning to go out on adventure trip? The answer to improve your functional capacity or quality of life is physiotherapy under supervision of qualified physiotherapist.Physiotherapist & Ergonomist of “Be Active” clinic, Dr Aditi Kulkarni says “Physiotherapy has both curative and preventive disciplinary aspects”. As it is a drugless therapy it has become an integral part of healthcare industry and is becoming more & more popular among all age groups.In Be Active clinic physiotherapy, relaxation technique, tapping, electrotherapeutic modalities such as SWD, IFT, TENS, Wax Bath, EMS, Ultrasound and Traction machine along with lifestyle modification tips with the help of ergonomics are available under one roof.With the combination of above mentioned therapies one can hasten body’s natural healing processes by maximizing recovery & ensure optimal outcome on long-term basis, even in post operative rehabilitation and in chronic neurological conditions like Parkinson’s, Multiple Sclerosis, Paralysis, etc.Dr. Aditi also mentioned “ age or work related joint aches or dysfunctions, chest complications or sport injuries like pulled hamstrings, stress fractures, Osgood shatter disease/ runners knee, carpel tunnel syndrome, heel pain, ankle injuries or sprain” are some of the problems which can be cured completely with the help of physiotherapy and ergonomics.With the experience of practising in this field Dr. Aditi feels the real success of any treatment lies in healthy and happy atmosphere and cooperation between the therapist, patient and his family.

Shirodhara- Best Therapy for Mental Stress

Dr. Pritam Raj, Ayurveda
Shirodhara a snehan treatment in Ayurveda is basically one of the most relaxing, healing and rejuvenating therapy in today's world. The roots of this treatment stems out from the 6000 year old Indian science of Ayurveda.Its a gentle pouring of a stream of warm medicated oil on your forehead specifically on the third eye or the Ajna chakra located between the brows.Shirodhara has an ability to cure multiple neurological disorders like Alzheimer, Parkinson, multiple sclerosis, dementia, paralysis,etc. It's the only complete therapy for brain, some of benefits are:It nourishes the brain cells called neurons by increasing the blood circulation. Strengthens the nerves originating from the brain. Increases the secretions of neurotransmitters like dopamine,Influences the master glands improves its secretionsIncreases the production of serotonin and endorphin's, which eventually improves the quality of sleep, and creates a condition of heightened consciousness which is attributed to the fact that the treatments unblocks the chakra and creates an increased flow of prana the vital energy towards the brain.Hence, we can say that it's an energizing treatment.It's an excellent form of therapy for people suffering from insomnia, migraine, Trigeminal neuralgia, etc. Even if you are not suffering from any disorders it is always advisable to take Shirodhara once in a month, to nourish the scalp, improve the thought process, gain mental clarity, de-stress, as a preventive treatment for hair loss, baldness, neurological disorders, keeping our concentration and memory in better condition,It's a therapy recommended highly for the stressed out people, and you need to undergo this treatment to experience the benefits. I am talking about one of the most amazing the therapeutic experiences.It wont be wrong to say that its one of the gift to the mankind from Ayurveda.Avail Shirodhara in its authentic form only at nirvana spa' n' wellness center running at GK-1,GK-2 & GREEN PARK