Monthly Archives: July 2014

Knee Injury types and role of physiotherapy

Role of physiotherapy, post operation for Rehabilitation of knee injury comes after the right identification of type of knee injury and its location.

Knee Injuries can be broadly  classified as:-

1)Bony Injuries

2)Soft Tissue Injuries

Picture below showing bony & soft tissue structure around knee joint.

Basic Structure Of Knee Joint Showing Bones & Soft Tissues around Knee Joint

Basic Structure Of Knee Joint Showing Bones & Soft Tissues around Knee Joint

Bony Injuries :-

It can be a fracture of bones around knee joint.These are:-

1) Patellar Fracture(knee cap bone fracture):-

Patellar Fracture Classification

Patellar Fracture Classification

2) Fracture of Femoral Condyles:-

Femur is the upper bone of knee joint it’s broadened lower end called “condyle”.There are 2 condyles in Femur bone inner(medial), outer(lateral). The fracture may occur above the condyles between 2 condyles or one out of the 2 condyles. As shown in figure below:-

Classification of Fractures Of Femoral Condyles

Classification of Fractures Of Femoral Condyles

 

3)Fracture of Tibial Condyles:-

Tibia is lower bone of knee joint it’s broadened upper ends are called “Tibial Condyles”. As in Femur it also has 2 condyles inner & outer. Classification of there fracture is shown here:-

Classification Of Tibial Condyle Fracture

Classification Of Tibial Condyle Fracture

Knee Joint Dislocation:-

Dislocation of joint is defined as Abnormal separation of joint.

Picture Showing Types Of Knee Joint Dislocation

Picture Showing Types Of Knee Joint Dislocation

Knee Cap Bone Dislocation

Picture Showing Patellar (Knee Cap Bone Dislocation)

Soft Tissue Injuries:-

Main Soft Tissue Injury around knee are:-

Ligament Injuries

Meniscal Injuries

Tendon Injures

1) Ligament injuries:-

As shown above in picture(structure of knee joint) there are 4 main ligaments around knee joint. These are:-

Medial collateral Ligament(MCL)

Lateral collateral Ligament(LCL)

Anterior Cruciate Ligament (ACL)

Posterior Cruciate Ligament (PCL)

Ligament injuries are common in sports persons or in twisting injuries of knee joint.

Ligament Injuries around Knee Joint

Ligament Injuries around Knee Joint

Posterior Cruciate Ligament(PCL) Tear

Posterior Cruciate Ligament(PCL) Tear

2) Meniscal Injuries:-

Menisci are pad like structures lies between two bones of knee joint . There are two meniscus in each knee joint one is inner(medial) meniscus another is Outer(lateral) meniscus.

Meniscal Injury

Meniscal Injury

3) Tendon Injuries:-

The picture below showing muscles & their tendons around knee joint.Injury of any one of them can cause pain around knee. Tendon injuries occur due to sudden pull of muscles commonly termed as “Strain”.

Muscles Around Knee Joint

Muscles Around Knee Joint

 

Shoe review: Adidas Adios Boost

For:

  • Lightweight, but still cushioned and responsive
  • Great transition from rear to forefoot
  • Durable Continental rubber outsole

Against:

  • Not for those with wide feet, narrow toe box
  • Lacks finer road feel (for those who require it)
  • Price tag

Cost: $200

Verdict:  4.5/5 STARS

A very slick racing shoe which can well be used for everyday speed or interval training.  Adidas have made very few changes to this version, most noticeably by adding a Boost midsole and Continental outsole. Only after a few speedy runs, you’ll appreciate why they’ve become the world’s preferred marathon racer.

These are the very shoes worn by the Emperor Haile Gebrselassie towards the end of his distance running career, and the current marathon world record holder Wilson Kipsang. It may be a stretch comparing ourselves with such greatness, but the race-bred heritage of this shoe has been deftly transferred by Adidas to bring us (plodders) a shoe that will appeal to most.

Featuring a 10mm offset between heel and toe height, this shoe is a well cushioned performance-oriented racing flat with a smooth transition and a fit that will appeal to a wide range of runners and abilities.

The Adios racer cuts a very slick low profile. Note the hard plastic (flouro) insert on the medial heel counter; this serves to lend some stiffness to the Boost material.

UPPER:
Let me begin by saying that this shoe will not work for you if you have wide (2E size) feet. I’d describe the fit of the Adios Boost as a little on the tight side, but this is a racing shoe and the fit has to be snug. In sizing, the majority of runners will be at their standard size PLUS a half size larger at most. The forefoot has a little more room in comparison; width is not too tight, not too wide and the toe box is adequately wide with a taper towards the toes.

A snug fit: as it should be for shoes of this pedigree. Note the slightly bevelled lateral heel on the upper shoe. This add to that super smooth transition for the lateral foot strikers.

Even with this snugness, I never encountered any issues with blisters or abrasions from pressure points. The Adios has a breathable conventional mesh upper with a thin tongue with minimal padding. A standard lacing system with standard (thankfully) laces complete the upper. The heel counter (the part which cups around your heel bone) is somewhat firm in the shoe, which is unusual for a racing shoe. Again here, Adidas has attempted to ‘cross over’ these racers to increase its appeal to a broader audience.

Some may find the toe box a little too narrow; ensure to select at least a half size up.

MID & OUTSOLES:
The midsole is obviously made with Adidas’ own Boost which is not EVA foam as the majority of technical running shoes are made of. Adidas launched Boost with great fanfare and much publicity, claiming its superiority over traditional materials. The company’s confidence in the material is so high that now nearly all adidas running shoes are made with Boost.

Boost is different than typical EVA midsole foam in that it is composed of thermoplastic beads that are fused together. Adidas claimed that the Boost midsoles will last longer, would not be as temperature sensitive, and would provide greater energy return than EVA.

A close up of the forefoot interplay between the Boost (white) Torsional System brace (yellow/flouro) and outsole (solid black & black flecks).

Although not stated implicitly, Adidas hints that improved energy return from Boost would increase running economy and thus performance. As with all such claims, I feel that the jury is still out. A quick search of physiological journals reveals no published results, nor does Adidas provide links to prove a link between mechanical testing data and actual physiological performance.

The actual outsole is branded Continental rubber, which translates to excellent traction and durability. I cannot say I ever encountered any loss of traction with the Adios even on hilly trails with a loose surface under foot.

THE RIDE:
The Boost material felt VERY different initially, but very quickly you come to appreciate their shock absorbing ability. I’m not sure how much of a rebound effect you get, but these midsoles certainly ‘turn down’ the road noise. At the 35km mark of a marathon, this effect will be much appreciated by most people!

The outsole/midsole interface features the Adidas Torsion System as on the Energy Boost, a web of thin, stiff green plastic under the arch and extending in strips on the outer edges towards the toe. This system provides the longitudinal stiffness (resistance to flexion and rotation) you feel while in the shoe.

The Boost material and torsion system combine to make a fast shoe which has good impact absorbing properties thanks to the Boost bubbles. I never felt that either of these were so stiff that they interfered with my natural foot motion.

The adidas Torsion System placed midfoot, spreads out to lend stiffness longitudinally.

IN CONCLUSION

After nearly 350 kilometers in these shoes, I have to say that I look forward to my next run with them, and that’s saying something! I do have to qualify that statement by saying that I reserve these shoes for fartlek and speed effort sessions, and never for steady paced runs. They feel much springier when accelerating or running at speed, but not necessarily on steady jogs. Perhaps this is the boost effect?

Adidas have managed to come up with a long distance racer which can be used by the ordinary ‘middle of the pack’ runner, and this shoe balanced perfectly between being too soft and too stiff. I do feel however that the Adios will still be suitable by those who would normally require more control and cushion in a running shoe.

Shotover Moonlight Mountain Marathon 2014 Race Report

Congratulations to our Indooroopilly sponsored athlete Ben Duffus on taking out the Shotover Moonlight Mountain Marathon in New Zealand. Here is his exciting race report which captures the scenery and terrain – as well as his emotions – during this exciting 42km mountain race. Over to Ben …

As the Queenstown Rafting shuttle bus filled with eager runners wound its way down the twists and turns of Skippers Road, my excitement for what the next few hours held for me grew. Animal shaped silhouettes cast by the rock formations that littered the canyon were the only thing that turned my gaze from the vast mountain range that loomed before us. My year so far had been rather subdued running wise due to an Achilles problem that developed at the end of 2013. Fortunately through the fantastic work of my coach Andy DuBois and my physiotherapist at Allsports Indooroopilly, I was feeling that it should be able to handle the 42km and 2400m of vertical gain/descent of the Shotover Moonlight Mountain Marathon. I could tell that my father sitting next to me was also being thrilled by the beauty of the landscape and I fed off his positive energy to keep any doubts at bay.

The race commenced with competitors in high spirits after a rousing Haka saw us off. I tucked in behind fellow Aussie Blake Hose as another Aussie, Matty Abel lead the charge from the start line. Within a couple of minutes I had taken my first fall of the day but luckily nothing but my pride was hurt. It was a stark reminder that I would have to sacrifice some of the time I would like to spend admiring the scenery watching my footing instead.

It wasn’t long before Blake, Grant and I were running single file along a narrow track with steep rock walls on one side and a drop off on the other. Having run the event before, Grant knew what to expect but Blake and I had no idea what we were in for along this stretch of trails that would be inaccessible any other day of the year. Around every corner lay some new spectacular sight and we were both too busy chatting about how awesome the course was to really think about “racing” each other!

Eventually the trail ran out and we were faced with a near vertical wall of tussocks lined with course markings leading upwards. The grass made for good handholds as we scaled the steep ridge, making our way towards the water drop at the summit.

The three of us stuck together until the following water stop a few kilometres later, at which point Blake and Grant ran straight through and hurtled down the hill over the other side while I quickly grabbed a drink. They already had a 50 metre gap on me and despite my best efforts I quickly realised they were pulling away from me. The lack of recent running meant I simply didn’t have the speed to match them, so I put any notion of catching them out of my mind and instead focused on simply running comfortably and enjoying this amazing place. On went the internal iPod with the theme song to the Lord of the Rings on repeat as I entered a forest that appeared so mystical, I half expected an elf to pop out from behind one of the trees.

I was greatly surprised several kilometres later, as I commenced the biggest climb of the day that I could actually see Grant only a few minutes up ahead. I kept chugging along at the same intensity as I had been and eventually caught up with him near the top. Further along the undulating ridgeline I could see Blake hoping along the rocks, almost at the summit. Despite still feeling quite comfortable at this stage, I simply lacked the ability run much faster and really had no clue whether I was gaining or losing ground on Blake.

From the summit, the course followed a fence line down to a bridge crossing the creek below. It was just before reaching this bridge that I suddenly saw Blake only a hundred meters ahead. Climbing up from the creek on the other side of the bridge I finally caught up with him and offered some words of encouragement trying to rally him to run along with me for the final 8km stretch. However, that wasn’t to be.

The course finished with 5km of flat running beside and through Moonlight creek. The first creek crossing was refreshing, though I must admit as the number of crossings reached double digits I was starting to stiffen up a little from the cool water! But nothing was going to dampen my spirits and as the finish line came into sight only a kilometre up ahead I was feeling the best I had all day.

Finishing in 4hr 42min, I felt elated to not only have been able to experience this fantastic piece of New Zealand without my Achilles playing up, but to do so in first place. Several minutes later Blake Hose crossed the line to secure an Aussie 1-2, with Grant Guise securing a spot for the Kiwis on the male podium.

Looking back on the fun-filled trip that was the Shotover Moonlight Mountain Marathon 2014, I can safely label the race as the most scenic I have ever done. Furthermore, it felt great to be racing again, pain free, and filled me with high hopes for 2014!

The ABCs of Knees

In 2007, the Australian Institute of Health and Welfare published a study showing that 38.7% of all touch football injuries presenting to hospital were knee injuries. Changing direction at speed, side-stepping, jumping and landing can all cause damage to the structures of the knee if they are uncontrolled or performed with excessive forces.

So if you were to hurt your knee playing Touch Rugby League, how do you know when it requires attention? If your knee has swollen, particularly with a specific mechanism of injury, if your knee is limiting your walking, if there is difficulty bending or straightening or if it is clicking, popping or cracking, a visit to a healthcare professional is advised.

When you present to the physiotherapist with a fresh knee injury there are a few standard questions that you can expect to be asked. Your responses to these queries will dictate the most appropriate management.

1. Mechanism of your injury

How did it happen? Did someone or something land on your leg or did the injury occur during a step or landing from a jump? If your leg was in contact with the ground and bearing the weight of the body through it, there is a greater likelihood of structural damage within the knee. If the knee was twisting one way or another it is important to note the direction of movement as this will indicate which structures took the brunt of the impact.

 2. Snap, Crackle and Pop?

Did you hear anything when you injured your knee? A rupture of ligaments in the knee can often be accompanied by the sensation or even sound of a snap or pop. Clicking or catching can also indicate damage to other structures within the knee including cartilage and bony surfaces.

3. Swelling

Is there any swelling? Structures in the knee with a high level of blood supply will cause more rapid swelling. The amount of swelling and its location are also factors that your physiotherapist will take into consideration. Keep in mind that a tear of the cartilage in the knee can become increasingly stiff and swollen over a matter of days.

4. Investigations

A set of rules developed in Ottawa,Canada is widely used by therapists to determine whether an acute knee injury requires immediate imaging (Stiell et al., 1996). These rules suggest that anyone who fits any of the following criteria should seek immediate investigation:

  • Over the age of 55
  • Has isolated tenderness over the Patella (kneecap)
  • Pain over the head of the fibula (bone on the outside of the shank)
  • Unable to flex the knee to a right angle
  • Unable to take weight through the leg for 4 steps immediately post injury or in the emergency department

5. Range of motion

As discussed above, a lack of knee bend is a concerning feature of a knee injury, as is an inability to fully straighten the knee. This requires a thorough assessment and treatment to prevent any further injury occurring as a result of poor biomechanics

Hopefully these simple guidelines will allow you, or any of your teammates, to make a well informed decision regarding the management of your knee injury, should you sustain one during this season. If your injury fits any of the above descriptions  it would be advisable to have it assessed by an appropriately trained health professional as soon as possible.

As always, feel free to contact us with any concerns!

Kind Regards,

Ollie Codd

Allsports Physiotherapist – Jindalee Clinic

E-Mail: olliec@allsportsphysio.com.au

Phone: 3279 3752

Avoiding overuse injuries

With 2014 still young, you only need take a look at the pavements and sporting fields to see that there are lots of people enthusiastic about their training at the moment.

While this enthusiasm is a great thing, many of these avid trainers may suffer burnout either physically or psychologically by the time the weather starts to get cool.

Overuse injuries are a common risk associated with the rigors of physical training. Unlike acute injuries, which are usually the result of a single traumatic event, overuse injuries are subtle and usually occur over time, making them more challenging to diagnose and treat.

How do overuse injuries occur?

Many overuse injuries can be the result of ‘too much, too soon’, with those who rapidly increase the intensity, duration, or frequency of activity at the most risk. Overuse injuries are also common in people returning to training after injury or a break, who are keen to get ‘back in the game’.

It’s important to note that some people are more prone to overuse injuries, with body alignment issues such as knock-knees, flat or high arches and bow legs sometimes contributing to these issues. Also, any joints where there’s imbalance between strength and flexibility are potential problem areas.

Tips to avoid overuse injuries

  • Gradually increase your training workload by just 10 percent each week. This will help to reduce the risk of muscle or joint injury such as tendonitis or stress fractures caused by repetitive trauma.
  • Always remember to warm up and cool down effectively before and after training.
  • Incorporating strength, flexibility and core strength work into your training will help minimise overuse injuries.
  • Check your technique with a professional to make sure you’re looking after your body and any potential weak spots.
  • Listen to your body and use ice after an activity if you have any minor aches and pain.
  • Allow adequate recovery time between sessions of activity. When initially resuming exercise, 48 hours is optimal, especially with same-activity sessions (e.g. two long runs only a day apart is risky).
  • Set realistic short and medium term goals to help you to self-moderate while staying motivated.
  • Make sure you are using appropriate equipment, such as the correct footwear for your planned activity and any other safety gear that may be required. You may be keen to get started, but throwing on your Dunlop Volleys, which you usually mow the lawn in, to go for a run is fraught with danger for overload injuries.

In essence, keep the progressive changes in your activity levels gradual, listen to your body, and make incremental adjustments in time and intensity until you reach your new fitness goals.

As your body gets conditioned to increased levels of activity, there will be some normal mild soreness but if you’re experiencing pain of an intensity which is affecting your ability to carry out normal daily activities, or the pain is persisting/not improving after 48 to 72 hours, it may be time to make an appointment with an Allsports physiotherapist.

To read more on overuse injuries, click here.

Allsports Kangaroo Point opens new clinic

Allsports Physiotherapy – Kangaroo Point has now opened its brand new clinic. The new clinic is located in the heart of Kangaroo Point, just behind the famous Story Bridge Hotel, at Level 2, Suite 5, 22 Baildon Street, Kangaroo Point.

As well as physiotherapy, clients can also access onsite massage therapy, podiatry and exercise Physiology at the purpose-built clinic. Massage therapy is provided by RechargeHQ, who look after the Brisbane Broncos Rugby League team, and iFix Massage Therapy, who manage the Queensland Firebirds Netball team.

Also consulting from the purpose-built clinic is Allsports Podiatry and Personalised Performance Exercise Physiology, with its own on-site rehabilitation gym.

Allsports Physiotherapy – Kangaroo Point caters for all patients including private clients, Veterans’ Affairs, WorkCover, Compulsory Third Party (CTP) claims and Medicare Enhanced Primary Care (EPC). We also have access to HICAPS which provides on-the-spot health fund claims.

Because physiotherapists are ‘first contact practitioners’ you do not need a doctor’s referral to see a physiotherapist (unless you are seeking physiotherapy via a WorkCover claim, CTP claim or EPC), although we frequently work alongside GP’s, sports physicians, or other specialists to manage specific conditions.

Physiotherapy is a four-year Bachelor’s Degree which enables graduates to thoroughly assess, diagnose and treat your condition. Whether you’re young or old, active or less active, there’s a good chance you could benefit from physiotherapy at some point.

Here at Allsports Physiotherapy – Kangaroo Point, we pride ourselves on friendly and professional service where accurate assessment and quality hands-on treatment aims to manage not only the symptoms, but more importantly the cause of the dysfunction.

With easy access via Ipswich Road from East Brisbane, Norman Park, Woolloongabba and West End; Fortitude Valley, New Farm, Teneriffe and Brisbane City via the Story Bridge; and also the FREE ferry from the City, come see why some of Brisbane’s biggest sporting teams use our services.

Our team includes physiotherapists Van Tran and Andrew Thorp, Podiatrist Craig Page and Massage Therapists Matt Parry, Rachel Pole, Michelle Watson and Fiona Maxwell.

We look forward to looking after you. Appointments are available Monday to Friday and Saturday mornings.

Active Exercises

Active exercises

These are further categorized into:-
a) Free Active Exercises
b) Resisted Exercise

a) Free Active Exercises

Neck

 Elbow

elbow

 wrist & fingers

wrist & fingers

Shoulder Exercises

Hip Exercises 

 Rotation Exercises for trunk

Rotation Exercises for trunk

 Simple Trunk Bending Exercises

 

Simple Trunk Bending Exercises

 

 

 Side Bending Exercises For Trunk

Side Bending Exercises For Trunk

 
b)Resisted Active Exercises

Free Active Exercises are easiest form of exercise in which joint is moved in it’s full range. It may be an open chain or close chain exercise.Position is most important during these exercis Resisted Active Exercises are done for improving muscle strengh.Joint moved in it’s full range but against some resistence. e.g.: Weight,Springs,Thera bands etc.

resisted exercises

Various Resisted Exercises Using Rubber Tubing

 

Weight Cuffs Used For Resisted Exercises

 

Apply Weight at distal part of Limb & then movement of part give good resistance

Tubings Used For Resisted Exercises teir resistance vary according to teir colour.

Thera Bands Used For Resisted Exercises

Their Resistance Vary according to their colour

Physiotherapy exercises

ALL EXERCISES MENTIONED BELOW SHOULD BE UNDERSTOOD & PERFORMED UNDER SUPERVISION OF PHYSIOTHERAPIST

Therapeutic exercises are helpful for maintaining body fitness as well as to prevent some diseases that occur with increasing age. Therapeutic Exercises are:-
1.Stretching exercises.
2.Active exercises.
3.Muscle conditioning exercises.
4.Balancing  exercises.
5.Deep Breathing exercises.

Stretching exercises:-

These  exercises are helpful for maintaining flexibility of  body. Stretching exercises are:- Ballistic stretching. Sustained stretching. 1st one is high intensity short duration stretching beneficial for sports person. 2nd one is long duration stretching in which muscle stretch is hold for 30 sec.,3 repetition. Stretching should be done  on alternate day as it causes muscle soreness.

aeerobic flexibality

2.Active Exercises :- Click here

3.Muscle Conditioning Exercises:-

Specially done for back,knee,neck.In these exercises tension in a muscle develop without joint movement.
The common procedure adapted for this is – to press the towel roll for 10 second sets 10 times.

For Knee

For neck

For Back

The process here in to hold your waist and press the soft mat by your pelvis bone for – 10 seconds 10 sets.

4. Balancing Exercises:-

Balancing Exercises are useful in old aged persons,as there is loss of balance with increase in age. Some easy balancing exercises are Standing with both feet close to each other& eyes closed,Single leg standing with eyes closed etc.

 

balancing exercises

balancing exercises

balancing exercises

5.Deep Breathing Exercises :-

In a normal person these exercises are very helpfull to improve exchange of gases at Lung & Tissue level,thus improve general health,provide Relaxation.

Breath In

Breath Out

 

Degenerative Meniscal Tear

Menisci are soft tissue pad like structures between 2 bones of knee joint which act as a cushion. With increase in age wear & tear of these soft tissue is very common.

There are 2 menisci in knee joint :-

Inner(medial) meniscus

Outer(lateral) meniscus

Out of them inner one is more prone for wear & tear as the load is more commonly on it & its mobility is low as compared to other one.

Symptoms:-

Most common symptom is knee pain mostly on inner and back side of knee.
Person feels locking during knee joint movement.
Pain usually more in morning time and after activities like walking,running.
Reduced range of motion of knee joint.

Diagnosis:-

Diagnosis is done on the basis of some special tests performed manually either by physiotherapist or by orthopedic surgeon. The tests are:-
Apley’s test
Apley`s Test (Click to  see video)

Mcmurrey test
McMurrey (Click to see video)

After this physical examination a proper MRI is done & On  the basis of MRI report.( Which shows tear )

Meniscal tear

Please note that X-Ray can be done but picture may not be clear.

Treatment :-

Surgery is the only solution on tear length of 1 Cm and above.
After surgery, physiotherapy is required for rehabilitation of knee.
In case of more detail please consult our doctors for more details

For tears less than 1 CM physiotherapy may be effective but in very rare case.
Physiotherapy here may give symptomatic relief to patient

Surgery can be delay with the help of physiotherapy without any further growth in tear.

 

knee osteoarthritis

In knee osteoarthritis there is roughning of tissue(cartilage) that covers ends of knee joint bones. Loss of smoothness in this tissue causes painfull knee during movement and weight bearing.

Knee osteoarthritis is classified into:-

1)Patellofemoral

Patellofemoral arthritis

2)Tibiofemoral

Symptoms:-

A) Knee Pain – specially on weight bearing, during ascending & descending stairs.

B) Knee Stiffness :-
Stiffness occurs more in morning.

C) Limitation in movement of knee joints

Diagnosis :-

Diagnosis made on the basis of sign & x-ray report (X-ray :: of knee – AP view & Lateral view).

Sign –

1) Swelling of knee joint.
2) Pain along joint line on touching (palpation)
3) On joint movement makes a crackling noise (crepitus)
4) Range of motion of  knee joint is reduced.

X-Ray Report :-
(X-ray :: of knee – AP view & Lateral view)

1) Decreased joint space
2) Osteophytes
3) Decreased bone density
4) Deformity in latter stage

 Treatment of osteoarthritis :-

 

Can be done with Medicines (NSAIDS) , Physiotherapy and Surgery (Knee repalcement surgeries).

Physiotherapy for osteoarthritis:-

Line of treatment

0) Cryo therapy (Application of ice at knee joint)

Twice a day for 15-20 minutes of duration

Icing on knee
1) Electro Therapy

– A small supply of current is passed through joint to stimulate the muscles which reduces swelling & pain in area. It is called interferrential therapy (IFT).
Electrical muscle stimulation (EMS) is done by D.C current, the position of electrodes is changed to muscle motor points for strengthening of muscles. EMS is not a compulsion of treatment it depends on condition of muscle in patient`s body.
Ultra sound Therapy (UST) It is done by 2 ways :-
A) Simple use of ultra sound therapy for normal pain.
B) Ultra sound frequency is used to insert the pain relief chemical (Diclophynic gel), which penetrates to certain extent & eases the pain and swelling.
– Iontophoresis Here ions are inserted through electrodes to relief the pain.

2) Exercise Therapy

Please read article over here for more details of knee exercises.

3) Manual Therapy

Caution :- this needs to be done by Physiotherapists. Please consult your doctor Or contact-Us.

4) Lifestyle modification

Click here to read more.

5) Orthotic devices (Click here)

6) Taping Techniques

For pictures please see here.

Done by using adhesive tape in case of knee diseases. Please contact your physiotherapist Or Contact us for detail.