Author Archives: Ritika

About Ritika

Physiotherapist by interest & is ready to help any one at any time of day !! I have done Physiotherapy from MGM medical college Indore and currently practicing in vadodara !!

Movement, awareness of Kenyan runners in Mumbai Marathon

Mumbai Marathon has always been the place where we see the running spirit of mankind comes in all its form & from all across the globe.  We see lots of foreigner & in surprise out of past 10 years winners – 6 times the reward is taken by Kenya people &  details of 4 people is not available on Wikipedia!

Coming to the point, why is it possible that a person from Kenya can win consistently & we Indians cannot even come close to the brim; take a close look at the records, Indians are at 4th all the time!

On a deeper analysis, we come to know that the movement, awareness of Kenyan runners in Mumbai Marathon is on top of all.

Following article give a lot of insight of balanced physio lifestyle :-

Watch more videos on Flotrack

“I think Kenyans are very much in tune with their bodies, they’re in tune with movement, in tune with the ground.

Some of them become very very sensitive and know the limits of their body, they know it instinctively.” Brother Colm O’Connell – running coach.

At Balance we’ve long been encouraging clients to place their attention on good movement, to invest time improving body awareness. This message has often fallen on deaf ears – those who feel they are already “good performers” often believe that pain free and back to full training means the task is complete and effective performance is secure. Equally those who have no desire to “perform”, who have over time become completely UNaware of themselves can’t see the importance of competent and mindful movement to their “simple” goal of health and injury recovery. We persevere.

However it does appear that the message is slowly becoming more mainstream, resilience is a term more widely used and applied in a variety of context.

Video intros like the one above are great but there is a subtle suggestion that awareness and “feel” are a genetic “gift”. We don’t believe that’s true.

Its not about changing the way you move its about knowing how YOU move. THEN you will know the limits and capabilities you have, on any given day.

So, what are you guys waiting for!

Go out there and know yourself, know your bodies response to running.

Thanks for original article on

Enhance your health, increase your movement, reduce your sitting

If you’re sitting more than six hours a day the evidence tells us that you’re really could be doing a lot of harm. What’s more you’re unlikely to correct it by going to the gym…so think again. Enhance your health, increase your movement, reduce your sitting

We know that if you sit for more that six hours:

the electrical activity in the muscles drops — leading to a cascade of harmful metabolic effects. Your calorie-burning rate immediately plunges to about one per minute, a third of what it would be if you got up and walked. Insulin effectiveness drops within a single day, and the risk of developing Type 2 diabetes rises. So does the risk of being obese. The enzymes responsible for breaking down lipids and triglycerides plunge, which in turn causes the levels of good (HDL) cholesterol to fall.

So how much better is standing than sitting:

if you stand for three hours a day for five days that’s around 750 calories burnt. Over the course of a year it would add up to about 30,000 extra calories, or around 8lb of fat.
….if you want to put that into activity levels, then that would be the equivalent of running about 10 marathons a year. Just by standing up three or four hours in your day at work.”

Sit to stand desks are easier than running a marathon!

And exercise?…..30 minutes a day is generally recommended. However, recent evidence underlines the importance of also focusing on sedentary behaviors—the high volumes of time that adults spend sitting in their remaining “non-exercise” waking hours. The evidence is compelling for the distinct relationships between ‘too much sitting’ and biomarkers of metabolic health and, thus, increased risk of type 2 diabetes, cardiovascular disease and other prevalent chronic health problems.

So the evidence for how ‘harmful’ prolonged sitting can be on your health is growing and the take home message is that the gym may not be enough to undo the harm of sitting. The Department Of Health’s emphasis for good health being partly dependent on 30 mins exercise 3 times a week, could soon be a thing of the past being replaced instead with advice on preventing sitting prolonged sitting in favor of standing desks…

Come and try the best of them at Balance Performance…


Article courtesy :-
Dr Lucy Goldby.

Br J Sports Med 2009;43:81-83 doi:10.1136/bjsm.2008.055269

To consult with Lucy on ergonomics, your set up at work, at home or when you are on the move call 02076272308 or contact via FaceBook or Twitter.




Pain – Measurement & analysis

Pain is a critical feeling that cannot be expressed in any scale. Therefore, pain – measurement & analysis is critical to doctor & patient both. Pain is difficult to communicate. There is no scale so a doctor has to ask it in a very common form – on a scale of 1 to 10 how much is the pain. If customer says its 10 out of 10 you, as a physiotherapist have to accept it as a 10/10. This is what theory says, but in actual, we all know that if  it is 10/10 pain then the expressions of the patient is – sweating, closing eyes with high pressure and blowing air from mouth. So it is possible to understand the – pain, measurement, analysis part of treatment in real world.

Psychology of pain

The true part comes when patient`s psychology ” of pain is still there even after treatment” comes. This is the place where you go to real world & try to look the reaction of rest of the body parts when you churl the injury.


if a patient was suffering from Knee ligament failure & you were not able to rotate it by say 30 degree on each side but post treatment, you are now able to move it to 60-70 degree on each side; so you should accept the treatment or the line of treatment as a success.

 Communication of pain

The communication of pain to your physiotherapist is a must part. Where you should give him the exact intensity of pain so he/she can decide the correct line of treatment. There exists a variety of causes for a pain in certain place (read our article for knee pain as example) and if that is diagnosed correctly the line of treatment of its permanent cure lies in patient`s feedback of improvement or change in pain.

For more please read the post But they walked, hopped and jumped on it! from the blog Body in Mind.

What is Radial Shockwave Therapy


What is Radial Shockwave Therapy?

Radial shockwave therapy is a new breakthrough technology used to treat chronic (long term) tendon disease such as Achilles tendinitis that has failed to respond to normal treatment.

The technology is based on lithotripsy, which has been used for many years to treat kidney stones. High energy sound waves are created and focused on the injury using a special applicator. Shockwaves are repeatedly applied to the injury area, and will break down scar tissue and calcifications in the area, which in chronic cases the body is unable to repair itself. As the shockwave breaks down the tissue, the body starts generating new tissue leading to healing.

What is the benefit of this treatment over surgery?

  • Outpatient treatment

  • no anaesthesia

  • non-invasive

  • virtually painless after treatment

  • no medication

  • quick results

  • high success rates

  • improved quality of life

Shockwave therapy is proven to be as effective as traditional surgery and doesn’t involve an operation, being in plaster, or a long rehabilitation period which can last over 6 months. Shockwave therapy only requires one treatment weekly over 3-4 weeks. Treatment is safe, non-invasive, only takes 10 minutes and is as good as results achieved by surgery.

What conditions can be treated with shockwave therapy?

conditions treated successfully with shockwave therapy include:

  • plantar fasciitis

  • achilles tendinitis

  • shin splints

  • patella tendinopathy  (knee pain)

  • hamstring tendinopathy

  • Greater trochanteric syndrome (hip pain)

  • lateral epicondylitis (tennis elbow)

  • calcific tendinitis of the shoulder

Can diagnostic uncertainty bias patients’ memory?

Our thoughts shape our emotional and behavioral responses. This is a well-established principle in psychological research and Cognitive Behavioral Therapy. We use preconceptions – known as “schemas” – to help us filter new and ambiguous information. These schemas are helpful in many ways, but they do not always serve us well: they will often produce biases in the way we process information, influencing our attention, memory and interpretation of new information. Read more on Can diagnostic uncertainty bias patients’ memory? which first appeared on Body in Mind.

How to deal with diagnoses results :-


Go to a doctor, he has taken a degree to get all the tests to be done & understanding those results.


Even still, if you are reading the diagnoses on your own, Always pay attention to the specification. Say for a low hemoglobin count is generally defined as less than 13.5 grams of hemoglobin per deciliter (135 grams per liter) of blood for men and less than 12 grams per deciliter (120 grams per liter) for women. In children, the definition varies with age and sex. The threshold differs slightly between medical practices. Still we recommend you to be in contact with your doctor.

How to read research papers

The biggest problem in research paper publishing is that people go just by “intro” part OR “research problem statement”  & give their judgement. The hefty time & research done by the person or group is in vane. Here is a set of article that helps on ” How to read a research papers” so that in future, if you come across an article that is attached to research paper you know how to go through it.

Simple steps that you need to take at a research papers are :-

  • Read the index

There are times when people do not look at index, they just jump at the volume of the book (say 600 pages) & look at introduction part.

  • Read the “Subject” of research in between

Make sure that the subject part of the research is in your head all the time while reading through it. To keep that enacted, keep reading the the “topic” OR “Subject” line of research paper.

Side Note :- Research paper writers are requested to keep the Subject heading on the right hand side top of the page all the time.

Please read the article,  Making sense of research and helping it guide our practice which appeared first on Body in Mind.

Physiotherapy in Sports

Role of Physiotherapy in sports is hard to define, here is an experience borrowed !!

The Brisbane Strikers played the first game of Round thirty two in the Westfield FFA Cup recently which was hosted by local team, Broadmeadow Magic in Newcastle.  The competition is a national knockout competition modelled on the English FA Cup.  It is run by Football Australia and entry is open to semi-professional and amateur teams through state based qualifying rounds.  From 621 teams Australia wide, the state based competition results with 22 clubs qualifying to compete in the National FFA Cup where they are joined by the 10 A-League soccer clubs.

The importance of this competition is that it enables lower tier clubs to play against some of the best players in the country and showcase their skill, with the possibility of causing an upset by knocking out one of the professional A-League teams!  A national competition like this also helps to build the profile of soccer within Australia and subsequently improve community support and participation.

As the physiotherapist who travelled with the team on this occasion, it was Nuala’s responsibility to ensure players were adequately prepped for competition by treating any existing injuries at the hotel prior to heading out to the game.  At the grounds, the remaining preparation of strapping ankles (mostly) and assessing any concerns that crop up during warm-up was done.  During the game, Nuala sat on the side line with the coaching staff and was required to run on and assess any injured players as called for by the referee.

Given this competition is being run alongside the Strikers regular NPL season games, there was a three day turnaround to the next match.  As such, the player’s recovery following the game was also a high priority with any niggles promptly treated upon return to the hotel that evening and the following morning before the team headed back to Brisbane.

According to Nuala, travelling with the team was a fantastic experience. Whether it be elite or sub-elite, the attraction of working as a physio travelling with a sports team is the ability to gain an in depth understanding of the requirements of an athlete to compete at that level.  Being involved in all aspects of the athlete’s experience, including their preparation, during the game performance and their recovery, gives valuable insights into their needs and requirements.  In addition, being able to see the injuries first hand is invaluable. The overall experience whilst demanding, was one which left Nuala feeling, “…very lucky to work with such a friendly and inclusive group of players and coaching staff”.

For Nuala, the most valuable thing learnt from travelling with the Brisbane Strikers on this occasion was definitely time management!  As James Chiang (Allsports – Toowong) and Pete Wylie (Allsports – Camp Hill) who covered the Olympic FC vs Melbourne Knights FFA Cup match in Brisbane can attest, being a televised match, there was absolutely no room to be running late with Fox Sports running a very tight ship. “If you have even the slightest interest in sports physio, then [I] definitely [recommend going on tour with a sports team]!  It puts your skills to the test and is a fantastic learning experience.”

Ligament Knee Injury and role of physiotherapy

Ligament knee injury radiates pain which can easily be sighted by external swelling that appears on the knee zone.

This usually occurs while – playing sports OR in accidents. Basic cause of ligament injury is sudden motion of knee joint in cross direction (Left to right rather than front to back).

Most common Ligament knee injury Occur on it’s inner aspect ligament i.e. Medial Collateral Ligament (MCL) . ligament provides stability to knee on inner aspect as well as nerves present in it helpful for balancing.  It lies beneath muscles of knee joint. The results of treatment are very good if treated at right time.

Ligament knee injury

Picture Showing Attachments Of Inner Ligament Of Knee

Mechanism Of Injury:-

Two mechanism are possible.

1) When thigh bone is fixed twisting of leg bone can cause ligament tear.

2) When leg bone is fixed on ground and twisting of thigh bone over it. But the direction of force must be from outside as shown in picture below.

Ligament knee injury

An Outside Force (Valgus force) Causes Injury


Severity of symptom depend on grade of tear.The symptoms are:-

Picture Showing Grades Of MCL Injury

Picture Showing Grades Of MCL Injury

1) Pain


3)Person unable to bear body weight as it causes knee pain along with it he feels instability in knee joint.


Made on the basis of history & some special tests as defined below :-


Patient will tell about mechanism of injury & in case of grade 3 tear he may give history of snap sound in knee during injury.

Special Test:-

Perform manually by specialist.As shown below

Valgus Stress Test For MCL Tear

Valgus Stress Test For MCL Tear

MRI reports are helpful to confirm severity of tear.


Vary according to severity. Grade 1&2 tear can be treated conservatively i.e. By medicines & Physiotherapy. For grade 3 tear surgical repair of ligament & post surgical Physiotherapy is required.

Physiotherapy Treatment:- If your knee shows symptoms mentioned above then without any delay contact your therapist for proper exercise and other physiotherapy treatment session such as:-

Ultrasound Therapy.


Proprioceptive Training.

Gait Training.

Life Style Modification Advices etc.

Supportive Braces (if Required).

Proper physiotherapy treatment taken at right time also reduces future risk of ligament injury. Use our free physiotherapy consultation form to get physiotherapy consultation online.

Smiling for Smiddy Update


On Wednesday the 30th of July, 2014, Cameron Schembri from the Allsports Jindalee team chatted with the Smiling for Smiddy members that will be participating in the 2014 Noosa Triathlon, taking place on November 2nd. Smiling for Smiddy is a group of cycling enthusiasts riding long distances to raise funds for vital cancer research, founded in memory of Adam Smiddy, who passed away due to cancer in 2006. The Allsports Physiotherapy Group is proud to be involved in such a great charity and has been supporting the Smiling for Smiddy riders since 2007.

Schembri, and experienced Ironman athlete and partner at the Allsports Jindalee clinic, was on hand to inform newcomer triathletes on injury prevention and management across all three disciplines of triathlons. He will be holding a bike fitting session for this group on August 24th so that they can enjoy a comfortable Noosa Triathlon injury-free. Be sure to look out for the Allsports Physio’s marquee at this year’s Noosa Triathlon near the finish line, alongside the Smiling for Smiddy tent. The Allsports team will also be on hand to provide post-race physiotherapy treatment and massages to Smiddy triathletes, as well as several Allsports colleagues, including Cameron Schembri, who will be racing on the day.

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