Dr. Priyanka Arlekar
BPTh (Mum), MHS.PT (MSK) (US), MBA (UK).
With a journey of 10+ years in the Physiotherapy field of working in hospitals, skilled nursing facility, outpatient and home health setting, I started Decode Physio Rehab (DPR) with a mission to make a difference in your life by empowering you to own your lifestyle. DPR is an online medium through which I can connect with you remotely.
Drop me an email and I will send you out weekly newsletter on latest health updates.
If you are looking for a remote video consultation, drop me a mail or DM me on Insta.
Use the free content on my Insta and YouTube channel and let's work together to create a balanced tomorrow.
Top 5 Myths for Back Pain -Decoded
20th AUGUST, 2020
Some say "rest it out"; while some say "be on the move". The more people you ask, the more opinions you will get about how to manage your back pain. So which advice is correct for you?
How I would like to approach this question is to understand : why did I get back pain in the first place?
Not all pains originate from slipped discs, not all pain are sciatica, in fact 90% of low back pain are non-specific or in simple terms without any pinpoint cause. Thus, it's important to understand that every individual is unique and experiences pain differently. So let's decode the common myths related to back pain.
#1. "You need to Rest"
Listen to your body first. If you are able to get out of your bed and do all your daily activities without any pain, then clearly your body is telling you that you don't need to rest. If you experience pain only while doing a specific activity like bending forward or in a specific position like prolonged sitting in front of the laptop, then you don't need to stop everything and rest. However some people may experience acute severe episodes of pain or even find it difficult to get out of bed; in such a scenario resting for 24-48 hours would allow the pain to subside and allow your body to self- heal. Again reiterating your doctor and your body are your best guides.
#2. "Don't Bend Forward?"
I have been hearing this time and again from my patients that if I bend forward, I will get back pain or I will aggravate my back pain, not true for everyone.
Everybody moves differently. If I tell a patient with knee arthritis to bend forward from the knees and not the back , then it's an unrealistic advice. However, if your pain aggravates with long periods of sitting or forward bending activities, then post an acute episode of back pain you may avoid forward bending from the spine for around 1-2 weeks and work on your core and back muscles strengthening. Towards the end of your rehabilitation somewhere around 4-6 weeks, forward bending of the spine should be incorporated in the rehab program to reduce chances of recurrence.
#3. "Don't Lift Weights"
Well if our spine can bear our body weight then lifting a few kgs should not be a problem provided you are able to maintain your neutral spine. Strength training is an important aspect of the low back pain rehabilitation, so it's important to differentiate between straining the spine versus stressing the right muscles to build up strength.
#4. "Be on the Move"
Well, not always , as I said your body tells you better when you should be on the move. Respect acute pain and don't push through pain. Positioning, rest and cryotherapy should be the mainstay for acute pain management for the first 24 hours.
#5. "My increased Weight is the root cause"
Probably not. Your lack of physical activity leading to increased weight is a more probable cause. It's a vicious cycle which is difficult to break and therefore, a holistic approach is necessary to manage low back pain along with lifestyle modifications.
Top 5 Tips for Osteoarthritis Knee Pain Rehab
6th August, 2020
"Walk as much as you can." "Rest it out." "I will never be able to go back to my sport." "It's in my genes." "Nothing can help me." Different people experience different emotions and perceive their Osteoarthritis Knee pain in a unique way. Hence, there is no absolute perfect Rehab plan that fits all. However, the basic principles of Physiotherapy Rehab stay consistent . So, below are my Top 5 Tips for Osteoarthritis Knee Pain Rehab which can be used as a guideline universally.
#1. Understanding Pain
"Do I feel Pain or stretch or soreness?"
"Pain" can be described as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Thus, everyone perceives pain differently. While some muscle soreness is expected post-exercise, it is important to differentiate it from "bad" pain. Any sharp or unremitting pain lasting for 24-48 hours post-exercise can be termed as "bad" pain and you should seek medical advice if any such situation arises.
#2. Too Much Too Soon
"I should be running 10k on Day 1".
The most immediate response of our body to pain is tissue inflammation which results in stiffness. Consequently, targeting the key muscles and their specific activation in various load-bearing positions is of utmost importance. However, building up muscle strength takes at least 4-8 weeks to show any noticeable change. Hence, hurried progression of loading the muscles can actually be harmful and cause undue damage.
#3. Focus On Knee Only
"My problem area is the knee, so I will focus only on the knee."
While the knee is the mainstay rehab focus, ignoring the hip and ankle in rehab is the most common cause for recurring pain. Weak hip muscles, namely gluteus medius and gluteus maximus or reduced ankle mobility can lead to biomechanical alterations at the knee joint and cause exacerbation of pain.
#4. Using External Support
"I don't think walking without knee caps is safe".
Knee caps or braces are commonly used by patients as they provide support and you feel more confident. However, there is no substitute to building your internal support (muscle strength and joint function). While knee caps can provide temporary support, prolonged psychological dependency on their use can affect muscle activation and strengthening rehab.
#5. Moving In the Right Direction
"It's been 3 days and there is no improvement".
Is that really so? While conventional objective outcome measures such as pain, standing time, walking time, walking distance, etc. are often used, reduction in other markers such as SOS medication dependency and dependency on external supports also suggest that Rehab is on the right track.