Physiotherapy and Healthy Life

Clinical Experience (2010–2012) Presenting Complaint: A 53-year-old female patient presented to the physiotherapy outpatient department with complaints of pain and stiffness in her right shoulder. She reported difficulty performing daily activities such as combing her hair, dressing, and reaching overhead. The symptoms had progressively worsened over a few weeks. The primary concern was the inability to externally rotate her right shoulder, accompanied by pain at end range. History and Background: The patient was a housewife with a known history of type 2 diabetes mellitus, moderately controlled with medication. There was no history of trauma or previous shoulder injury. Her lifestyle involved repetitive use of the upper limbs for household work. Assessment: On physical examination: • Observation: No visible swelling or deformity • Palpation: Mild tenderness over the anterior shoulder joint • Active Range of Motion (AROM): - Flexion: Limited - Abduction: Limited - External Rotati...

Managed in Clinical Physiotherapy Setup | Continuing Sessions | 2010–2012 This was a case that came to me during 2010–2012 and left a lasting impression. A 10-year-old girl was brought in by her mother following a traumatic injury. She had been walking on the footpath when she was hit by a car, resulting in what was later diagnosed as Erb’s palsy—a type of upper brachial plexus injury. Her mother shared that, after the accident, the child had lost the ability to bend or lift her right arm, and she could not move her shoulder, elbow, wrist, or fingers. The limb hung by her side with a characteristic "waiter’s tip" posture. It was understandably distressing for both the child and her family. Presentation and Complaints: • Complete weakness of the upper limb, especially shoulder abduction, elbow flexion, wrist, and finger movements • No sensation loss, but the limb was flaccid and non-functional • Difficulty in dressing, writing, and eating with the affected hand • Psych...

Hospital Experience (2010–2012) Presenting Complaint: A 33-year-old female patient diagnosed with Multiple Sclerosis (MS) was referred to the physiotherapy department for long-term rehabilitation. The patient attended sessions three days a week, accompanied by her mother, who was also her primary caregiver. Her main challenges included wasting of muscles in both the foot and hand, leading to functional difficulties in walking, gripping, and general mobility. History and Background: The patient had been diagnosed with relapsing-remitting MS. At the time of physiotherapy referral, she was in a relatively stable phase but exhibited signs of muscular atrophy in the distal limbs, particularly the intrinsic muscles of the hands and the dorsiflexors of the feet. She reported early fatigue, difficulty in maintaining balance, and decreased ability to perform daily activities independently. She relied heavily on her mother for mobility support and emotional reassurance. Given the complexity of M...

  M anaged in Clinical Physiotherapy Setting (2010–2012) This case involved a 71-year-old female who presented with sudden onset facial asymmetry and difficulty in closing her right eye and mouth, which had developed overnight during the winter months. She was brought in by her daughter, concerned about the change in her facial expressions. The patient was hypertensive, but her blood pressure was under control with medication. There was no history of trauma, recent viral infection, or stroke, and the condition was identified as Bell’s palsy, likely triggered or aggravated by cold exposure, which is common during winter. Presentation and Complaints: • Inability to close the right eye completely • Drooping of the right corner of the mouth • Difficulty with facial expressions (smiling, blowing, frowning) • Mild drooling while eating • Slight slurring of speech • No limb weakness, vision disturbance, or altered consciousness • Symptoms appeared within 24 hours, and she so...

Clinical Setting- (2010-2012) Subjective: A 75-year-old male presented to the clinic accompanied by his wife with a diagnosis of Parkinson’s disease. Due to the passage of time, full medical history is not available, but the patient exhibited classic symptoms including bradykinesia, gait instability, and postural changes. The wife reported increased difficulty with mobility, frequent imbalance, and reduced confidence in walking independently. The patient had not previously undergone structured physiotherapy. Objective: • Observation: Stooped posture, shuffling gait, reduced arm swing, and masked facial expression. • Gait Assessment: Shortened stride length, reduced foot clearance, and episodes of freezing. • Motor Assessment: Bradykinesia, mild resting tremor, rigidity in upper limbs, particularly during passive movement. • Balance: Impaired dynamic balance and postural instability noted. • Outcome Measures : Unified Parkinson’s Disease Rating Scale (UPDRS) – for motor sympto...

Managed in Clinical Physiotherapy Setup | Short-Term Rehabilitation | 2010–2012 This case involved a 12-year-old girl who came to the clinic with her mother complaining of pain in the hip region, following excessive running during her school’s sports day events. The injury appeared to be a muscle sprain, likely due to overuse and inadequate warm-up before intense activity. This was a short-duration case, and with timely intervention, she made a full recovery within a few sessions. Presentation and Complaints: • Sharp pain in the hip region, especially during walking or any weight-bearing activity • Mild swelling and tenderness over the lateral hip • No visible bruising or signs of serious trauma • Reduced range of motion, particularly in hip abduction and extension • Pain aggravated during running, climbing stairs, or getting up from sitting position • Slight limp due to pain avoidance Assessment (As per Clinical Practice at the Time): • Visual and palpation-based examina...

Managed in the physiotherapy department, with playful therapy approach I had the privilege of working with a young child diagnosed with congenital hip dislocation in the early years of my practice. The child, a 3-year-old, was brought to the clinic by his mother following a corrective surgical procedure for the dislocation. The primary goal was to assist with post-surgical rehabilitation and support the child in regaining functional mobility. Presentation and Common Complaints: The child presented post-surgery with: • Limited movement in the affected hip joint • Difficulty with weight-bearing on the affected leg • Reduced ability to perform basic functional tasks, including standing and walking • Lack of confidence in using the affected leg due to pain and stiffness • Emotional distress (fear of movement, crying when attempts were made to engage the affected limb) Assessment: I began by conducting a thorough assessment: • Range of Motion (ROM): Limited abduction and flexion...

Managed in Clinical Setting: Rehabilitation in Physiotherapy Department During my practice, I worked with a 13-year-old girl diagnosed with spastic cerebral palsy (CP), presenting with bilateral spasticity affecting both the upper and lower limbs. This was an ongoing case, with the patient attending regular physiotherapy sessions for several months. Although the case details were limited, the focus was on improving mobility, managing spasticity, and enhancing the girl’s overall functional abilities. Presentation and Common Complaints: The child presented with the following clinical features: • Spasticity: Most evident in the lower limbs (particularly in the calf muscles and hamstrings), limiting her ability to walk with proper gait mechanics. • Limited range of motion (ROM) in both upper and lower limbs, particularly in the ankle and knee joints. • Functional Impairments: Difficulty with independent ambulation, walking with an abnormal gait pattern, and challenges in performing...

Management in a Hospital Setting (2010-2012) A 47-year-old male presented with acute onset radial nerve palsy affecting the right upper limb. The patient reported no prior medical history and was otherwise healthy and active. History and Onset: The condition developed after the patient overslept in a prolonged malposition, likely compressing the radial nerve. He woke with weakness in wrist and finger extension, commonly referred to as "wrist drop." Assessment: Clinical examination confirmed radial nerve involvement, with reduced motor function in the extensor muscles of the forearm and diminished sensation over the dorsal hand. No signs of trauma or systemic illness were observed. Electrodiagnostic studies were not initially required due to the clear clinical presentation and spontaneous cause. Treatment Plan: • Initiated electrical nerve stimulation targeting affected muscles to promote nerve reactivation and prevent muscle atrophy. • Prescribed progressive strengthening...

Management of Clubfoot-Clinical Setting (2010-2012) Subjective: A 1.5-year-old male presented with a diagnosis of congenital talipes equinovarus (clubfoot), referred for physiotherapy. The child was initially uncooperative during treatment, displaying anxiety and fear in the clinical setting. His mother reported difficulty in calming him during sessions but remained actively involved and motivated throughout the process. Objective: • Observation: Right-sided fixed deformity with forefoot adduction, hindfoot varus, and equinus. • Gait: Delayed gross motor milestones; the child was not independently ambulatory at the time of initial assessment. • ROM: Limited passive and active dorsiflexion of the ankle. • Muscle tone: Mild tightness in the triceps surae. • Behavioral response: Crying, withdrawal from contact, refusal to engage in tasks in early sessions. Outcome Measures: Gross Motor Function Measure-88 (GMFM-88): Administered periodically to track functional mobility and gait...

A 43-Year-Old Male- Managed in Clinical Setting (2010–2012) During my early years of practice, I treated a 43-year-old male who had undergone Anterior Cervical Discectomy and Fusion (ACDF) due to cervical disc pathology. The patient was referred for post-surgical rehabilitation to improve neck mobility, relieve residual discomfort, and restore functional activity. Unfortunately, I do not recall all the details due to the time that has passed, but I distinctly remember managing the case with a focus on neck exercises and gradual recovery of function. Presentation: The patient presented in the post-operative phase with common post-ACDF complaints, including: • Neck stiffness and reduced mobility • Mild residual pain on movement • Apprehension with neck motion, especially with rotation and extension • Mild postural imbalance and difficulty in prolonged sitting or desk work Assessment: Although a detailed assessment record is not available, based on standard practice at that time, ...

Managed as a Freelance Physiotherapist- 2019-2020 Patient Overview Name: Mr. S. (pseudonym for confidentiality) Age: 40 yrs Occupation: IT Professional Presenting Condition: Acute low back pain (LBP) Onset: Sudden onset of pain after lifting and throwing a bucket of water. Medical History: No previous history of low back pain or significant medical conditions. Presenting Symptoms Mr. S. presented with sudden, severe low back pain following a physical strain from throwing a bucket of water. He described the sensation as "locked" in his lower back, with an inability to sit, stand, or walk without experiencing significant pain. The pain was localized to the lumbar region, and he was unable to perform daily activities without considerable discomfort. He also reported difficulty finding a comfortable position, whether seated or standing. Initial Assessment On initial assessment, Mr. S. displayed the following signs: • Posture: A significant antalgic posture, with noticeable guar...

Managed in Clinical Physiotherapy Setup- 2010–2012 One of the most memorable cases I handled during 2010–2012 was that of a 48-year-old woman who had developed right-sided hemiplegia following a cerebrovascular accident (stroke). She was brought to the physiotherapy department by her family members shortly after her hospital discharge. In the beginning, she was quite uncooperative—showing no interest in engaging with therapy, often refusing to participate, and showing frustration and emotional resistance to movement. However, with time, consistent care, and reassurance, her attitude gradually began to shift. As she started noticing small improvements—especially regaining slight movement in her hand and becoming more upright during transfers—her confidence grew. Eventually, she became an active participant in her own rehabilitation, attending sessions willingly and even encouraging other patients. Presentation and Complaints: • Complete weakness on the right side (upper and lower limb...