Physiotherapy and Healthy Life

Clinical Experience (2010–2012) Presenting Complaint: A 45-year-old female clerical staff member reported with pain on the outer aspect of her right elbow. She complained of discomfort during wrist extension, gripping objects, and especially while twisting movements like turning a key or wringing clothes. The pain had gradually developed over the past month and had worsened with her daily office work, which involved repetitive keyboard use and paperwork handling. History and Background: The patient was right-hand dominant and had no history of trauma. Her occupation required prolonged sitting and repetitive hand movements, contributing to strain on the extensor tendons. Her symptoms were typical of overuse injury, consistent with lateral epicondylitis (tennis elbow). Assessment: During the clinical evaluation: • Observation: No visible swelling or redness • Palpation: Point tenderness over the lateral epicondyle of the humerus • Pain Provocation Tests: o Resisted wrist extensio...

  Clinical Experience (2010–2012) Presenting Complaint: A female patient, approximately 49 years old, presented with pain in the left shoulder, particularly during overhead activities and when lying on the affected side. She described a dull, aching pain that had persisted for a few weeks, gradually worsening. Her main complaint was difficulty lifting objects, combing hair, and reaching overhead due to sharp pain at the top and lateral aspect of her shoulder. History and Background: The patient reported no recent trauma but had a physically demanding routine involving repetitive arm movements due to household work. She had no known history of diabetes or other systemic conditions. Symptoms suggested overuse and strain of the rotator cuff muscles, particularly the supraspinatus. Assessment: On examination: • Observation: No swelling or visible deformity • Palpation: Tenderness localized over the supraspinatus tendon (just below the acromion) • Active ROM: o Painful arc betwe...

Clinical Experience (2019-2020) Presenting Complaint: A 42-year-old male patient was referred for physiotherapy following open reduction and internal fixation (ORIF) for a distal tibial fracture sustained during a road traffic accident. The patient was recovering at home post-surgery and required a structured rehabilitation plan to regain mobility, strength, and functional independence. I conducted home visits to manage his recovery and guide his progression. History and Background: The patient underwent ORIF with plates and screws to stabilize the distal tibial fracture. By the time physiotherapy was initiated, he had been cleared for gradual weight-bearing and movement. He presented with swelling, pain on movement, reduced ankle and knee mobility, and difficulty with weight-bearing due to prolonged immobilization and surgical trauma. The main goals were to reduce post-operative complications, restore range of motion, improve muscle strength, and assist him in returning to normal dail...

Clinical Experience (2010–2012) Presenting Complaint: A middle-aged patient (exact age not recalled) presented to the physiotherapy department following conservative treatment for a Colles’ fracture of the left wrist. The fracture had been managed with immobilization in a cast, which had recently been removed. The patient reported stiffness, restricted wrist and finger movement, reduced grip strength, and difficulty in performing routine activities such as lifting objects, turning doorknobs, and writing. History and Background: The patient sustained the fracture due to a fall on an outstretched hand and was managed non-surgically with a below-elbow cast for approximately 6 weeks. Upon removal of the cast, the patient was referred for physiotherapy to regain wrist mobility and function. Assessment: During initial assessment, I conducted the following: • Observation: Mild swelling and visible atrophy of forearm muscles; healed scar at the dorsal wrist (from cast contact) • Palpation...

Clinical Experience (2010–2012 – Pediatric Outpatient Setting) Presenting Complaint: An 8-month-old female infant was brought to the clinic by her parents with a visible tilt of the head to the right side and difficulty turning her head to the left. The parents reported that the condition had been present since early infancy and was becoming more noticeable as she began to sit and attempt crawling. They were concerned about her head posture and its possible effect on her development. History and Background: The infant was diagnosed with congenital muscular torticollis, suspected to have resulted from intrauterine positioning. There was no history of trauma or birth complications. On initial observation, the child exhibited a consistent right-side head tilt with limited cervical rotation to the left. Despite her condition, she was a bright, playful, and cheerful infant, and from the very first session, she responded positively to interaction. I took special care to build rapport through...

Clinical Experience (2010–2012 – Outpatient Setting) Presenting Complaint: A 68-year-old female patient attended the physiotherapy outpatient clinic with a primary goal of improving her functional mobility and joint flexibility. Diagnosed with Rheumatoid Arthritis (RA), she experienced generalized stiffness, joint pain, and reduced endurance—particularly in her hands, wrists, knees, and ankles. Her motivation was to maintain independence in her daily routine and reduce morning stiffness. History and Background: The patient had been living with RA for several years and was under medical management with a rheumatologist. At the time of referral, she was in a relatively stable disease phase with no acute flare-ups. She presented with mild joint deformities, stiffness in the morning lasting about 30–45 minutes, and difficulty with prolonged walking or gripping small objects. Despite her age, she was active, mentally sharp, and highly cooperative. She showed enthusiasm toward participating ...

Clinical Experience (2010–2012 – Outpatient Setting) Presenting Complaint: A 58-year-old female, a housewife by occupation, presented to the physiotherapy outpatient department with chronic bilateral knee pain, more pronounced on the right. She had been experiencing discomfort and stiffness for several years, particularly aggravated by prolonged standing, stair climbing, and squatting. Her primary goal was to reduce pain and improve her ability to perform daily household activities independently. History and Background: The patient had been diagnosed with osteoarthritis (OA) of the knee, confirmed radiologically. She had no history of trauma or surgery but reported gradual worsening of symptoms over time. Despite the chronicity, she remained active and highly cooperative, expressing a strong desire to follow all prescribed therapy and home exercise regimens. Assessment: Initial clinical evaluation revealed the following: • Observation: - Mild genu varus deformity - Joint swelling and...

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...