Bowtech-Bowen Therapy

29/12/2022

Knee Pain ⚡️

02/08/2022

02/08/2022

29/05/2022

🔊 CALCIFIC TENDONITIS OF THE SHOULDER

🔔 INTRODUCTION

Calcific tendonitis of the shoulder happens when calcium deposits form on the tendons of your shoulder. The tissues around the deposit can become inflamed, causing a great deal of shoulder pain. This condition is fairly common. It most often affects people over the age of 40.

🔔 ANATOMY

Calcific tendonitis occurs in the tendons (tendons attach muscles to bones) of the rotator cuff. The rotator cuff is actually made up of several tendons that connect the muscles around your shoulder to the humerus (the larger bone of the upper arm).

Calcium deposits usually form on the tendon in the rotator cuff called the supraspinatus tendon.

There are two different types of calcific tendonitis of the shoulder: degenerative calcification and reactive calcification. The wear and tear of aging is the primary cause of degenerative calcification. As we age, blood flow to the tendons of the rotator cuff decreases. This makes the tendon weaker. Due to the wear and tear as we use our shoulder, the fibers of the tendons begin to fray and tear, just like a worn-out rope. Calcium deposits form in the damaged tendons as a part of the healing process.

Reactive calcification is different. Why it occurs is not clear. It doesn't seem to be related to degeneration, though it is more likely to cause shoulder pain than degenerative calcification.

No one knows what triggers the body to reabsorb the deposits. But once this occurs and the tissue begins to be remodeled, the pain usually decreases or goes away altogether.

🔔 SYMPTOMS

While the calcium is being deposited, you may feel only mild to moderate pain, or even no pain at all. For some unknown reason, calcific tendonitis becomes very painful when the deposits are being reabsorbed. The pain and stiffness of calcific tendonitis can cause you to lose motion in your shoulder. Lifting your arm may become painful. At its most severe, the pain may interfere with your sleep.

🔔 REHABILITATION

Even if you don't need surgery, you may need to follow a program of rehabilitation exercises. It is recommend that you work with a physical or occupational therapist for four to six weeks. Your therapist can create an individualized program of strengthening and stretching for your shoulder.

It is very important to strengthen the muscles of the rotator cuff, as these muscles help control the stability of the shoulder joint. Strengthening these muscles can actually decrease the pressure on the calcium deposits in the tendon. Your therapist can also evaluate your workstation or the way you use your body when you do your activities and suggest changes. Simple changes in the way you sit or stand can ease pain and help you avoid further problems.

15/05/2022

SCIATIC NERVE (SN)

The SN is a major nerve of the lower limb. It is a thick flat band, approximately 2cm wide – the largest nerve in the body.
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ANATOMICAL COURSE
The SN is derived from the lumbosacral plexus (Nerve roots: L4-S3). After its formation, it leaves the pelvis and enters the gluteal region via greater sciatic foramen. It emerges inferiorly to the piriformis muscle and descends in an inferolateral direction. As the nerve moves through the gluteal region, it crosses the posterior surface of the superior gemellus, obturator internus, inferior gemellus and quadratus femoris muscles. It then enters the posterior thigh by passing deep to the long head of the biceps femoris. Within the posterior thigh, the nerve gives rise to branches to the hamstring muscles and adductor magnus. When the sciatic nerve reaches the apex of the popliteal fossa, it terminates by bifurcating into the tibial and common fibular nerves. In approximately 12% of people they separate as they leave the pelvis, that’s why the SN can be described as 2 individual nerves bundled in the same connective tissue sheath.
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MOTOR FUNCTION
Although the SN passes through the gluteal region, it does not innervate any muscles there. However, the SN does directly innervate the muscles in the post. compartment of the thigh (biceps femoris, semimembranosus and semitendinosus) and the hamstring portion of the adductor magnus.
The SN also indirectly innervates several other muscles, via its two terminal branches:
TIBIAL NERVE - the muscles of the posterior leg (calf muscles), and some of the intrinsic muscles of the foot.
COMMON FIBULAR NERVE - the muscles of the anterior leg, lateral leg, and the remaining intrinsic foot muscles.
In total, the SN innervates the muscles of the posterior thigh, entire leg and entire foot.
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SENSORY FUNCTION
The SN does not have any direct cutaneous functions. It does provide indirect sensory innervation via its terminal branches:
TIBIAL NERVE - innervates the posterolateral and anterolateral sides of the leg, and the plantar surface of the foot.
COMMON FIBULAR NERVE - innervates the lat. leg and the dorsal surface of the foot.

06/05/2022

🔈 RELATIONSHIP OF SCIATIC NERVE TO PIRIFORMIS

(A) The sciatic nerve usually emerges from the greater sciatic foramen inferior to the piriformis.
(B) In 12.2% of 640 limbs studied by Dr. J. C. B. Grant, the sciatic nerve divided before exiting the greater sciatic foramen; the common fibular division (yellow) passed through the piriformis.
(C) In 0.5% of cases, the common fibular division passed superior to the muscles where it is especially vulnerable to injury during intragluteal injections.

06/04/2022

The body is amazing isn't it!

🔈 THE FIVE JOINTS OF THE SHOULDER

Right shoulder, anterior view. A total of five joints contribute to the wide range of arm motions at the shoulder joint. There are three true shoulder joints and two functional articulations:

✅ True joints:
1. Sternoclavicular joint
2. Acromioclavicular joint
3. Glenohumeral joint

✅ Functional articulations:

4. Subacromial space: a space lined with bursae (subacromial and subdeltoid bursae) that allows gliding between the acromion and the rotator cuff (muscular cuff of the glenohumeral joint, consisting of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles, which press the head of the humerus into the glenoid cavity.
5. Scapulothoracic joint: loose connective tissue between the subscapularis and serratus anterior muscles that allows gliding of the scapula on the chest wall.

Besides the true joints and functional articulations, the two ligamentous attachments between the clavicle and first rib (costoclavicular ligament) and between the clavicle and coracoid process (coracoclavicular ligament) contribute to the mobility of the upper limb. All of these structures together comprise a functional unit, and free mobility in all the joints is necessary to achieve a full range of motion.

This expansive mobility is gained at the cost of stability, however. Since the shoulder has a loose capsule and weak reinforcing ligaments, it must rely on the stabilizing effect of the rotator cuff tendons. As the upper limb changed in mammalian evolution from an organ of support to one of manipulation, the soft tissues and their pathology assumed increasing importance. As a result, a large percentage of shoulder disorders involve the soft tissues.

Would you like to find out more about human anatomy, physiology and pathology? Stay tuned and make sure you turned on notification on Healthy Street and see all posts and updates.

09/02/2022

Your body needs essential micronutrients (vitamins and minerals) and macronutrients (carbohydrates, protein, and fat) to function, however relying on getting them from the food you eat alone won't cut it.

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04/02/2022

This makes it easier for you to make sense of your own xrays and also what the radiographer says in his report.

ABDOMINAL X-RAY ANATOMY ⁣
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👨🏽‍💻This is something I found challenging as a student but by using a structured system it became more straightforward. I highly recommend using a system, the system I use is the mnemonic AC POP:⁣
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AIR⁣
▫️Track every lucency you can see on the X-ray. Does every focus of gas look like it is in the bowel? If not there could be a perforation. Triangles of gas are bad news and commonly reflect extraluminal gas⁣
▫️Is there a Rigler sign? Ie can you see both the inner and outer bowel wall - this can be tricky in more subtle cases ⁣
▫️Is the bowel dilated? Small bowel can measure up to 3 cm, large bowel 5 cm and caecum up to 9 cm. If dilated we need to decide whether this represents a complete mechanical obstruction - a lack of gas within the re**um can help although the presence of re**al gas does not exclude a significant obstruction⁣
▫️Dilated small bowel tends to be central with valvulae conniventes traversing the whole bowel wall. Dilated large bowel peripheral with haustra that don’t traverse the whole wall⁣
▫️Is there pneumatosis? This is a mottled lucency which represents gas in the bowel wall and commonly a sign of ischaemia - if present check the liver for branching peripheral lucency representing portal venous gas ⁣
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CALCIFICATION⁣
Look for abnormal calcification in the following places:⁣
▫️Pancreas in chronic pancreatitis⁣
▫️Appendicolith in RIF⁣
▫️Gallstones/kidney stones⁣
▫️Outline of a calcified AAA⁣
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PSOAS⁣
▫️Outline the psoas muscles. These can be expanded in abscess or haematoma. Gas outlining the psoas can be a sign of a perforation affecting a retroperitoneal structure such as ascending or descending colon⁣
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ORGANOMEGALY AND SOFT TISSUE⁣
▫️Try and outline an enlarged liver/spleen or kidney (as in polycystic kidney disease)⁣
▫️Look for effaced bowel due to a soft tissue mass⁣
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PELVIS AND SPINE ⁣
▫️Don’t miss a fracture!⁣
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———-⁣
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👨🏽‍💻Try and look at as many AXRs as possible and use a system and I promise that you will become more confident once you know you have looked for all of the major pathology⁣
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🔻

05/10/2021

These seem to help all types of back pain

Share these stretches with those suffering from back pain. Find more low back pain stretches here: https://bit.ly/35BtziP