زندگی بدون درد ----- Pain Free Life

ارائه راهکارهای مفید در زمینه فیزیوتراپی

زندگی بدون درد ----- Pain Free Life

ارائه راهکارهای مفید در زمینه فیزیوتراپی

Trigger Point Therapy - Text Neck

There's no getting away from it ..... we are all using smart phones and tablets to keep us connected more than ever before

So-called ‘text neck’, is becoming a common description for a range of painful musculoskeletal injuries , and something that is set to grow at a phenomenal rate as a result of our ever increasing use of phones and tablets

A recent report by Facebook showed that close to 80% of people aged between 18 and 44 have their mobile phones with them almost all the time – meaning that they only spend two hours each day (apart from when they are asleep!) without a phone or tablet device in their hands

What do the therapists say

These type of injuries are nothing new. It’s not just phones and tablets that make us look down. Many of us also look down to read or for every day tasks involved in our work activities. The issue that we're facing here is that the use of our phones, especially for constant checking-in for social media, means that we're suddenly looking down more than ever before

“In the past three years we've seen a dramatic rise in the number of young children being brought into our clinics with severe neck and shoulder pain. This is really something new. 10 years ago, children under the age of 14 accounted for a tiny proportion of our patients. This number has risen exponentially over the last 2-3 years

"Text neck" is particularly concerning when it affects young people as growing children are likely to be at risk of permanent damage that could lead to lifelong problems with their necks,

backs and shoulders

Other studies have also suggested that "text neck" may even lead to the early onset of arthritis in the neck

What are the symptoms and common signs of "text neck

"Text neck" typically causes chronic, nagging pain in the upper back and neck, severe upper back muscle spasms, as well as shoulder pain and tightness. In some cases young children suffer painful shoulder muscle spasms and pain radiating down the arms and into the hands

So what to do about "text neck

Just about all healthcare professionals agree that prevention is the key. Simply by controlling and reducing the amount of time that we look down at our phones and tablets, will undoubtedly reduce the incidence of "text neck

Wherever possible we should be trying to hold our phones at eye level to prevent us bending our heads forward, just as we have learned to do with computer screens and laptops

We should also be re-training ourselves to take regular breaks from our phones and tablets. The concern however, is that whilst we may be able to get this message through to adults, it's a seemingly impossible task to get children and young people to understand the dangers without a massive educational effort

Trigger Points and "text neck"

There is an undeniable connection between trigger points and "text neck". These are all the same trigger point issues that we've been seeing in postural issues for decades. The major difference here, is that these trigger points are forming in young people which is definitely a modern phenomena

The good news is that treating these trigger points, especially in the young, can have a fast and profound effect on the painful symptoms. Taking your child to see a therapist for treatment is also an opportunity for the child to receive some education from the therapist visit, and some sound advice on changing habits

Remember of course, that "text neck" is not restricted to young people only. If you work your way through your 20's, 30's, and 40's continually looking down at your phone to check your email and social media pages, you will undoubtedly be increasing the risk of developing some nasty trigger points in your postural muscles. left untreated, these may increase your risk of longer term and more serious injury further down the road

 mindfulness help people manage their diabetes

Some people with diabetes can find it difficult living with the condition and having to carry out complex tasks multiple times per day to regulate their blood

About one third of adults with diabetes experience significant levels of anxiety and depression and this can make it even more difficult for them to manage effectively their condition

Managing Type 1 diabetes

People with Type 1 diabetes have to continually balance three key factors of their life: carbohydrate in food drives blood glucose levels up, whereas injecting insulin and engaging in activity lowers glucose levels. Different foods have dissimilar amounts of glucose and release it at varying rates. Some insulins work in different ways, and some activities burn up glucose at quicker rates than others. It's an endless, complex balancing act

"As well as trying their best to manage their condition, like everyone else, people with Type 1 diabetes have to deal with the usual ups and downs of life. It's not surprising that some people with diabetes can become anxious and depressed

"Both these conditions have characteristics that make managing diabetes even harder. For example, people who are anxious have high levels of stress hormones such as adrenalin and cortisol, and these cause glucose to be released into the bloodstream, driving up blood glucose levels. Also, depression is characterised by fatigue and low motivation, which can make it tricky to devote the time and energy required to manage complex long-term conditions like diabetes

"Anxiety and depression are characterised by certain styles of thinking, namely worry and rumination. Worry is a style of thinking that focuses on imaginary future catastrophes that rarely, if ever, actually occur and is often accompanied by planning what to do should they happen. Rumination on the other hand is often focused on the past, and concerns continual reflections about our imagined failings and how, because of these, life is unlikely to improve. Psychologists and others believe that these unhelpful ways of thinking maintain anxiety and depression"

What is Mindfulness and how could it help

"It is best to think of mindfulness as a skill. "It is a way of helping people be better able to focus on the 'here and now' of their lives, and disengage with unhelpful ways of thinking, such as worry and rumination

"If you change the way people think, then you change the way they feel. We definitely know that anxiety and depression can be significant barriers to effectively managing diabetes, and by alleviating these we can give people the opportunity to invest more time and energy into looking after themselves if they want to do that

May 20, 2016 by Euan Wemyss

,ترجمه به فارسی

"آگاه بودن" به افراد کمک میکند تا بهتردیابتشان را اداره بکنند.برخی از افراد دیابتیک، با این موضوع که در طی روز باید چندین بار عملیاتی جهت کاستن میزان قند خونشان انجام بدهند، مشکل پیدا میکنند.تقریبا یک سوم از افراد بالغ دیابتیک، سطوحی از اضطراب و افسردگی را در زندگی خود تجربه میکنند که خود همین مسئله ، کنترل وضعیتشان را سختتر میکند.

مدیریت دیبت نوع اول:
افراد دیابتیک از نوع اول ، بطور مداوم با سه چالش روبرو هستند. کربوهیدرات موجود در مواد غذایی، گلوکز خون را بالا میبرد، درحالیکه تزریق انسولین و یا انجام فعالیتهای مختلف سطح گلوکز خون را کاهش میدهد. میزان گلوکزموجودآزاد شده از غذاهای مختلف یکسان نیست. عمل انسولینها همیشه مشابه هم نیست.برخی از فعالیتها نسبت به بقیه گلوکز بیشتری مصرف میکنندو این مسائل همیشه وجود دارند و ایجاد بالانس رو پیچیده میکنند.
مثل همه افراد دیگر، دیابتیکهای نوع اول نیز با مسائل پمعمول بالا پایین زندگی درگیر هستندوخیلی تعجب برانگیز نیست که این بیماران دچار هیجان و افسردگی مکرر بشوند.هردو حالت اضطراب و افسردگی، خصوصیاتی دارند که اداره این بیماری را سختتر از قبل میکند.برای مثال افراد هیجانی ، سطح بالایی از هورمون استرس مثل آدرنالین و کورتیزول را در خونشان دارند و این مسئله بنوبه خود باعث واردشدن مقادیر زیادی از گلوکز به خونشان شده و سطح گلوکز خون را بالا میبرد.
اگرچه افسردگی با خستگی و کاهش سطح فعالیت همراه هست و میتواند زمان و انرژی جهت رسیدگی به بیماریهای مزمن را به شخص بدهد، اماهردو این حالتها یعنی اضطراب و افسردگی هردودر ارتباط با نوع طرز تفکر شخص هستندکه بنام نگرانی و نشخوار افکار شناخته میشوند.
نگران بودن نوع خاصی از طرز تفکر هست که باعث میشود شخص روی آنچه که هنوز اتفاق نیافتاده و احتمال وقوع آن ناچیز هست ، تمرکز کند و حتی اگر احتمال وقوع آنهم باشددائما به راه حل جلوگیری از آن واقعه فکر بکند.
از طرف دیگر، نشخوار فکری بیشترروی گذشته تمرکز میکندو دائما نگران عکس العمل اتفاقات بدی هست که در گذشته برای شخص اتفاق افتاده است. هردو این حالتها ، زندگی را برای شخص ناخوشایند میسازند.سایکولوژیستها معتقدند که این روشهای فکر کردن، اضطراب و افسردگی را شدت میبخشد.
آگاهی چیست و چه کمکی میتواند بکند؟
بهتر است که فکر کردن به روش آگاهانه را یک مهارت به حساب بیاوریم. این نوع فکر کردن باعث میشود که مردم روی " همین حالا و همین جا" از زندگی خودشان تمرکز بکنندواز نگرانی و اضطراب دور باشند.
اگر شما بتوانید طرز فکر کردن مردم را عوض کنید قادر خواهید بود که نوع احساس آنهارا نیز تغییر دهید.یقینا همه ما میدانیم که اضطراب و نگرانی سدهای محکمی در برابر درمان دیابت هستندو با کاستن این دو میتوانیم این موقعیت رو برای بیماران بوجود بیاوریم که همه زمان و انرژیشان را برای مواظبت از خودشان صرف بکنند،البته اگر خودشان بخواهند.

  • Most common cause of foot pain in athletes. Occurs due to over use and stress on plantar fascia, which can result in tissue fatigue & micro tearing

  • Causes plantar fasciitis
    Overuse, due to over training, poor technique, running on hard surfaces or prolonged standing, dancing or running
    Predisposing factors
    Poor biomechanics – excessive pronation, supination of the subtalar joint or excessive external rotation of the hip joint while walking
    Short & tight gastrocnemius & soleus muscles, which predispose foot to pronation
    Improper footwear that is worn out, too flexible, stiff or does not provide adequate arch support.
    Weight gain. Including pregnancy, which stresses the plantar fasciaSymptom picture plantar fasciitis
    Can be unilateral or bilateral
    Symptoms range from mild to severe. Pain has initial slow onset, with no history of injury or trauma
    Tension is placed on plantar fascia with repeated use & overtime is unable to repair itself & is partially torn away from calcaneus. After an initial period of acute inflammation, chronic inflammation sets in, accompanied by adhesions & fibrosing of the fascia. The plantar fascia thickens with chronic inflammation. Healing is slow as poorly vascularised
    Pain occurs with the first few steps after non weight bearing (getting out of bed in the morning). Symptoms are worse during pre swing phase of gait cycle an during stair climbing. Pain lessen with activity (30-45mins) then intensifies 2-3 hrs later with continued activity. Usually relieved by rest
    Pain Is usually located on antero-inferior surface of calcaneus on weight bearing. It may also extend along medial border of plantar fascia toeards meta tarsal heads
    Pes planus, cavus & Achilles tendonitis are often present. With repeated stress a bone spur may develop on medial aspect of calcaneusTreatment plantar fasciitis
    Hydrotherapy is cold to affected area
    Reduce edema if present
    Reduce sympathetic nervous system firing & pain
    Treat compensating structures
    Hydrotherapy deep moist heat prior to stretch. Contrast after, increase local circulation
    Reduce sympathetic nervous system firing & pain
    Treat compensating structures
    Cross fibre frictions used within clients pain tolerance
    Mobilize hypomobile ankle joints

Chronic pain is a condition that occurs when the brain concludes there is a threat to a person's well-being based on the many signals it receives from the body. This condition can and often does occur independently of any actual body tissue damage (due to injury or illness), and beyond normal tissue healing time.

It is estimated that 116 million Americans have chronic pain each year. The cost in the United States is $560–$635 billion annually for medical treatment, lost work time, and lost wages.

The causes of chronic pain vary widely. While any condition can lead to chronic pain, there are certain medical conditions more likely to cause chronic pain. These include:

  • Trauma/injury
  • Diabetes Mellitus
  • Fibromyalgia
  • Limb amputation
  • Reflex Sympathetic Dystrophy


Background History taking is an important component of patient/client management. Assessment of student history-taking competency can be achieved via a standardized tool. The ECHOWS tool has been shown to be valid with modest intrarater reliability in a previous study but did not demonstrate sufficient power to definitively prove its stability.

Objective The purposes of this study were: (1) to assess the reliability of the ECHOWS tool for student assessment of patient interviewing skills and (2) to determine whether the tool discerns between novice and experienced skill levels.

Design A reliability and construct validity assessment was conducted.

Methods Three faculty members from the United States and Australia scored videotaped histories from standardized patients taken by students and experienced clinicians from each of these countries. The tapes were scored twice, 3 to 6 weeks apart. Reliability was assessed using interclass correlation coefficients (ICCs) and repeated measures. Analysis of variance models assessed the ability of the tool to discern between novice and experienced skill levels.

Results The ECHOWS tool showed excellent intrarater reliability (ICC [3,1]=.74–.89) and good interrater reliability (ICC [2,1]=.55) as a whole. The summary of performance (S) section showed poor interrater reliability (ICC [2,1]=.27). There was no statistical difference in performance on the tool between novice and experienced clinicians.

Limitations A possible ceiling effect may occur when standardized patients are not coached to provide complex and obtuse responses to interviewer questions. Variation in familiarity with the ECHOWS tool and in use of the online training may have influenced scoring of the S section.

Conclusion The ECHOWS tool demonstrates excellent intrarater reliability and moderate interrater reliability. Sufficient training with the tool prior to student assessment is recommended. The S section must evolve in order to provide a more discerning measure of interviewing skills.