Wednesday, 14 June 2017

Treatment for Adductor Muscle Strain in Malaysia


Physiotherapy and chiropractic treatment can be commenced as soon as possible when an acute adductor strain in the hip is present. Patients normally present with inner thigh pain or groin pain near the inferior pubic bone. The strained adductor muscle can be very tender upon palpation and stretching of the adductor muscle can reproduce the pain. The initial treatment approach is to reduce swelling and bleeding at the injured site. Therapeutic modalities that help to promote soft tissue healing can be used.

Active pain-free exercises and gradual strengthening exercises for the adductor muscle can be commenced with care after the first 48 hours of injury. Functional strengthening that involves more aggressive movements such as stationary bike, pool running, jogging or swimming can be part of the treatment in the later stage. Once the full passive and active range of motion of the injured hip returns to normal and with full strength, the athlete can return to progressive sport-specific training that involves sudden and rapid change of direction.

Exercises such as running in a straight line or figure of eight and kicking should be avoided in the early stages of rehabilitation. Early return to these exercises without sufficient rehabilitation may predispose the athlete to recurrent adductor muscle strain. The treatment for adductor muscle strain should include management of the associated low back pain or pelvic imbalance at the same time in order to prevent chronic recurrent pelvic and hip injuries. 

Thursday, 8 June 2017

Adductor Muscle Strain in Malaysian Athletes


Adductor muscle strains are very common among athletes whose running involved sudden changes of direction. The location of the pain is usually very easy to identify as the pain usually present at the belly of the adductor longus at the inner thigh or near the origin on the inferior ramus. The pain normally will start immediately after the injury. Physiotherapy and chiropractic care can help to increase the healing rate and reduce the time required to get back to sports. Stretching of the adductor muscle with passive hip abduction can cause the pain. Resisted adduction will cause active contraction of the muscle can cause pain at the injured site too.


PRICE regimen for acute injury should be initiated within 48 hours after the injury to reduce the swelling and bleeding at the injured site. PRICE regimen includes protection, relative rest, ice, compression and elevation. Early stretching of the adductor muscle is not recommended for treating acute muscle strain as this may cause chronic tendinopathy of the adductors in the future. Progressive strengthening exercises such as pain-free range of motion (adduction and abduction) can be commenced after the first 48 hours if there is no other re-injury of the adductor muscle. Resisted adduction/flexion of the hip with a resistance tube or light weight can be included if active abduction and adduction are not causing any pain. Stabilising exercises such as pulleys with other leg and one leg squat is recommended to strengthen the core muscles and the adductor muscles at the same time. 

Friday, 2 June 2017

Hip and Groin Pain in Athletes


Sudden onset of hip pain is quite common in athletes who are involved in sports that require a lot of twisting, turning and kicking. Athletes who are actively involved in soccer and Australian football are at a higher risk of sudden hip and groin pain due to musculoskeletal injuries. The presenting symptoms may vary according to the structures that are damaged. Adductor muscle strain is a very common cause of inner thigh pain. Injury to the hip joint, such as labral or chondral tear, can lead to severe hip and groin pain. Injury of the muscles and bursae associated with the hip joint can co-exist with a hip joint injury.

The location of the pain is the most useful sign to localise the area abnormality. Differential diagnosis can be made based on the location of the pain. The adductor muscle, iliopsoas and rectus femoris are the more commonly strained muscles. A strain of the above-mentioned muscles can cause pain at the inner thigh or groin region.


There are some more severe causes of hip and groin pain that should not be missed by the health care practitioners. Intra-abdominal abnormality such as appendicitis or urinary tract abnormality can sometimes refer pain to the inner thigh and hip region. Rheumatological disorders such as ankylosing spondylitis can cause hip and groin pain as there are extensive tightness in the hip flexors. 

Saturday, 27 May 2017

Prolonged Sitting is Killing the Lower Back in Malaysia

Sitting over a prolonged period of time is one of the most important factors that aggravate the lower back condition. Most of the Malaysians are adopting the sedentary lifestyle which involves a lot of sitting. Most people spend about 75% of the time in a day in a seated position. Malaysians are trained to sit since our younger age. We spend at least 15 years sitting in the classroom for studies if not more. The lectures may last from 30 minutes to 2 hours for each subject and school kids spend 6 to 8 hours in the school almost every day.

The working environment for adults is actually creating more issues that are affecting the health of our spine. Long hours of desk work or computer work, prolonged sitting for meetings and prolonged driving are causing continuous damage to the spine. Repeated damage to the spinal disc over a prolonged period of time can cause severe spinal problems and severe pain in the lower back or lower limbs.


The weight of our body transmitted to the spinal disc in the lower back will increase tremendously in a seated position when compared to standing or lying down. This is causing a lot of stress and continuous damage on the lowest segments in the lumbar spine. If this repeated damage occurs every day over the years, the spinal discs are unable to recover properly. This can lead to serious spinal disc problems that can present as lower back pain and pain and/or paraesthesia that radiates into the lower limbs.

Monday, 22 May 2017

Jaw Exercises for TMJ Pain in Malaysia

Place one to two fingers on both sides of your jaw. Apply a gentle pressure against the jaw while try to open the mouth slowly without letting it clicks. Repeat the exercise again if the jaw clicks in the middle of the procedure. Repeat this exercise without clicking of the jaw for 10 times. This exercise allows a better control of your jaw movements and the gentle pressure applied helps to correct the jaw misalignment.

Another exercise that can increase the mobility of the jaw while allowing better rotation of the jaw. Place the tongue against the roof of your mouth and slowly open your mouth as wide as you can. Hold for 2 seconds while breathing in slowly. However, the tongue should remain in contact with the roof of your mouth throughout the whole exercise. Repeat the exercise for 10 times.

Strengthening exercises for the jaw muscles are needed to make sure the temporomandibular joint has the stability and mobility to perform all the movements required. Isometric strengthening exercises can strengthen the jaw muscles while relaxing the muscles on the opposite side. Make a fist and place it under your chin. Open your mouth slowly while the fist is applying a gentle upwards force under the chin. This upwards force should resist the opening of the mouth. Hold the pressure for 10 seconds. Repeat this exercise for 10 times.


The next exercise is similar to the one described above. Place the left hand on the left side of your face. Move your jaw to the left side against the left hand while applying a gentle force to the right with your left hand. Hold for 10 seconds and repeat the procedure on the right side. 

Wednesday, 17 May 2017

Exercises for Jaw Pain or Temporomandibular Joint (TMJ) Pain in Malaysia

If you are suffering from severe jaw pain and have difficulty chewing or talking, health care practitioner such as physiotherapist or chiropractor can help you to relieve the pain. Jaw pain in Malaysia commonly consists of a restricted range of motion in TMJ, muscle tightness and pain around the jaw, upper neck pain, and headache. There are a few exercises that can improve the jaw pain while getting more mobility in the jaw.

You can apply heat packs on both sides of the jaw for 10 minutes before you start the exercises. This helps to increase the blood circulation to the jaw muscles and can further relax a tight muscle. Then you can try to massage the jaw on both sides of your face gently with two fingers in a circular motion. Try to be as gentle as possible within your comfortable level as this may cause you more pain if you overdo it.


Gently and slowly open your mouth and place one finger in between your front teeth. Hold for 5 seconds and repeat the exercise for 5 times. Next, try to place a knuckle in between your front teeth. Hold for 5 seconds and repeat the exercise for 5 times. Then repeat the same procedure with 2 fingers, 2 knuckles or 3 fingers gradually. This can help to stretch the jaw and improve the range of motion of the jaw. A jaw with a normal range of motion can easily accommodate 3 fingers in between the front teeth with no pain and discomfort. 

Friday, 12 May 2017

Rehabilitation Program for Musculoskeletal Injuries with Spinercise in Malaysia


The conservative management of a musculoskeletal injury should include a multi-modal treatment program that may include chiropractic care and physiotherapy to address different aspects of the injury. The initial treatment approach involves pain management and preventing further damage to the injured structures and tissues. This part of the treatment program may give the patient a pain-free period while able to return to activities of daily living. However, the rehabilitation exercises in the later part of the treatment program are needed so that the patient is able to return more aggressive sports injury and to prevent reoccurrence of the same condition.

Rehabilitation is necessary after musculoskeletal injuries and post-surgery. Rehabilitation allows a patient or athlete to return to aggressive activities of daily living or sports with full function in the shortest possible time. If rehabilitation after a musculoskeletal injury is not done properly, the damaged site may be re-injured again easily. Other than that, the joints or soft tissues adjacent to the damaged site are at a higher risk of injury as the patient may compensate with other parts of the body to perform the activities. An athlete may not be performing at his or her best state or even may not be able to perform at his or hers pre-injury standard.


Spinercise is a device designed specifically for musculoskeletal rehabilitation, especially for lower back and knee injuries. Spinercise helps to strengthen the specific muscles required to provide stability to the joints.