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. 

Sunday, 7 May 2017

Less Common Causes of Cervical Myelopathy in Malaysia

Compression of the spinal cord in the cervical spine that results in motor and sensory dysfunction affecting the upper extremities is known as cervical myelopathy. Sometimes a severe compression of the spinal cord at the cervical region can also cause motor and sensory deficient in the lower extremities and disrupt the bowel and bladder function. Degenerative changes in the cervical spine can cause severe cervical myelopathy. There are a few causes that lead to compression of the spinal cord in the cervical region. Narrowing of the spinal canal where the spinal cord is located due to degenerative processes or congenital causes can cause cervical myelopathy. Ossification of the posterior longitudinal ligament or calcification of the ligamentum flavum can result in spinal cord compression. Posterior bony osteophytes arising from the vertebral bodies and uncinated processes can cause narrowing of the spinal canal. Disc herniation or slip disc in the neck is another common cause for cervical myelopathy.


Degenerative changes of the lower cervical spine are more common and can cause more significant signs and symptoms in the affected region. C5/C6 and C4/C5 are the two most common levels affected by degenerative processes in the cervical spine. Spondylosis of the facet joint or hypertrophy of the facet joints can be a cause of spinal canal stenosis and cervical myelopathy. However, the presence of spondylosis or hypertrophy of the facet joints only rarely causes spinal cord compression. There may be other factors that are causing spinal cord compression at the same time. 

Tuesday, 2 May 2017

Knee Pain after Sports Activity in Malaysia


Acute knee pain is very common during sports, especially football, basketball, netball and alpine skiing. These activities involve a lot of twisting around the knee joint and sudden changes of direction. These movements will put additional stress on the knee joint if there is insufficient muscle strength to support the knee. Acute knee injuries can be disastrous for athletes as they can lead to disability, time off sport and recurrent injuries.

The knee actually involves two different joints that are located very closely to each other. The tibiofemoral joint consists of the thigh bone (femur) and the leg bone (tibia).  This tibiofemoral joint is commonly referred as the knee joint. Medial and lateral collateral ligaments, anterior and posterior cruciate ligaments and the meniscus that is associated with the tibiofemoral joint are the major stabiliser of this joint. The patellofemoral joint consists of the knee cap (patellar) and the thigh bone (femur). The stability of the joint comes from the medial reticulum and the patellar tendon/ligament.


Each and every ligament associated with the knee and the meniscus play different role to provide stability to the joint. Therefore understanding the mechanism of injury during history taking can provide crucial information to find out the most likely injured structures in the knee. However, there will be damage to multiple associated structures when there is ligamentous damage in the knee. A holistic treatment
approach for knee pain that involves ligamentous damage should also address the other associated structures.