Physical therapy for COVID 19 – A complete guide to managing COVID 19 patients with Rehabilitation

By Bijal Shah

Corona Virus has made its way globally. At this point, we all are aware of COVID 19 and the majority of symptoms caused by COVID 19.  While every nation around the globe is fighting hard to design some method that can either manage symptoms or viruses, exercise remains one important factor. This includes various options like vaccines, medicines, antibodies, blood transfusions, etc. In this article, I am going to share some proven exercise strategies, and core outcome measures for patients with COVID 19. 

Physical Therapy for COVID 19 patient

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Pain in Pinky finger : Is this the Ulnar Tunnel Syndrome?

By Bijal Shah

What is Ulnar Tunnel syndrome?

Ulnar tunnel syndrome is a compression of the ulnar nerve at the wrist. The compression of this major nerve at the wrist is a relatively uncommon condition. The nerve usually is compressed at the elbow, in the cubital tunnel leading to a condition called cubital tunnel syndrome.

Anatomy of Ulnar Tunnel:

The ulnar nerve passes through Guyon’s canal in the wrist. From here, the nerve innervates to the digits. This is the most distal end of the nerve. The ulnar nerve becomes vulnerable to compression while traveling through this narrow tunnel.

It is important to remember that clinically, the cubital tunnel is most frequently seen ulnar nerve compression. The compression of the Ulnar nerve at Guyon’s canal is a relatively uncommon condition.

Causes of Ulnar Tunnel Syndrome:

  • A benign tumor is the most important cause of ulnar tunnel syndrome.
  • A ganglion cyst in the wrist can also compress the nerve at the wrist area.
  • Repetitive trauma and chronic pressure to the area can also lead to compression of the nerve.
  • Ulnar artery Thrombosis or aneurysm.
  • Fracture of the hook of Hamate bone
  • Repetitive trauma of the hypothenar muscle is a condition called Hypothenar Hammer Syndrome. This condition also leads to ulnar nerve compression in Guyon’s canal.

Clinical presentation of Ulnar Nerve Compression:

  • A person reports with an onset of a gradual weakness and numbness of the little finger and partial ring finger. This is the area of the hand that innervated by the Ulnar nerve.
  • A patient may or may not complain of pain.
  • The patient also complains of difficulty with gripping, pinching, typing or playing a musical instrument. Opening a jar, holding objects as well as tasks that require finger coordination becomes difficult to perform.

Ulnar Tunnel Syndrome

Diagnosis of Ulnar Tunnel syndrome:

Physical examination and clinical presentation are crucial in the case of ulnar tunnel syndrome. Additionally, a physician may ask for a nerve conduction velocity test to identify the function of the nerve. In some cases, a patient needs to get an MRI or CT.

Treatment of Ulnar Tunnel:

Treatment of the ulnar tunnel syndrome is to find the root cause that compresses the nerve and attempt to remove it. Anti-inflammatory and analgesic medications help to relieve the symptoms temporarily.

Ergonomics are crucial especially if the nerve is getting compressed due to a faulty position or improper biomechanics. For example, typing or playing musical instruments with improper wrist support can compress the nerve. Correcting the biomechanics not only relieve the symptoms but also prevent the recurrence.

There are a variety of the braces available in the market that can help reduce the symptoms as well as prevent further compression. These braces help maintain the correct ergonomics of the wrist and digits.

Exercises for Ulnar nerve compression:

Nerve gliding exercises help to maintain normal nerve course and prevent any physical symptoms. Also, wrist and finger strengthening and stretching exercises help to perform daily activities in a pain-free range.

I describe exercises specific to the ulnar nerve in the article Cubital tunnel syndrome.

Additionally, you can find strengthening and stretching exercises for wrist and fingers in my previous article exercises for carpal tunnel syndrome.   


Medial Epicondylitis: Is It Golfer’s elbow or Baseball elbow?

By Bijal Shah

What is Medial Epicondylitis?

Medial epicondylitis is a pain and inflammation on the inside of the elbow. A person complains of pain from the elbow down to the wrist on the inside (medial) of the elbow. Repetitive forceful movements of the wrist usually cause the medial epicondylitis. These movements lead to micro-tears or inflammation of the tendons of the forearm muscles resulting in pain at the medial epicondyle.

Medial Epicondylitis

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Cubital Tunnel Syndrome

By Bijal Shah

What is Cubital Tunnel Syndrome:

Cubital Tunnel Syndrome is a compression of the ulnar nerve at the level of the elbow. This is the most common place for ulnar nerve entrapment. The nerve gets compressed behind the inside part of the elbow, causing numbness and tingling in the little and ring fingers and hand.

The Ulnar nerve passes from the neck and runs down to the arm. At the elbow, it travels through the tunnel of tissue called “cubital tunnel”. Here, the nerve runs behind the medial epicondyle -a part of the humerus bone. The nerve is very superficial here and can get irritated just by pressing very hard at the site. Continue reading “Cubital Tunnel Syndrome”

Three Biceps strengthening exercises to improve range of motion.

By Bijal Shah

Biceps is an important muscle in the human body. We use this muscle to perform many activities of daily living. In addition, biceps holds its crucial place cosmetically. It is the muscle that gives the look of “masculine build”. This is created by biceps strengthening to create hypertrophy of the muscle. And therefore, it may not be the largest or the biggest muscle but surely it is one of the most important muscles of the human body. Continue reading “Three Biceps strengthening exercises to improve range of motion.”

Three Ways to perform Triceps Stretch

By Bijal Shah

Triceps stretch is an important stretching exercise to maintain the elbow range of motion as well as the flexibility of the triceps muscles. There are a few different ways to stretch this muscle.

Triceps is a muscle that makes up the back of your arm. This muscle straightens the elbow. When you are doing push-ups, planks, or just standing from a sitting position with pushing your arms, you are using this important muscle of your arm. Many times, people are so concentrating on biceps and that “v” look of arms, while building their muscles, they totally forgot this key muscle on the back of the arm. This causes muscle imbalances and invites a lot of pain as well as injury. Along with the strengthening of the muscle, stretching is also crucial. Continue reading “Three Ways to perform Triceps Stretch”

Quadriceps Stretch : How to stretch this key muscle

By Bijal Shah

Quadriceps stretch is easy yet crucial for many reasons. Arthritis, knee pain, reduces the range of motion, or just simple workout session, all require a functional stretch of this muscle.

Stretching is an important part of any workouts. You can perform this during the cool-down period to prevent or minimize the DOMS, or you can incorporate the stretching exercise in your work out itself. For Example, While performing yoga, you are performing stretching, strengthening, and balancing exercises at the same time. Continue reading “Quadriceps Stretch : How to stretch this key muscle”

Getting off the Floor – without hurting your knees.

By Bijal Shah

It is difficult to sit on the floor. It is even harder if you lose your balance and end up on the floor.. Or you happen to take some yoga classes or Jazz classes for entertainment. While practicing, you find yourself doing some cool moves on the floor. All that is fine, till you can do it or you are not hurting yourself. But the question comes, how to get up from this position, how to come back to an upright position, safely, without pain, without hurting joints??

This question is important particularly to people who have bad knees or hips, have arthritis, or have painful joints. The geriatric population also has difficulty getting off the floor due to age-related changes in flexibility and bony structures. Continue reading “Getting off the Floor – without hurting your knees.”

Spinal Stenosis

By Bijal Shah

What is Spinal Stenosis:

Spinal stenosis is the narrowing of the spinal canal. It is more common in older populations, mainly after 50 years of age. As the degeneration takes place in the vertebrae, the spinal canal narrows down. As a result, it may push the spinal cord inside the spinal canal. Spinal Stenosis usually occurs in the cervical and lumbar area. Patients may or may not show symptoms or restrictions in their daily routine. The presence, as well as the severity of signs and symptoms, depends on the severity of the condition and varies from person to person. Continue reading “Spinal Stenosis”