Dr. BL Prakash | Senior Consultant Orthopaedic & Joint Replacement Surgeon | Tuesday between 9.00 am & 1.00 pm at BOSH Hospital | Call for Appointment
Physiotherapy | BOSH | Bangalore

We work with you to help restore your movement and function to as near normal as possible when this has been affected by injury, illness or by developmental or other disability.  Physiotherapy is used to improve a patient's quality of life through examination, diagnosis, prognosis, and physical intervention. Physiotherapists at BOSH offer treatment to individuals of all ages to reduce the risk of injury in the future and maintain your overall health and well-being.

Physiotherapy can involve a number of different treatment and preventative approaches, depending on the specific problems you are experiencing. The physiotherapy treatment has application in all disciplines of modern medicine- Orthopedics, Neurology, Cardio thoracic, Oncology, Obstetrics and Gynecology, Gerontology, Pediatrics and Neonatology, General Surgery, Plastic Surgery and Cosmetic Surgery, Diabetology, Rheumatology, Sports Medicine, etc. The team at BOSH will provide with pre-operative and post-operative physiotherapeutic intervention to out-patient and in-patients. Individualized treatment plan tailored to a patient's need and his lifestyle is our goal.

Hands-on Physiotherapy Techniques

Joint mobilisation (gentle gliding) techniques: Joint mobilisation techniques focus on attaining a normal range of pain-free joint motion. Nearly every restriction in movement can be regained by a specific joint technique. And the good news is joint mobilisation techniques have certainly improved over the years with very gentle and pain-free options available. The old crunch and munch, click and pop techniques are thankfully a thing of the past! Plus, it is also very important not to overstretch a joint to create hypermobility or instability. Hypermobile joints require different treatment techniques to a stiff joint. BOSH provides the best advice and an individual assessment.

Physiotherapy Exercises: Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises have been scientifically proven to be one of the most effective ways that you can solve or prevent pain and injury.

Your physiotherapist is an expert in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.

Common Examples of Joint Mobilisation & Pain Relief Techniques may include

  • medical Gentle Joint Mobilisations: joint mobilization is performed to improve mobility in areas that currently have a limited range of motion due to any type of strain, stiffness, tightness, injury, paralysis or chronic pain. The most common joint mobilization is performed on the neck, when its rotated to its full range of motion and then back in sudden thrusts. Joint mobilization strokes consist of basic and advanced mobilizations, thrusts, as well as traction and gliding mobilizations. After the mobilization portion of the therapy is complete, complimentary treatments - such as certain stretching and strengthening exercises - are sometimes recommended as a preventative measure.
  • medicalMobility Exercises: Help to improve strength and power
  • medicalMinimal Energy Techniques: Muscle Energy Technique (MET) is a manual therapy technique which uses a muscle’s own energy in the form of gentle isometric contractions to relax the muscles via autogenic or reciprocal inhibition, and lengthen the muscle.
  • medicalJoint Manipulation::Joint manipulation is a hands-on movement technique applied to a stiff spinal or peripheral joint. If you’re suffering from stiff joints, joint pain or are feeling generally ‘tight’ and in the need of ‘loosening’, then our joint manipulation might well be the answer you’re looking for. A hands-on physiotherapy treatment, it involves applying pressure through the joint alongside advanced joint movements that often give the sensation of a ‘click’. A great way to relieve pain, reduce joint stiffness and improve posture, joint manipulation also facilitates an increased range of movement, function and body efficiency in sports people and for every day life.
  • medicalTraction / Distraction Techniques: used to treat many conditions of the lumbar spine. It is a non-surgical technique aimed at increasing spinal motion and resolving disc bulges and disc herniations. The treatment is excellent as a safe, gentle, non-force procedure and works well to take pressure off the spinal nerves that may be injured or dysfunctional.
  • medicalMuscle stretching: Basic muscle strength is required for joint control during your simple everyday tasks. These tasks can include static activities (such as sitting or standing posture) or dynamic activities (such as walking, running, reaching, lifting or throwing). The tasks that you require strengthening for pre-determines the specific strengthening exercises that will help you to achieve your goals. Your physiotherapist is an expert who can guide you.
  • medicalMassage and soft tissue techniques:A soft tissue massage includes a whole range of massage depths, pressures and durations. Your remedial massage therapist is a professional who understands what techniques are right for your body at any given time. Your soft tissue massage aims to alleviate aches, pains and injuries that are attributed to your body’s soft tissues.

Electrical Stimulation

Electrotherapy and local modalities are used to assist pain reduction and the natural healing response via an increase in energy (electrical, sound, light, magnetic, temperature). These modalities can be used for both pain relief and functional improvements, even in cases involving neurological disorders. In fact, it has proved effective in facilitating functional facial movements in patients with Bell’s palsy.

Electrotherapy Modalities include

Ultrasound: Many different musculoskeletal conditions, such as muscles strains and tendonitis, are treated with ultrasound by a physical therapist. Often used to reduce local inflammation, promote tissue healing by increasing blood supply in relatively superficial tissues, no deeper than 5 or 6 centimeters. High frequency sound waves that produce a form of deep tissue heating for relief of pain and muscle spasm, promotes circulation and relaxes tight muscles/soft tissue and prepares tissues for stretching.

Transcutaneous Electrical Nerve Stimulation (TENS):is a therapy that uses low-voltage electrical current for pain relief. A TENS machine is a small, battery-operated device that has leads connected to sticky pads called electrodes. You attach the pads directly to your skin. When the machine is switched on, small electrical impulses are delivered to the affected area of your body, which you feel as a tingling sensation. The electrical impulses can reduce the pain signals going to the spinal cord and brain, which may help relieve pain and relax muscles. They may also stimulate the production of endorphins, which are the body's natural painkillers.

Interferential current therapy (IFC):is an effective therapy option used by in our clinics to relieve pain and accelerate the self-healing process, getting your body back to a healthy, pain free state. The high frequency signals of an IFC penetrate through the skin into deeper lying muscle tissues. It reduces or eliminates pain safely with noticeable decrease in swelling and inflammation and restores lost movement and improves restricted movements and coordination.

Local Modalities include

Ice: Use of "ice packs" or "ice massage" in acute injuries and for pain relief (acute or chronic). Reduces swelling, inflammation, muscles spasm. Spray and stretch technique is used to facilitate stretching of very sensitive muscles in spasm while applying manual therapeutic techniques.

Heat: Moist Heat (Hydrocollator)- Produces a deeper heat than a dry heating pad; still relatively superficial due to local blood cooling effect; penetrates only 1-2 cm. Increases local circulation, reduces swelling, relaxes muscles/soft tissue, prepares tissue for other treatments.
Paraffin- A form of heat using paraffin wax and mineral oil. Usually applied to hands or feet where other applications of heat are difficult. Wax therapy improves mobility by warming the connective tissues.
Short Wave Diathermy- Deep soft tissue heating; 5-10cm tissue depth; Increases muscular blood supply and tissue perfusion; Increases healing and extensibility of these tissues.

Foot Assessment & Insole

Orthotics (or orthoses) are shoe inserts that control or correct structural problems within the foot. They may be used to treat many conditions such as heel pain, knee pain and sports-related problems. There are a number of different types of orthoses, with varying degrees of control. Orthoses are suitable for all age ranges, from children to the elderly. With some conditions, orthoses required be used to cushion areas of the foot rather than correct structural problems. Orthoses can be made specifically for a person's foot (casted orthoses) or off the shelf (non-casted).

Good foot care can have a range of benefits including:

  • medical Reducing pain - painful feet can impair balance and functional ability
  • medical Increasing mobility and physical activity - foot problems are a major causes of walking difficulties in older people
  • medical Increasing self-esteem
  • medical Increasing social contact and participation in leisure and cultural activities
  • medical Reducing risk of trips and falls - foot pain can cause people to wear loose footwear, which can contribute to falls

Posture and Ergonomics clinic

  • medical Ergonomics:This is the way we sit, stand, bend, lift, push and generally position our body to perform simple or complex physical tasks, during regular activities of daily living [ADL’s] or within the worksite environment. Physical therapists at BOSH are trained to understand proper movement techniques and identify incorrect techniques, with the goal of correction to a more efficient and productive movement model. We utilize our education skills, teaching corrective and proper technique, sometimes our manual skills to correct certain body impediments to proper mobility and corrective exercise to strengthen and fortify those body areas necessary for long term effectiveness
  • medical Gait Training::Analysis of the different stages of walking to determine any deviations and the training to re-educate the body in the proper movement patterns
  • medical Balance/Coordination Training:Exercises and activities to improve the ability to maintain the body in equilibrium both statically (indifferent positions) and dynamically (in different activities).
  • medical Postural Training::Analysis of the body’s posture to identify areas of imbalance and inordinate stress, possibly contributing to a person’s chronic pain or functional impairment. We use corrective measures to restore proper alignment of the musculoskeletal system to reduce undue stress and strain.
  • medical Neuromuscular Re-education: Retraining of movement, balance, coordination, posture and position sense. This is a highly specialized form of therapeutic exercise and movement re-training that often involves computerized pre-exercise testing to guide and evaluate treatment and the use of visual biofeedback techniques in order to enhance the effects of training.

Therapeutic Exercise Prescription

Exercise is a very common and non-invasive method of treatment used in a physical therapy setting. Exercise can help to improve a patient’s strength, flexibility and range of motion, and can help a patient regain their functional and mobile independence.

  • medical PASSIVE:Manual procedures [different than those previously described above] carried out by the therapist, without active patient participation.
  • medical ACTIVE: Movements performed by the patient, either independently or with some form of manual or mechanical assistance. This is generally used to increase or restore normal joint mobility and to prepare for more vigorous exercise.
  • medical RESISTIVE: Active movements performed by the patient, in order to produce muscle contraction that will ultimately result in increased muscular strength. This form of exercise can be used at various stages of tissue healing, as guided and directed by the physical therapist. There are many types of resistive exercise, each having its own main benefit and precautions; Using your own body weight, external weights, elastic bands or exercise machines, your physical therapist will determine which exercises are appropriate for you and in which way to start and progress or change them.

Patient Education: Since many injuries or disorders that physical therapist treat are sustained due to overuse, incorrect body mechanics or the unique stresses employed in certain sports, occupations or everyday activiites, our team of physiotherapists are trained to teach patients the underlying causes of these disorders. We routinely discuss, educate and train patients accordingly-

Postural correction and training:

  • medical ADL’s [Activities of Daily Living]
  • medical Body mechanics; lifting, bending, reaching
  • medical Occupational Ergonomics
  • medical Bed/body Mobility
  • medical Gait and ambulation training
  • medical Balance recovery and fall prevention
  • medical Low back pain management

Continuous passive motion (CPM): is widely used as part of rehabilitation following knee surgery and there is evidence that its use following total knee replacement can lead to a reduction in both hospital stay and analgesic requirements and an increase in early range of motion. Continuous passive motion (CPM) is a way of providing regular movement to the knee using a machine.

Stroke Rehabilitation: The goal of stroke rehabilitation is to help you relearn skills you lost when a stroke affected part of your brain. Stroke rehabilitation can help you regain independence and improve your quality of life. The severity of stroke complications and each person's ability to recover vary widely. People who participate in a focused stroke rehabilitation program perform better than most people who don't have stroke rehabilitation.

Physical activities might include:

  • medical Motor-skill exercises-These exercises can help improve your muscle strength and coordination. You might have therapy to strengthen your swallowing.
  • medical Mobility training-You might learn to use mobility aids, such as a walker, canes, wheelchair or ankle brace. The ankle brace can stabilize and strengthen your ankle to help support your body's weight while you relearn to walk.
  • medical Constraint-induced therap-An unaffected limb is restrained while you practice moving the affected limb to help improve its function. This therapy is sometimes called forced-use therapy.
  • medical Range-of-motion therapy- Certain exercises and treatments can ease muscle tension (spasticity) and help you regain range of motion.

Cognitive and emotional activities might include

  • medical Therapy for cognitive disorders: Occupational therapy and speech therapy can help you with lost cognitive abilities, such as memory, processing, problem-solving, social skills, judgment and safety awareness.
  • medical Therapy for communication disorders: Speech therapy can help you regain lost abilities in speaking, listening, writing and comprehension.
  • medical Psychological evaluation and treatment: Your emotional adjustment might be tested. You might also have counseling or participate in a support group.
  • medical Medication: Your doctor might recommend an antidepressant or a medication that affects alertness, agitation or movement.

Physiotherapy Doctors