Do you think that the weight of the World is on your Shoulders?

Everyone knows that if you work at the desk whole day, you are likely to suffer from neck pain.In the last 7 months when we have been in lockdown mode, with the “work-from-home” orders, most of the calls I got from patients were with complaints of neck-and-shoulder pain, as they were working long hours; sitting in uncomfortable positions on beds, sofas, and dining chairs. To make matters worse, as you all know, the emotional stress has been high too! Most people suffered neck pain, specifically pain in the trapezius muscle.

Buying the correct chair, table, and all the right gear to make your working posture ergonomically sound, is part of the solution to this occupational challenge. But I want to talk to you about another matter today.

Even with the best, and most appropriate furniture, you are still likely to develop neck pain if you work at a desk for long hours each day, especially under stressful, or demanding conditions.

Our natural, and most desirable posture is with the head placed directly over the torso in such a way that the ears and the shoulders are kind of aligned. This way, the large Trapezius muscle at the back of our neck, is relaxed. But, when we are engrossed in reading, writing, or we are concentrating on a laptop, we ALWAYS LEAN IN, moving our head ahead, and our ears ahead of the shoulder line.

You can do just some relaxed reading, or regular scrolling, while sitting in the correct posture, but the minute some urgent, last-minute work deadline comes up, you will unconsciously shift that head forward and lean in!

This is how we are ALL genetically programmed to perform well. Our brain engages best with the task at hand if we lean into our work. If you want to perform well, or meet a deadline, this is also something you will want to do.

The minute your head moves forward, the relaxed Trapezius muscle must contract, and maintain that contraction for as long as you continue working, so that you can keep your head in this position till you finish that work. Mental stress also leads to a slight hunching of our shoulders, leading to more Trapezius contraction. We know that a work deadline, and mental stress often go hand in hand. Now, imagine if you must work at this intense level for eight hours a day: A tightly contracted Trapezius for eight straight hours is definitely going to generate pain.

So, getting yourself the right gear is very important, but it is not enough. It is also very important to get up and move, or just interrupt your intense concentration often through your long day. Keeping the Trapezius muscle in a state of constant static contraction for very long hours, is terrible for the long-term health of your cervical spine, shoulders, and low back.

So, pause, take a small break, do some stretches, walk around, chat with your colleagues or family (in person, not on the phone), and then get back to work. Do this several times a day.

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“We are all free to disagree, just do it respectfully”:How I learnt best when I was allowed to have an opinion

In 1985, I did a one year Yoga Teachers Training Course with Yoga Vidya Niketan in Dadar.

I learnt Yoga directly, from the founder, Padmashri Yogacharya Shri Sadashiv Nimbalkar. An amazing teacher, and a true seeker, he encouraged us to find scientific reasoning to everything that was being taught.

The course was 1 year long, very thorough and included 1 hour of Yoga practices every day, which Sir conducted himself, at that time. On Sunday mornings we had lectures on the theory aspect of Yoga; and also on Anatomy and Physiology, which were taken by a Physician. Towards the end of the year, we had to take 3 real lessons for a group of other students; we had an examination, and also had to submit a small dissertation.

I was just 19, and I was simultaneously doing 2nd year of Physiotherapy studies at KEM hospital in Mumbai. I was a very subdued student in Physiotherapy, but in the Yoga classes I was a cocky, opinionated, precocious student. I was the youngest in the class, and also 1 out of just 2 students from a medical field (the other was my friend who was also studying physiotherapy). This made me feel somewhat superior and entitled. I questioned everything. I argued about everything. But Nimbalkar Sir patiently listened to my views which were diagonally opposite from his; he respected the difference of opinions, because he looked deeper than my superficial bravado and recognized my deep desire to learn Yoga. He knew that my questions and reservations needed to be acknowledged, so that I would believe in the process. He realized that I had the same goal as other students towards learning the practical aspects of Yoga; just a different perspective to some parts of the theory. He knew that if he allowed me to have my interpretations, I would learn better. He was far, far, ahead of me; he had nothing to lose from my challenges, and they did not faze him at all. He was always willing to listen to me, and guide me.

When we were almost at the end of the course, one day he arranged a debate. The topic for the debate was “Does Yoga have an application in the 20th century?” Those who wanted to participate were divided into 2 groups, the ones who said “Yes”, and the ones who said “No”. Everyone wanted to choose the side of the Ayes, so I chose the Nays, even though I believed the opposite. I was made the leader, and the others in my group were reluctant members. Everyone was sure that the Ayes would win. It was a no-brainer, and Nimbalkar sir was our judge.

The Nays won. He laughed as he presented me with the prize. He congratulated me, saying, “I cannot believe that I am giving you this prize, but you almost convinced me that Yoga is unnecessary in this century. I still do not agree, but your arguments were brilliant, and our other team could not match, so you win this time”. I hastily replied that I believed in the need for Yoga in any century, and if given a chance, I could argue that side even more convincingly!

He was fair and open-minded; respectful of an opinion that was backed up with a valid argument; pleasant and encouraging. You end up respecting such a teacher wholeheartedly, without any reservations. And when reservations disappear, you are free to learn. Over the period of that one year the precocious side of me had slowly dissolved. I did not need to argue. I respected his way of viewing Yoga just like he respected mine. He didn’t give up on me, and I gained a priceless education: not just in Yoga, but also in the art of subtly influencing people.

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Greatness is a lot of small things done well every day.

One of these small things is valuing the time that others give you.

I have been treating and training Sachin Tendulkar since 2002, and over all these years, I can count just 2-3 times that he has cancelled a session without sufficient notice. In fact, I remember even in the early days when he was at the height of his career, (and I was not), he would send a message with an apology if he was getting delayed by as little as 5 minutes!

I got a message from him today, well over an hour before I was to see him. He was not feeling too well and needed to cancel the session. The message came with an apology “Sorry for the last minute change” and a “Thanks”, even though there was sufficient reason to cancel. A simple acknowledgement of the value of my time.

Especially in a city like Mumbai where commute is difficult and time-consuming, and time is extremely valuable, all of us need to respect each other’s time.

At Prakruti SSPC Pvt Ltd. we rarely keep any one waiting for their appointment. We try our best to space out appointments, so that the clinics are not crowded, and our patients are comfortable.

But we often have to deal with a few patients repeatedly cancelling sessions at the last minute, sometimes not showing up without bothering to cancel, and sometimes coming extremely late for an appointment, All of this without an apology. A late cancellation means that we lose valuable time, find it difficult to function efficiently, and of course we lose revenue because we had reserved that time-slot and denied it to someone else.

In today’s fast-paced world, “Time is money”. It is therefore not wrong to say that those who regularly miss appointments, or fail to cancel them in time, are squandering our money!

Greatness is a lot of small things done well every day.

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Importance of Exercise in Osteoarthritis

Osteoarthritis, though usually diagnosed in the later ages, actually starts much earlier. Just like car tyres get worn out over time and with use, our joints too undergo wear and tear throughout life. Food, environment, lifestyle, weight, physical activity, genes, exercises, previous injuries or surgeries, etc. all will determine the severity of the degeneration, the age that it will start, and the rate it will progress.

Some people will power on, and continue their activities and exercises till pain is unbearable; while others will stop everything and take “rest” at the first hint of pain.

Is one better than the other? Well, no!

If you have pain, do not continue the same program. Exercises have to be modified, please ask for help!

But also, please do not choose to rest! Exercise is the most important part of treatment for osteoarthritis.

Osteoarthritis cannot be cured. The treatments are all designed to reduce pain, increase movement, and eventually slow down the progression.

Well-designed exercises can help to strengthen muscles, increase flexibility and mobility, may help maintain or reduce weight, and also keep the bones healthy.

Most of us exercise to remain “fit”. Don’t you think then, that the exercises we choose should work WITH our body and not AGAINST it??

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WARM UP

Warm up in a warm city?? Is it really necessary? What does that really mean?

1. If you are exercising first thing in the morning, you probably need a “proper” warm up. Sleeping makes the body stiff, especially so if you’ve slept in an air-conditioned room. The metabolic processes have slowed down too, and so have your reflexes. You need to prepare your body for the demands that you will put on it. You should spend at least 20 min doing light, aerobic, whole body movements and stretches before increasing the intensity to what your actual exercise for the day is.

2. If you are exercising an hour or two after you wake up, and you have been moving around the house getting things done, you probably do not need a full warm up. You might do alright with a 2-3 minute quick warm up followed by a few quick stretches.

3. If you have been sitting in the office all day and plan your exercise session after that, you will need a moderate warm up, but a good amount of stretching to prepare for your exercise.

4. The type and intensity of the warm up also depends on the exercise itself. For a cardio activity like a 5-10 k run, a light 5-7 minute jog and a whole body active stretches routine will be a good warm up. For a generalised whole body beginner-intermediate strength training routine, warming up the whole body with a light version of calisthenic-like free hand exercises and stretches is best. But if you plan an advanced level, heavy strength routine, a light 5-7 minute jog, followed by whole body free-hand exercises and stretches, and then a lighter set of each of the exercises before the actual sets should all be part of your warm up.

5. Warm up is not only for cardio/sport/gym strength. Even for a Yoga session, your body needs to be warmed up. Before going into the actual poses, it would be good to do a lighter version of them or some similar stretches.

Your body will perform best when you prepare it by clearly demonstrating what you really need from it. There will then be enough blood flow to the required areas, enough glucose and oxygen supplied, muscles pliable and prepped up, joints moved through the full required ranges and not surprised or suddenly shocked with the movement or forces, brain perfectly synced with body to provide best support and coordinate the movement, heart and lungs ready for the upcoming demand to scale up performance, nervous system and reflexes sharpened and prepared to anticipate sudden changes.

A good warm up is like the key that smoothly opens a door. Always use it.

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WORLD CANCER DAY

As I sat down to write a blog for World Cancer Day, I found this great article from 2017 that validated everything that we believe in and apply when we design programs for cancer survivors at Prakruti.

So instead of writing a blog, I have just abridged this article and highlighted a few areas.

Initiating Exercise Interventions to Promote Wellness in Cancer Patients and Survivors

By

Anna L. Schwartz, PhD, FNP, Hendrik Dirk de Heer, PhD, MPH and Jennifer W. Bea, PhD

Oct 15, 2017

The article discusses exercise recommendations for cancer survivors at different stages of survivorship as defined by the American College of Sports Medicine (ACSM) and the impact of acute, long-term, and late effects of cancer and its treatment on the ability to exercise.

Cancer treatment causes profound debilitation that leads to reduced physical function and impairs quality of life. Negative sequelae have been observed across a range of treatment type — from surgery, to radiation, to hormonal treatment and targeted therapies. The declines in physical abilities and physiologic function that are commonly observed in cancer patients can be minimized or prevented with a well-thought-out progressive program of restorative exercise. Exercise during and following treatment has been associated with reductions in cancer recurrence and disease-specific mortality rates of 30% to 60% in breast and colorectal cancers. Exercise also has been found to prevent or ameliorate many treatment-related negative effects — such as fatigue, muscle weakness, declines in cardiovascular function and reduced quality of life.

Only a moderate amount of physical activity is required to achieve many of the protective benefits of exercise. Walking for 30 minutes 5 days a week at a speed of about 2.5 miles per hour conveys health benefits and is an attainable goal for most cancer survivors.

Acute treatment-related side effects are those that occur during active treatment for cancer, when patients are often immunocompromised. Exercise is possible during active treatment and any planned exercise program should be adapted to the individual’s abilities and should focus on improving specific physical limitations.

Long-term effects of cancer treatment are side effects that begin during treatment and linger many months or years after the completion of treatment. Long-term effects often necessitate adapting an individualized restorative exercise program to minimize the risk of injury or lymphedema.

Late effects of cancer treatment can develop years after treatment has ended and may impair the survivor’s functional ability and ability to exercise.

It is time that we change our thinking about caring for cancer survivors and become proactive advocates for restorative exercise during and following treatment. Ideally, restorative exercise should begin as soon as possible after diagnosis to enable the cancer patient to improve his or her tolerance of treatment, and to reap the physical and emotional benefits of exercise. However, it is never too late to refer a survivor to an exercise program. Exercise at any point in the survivorship trajectory helps to maintain and improve functional ability, body composition, and quality of life.

Prakruti SSPC has always believed in individualized exercise programs based on simple patient-centric goal-setting for each phase. We have experts to manage lymphedema while we look after your strength and nutritional health so that you can have better mobility and function.

Do consult us if you or a dear one needs our help.

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Why I love my walking stick

I often see older patients (and sometimes even younger ones) with lower limb dysfunctions, who resist using a walking stick for support — choosing reduced mobility and pain instead — with the misplaced belief that avoiding using one makes them more tough and hardy.
Obviously they look at it as a “dependency”, a sign of weakness and disability.
But what if you look at a cane as an instrument of “independence” and ability? After all, mountaineers carry one (and sometimes two) to enable them to overcome the obstacles they face on treks.
Look at what a cane can do for you:
1. If you are allowed to walk but are unable to walk much because of pain in the knees/ankle/hip, a cane will help you to walk more distances by taking the load off the painful limb or joint.
2. If your gait (walking pattern) is altered because of very weak leg muscles or because you are protecting a painful area in your leg, just using a cane will help you to walk straighter and in the long run prevent damage to other joints of your body.
3. If your balance is poor, or if you often tend to hold on to a wall or furniture, a cane might help you prevent an unnecessary fall and injury, as it will improve your balance.
4. If you have lost your independence after your injury/disability, you can regain it if you choose to use a cane, especially when going outdoors for work or pleasure.
5. Gaining confidence and mobility will improve your psycho-social health; and increasing the distance you can walk will help control weight and other systemic disorders. You will do more, see more of the world, and be more useful to those around you.
I used a trekking stick when I trekked the high mountains. Then an unfortunate accident on one of my treks has left me with an excessive weakness in my left leg.
I use a walking stick now, on my long walks either here in Mumbai or for sight-seeing on holidays. Without a stick I would not be able to walk more than half a kilometer, and if I did, I would end up with back and knee pain. With a stick, I can easily walk fifteen kilometers every day, without a hint of pain.
My stick sets me free, makes me independent, empowers me, and keeps me safe.
I love my walking stick!

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OSTEOPOROSIS

The human body is made up of large quantities of gaseous elements like Oxygen, Carbon, Hydrogen, Nitrogen; smaller quantities of minerals like Calcium, Phosphorus, Potassium, Sulphur, Sodium, Chlorine, Magnesium; and then some other trace elements.

Calcium is the most abundant mineral found in the human body. We think that our bones and teeth are mostly made of calcium, but they are not: Calcium is only a small part of their composition. In fact, the total amount of calcium that our body holds, is only 1.5 – 2 % of its entire weight.

Then why is Calcium so important?

Calcium is required for each and every muscle contraction, even for the beating of your heart. Blood clotting, normal functioning of many enzymes (and these enzymes control each and every function of the body), and the rhythm of your heart is dependent on calcium. And, obviously, it is required for the composition of your bones and teeth. Bones form your skeletal system, give structure to the body, and also protect your vital organs.

As Calcium is required for the most important functions of the body, obviously the blood always has to carry enough of it at all times, and make it available for the body to use. Unless something terribly wrong is going on in the body, your blood calcium levels will always remain adequate. If enough is not made available from food, it is withdrawn from the calcium bank in your bones.

Your bones act as the calcium stores for the body. There is a continuous building and breaking down activity going on in the bones throughout life. The “building up” activity is dominant till the early thirties, and the “breaking down” activity is more after that. If you do not deposit enough calcium in this bone bank in your childhood and early adulthood, you are likely to use the calcium stores faster as you age. Bone structure and strength is at its “peak” in your early thirties. This “Peak Bone Mass” is dependent on genetics too. Women unfortunately, tend to have less peak bone mass than men, and they also lose more bone mass after menopause. The amount of calcium that your bones can absorb and store reduces as you age, and it is almost impossible to build up the stores in later life.

People who smoke, and those that drink excessive amounts of alcohol and caffeine are likely to have lower calcium deposits and lose them faster. Regular consumption of carbonated drinks (soft drinks); high intake of saturated animal fats, and sweets or simple sugars also can cause excessive bone loss.

While opinion on whether one should have milk, and whether it is harmful to the human body is divided, it is still true that milk and milk products are the easiest sources of calcium available to us. Calcium can also be obtained from green vegetables, nuts, whole grains, and fish bones.

After building up calcium stores, it is also important to maintain them through life. This can be done by encouraging the bones to absorb more every day, and you can do this by including a moderate amount of weight (strength) training throughout life. The force applied on the bones by a strong muscle contraction will stimulate the bones to absorb calcium.

Calcium absorption by the bone is also affected by your protein intake. Too less or too much protein, are both likely to cause bone loss. Plant foods (vegetables, grains, and fruits) fulfil most of our vitamin and mineral requirements, and vitamins and minerals play a vital role in Hormonal balance and Calcium absorption. So varied intake of plant foods is indirectly vital for maintaining strong bones.

A discussion on bone health cannot be complete without the mention of the “good” fats Omega 3 and 6. These too are important to maintain strong bones as you age. Several seeds and nuts can provide these in your daily diet.

Eating extremely low-calorie diets can actually stimulate bone loss. Studies show that eating balanced meals and maintaining an even and adequate calorie intake throughout life helps to maintain available bone mass. Going through repeated cycles of weight gain and loss through life might affect bone health drastically.

I think the most important nutritional supplement you can take to ensure bone health is an adequate amount of water. Just a slight dehydration on a daily basis can keep your body in a continuously “stressed” mode, triggering biochemical reactions that will promote bone loss. Remember, water is also important for digestion and absorption of all nutrients, so even if you “eat healthy”, the body might not get the benefit of nutrients unless you “drink healthy”.

So you see, just like everything in life, balance and moderation is also the key to bone health.

#PrakrutiSSPC #WorldosteoporosisDay #Benefitsofcalcium #rightnutrition #healthybones #healthyus!

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WORLD OBESITY DAY

World Obesity Day is observed globally on 11 October with the view of promoting practical solutions to end the global obesity crisis.
Dr. Harshada Rajadhyaksha shares her view on this occasion.

End Weight Stigma

Just think,
When you meet a person for the first time, what is the first thought that comes to mind?
Do you notice their colour, race, clothes, religion, profession, economic status? Their personality? Do you notice their size?
We are taught that first impressions count. But first impressions are only a quick judgement, aren’t they?
Haven’t we all, at some time in life, made a quick judgement, and then changed our hastily-made opinions about people we know?
Can we look at people without forming opinions? Because, whether we voice these opinions or not, by just having them, we own them.
World Obesity Day this year, has the theme “End Weight Stigma”.
“Stigma”: A disgrace associated with a particular circumstance, or a quality, or even a person.
Just like people are of different colour and height; have different backgrounds, languages, and beliefs; they also have different sizes and weight.
If weight does not negatively affect health, there is no reason to notice it. It has no meaning whatsoever in the interaction you will have with the person.
“Obesity” on the other hand, is a disease that afflicts a section of society; just like “Arthritis” is a disease that afflicts a section of society. A person is not obese, a person suffers from Obesity; just like a person suffers from Arthritis.
Obesity is also a result of our collective choices: The lifestyle choices we made when we chose industrialization and urbanization over manual labour and foraging. The choices we make daily when we choose to use our devices of convenience, and eat our artificial foods.
Our species chose to live, eat, and work this way. We are collectively, genetically going to evolve and live with the diseases we inherit.
Yes, I did say “inherit”. Research shows that we are all linked by genetics more closely than we earlier thought. This means that the lifestyle choices our species made over the last few decades have probably affected the genes we inherited and will pass down.
I believe obesity is one of these genetically passed-down diseases. Do not judge a person who suffers from obesity. Each one of us will suffer from a lifestyle related disease at some point in our life; some of these diseases are visible, others are not. Obesity is visible, Arthritis is often invisible.
Let us take the away the stigma and come up with compassionate and practical solutions for those who suffer from Obesity. Let us accept that Obesity is a disease, and look at ways to prevent it. Let us admit that we need to return to more natural food and work choices so that the future generations do not have to deal with an endemic crisis.

#PrakrutiSSPC #stormoutthestigma #acceptthefacts #letsfightitout #Togetherwecanmovemountains!

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Plastic and the Environment

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  • Dr Harshada Rajadhyaksha

    In Sanskrit, the word “Prakruti” means “Nature”: the primal motive force of the Universe; Ayurveda recognized that no two humans are alike, and called this basic, very unique, individual constitution, “Prakruti”.

    At Prakruti Sports Science and Physiotherapy Clinic, we provide the environment, expertise, and support required to assist natural healing.

    True healing begins from within the self: Doctors and Healers can only assist along the process. After 22 years, we continue to remain humble in our approach to diagnosis and treatment, our focus remains on the complete wellbeing of our patients, and we continue to promote the prevention of lifestyle-related diseases in the community.

    Our patients’ trust and faith in us, and our honest concern for their wellbeing has been the foundation of our success.