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admin – Health Fixit Mon, 10 Apr 2017 21:03:24 +0000 en-US hourly 1 Hypervolemia Sun, 09 Apr 2017 16:41:29 +0000 Hypervolemia Facts

Hypervolemia, also known as fluid overload, is an excessive increase in the volume of fluid volume. It is an abnormal increase in blood plasma volume, which causes an elevated blood volume. [4, 2]

The condition involves expansion of the volume of extracellular fluid and covers the interstitial and intravascular space. The cause can be the overproduction of the isotonic fluid that is composed of sodium and water. [1,2, 3,6]

Hypervolemia and hyponatremia

Hyponatremia is a condition caused by abnormally low levels of sodium in the body. As an electrolyte, it regulates the amount of water in and around the cells. Hyponatremia causes the rise of water levels causing the cells to swell and retain water. [2, 4, 6, 7, 8]

Signs and Symptoms

One or more of these signs and symptoms may manifest when there is excess plasma volume:

  • Increased rate of respiration and shortness of breath. This is caused by the decreased number of red blood cells. Once blood is diluted, the body compensates it by an increase in respiration to enable all the cells to get enough oxygen.
  • An increase in the pulse rate, which is caused by the overload on the circulatory system and elevated contractility of the cardiac muscles.
  • Central venous pressure (CVP), pulmonary artery pressure (PAP) and shift of fluids from plasma cause edema in the ankles and the legs.
  • An increase in the volume of fluids among the lung pleural spaces causes labored and difficulty in breathing, a condition called pulmonary edema. The collection of the fluid in the lungs also causes paroxysmal nocturnal orthopnea (difficulty of breathing when lying down) and dyspnea (difficulty in breathing).
  • Crackling when auscultated due to the increase in hydrostatic pressure in the pulmonary arteries
  • Moist skin as the body tries to eliminate the excess fluid through sweating
  • Jugular vein distention caused by increased volume of the blood and the preload.
  • Excessive and rapid weight gain because of the building up of the extracellular fluids. There is also fluid buildups in the abdomen as the fluid drains from different parts of the body.
  • The feeling of a third heart sound, also known as S3 gallop during auscultation due to rapid filling of the articular part of the heart during systole and overloading of the ventricular part during diastole.
  • There is also an abnormality in the renal function that leads to specific alterations of gravity, change in the levels of the electrolytes, oliguria and azotemia.
  • Neurological changes such as change of the mental status characterized by lethargy or confusion, anxiety and restlessness. [2,3, 5,8,9,10, 11]

Hypervolemia and hypertension

Circulatory overload and an increase in the mean arterial pressure causes hypertension along with pulmonary artery pressure (PAP) and central venous pressure (CVP).  [1, 2, 3, 4, 5, 7, 11]

Hypervolemia and pregnancy

Pregnancy-induced hypertension called pre-eclampsia is common in women during their gestation period. It characterized by edema and presence of proteins in the urine. The expectant mother should get treatment for fluid retention promptly. [1, 3, 5, 10]

Hypervolemia pathophysiology

  • In the normal function, the body creates processes in which it enhances the electrolyte equilibrium, relinquishes, and compensates fluid. The process is achieved through the help of such hormones as aldosterone, antidiuretic hormone ADH and atrial natriuretic peptide ANP. The hormones influence the release of sodium and water that are essential to the body from the nephrons of the kidneys.
  • Here is an illustration of the fluid balancing mechanism. If an electrolyte is in higher concentration within the cells than the outside, fluids will move from outside the cells to inside the cell. If the electrolyte concentration outside the cells is higher than on the inside of the cell, the fluid moves outside. This body mechanism maintains the normal concentration of the electrolyte and balance of the fluid. [1, 3, 10, 11]
  • There may be cases of hypervolemia when they are cases of elevation of volume levels in the intramuscular space. The cause of the condition could be due to the shifting of the fluids from interstitium to the plasma, the excessive occurrence of intravenous fluids reduced water and sodium excretion and chronic stimuli on the renal part of the kidney causing the conservation of both the elements. [1, 3]
  • The elevation of the fluids in volume overloads the circulatory systems and leads to abnormally amplified contractility of the cardiac muscles, increases the mean artery pressure MAP and elevates the capillary hydrostatic pressure. The latter action leads to a shifting of the fluids to the interstitial space, which results in edema.  [1,2,3,4,5,10,11]
  • If the case of hypervolemia gets severe or in case the patient suffers from a history or cardiac dysfunction, the body’s compensatory mechanisms may not work. Moreover, he or she may experience a shortfall of urinary excretion of water and sodium. In a worse case, the aldosterone and antidiuretic hormone may not be stopped from causing an elevation of mean arterial pressure. The result is usually pulmonary edema, which is followed by heart failure. [1, 3,]

 Causes of Hypervolemia

  • Excessive intake of fluid or sodium
  • Intravenous (IV)therapy
  • Hypervolemia may occur if an intravenous fluid is administered in a larger volume or rapid rate than directed by the doctor.
  • When a wrong intravenous fluid is administered, it may alter the sodium levels in the blood.
  • Use of hypotonic fluids on perioperative patients who are undergoing an intravenous therapy [1,3]
  • Body’s reaction to transfusion when a large volume of blood products are infused or the process if infusion done rapidly [3]
  • Excessively taking of dietary sodium  [1,2,3,4, 5, 11]

Retention of water and sodium

Heart problems

  • Acute and chronic heart diseases
  • Congestive heart failure; where the heart is unable to pump the blood effectively throughout the body. The blood backs up in veins causing an increase in fluid volume. [1,3,5]

Kidney disorders

  • Glomerulonephritis that makes the kidneys unable to excrete excess fluids from the body.
  • Nephritic syndrome that causes the deficiency in as protein called albumin. The deficiency leads to transfer of fluids from the blood to the body tissues, which ends in edema. The kidney on the other hand, tends to retain more fluid and salt. [7,8]
  • Liver cirrhosis also contributes to the overload of the fluid as it leads to increase in plasma levels [1,2, 3]
  • Certain medications such as chemotherapy drugs and corticosteroid therapy drugs [1,2,3]
  •  Low protein intake [3]
  • The body’s reaction to stress such as after an injury of surgery. Head injury patients all experience increased antidiuretic hormone levels that lead to sodium and water retention. [3,8]

Shift of fluids into intravascular space

  • In burn patients during fluid remobilization
  • Intravenous infusion of plasma proteins [ 1,3]

Leg edema because of a result of capillary leak syndrome
Source: Wikimedia

Diagnostic tests and lab values

Below some of the common laboratory tests used for accessing a person’s hydration status

  • Hematocrit test – This test measures the percentage of the blood that is made up of red blood cell. The test is often a part of complete blood count. Hematocrit decreases at the increase of hydration
  • Normal adult male values; 40.7 % to 50.3 %
  • Normal female values : 36.1 % to 44.3 %
  • Sodium test – The test measures the amount of sodium in the blood and is often done when the doctor suspects electrolyte imbalance. Overhydration causes hyponatremia, which are low amounts of sodium in the blood.  Normal values in adults is 135-145 mEq/L
  • BUN (Blood Urea Nitrogen Tests) – The test measures the amount of nitrogen and urea in the blood as part of kidney function evaluation. BUN decreases with overhydration. Normal adult values: 10-20mg/dl
  • Serum Osmolality Test – The test seeks to determine the number of solute in the blood or serum sample. It is a common test in the evaluation of hyponatremia (loss of sodium). Osmolality decreases with overhydration. [6, 8]

Pitting edema LEG
Pitting edema before and after the application of pressure on the skin. The action shows the extent of swelling in the leg.
Source: Wikimedia

Treatment of Hypervolemia

There are several treatments and nursing interventions that can manage the problem as listed below

  • Medication – Patients are given diuretics to help in the excretion of the excess fluids while heart failure patients are given inotropes
  • Modification of diet – The doctor may recommend a low salt diet for hypervolemia patients to ease the workload on the kidneys.
  • Isolated ultrafiltration – The process uses an extracorporeal filter for the elimination of isotonic fluid. It is effective in the removal of excess sodium from the body. [1, 2,3,4,5, 9, 10, 11]

  6. Fluid Excess/Intoxication – Physiopedia, universal access to physiotherapy knowledge. [Internet]. 2015 [cited 22 December 2015].
  7. Weir M. Hypervolemia and Blood Pressure: Powerful Indicators of Increased Mortality Among Hemodialysis Patients.
  8. Androne AS e. Relation of unrecognized hypervolemia in chronic heart failure to clinical status, hemodynamics, and patient outcomes.  – PubMed – NCBI [Internet]. 2015 [cited 22 December 2015].
  9. Merck Manuals Professional Edition. Hyponatremia – Endocrine and Metabolic Disorders [Internet]. 2015 [cited 22 December 2015].
  11. Fluids Hypervolemia And The Heart
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Facet Arthropathy Fri, 24 Mar 2017 13:45:17 +0000 What is Facet Arthropathy ?

Facet arthropathy has been considered a leading cause of lower back pain for over 50 years. It rarely involves the spinal nerves but can cause great distress and discomfort.

The facet joints are those that help with the flexibility in the back. Their scientific name is zygapophyseal joints.  The word arthropathy specifically means diseased joint. Therefore facet arthropathy is diseased facet joints found in the back and neck which can be noted with or without inflammation or swelling. It also does not include infection.  (1,3,7)

In this article, you will read more about the facet joint anatomy, symptoms, causes, diagnosis process and treatments.

Facet joint Anatomy

The facet joints are true synovial joints and are made up of the following:

  • Joint space
  • Hyaline cartilage surfaces
  • Synovial membrane
  • Fibrous capsule
  • Nerve fibers
  • Substance P (inflammatory mediator) (1)

The following link shows a quick video with a good explanation of the anatomy of the facet joint:

see a side view of the spinal bones and joints.photoFigure 1 : A side view of the spinal bones and joints.
Image Source :

The initial studies of facet arthropathy were done by injecting saline into the facet cavity. This caused inflammation and similar pain to that experienced with arthropathy. Therefore assisting doctors to better diagnosis the issue at hand(11)

see a cross section view of a normal vertebra.pictureImage 2: The cross section view of a normal vertebra.
Photo Source :

Facet Arthropathy Symptoms

Lower back pain due to facet arthropathy is difficult to assess without using invasive techniques. But the following can be seen as common symptoms and may help with diagnosis:

  • Pain located in the lower back which radiates into the knee.
  • Usually, does not cause pain in the central back.
  • Pain could even radiate past the knee
  • Pain occurs a few times a month or as little as a few times per year
  • Tenderness to touch
  • Discomfort increases when bending backward more than when bending forward
  • Pain episodes that are recurrent
  • Muscle weakness
  • Numbness or tingling in extremities
  • In early stages may be noted as a stiffness in the mornings (1,3,4)

What is the difference between chronic and acute back pain?

  • Acute pain– Will begin to subside without treatment or with basic medications such as acetaminophen, aspirin, or ibuprofen.
  • Chronic pain– May or may not need surgery to go away. Usually does not get better with short term treatment and needs long-term physical therapy and behavioral changes.

How can a diagnosis be made?

Basically, your doctor will use the common symptoms stated above and may also use testing to rule out the following diagnosis:

  • Sacroiliac joint syndrome
  • Internal disk disruption syndrome
  • Lumbar spondylolisthesis and spondylosis
  • Chronic Pain syndrome
  • Lumbar compression fracture
  • Overuse injury
  • Fibromyalgia
  • Mechanical low back pain
  • Coccyx pain
  • Deep infection
  • Herniated disks
  • Fractures of the spine
  • Torn muscles
  • Acute intra-abdominal problems(1,3)

There are a couple studies that can be done to help determine facet arthropathy and disregard the above diagnosis. They consist of the following:

  • MRI Magnetic resonance imaging scans
  • Diagnostic blocks
  • CT scan
  • X-rays  (1,3)

lumbar spine.imagePicture 3 : A clear depiction of the lumbar spine which has faucet articulation issues.
Photo Source :

What Causes Facet Arthropathy?

There could be many causes noted and each of these causes having their specific initiation point. The following is not a comprehensive list of possible causes for facet arthropathy:

  • Microtrauma
  • Osteoarthritis
  • Synovial capsule distention and inflammation
  • Rheumatoid arthritis
  • Wear and tear
  • Excessive lifting
  • Poor posture
  • Poor body mechanics when lifting or bending
  • Obesity
  • Sports that cause overuse (1,3,4)

Locations for Facet Arthropathy

Facet arthropathy can be found in the neck or in the back. If it is noted in the neck joints it is called cervical facet arthropathy. In the case that it is the lower back it would be called lumbar facet arthropathy.

Sometimes the specific vertebrae affected will be noted as part of the diagnosis and may appear as the following:

  • Facet arthropathy l5-s1
  • Facet arthropathy L2
  • Lumbar facet joint

The spinal areas are marked by their names.image

Image 4 : In this image, the spinal areas are marked by their names.
Picture Souece :

Types of Facet Arthropathy

Lumbar facet arthropathy

Lumbar facet arthropathy is the degeneration of the lumbar joints. This could be called L1-L5 as mentioned in the above section. This is due to poor body mechanics and can radiate to the areas noted in the above picture.

Cervical facet arthropathy

Cervical facet arthropathy is degeneration in the joints of the neck area. This could be called C1-C7. This could have many causes ranging from poor body mechanics to blunt trauma injury. This pain could radiate into the arms and chest.

Degenerative facet arthropathy

Degenerative facet arthropathy is just another way to describe the actions taking place with facet arthropathy. It may be used as a full in depth diagnosis.

Hypertrophic facet arthropathy

Hypertrophy is the increase of an organ or area of the body which is abnormal. In this situation it would be a section of the facet joint. This will cause pain in the area near the specific joint affected.

Bilateral facet arthropathy

Bilateral means both side, knowing this helps explain that bilateral facet arthropathy means that the degeneration is happening to both sides of the joint.

Thoracic facet arthropathy

thoracic facet arthropathy is degeneration in the joints of the thoracic (chest or upper back) area. This could be detailed as T1-T12 and can cause radiating pain to the arms, chest, and lower back. (1, 2, 6, 7)

Surgical intervention is not needed for facet arthropathy. The following are other options of treatment. T(1,3)

  • Tramadol
  • Codeine
  • Tricyclic antidepressants
  • Serotonin-norepinephrine reuptake inhibitors
  • Gabapentin
  • Pregabalin
  • In severe cases – morphine (5)

Facet joint injections

  • Steroid injections
  • Radiofrequency ablation
  • Intra-articular joint injection (1)
  • This link leads to a video which vividly explains the joint injections: (3,5)

Facet joint Arthropathy exercises

Physical therapy

  • Traction
  • Behavioral modification (9)
  • Good posture is always helpful
  • Heat applications
  • Changes in routines
  • Sometimes anti-inflammatory medications can help with the pain. (3,5)

Facet arthropathy is normally considered a mechanical problem due to misuse of the joints. The best prevention is as follows.

  • Good posture while sitting or standing
  • Proper body mechanics while lifting or bending
  • Maintaining flexibility through exercise
  • Flexion
  • Extension
  • Stretching (9)

Eating a healthy diet which includes

  • Good source of calcium
  • Good source of vitamin D

Exercise which increases strength in the back

  • aerobics (9)

Risk factors for Facet Arthropathy

There have been no studies to show that race or sex have any risk factors for facet arthropathy. Although some studies do show that age can cause significant risk.  This study showed 18% chance of people between the ages of 31-40 and 44% change in people between the ages of 51-60. (1)

In this article, we discussed the various treatments, causes, and prevention of facet arthropathy. The best way to prevent and help with pain due to facet arthropathy is proper posture and healthy lifestyle. Be sure to always seek medical attention if the pain is severe.

  10. Essentials of Physical Medicine and Rehabilitation By Walter R. Frontera, Julie K. Silver, Thomas D. Rizzo Jr.
  11. Atlas of Image-Guided Intervention in Regional Anesthesia and Pain Medicine By James P. Rathmell
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Rectus Abdominis Muscle and Exercises Sat, 18 Mar 2017 14:25:39 +0000 Rectus abdominis is popularly known as the abs muscle. It is a pair of long and flat muscle extending vertically along the entire length of the abdomen just near the umbilicus.

The muscles have string of four fleshy muscular bodies that are joined by narrow bands of tendon. It gives the muscles a lumpy appearance when tensed and defined. It is the reason why the rectus abdominis muscle is called six-pack abs. Rectus abdominis are Latin words which means straight and abdominal. (1)

Rectus Abdominis Anatomy

Rectus abdominis muscle extends inferiorly from the pubic crest, pubic symphysis, and pubic tubercle. It surpasses the metastenum. The muscle inserts into the fifth, sixth, and seventh ribs of the costal cartilages by three different parts.

Origin and Insertion

rectus abdominis origin and insertion

Tent of the muscles, especially during contractions. Three bands of connective tissues crossed the rectus abdominis. It is called the tendinous intersections, which is situated just at the umbilicus level. he rectus sheath encloses the flat muscles and hold the muscle in place. It does not restrict the movem

Rectus abdominis is a Mathes and Nahai Type 3 muscle, which has two dominant pedicles. It has a rich supply of arterial blood vessels and consists of 53.9% type 2 fibers. The upper portion of the muscle contains blood from the superior epigastric artery. (3)

rectus abdominis muscle.picture

Image 1 : Rectus abdominis muscle
Photo Source :

Muscle Anatomy video

crunching exercises to significantly improve the appearance and strength of the rectus abdominis muscle.image
Picture 2 : Crunching exercises to significantly improve the appearance and strength of the rectus abdominis muscle
Image Source :

A woman performing rectus abdominis muscle exercises using a stability

Figure 3 : A woman performing rectus abdominis muscle exercises using a stability ball.
Picture Source :

What is the function and action of the Rectus Abdominis Muscle?

Rectus abdominis muscle helps in various bodily functions. Some of the notable functions of the rectus abdominis muscle include the following:

  • It helps human in maintaining proper posture.
  • It helps in activities that involve flexing of the lumbar region of the vertebral column such as performing abdominal exercises like crunches. (2)
  • It aids in breathing and respiration, especially when it comes to forced exhalation after performing an exercise.
  • It can stretch the abdominal wall and at the same time compresses the abdominal contents. The compression of the abdominal cavity is useful in emergency situations such as the Valsalva maneuver. (4)
  • It helps stabilize the pelvis to allow the lower limb muscle to work properly.
  • It controls the tilt of the pelvis during contraction. (3)
  • It helps in flexing the spine to the front down and forward towards.
  • It helps in the flexion of the thoracic spine and lumbar spine.

What is the Rectus sheath?

The rectus sheath contains the rectus abdominis and the pyramidalis muscles. It is the fibrous condensation of the aponeurotic layers (shiny white tendons) on the anterior portion of the abdominal wall. Aside from the rectus abdominis, the sheath also contains the epigastric vessels, subcostal and intercostal vessels and nerves. (7)

Injury involving the Rectus Abdominis Muscles

The rectus abdominis muscle is prone to injury or damage, especially during extreme workout. Athletes usually experience muscle strain of the abdomen. The muscles of the abdomen can be ruptured or torn depending on the severity of the injury. There will be a notable pain and discomfort in the abdominal area because of the injury.

There are instances when a person will suffer from aggressive fibromatosis or also known as desmoids tumors in the right rectus muscle. The tumor can be detected through a CT scan or MRI scan image. A person may also suffer from a condition called Diastasis Rectus Abdominis (DRA), which causes the rectus abdominis muscles to separate into half. Common symptoms for DRA include epigastric hernia. Some medical reports showed a possibility of endometriosis of the rectus muscle.  (3)

Rectus abdominis strain is one of the common conditions and caused by overstretching of the muscle. People who perform strenuous exercises have the tendency to experience rectus abdominis strain. To prevent muscle strain, you should warm up prior to exercising.

Do not forget to cool down afterwards. You should avoid sudden twisting motions as well as lifting too heavy objects. Rectus abdominis injury is common to swimmers, weight lifters, and those playing hockey and skating. It is also common to overweight people. (8)

Levels of injury to the Rectus Abdominis Muscles

  • First-degree strain – The rectus abdominis is abnormally stretched but is still intact.
  • Second-degree strain – There is a severe stretching of the muscle that resulted to a partial muscle tear.
  • Third-degree strain – There is a complete tear of the rectus abdominis muscle to the point that the muscle separates from the tendons. There is a possibility that the patient will develop a hernia (an abnormal protrusion of the intestines and connective tissues through the rectus abdominis and other muscles in the abdomen.

What are the symptoms of Rectus Abdominis strain?

  • Pain in the abdominal muscle area after performing vigorous activities like running, striking a ball, and prolonged sitting.
  • Pain while coughing, laughing, or sneezing.

Recommended Rectus Abdominis workout : Exercises

There are exercises you can do to significantly improve the appearance and functions of the rectus abdominis muscles. These are the following:

  • Sit-ups – This exercise aims to strengthen the rectus abdominis muscle. It is a simple exercise that is beneficial not just to the rectus abdominis but to other muscles of the body. Lye on your back with your knees bent. Your hand should be behind your head as you are carefully lifting your shoulder blades off the floor. You won’t need any exercising tools or equipment to perform sit ups. The principle is to basically rely to the weight of your body.
  • Stability ball – This exercise provides unstable surface for the rectus abdominis training. Using the stability ball, you can perform a variation of exercises such as sit-ups while on the ball. It enables you to lower your upper body beyond a parallel position to significantly increase the movement during abdominal training. Using the stability ball, lie face down on the ball and place your hands on the floor with your arms straight. Put your hands away from the ball until the ball sits against your shins. Tuck by bending the knees and keep the gently roll the ball towards your chest.
  • Static/Non-movement contractions – It strengthens the rectus abdominis. You can perform this exercise while sitting or even lying down. Just tighten your stomach by pulling the navel towards the spine.
  • Planking – This exercise helps in strengthening the core. Planking for a few seconds daily will make a huge difference in your rectus abdominis muscle. (8)

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Ischial Tuberosity Wed, 15 Mar 2017 09:43:41 +0000 Ischial tuberosity has two parts. The ischial comes from the word ischium which is a pelvic bone. On the other hand, tuberosity is a Latin word, which means lump.

A person with ischial tuberosity has a bony protrusion, which carries the weight of the body when sitting. Hence, it is tagged as the sitting bone. Its other names include sitz bone, tuber ischiadicum, and tuberosity of the ischium. When standing, the ischial tuberosity is covered by the gluteus maximus. (1)

A clear image of the ischial tuberosity, pelvic bone, and the legs.image

Picture 1 : A clear image of the ischial tuberosity, pelvic bone, and the legs
Photo Source :

Recommended exercises for patients with ischial tuberosity

Image 2 : Recommended exercises for patients with ischial tuberosity problems
Picture Source :

Where is the Ischium located in the human body?

Ischial tuberosity is a part of the ramus, one of the primary bones of the pelvic girdle. It is divided into upper and lower regions. It forms the lower and back part of the hip bone. It is located below the ilium and right behind the pubis.

It has three parts:

  1. the superior ramus
  2. inferior ramus
  3. body. (2)

What muscles are attached to the Ischium and what are the functions of the Ischial Tuberosity?

It is a site of attachment for various muscles and ligaments. They are the following:

  • Coccygeus muscles – It starts at the ischial spine and insert at the bottom part of the coccyx and sacrum. The function of this muscle is to support the organ in the pelvis. (3, 4)
  • Levator ani muscle – It is attached to the pubic bones, ischial spines, and levator ani (tendinous arch). Its function is to support the pelvic organs and resist abdominal pressure, which is useful in maintaining urinary and fecal incontinence.
  • Adductor magnus – A large muscle in the thigh area that is situated right next to the hamstrings. It is the one responsible for the lateral and internal rotation of the upper leg.
  • Biceps femoris, semimembranosus, and semitendinosus are also attached to the ischium. It extends the hind limb when kicking or propelling. (5, 6)
  • Semimembranos muscle – The middle of the three hamstring muscles in the back of the thigh which aids in the extension of the hip joint and bend the knee joint.
  • Sacrotuberous ligament – It anchors the sacrum to the hip bones to prevent tilting.

What is Ischial Spine and its purpose?

The ischial spine is a bony projection into the pelvic outlet from the ischial bones forming – lower border of pelvis. It gives attachment to the sacrospinous ligament and coccygeus muscle. The pudendal nerve goes via dorsal side to ischial spine. It can be palpated through the rectum or vagina. It is the point for needle tip while giving the pudendal nerve block.

Ischial Tuberosity Pain

Ischial tuberosity supports the weight of the body during sitting position. It adjoins different muscles, especially those have to do with the legs.

Athletes commonly used ischial tuberosity, especially for jumping, cycling, running, skating, and soccer. These activities can cause train on the muscles on the legs leading to ischial tuberosity pain. The pain can be very severe.

It will cause the muscles to pull which results to inflammation and injury. Extended sitting could lead to worsening of the condition. Severe cases could lead to detachment of the muscles and even tearing of the ligaments.

What causes Ischial Tuberosity pain?

Extended overload can lead to ischial tuberosity pain. Athletes experienced pain because of the continuous exaggeration of the leg muscles including the hamstring and adductor muscles of the thighs. The pain can be felt in the lower part of the buttocks. Severe pain can be felt even when running and walking fast. Prominent pain could lead to swelling. Pain in any form could mean injuries to the following:

  • Tear in the hamstring muscles
  • Ischial tuberosity tendonitis at the hamstring muscle
  • Stress fracture to the ischial tuberosity
  • A bruise at the hamstring attachment

Sitting on hard surfaces for a long period of time can cause damage to the ischial tuberosity. It could lead to ischial bursitis. The bursa is a fluid-filled sac located in the tuberosity. It acts as a cushion between the pelvis and the tendons nearby to prevent damage.

Sitting for extended period of time could lead to inflammation of the bursa as characterized by pain and tenderness in the hips and buttocks area. It could possibly lead to sciatica wherein there is numbness and pain, which could spread into the legs. (3, 4)

Injuries to the ischial tuberosity can be very painful. Hence, the patient is advised to rest and allow the area to heal. Pain is managed using pain medication. Cold compress is used to significantly reduce the swelling and inflammation.

Physical therapy is also helpful to get the muscles back to its pre-injured state. It also strengthens the muscles. For patients suffering from ischial bursitis, they are advised to sit on the padded surface. For severe damage, a corticosteroid injection is needed. Surgery can also be done when deemed necessary. (1, 2)

Other treatment management methods

  • Exercise – Free hand exercise or mild physical exercise helps in pain management. However, you should avoid doing heavy exercises as it could lead to severe pain.
  • Physiotherapy – It helps but does not provide permanent solution to the problem. However, it helps in providing temporary relief from the pain.
  • Medicines – Various medications are prescribed for the treatment and management of ischial tuberosity. Analgesics are used to reduce the pain. However, analgesics are for short term course as prolonged use has adverse effects to the body.
  • Prolotherapy – A sugar solution is injected to the damaged tissue to create a fluid flow onto the affected tissues. It increases the flow of blood and repairs the damaged part by boosting the function of the immune system on the affected area of the body. This procedure allows the growth of new collagen thereby helping in the restoration of the injured ligaments in the joints.
  • Stem Cell Therapy – This procedure produces inflammation to the affected ligaments thereby promoting self-restoration of the damaged tissues and to significantly reduce the pain. (3, 4, 5)

Ischial Tuberosity Exercises

  1. Leg Curls – Performing leg curls with the knees turned outwards can strengthen the hamstrings. You can curl the legs using an outdoor bike or an exercise cycle. There is a leg curl machine specially made to target the hamstrings.
  2. Adductor Machine – Adductor starts on the ischial tuberosity specifically in the adductor magnus muscle. Adductor machine strengthens the adductors.
  3. Hamstring Stretch – Tight adductors and hamstrings can pull the ischial tuberosity causing pain and injury. To relieve the tension, the muscles should be stretched and the flexibility of the hip should be increased.
  4. Frog Adductor Stretch – Adductor stretch helps relieve strain on the ischial tuberosity. Loose adductors can be tightened using stretching exercises. Frog adductor stretch improves the flexibility of the groin and inner thigh area. (6, 7, 8)

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Fordyce Spots Sat, 04 Mar 2017 07:12:31 +0000 What are Fordyce Spots?

Fordyce spots are raised areas of skin located on or around the sexual organs or on the face around the lips.

They are harmless and should not cause alarm. The color of these spots can range from pale red to yellow-white. They sometimes are flat and large and sometimes look more like a deep pimple.

They got their name from a dermatologist from the United States named John Addison Fordyce. He was the first dermatologist to not only study them but to publish his work. After much study Fordyce spots, they are considered non-cancerous and are only of cosmetic concern.  (1)

What is a Fordyce Spot?

Technically speaking they are ectopic sebaceous glands. In order to break that down, we can discuss what ectopic means. Ectopic is anything that is in an abnormal place. These glands are normal but usually are noted in the hair follicles. Sebaceous is the fatty area just under the skin and glands are organs which secrete something.

Sebaceous glands are those that secrete oils in the hair follicles. When they are not located in the hair follicle as in Fordyce they are called ectopic. They are harmless and benign.  When they do not have the hair shaft to give them an outlet they create these spots.  (1,4,5)

Are there any complications to Fordyce Spots?

There are no medical complications to Fordyce spots. In the case that they are visible as with on the face sometimes it may cause anxiety or depression due to cosmetic issues. Sometimes that they are on the genitals and they may cause irritation during sexual intercourse. Other than this they are completely harmless and do not require treatment. (1,4)

What are the most common symptoms of Fordyce Spots?

  • The only symptoms are the spots themselves.
  • They are usually small and pale.
  • They may be reddish or yellowish and may or may not be raised.
  • They have been noted to be between 1-3mm in diameter.
  • When found on the sexual organs they are usually red or purple.
  • They should not be painful or itchy. (1,4)
  • They can be one large lesion or look like many small ones grouped together.

Fordyce spots.imageImage 1: Fordyce spots on upper lip

Picture Source :

How are they diagnosed?

Most diagnosis efforts will be to rule out sexually transmitted disease as well as cancerous growths. Biopsy and palpitation may be done to check that it is none of that diagnosis. (4)

What causes Fordyce Spots?

  • Technically they are thought to be caused by sebum (natural oils of the skin)
  • They are naturally occurring and present in most adults.
  • Sometimes they are not even seen unless the skin is stretched.
  • They are also more noticeable with those who have greasy skin type.(4)
  • They occur more as one age and are noticed most in elderly people. (5)

How can you prevent Fordyce Spots?

They are not preventable as they are naturally occurring (1,3,4) A recent study has shown that they may be caused by high fat intake in the diet. It is possible that a low-fat diet could prevent and decrease force spots (8)

Where are Fordyce Spots located (Pictures) ?

More specifically Fordyce spots can show at times on the penile shaft, the scrotum, and even the labia for females. As stated before these are natural and appear on many adults.

Fordyce spots located on or around the mouth.photoPicture 2 : Fordyce spots located on or around the lips (mouth)
Image Source :

Fordyce spots on the penile shaft picture In this image, you can see the difference between natural Fordyce spots on the penile shaft as well as one that was irritated by the patient “picking” at the spot.

Fordyce spots on the penile shaft image photoThis image also shows the natural appearance of Fordyce spots on the penile shaft.

Fordyce spots show up on the labia of the female

This image above shows how the Fordyce spots show up on the labia of the female.

Do Fordyce Spots go away?

They could go away with the treatments noted above but will last anywhere between weeks to months.  In all cases, it is a good idea to get them looked at by a doctor to rule out any sexually transmitted disease. (3)

Are Fordyce Spots contagious?

They are often confused for genital warts which are contagious but Fordyce spots are not contagious and are not sexually transmitted. (3,5,7) nAlthough they are not contagious they are as common as to be in 80-90% of adults.  They are often not noticed until puberty due to changes in skin color during hormone changes. (3)

Are Fordyce Spots itchy?

No, the spots should not be itchy and in the case that they are medical attention is needed.

How to get rid of fordyce spots (Treatment and Remedies)

In reality treatment for Fordyce spots is not necessary because it is not an infection and is normal for many adults. Some medical professionals may even suggest that you do not treat them at all. Some treatments may cause more prominent scarring than the spots themselves.  But if you do want to find a way to get rid of Fordyce spots you could investigate the following treatments.

  • Electrodesiccation- this is the same treatment used for skin tags and other harmless skin conditions. It is the use of CO2 to “burn” off the lesions.
  • Pulsed dye lasers- This is usually used for a condition in which the sebaceous glands are enlarged. It is known to be expensive but may decrease the appearance of the Fordyce
  • Micro-punch technique- Is basically a biopsy method used to remove the spots. It is noted to have a high satisfactory result. (1)
  • Some people will try to express the white thick discharge by squeezing the lesion like a pimple. This usually only gets rid of it for a short time and could cause infection. (4,5)
  • Chemical peels such as trichloroacetic acid- Although this may not remove the bumps it can improve their appearance.
  • There are also many home remedies such as:
    • Garlic being consumed as a regular part of the diet
    • Good personal hygiene may help the appearance of the spots.
    • A diet high in Vitamin B complex, A, C, E, D, and K could help to reduce the spots and even help them to disappear. (5)
    • Adding healthy oils to the diet such as fish oil (6)
  • Topical creams may be used such as Tretinoin and acne washes using benzyl peroxide or salicylic acid.
  • There is a homeopathic cream called Anti-Sebum that may also help with the appearance.

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Difference between Arteries and Veins Sat, 31 Dec 2016 06:38:19 +0000 Overview of the Circulatory System

The circulatory system consists of the heart and blood vessels; hence it is also called the cardiovascular system, where cardio pertains to the heart and vascular pertains to the blood vessels.

Blood vessels are composed of arteries, veins, and capillaries. There are two types of circulation: the pulmonary circulation and the systemic circulation. Pulmonary circulation is responsible for oxygenation of the blood that will be transported throughout the body via systemic circulation [1].

schematic diagram of circulatory system

Picture 1: Schematic Diagram of the Circulatory System
Source: Koeppen BM & Stanton BA. Berne & Levy Physiology 6th edition. Elsevier, Inc. 2008.

In the pulmonary circulation, deoxygenated blood from the peripheral veins drain to the superior and inferior venae cavae towards the right atrium and right ventricle. Deoxygenated blood is then pumped to the lungs via pulmonary arteries. The lungs will get rid of the wastes and reoxygenate the blood. Oxygenated blood will pass through the pulmonary veins into the left atrium and left ventricle then back into the systemic circulation [1-3].

The heart pumps the oxygenated blood and circulates it to all parts of the body through the arteries. Arteries serve as the hydraulic filter because the continuous blood flow pumped by the heart is stabilized before it approaches the capillaries. Capillaries serve as the exchange point between oxygenated and deoxygenated blood. When it reaches the target organs, the target organs use up the oxygen that the blood carries, so it becomes deoxygenated blood. Veins carry deoxygenated blood back into the heart for reoxygenation and the cycle continues [1-5].

This article focuses on the differences between the blood vessels.

Layers of the Blood Vessels

artery vs vein vs capillary

Picture  2 : Layers of the Blood Vessels

The layers of the blood vessels basically determine their function. Both arteries and veins have tunica interna, tunica media, and tunica externa.

Tunica interna is the innermost layer made up of endothelial cells and is in contact with the blood. Capillaries only have this single layer of endothelial cells which makes it possible for diffusion of oxygen, carbon dioxide, nutrients, and waste products to take place.

Tunica media is the middle layer composed of smooth muscles and elastic fibers which regulates blood flow and pressure by vasoconstriction and vasodilation. This layer is thicker in arteries compared to veins that is why blood flow and pressure in the arteries are higher than in the veins.

Tunica externa is the outermost layer composed of connective tissue that serves as support to the entire blood vessel. This layer is also thicker in arteries that the veins to accommodate the higher blood flow and pressure [1,6,7].

Description of the Blood Vessels: Arteries vs. Veins vs. Capillaries

The blood vessel responsible for distributing oxygenated blood throughout the body is the artery. Since the blood is oxygenated, its color is bright red and when an artery gets injured, blood squirts because of arterial pressure is high compared to the vein [5,8].

The blood vessel that comes out from the heart is the aorta, the largest artery in the body. As the arteries continue peripherally, the wall becomes thinner, the internal diameter narrows, and they tend to be more muscular until they become arterioles. Since the surface area in the aorta and large arteries are relatively broad, blood pressure is relatively high, and resistance to blood flow are relatively low compared to smaller peripheral arteries and arterioles where the surface area is narrow so there is lower pressure and higher resistance to blood flow [7,9].

From the arterioles, the capillary beds (each consisting of 10-100 capillaries) arise. This is where the exchange of oxygen, nutrients, and wastes between blood and tissues take place through diffusion. This is made possible in the capillaries by its very thin walls, highly permeable endothelial cells, very short tubes, and low flow velocity [7,10].

From the capillaries, venules arise. Its side become bigger until they become veins. Veins are responsible for bringing deoxygenated blood back to the heart for reoxygenation so the body can use the blood further. As it approaches the heart, the veins become fewer in number, cross-sectional area becomes decreased, and the blood flow velocity increases. Also, veins have valves that prevent backflow of blood towards the organs, especially in the lower extremities, due to the effects of gravity. Arteries do not have valves [1,5,7,9].

blood vessel measurements

Picture 3: Measurement of blood vessels in terms of diameter, wall thickness, endothelium, elastic tissue, smooth muscle, and fibrous tissue
Source: Koeppen BM & Stanton BA. Berne & Levy Physiology 6th edition. Elsevier, Inc. 2008.

blood vessel relationship between pressure, velocity, and cross-sectional area

Picture 4: Relationship between blood pressure, blood flow velocity, and cross-sectional area of the blood vessel. Decreased cross-sectional area means higher pressure and velocity, as seen in large blood vessels like aorta, large arteries, large veins, and venae cavae. Increased cross-sectional area means lower pressure and velocity, as seen in arterioles, capillaries, and venules.
Source: Koeppen BM & Stanton BA. Berne & Levy Physiology 6th edition. Elsevier, Inc. 2008.

characteristics of blood vessel segments

Picture 5: Characteristics of Blood Vessel Segments
Source: Despopoulos A & Silbernagl S. Color Atlas of Physiology 5th edition. Thieme. 2003.

Comparison Chart

Internal Diameter Narrower (4mm) Wider (5mm)
Wall Thickness Thicker (1mm) Thinner (0.5mm)
Strength More Less
Distensibility Less More
Smooth Muscle More Less
Elastic Tissue More Less
Fibrous Tissue More Less
Cross-Sectional Area* Decreased Decreased
Pressure* High Low
Volume Low (15%) High (65%)
Flow Velocity* HIghest Low
Direction of Blood Flow Away from the heart Towards the heart
Oxygen in the Blood Oxygenated blood (except for pulmonary artery which carries oxygenated blood) Deoxygenated blood (except for pulmonary vein which carries oxygenated blood)
Color Bright red Dark red
Valves Absent Present
Injury to the Blood Vessel Squirting blood Pooling of blood

*Depends on the size of the blood vessel. There is inverse relationship between cross-sectional area vs. pressure and flow velocity.

  • This video shows the simple anatomy of arteries and veins. Watch it on:
  • This video emphasizes the main differences between the arteries and veins. Watch it on

  4. Despopoulos A & Silbernagl S. Color Atlas of Physiology 5th edition. Thieme. 2003.
  9. Koeppen BM & Stanton BA. Berne & Levy Physiology 6th edition. Mosby Elsevier, Inc. 2008.
  10. Guyton & Hall Textbook of Medical Physiology 12th edition. Saunders Elsevier, Inc.

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Lymph Nodes Wed, 10 Aug 2016 07:54:24 +0000 Most people wish to learn more about their lymph nodes when they notice a change in size. At times your doctor may even say he notes your lymph nodes swollen. This usually is significant in infections.

The lymph system has often been put in second place to the circulatory system. But if you are reading this article it is because you have become aware of the importance of the lymph nodes and the lymph system.

The location of the lymph nodes is important in knowing if there is infection or cancer in the body. The lymph system is certainly easier to understand if you have an understanding of what your circulatory system is. (6)

But that is not to say that they cannot stand separately. In this article, you will find answers to the questions such as:

  • What is the lymph system?
  • Where are the lymph nodes located and how can I find them in my body?

Be aware that this article is for information purposes only. If you note a difference in size or shape in any of the areas noted in the article bellow it is suggested that you advise your medical professional as soon as possible.

What is the Lymph system and What does it do?

1.  It is a one-way flow which brings lymph fluid to the cardiovascular system. Lymph fluid is full of toxic byproducts and needs to be eliminated from the body through the kidney, colon, skin, lungs, and liver and is brought there through the lymph system. (7)

2. It is necessary for body fluid homeostasis (keeping it at the norm), fat absorption, and immune response. (1)

3. It is the key when interstitial swelling or edema is noted. They lymph system is what helps to decrease this swelling and push the fluid into the circulatory system for elimination.

4. The system, in short, has vessels, organs, lymphoid tissue, lymph nodes and lymph fluid.

  • Lymphatic fluid: Not only contains toxins and cellular waste but also oxygen, nutrients, hormones, and fatty acids.
  • Lymphatic vessels: the method of transport for lymphatic fluid, and the method of dumping fluid into the circulatory system.
  • Lymph nodes: These are where the lymph fluid is regulated or filtered. It is where pathogens are eradicated and broken down. (1) This is why during infection they are swollen. This work process causes inflammation in the lymph nodes.
  1. They are scattered over the whole body in cluster type formations. Although they are scattered they do have a pattern.
  2. Your body has 600-700 lymph nodes.
  3. Lymph nodes contain a cortex and medulla. They are basically little filters throughout your body which also harbor white blood cells until they are mature and able to fight against invasions on the body by infections. The image bellow demonstrates the complexity of a lymph node.

The image shows the parts of the Lymph node including the Afferent and efferent lymphatic vessels which are where the lymph fluid enters and exits the lymph node.

Lymph node including the Afferent and efferent lymphatic vessels

Picture 1: Lymph node including the Afferent and efferent lymphatic vessels
Image Source:

The lymph nodes are considered as lymph organs but there are other organs involved in the system that should also be noted.

  1. Spleen: Also eradicates pathogens and helps to monitor blood components and the immunologic response.
  2. Thymus: Where T-lymphocytes mature and develop. T-lymphocytes are essential white blood cells in the immune system.

Lymph System functions:

  1. Absorb elements from the digestive system such as fats and fat-soluble vitamins and transfer them to the blood stream. (7)
  2. Restore the fluid balance in the blood stream. By transporting extravagated cells, plasma macromolecules from tissues and placing them back into the circulatory system to be filtered. (1)
  3. Place a defense in the body against foreign organisms. (7)

The lymph fluid is not pumped through the lymph nodes and vessels by the heart as in the circulatory system. Instead, muscle contraction helps to move the fluid. The lymph vessels have one-way valves so when pressure is applied the fluid can only move in one direction. (3)

This image helps you to visualize what is considered one-way valves.

one-way valves

Picture 2: One-way valves.
Image Source:

What is some common terminology used when discussing the lymph nodes?

  • Initial lymphatics – These are the smallest vessels involved in receiving fluids from tissues in the body.
  • Pre-collecting lymphatics – these vessels contain smooth muscle and are able to contract on their own. They connect the collecting vessels to the capillaries.
  • Collecting lymphatics – These do not have the one-way valves and is very similar in structure to blood vessels.

This image can help you see how the fluid can flow throughout the lymph vessels.

How the fluid can flow throughout the lymph vessels

Image 3:  How the fluid can flow throughout the lymph vessels.
Image Source:

Diseases and Disorders associated with the Lymphatic system

  • Lymphedema – edema or accumulation of fluid in the tissues caused by the lymphatic system not draining correctly.
  1. Primary- inherited
  2. Secondary- due to other causes.
  • Lymphoma– Cancer found in the lymphatic system.
  • LymphadenopathySwollen lymph nodes because of infection.
  • Lymphadenitis – Swelling in the lymph nodes because of bacterial infection.
  • Filariasis– When the lymphatic system is compromised by parasitic infection.
  • Splenomegaly – Swelling or inflamed spleen due to viral infections.
  • Tonsillitis – Swelling and infection in the tonsils. (7)

Locations of the Lymph nodes and how can you find them?

If the lymph nodes are swollen or inflamed you can feel them upon palpitation (light touching with pressure).

In this image, you can see the areas where clusters of lymph nodes are in the body. Not all lymph nodes can be felt upon palpitation unless they are inflamed. These clusters of lymph nodes are considered as:

clusters of lymph nodes

Picture : Lymphatic system – Location of various lymph nodes

lymph node regions location picture

Picture : Location of Lymph Node Regions in neck and body

1. Cervical, Axillary and Inguinal

  • often easy to palpate even when not swollen or inflamed.

axillary lymph nodes locationPicture : Axillary lymph nodes location and groups

axillary lymph nodes surface markin g

Picture : Axillary lymph node location (surface marking) skin

cervical neck lymph nodes classification and types

Picture : Cervical lymph nodes (Neck) classification – groups

inguinal lymph nodes location picture

Picture : Inguinal lymph nodes (Horizontal and vertical groups)

2. Superclavicular, supratrochlear, mesenteric, popliteal, and iliac

  • Usually only felt when swollen or inflamed.

3. Thoracic, Lumbar, Mediastinal

  • only viewed with imaging.

All can be seen clearly with imaging.

This image makes very clear the auxiliary lymph nodes and ducts which may become inflamed.

auxiliary lymph nodes and ducts which may become inflamed

Photo 4: Auxiliary lymph nodes and ducts which may become inflamed.
Image Source:

Imaging and Diagnosis

  1. Lymphography– Is the same as an angiography but the contrast must be injected in the correct area of the circulatory system in order to show the lymph system.
  2. Lymphoscintigraphy– Uses radioactive tracer and a scintillation camera to show the flow of lymphatic fluid through the system. This method does usually have a poor resolution and for this reason, is not readily used.
  3. MRI-(Magnetic resonance lymphography) – Non-invasive but uses contrast to cause a relaxation time.
  4. PET/CT-Uses a tracer and is used to look for metastatic colonies.
  5. CEUS (contrast-enhanced ultrasound) – Uses microbubbles or gaseous cores in lipid or polymer shells to increase visualization of the lymph nodes.
  6. NIR (near-infrared fluorescence imaging) – Based on light reflection from the tissue.
  7. New ways of imaging are being offered such as: OCT/OFDI (optical frequency domain imaging) – Also based on light reflection or scattering. It is also used for vascular mapping. (5)

This image reflects how clearly the lymph system can be seen with new technologies

lymph system can be seen with new technologies

Picture 5: Lymph system can be seen with new technologies
Image Source:

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Forearm Pain Fri, 05 Aug 2016 19:02:42 +0000 This topic has been very controversial over the last few years. The reason for this is due to the workplace and personal injury claims.

Also, there has been a huge increase in computer use at home and in the workplace, which some had thought was part of the issue.

Another major concern is continuous repetitive movements in the workplace or in sports. Many have even suggested a psychological or stress related cause. (1)

The main topic of discussion is the baseline cause of forearm pain. Physicians have to be very comprehensive in receiving history from patients who complain of forearm pain. (5) In this article, you will review the possible causes or diagnosis related to forearm pain as well as the specific symptoms and treatments of each.

Forearm Anatomy

The anatomy is important for left or right forearm pain. Bellow you can see the complexity of what all is involved in such a small portion of your body.

i.    Joints:

  1. Humeroulnar joint- for flexion and extension
  2. Humeroradial joint- for flexion and extension as well as pivoting or rotation.
  3. Proximal radioulnar joint- for supination and pronation, or turning the hand with palms up or down.

ii.    Ligaments

  1. Anterior medial collateral ligament (AMCL)
  2. Lateral collateral ligament (LUCL)
  3. Anular ligament

iii.    Muscle groups

  1. Biceps brachii
  2. Brachioradialis
  3. Brachialis
  4. Triceps
  5. Anconeus
  6. Supinator
  7. Pronator quadratus
  8. Pronator teres
  9. Flexor carpi radialis

iv.    Nerves

  1. Median nerve – initiates in C5-T1
  2. Ulnar nerve – initiates from C8-T1
  3. Radial nerve – initiates from C5-C7 (5)

anatomy of the arm forearm hand

Picture source :

This image is a complex example of the anatomy of the arm. Seeing the complexity of this system can help you to understand why there are so many possibilities to injury.

b.    The forearm

i.    Muscles

  1. Flexor profundus
  2. Flexor carpi radialis
  3. Palmaris longus
  4. Flexor digitorum superficialis

ii.    Bones

  1. Radius and Ulnar- are in contact at the ends and work as a team (7)

c.   Hand

i.    Bones and joints

  • There are 27 bones in the hand.
  1. Carpus
  2. Metacarpus
  3. Fingers (phalanges)

hand bones anatomy carpals metacarpals

This image helps you to see the many bones involved in hand movement. The complexity of the hand is many times involved in forearm pain.

Picture source :

ii.    Muscles

  • The hand has over 30 muscles that work together in order to function correctly.

iii.     Tendons and connective tissue

  • In this image, you can see the tendons as well as the nerve passage. The area affected by carpal tunnel is highlighted as well.

anatomy hand median nerve carpal tunnel

Picture source :

iv.    Nerves

  • Median nerve – supplies the flexor policies brevis, opponents pollicis and abductor pollicis brevis.  (3)

Forearm Pain  Causes

a. Psychological distress

Can be a cause of tension and also can be a cause of misinterpretation of diffuse bodily pain. (1)

b. Computer use

Specifically with extensive use of the mouse. Findings of one study actually suggest that computer use without the use of a mouse will not usually cause forearm pain. (2)

c. Diagnosis of Forearm pain

  1. Inflammatory diseases such as rheumatoid arthritis and synovitis
  2. Trauma such as lunate dislocation and supercondylar humerus fracture
  3. Vascular issues such as diabetes and microcirculatory disease.
  4. Injections causing hematomas
  5. Swelling due to pregnancy or hypothyroidism
  6. Growths such as ganglions, lipomas, or sarcomas
  7. Anatomical anomalies present in the muscles or facular area.(3)

d. Diagnosis which have forearm pain as a symptom:

i.    Entrapment neuropathies: loss of function or sensation and feeling of weekends in the upper extremities. Due to repetitive posture, motion, or force.

ii.    Syndromes such as

  1. Anterior interosseous syndrome
  2. Pronator syndrome
  3. Carpal tunnel syndrome
  4. Ulnar tunnel syndrome
  5. Cubital tunnel syndrome
  6. Superficial radial nerve syndrome
  7. Posterior interosseous syndrome
  8. Radial tunnel syndrome (3)

iii.    Lateral epicondylitis commonly known as tennis elbow. Risk factors could include carrying items heavier than 1kg constantly, carrying items heavier than 20kg around 10 times a day. (4)

iv.    Radial neuropathies – related to wounds, fractures or other open injuries to the arm. (6)

v.    Acute Compartment Syndrome (ACS)– most commonly caused by distal radius fracture. (8)

vi.    Intersection syndrome– when the radial wrist extensors show tenosynovitis.

vii.    Quervain tenosynovitis

viii.    Carpometacarpal (CMC) arthritis

ix.    Radial sensory nerve irritation

x.    Extensor pollicis longus tendinitis (9)

  1. Minor polyneuropathy – numbness and tingling. (1)
  2. Forearm and lateral elbow pain
  3. Tenderness in the lateral epicondyle area
  4. Increase in pain with wrist extension, flexion or supination.(4)
  5. Pallor
  6. Paresis
  7. Unable to find a pulse – In this case, medical attention should be immediate. (8)
  8. Swelling in the area of the forearm, wrist, hand, or fingers.
  9. Crepitus (a creaking sound or feeling around the joint) during movement. (9)

  1. Grip strength can show nerve involvement.
  2. MRI
  3. Radiographs
  4. EMG
  5. Nerve conduction testing (3)
  6. For proper diagnosis, the patient should be able to explain their pain appropriately this including the exact area of pain and any other area of the upper extremity that may have pain. In the images below you can see the areas that pain may occur. A neck region, B shoulder and scapula, C Upper arm, D forearm, and E hand and fingers.

region of pain neck shoulder scapula arm forearm hand fingers

pain in different classified regions

Picture source :

Forearm Pain Treatment

a.  The most common treatment for the variety of syndromes listed above includes:

  1. Physical therapy
  2. TEN unit placement
  3. Ointments and creams
  4. Massage
  5. Rest

b.  Many times surgical treatment is the choice if one of the above treatments are not successful. This is done to release pressure from the nerves and to prevent necrosis or the growth of scar tissue. (3)

c.  For tennis elbow, most patients respond to nonsurgical intervention such as therapy and rest. (4)

d.  Fractures must be set and sometimes pins will be needed for proper placement. (7)

Although there are many possible diagnoses associated with forearm pain the diagnosis most often considered is a syndrome due to workplace hazards. In these cases, psychological distress can increase or aggravate the current symptoms.

Most often forearm pain is associated with people who have had other type of musculoskeletal pain. (1)

One should always consult a doctor in order to receive a proper diagnosis.  (1)

References :

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Anterolisthesis Fri, 22 Jul 2016 17:18:20 +0000 Anterolisthesis vs Spondylolisthesis

Spondylolisthesis is the general term for slippage of one vertebra on an adjacent vertebra. The slippage can either be anterolisthesis or retrolisthesis.

Anterolisthesis Definition

Anterolisthesis is derived from two words: ante meaning front and listhesis which means slippage. The condition anterolisthesis is a form of spondylolisthesis where there is anterior displacement or forward slip of the spine. Retrolisthesis, on the other hand, is backward displacement of the vertebral bone in relation to the natural curve of the spine.

Adult anterolisthesis in the low back

Figure 1: Adult anterolisthesis in the low back

(Image source:

Anatomy of the Spine

In order to understand how anterolisthesis can affect one’s overall health, an overview of the human spine is important. Our spine is made of 33 individual bones stacked one on top of the other. Functions of the spinal column include support for the body and protection of the spinal cord from injury [3]. The bones of the spinal column, called vertebrae, does not only offer protection to the spinal cord.

The manner on how the vertebrae were put together provides enough space for the nerves to be connected to the rest of the body systems for proper functioning. Damage towards the vertebrae would also affect the nerve functioning of a body part or body system that is being supplied by that specific nerve.

The spinal column is divided into regions with specific functions. If you take a look from the side, the overall length of the spine takes a natural S-shaped curve. This allows the body to maintain balance, perform range of motion, and protection as well as it works like a coiled spring to absorb shock [3].

Regions of the Spine

The spinal column and its different regions

Figure 2: The spinal column and its different regions

(Image source:

  • Cervical spine contains 7 vertebrae and its main function is to support and hold the head which weights approximately 10 pounds.
  • Thoracic spine contains 12 vertebrae and have a gentle convex curve. This region of the spine has the many number of vertebrae because its main function is to hold the rib or thoracic cage and protect major organs of the body – the lungs and the heart.
  • Lumbar spine has 5 vertebrae that supports the weight of the body. If the thoracic spine has the many numbers of vertebrae, the lumbar spine has the largest vertebrae to provide support and prevent injury especially when lifting or hoisting heavy or large objects.
  • Sacrum contains 5 vertebrae that are joined together and holds the pelvic girdle.
  • Coccyx is comprised of four joined bones that provide connection for ligaments and muscles of the pelvic floor.

Anterolisthesis can happen in any region of the spine but it usually develops in the fourth and fifth lumbar vertebrae [4]. The outcome of the displacement of the vertebrae can result to compression of spinal nerves and other damages in the spinal cord.

Anterolisthesis Symptoms

The clinical presentation of anterolisthesis will depend on the degree of the vertebrae slippage and the location affected by the slippage.

  • Lower Back Pain
    The most common and possibly initial symptom that will be presented is lower back pain. The pain experienced by the person with anterolisthesis may be localized, meaning it only stays on one area, or widespread [4]. This is due to inflammation of the tissue relative to the disc, nerve roots and spine. At times, the pain can be felt in one or both legs and is also accompanied by weakness or numbness [4,5].
  • Difficulty walking
    Because of the pain, movement is limited and the person may report difficulty in walking as the pain extends to the legs [5].
  • Loss of bladder or bowel control
    If the anterolisthesis arise at the lower (lumbar) end of the spinal cord and affects the nerve roots in this area called cauda equina [4,5,6]. As such, symptoms of inability to control urine and bowel in terms of retention and elimination may be a problem.
  • Limited body movement
    The extent of inflammation and pain in the leg, back, or buttocks can lead to limited body movement like bending over or twisting [5].

Anterolisthesis Causes

There are many reasons that can cause anterolisthesis:

  • Injury to the spine can lead to forward displacement of the vertebrae [8]. Fractures are the most common reason.
  • Persons engaging in strenuous physical activities like weight lifting, gymnastics or football [7].
  • Genetics [9]
  • Growth of tumor in the spine [4]
  • Ageing [4]

Anterolisthesis Risk Factors

The following factors places the person more prone to develop anterolisthesis compared to others”

  • Physical factors
  1. Sex: Males are more common to have anterolisthesis compared to females primarily due to their engaging in more physical activities [7].
  2. Age: Ageing process could lead to degeneration of bone structure making them more fragile and prone to damage and injuries. Although it’s a natural process, older persons are more likely to develop symptoms of anterolistesis due this reason [4].
  • Occupational factors that requires heavy lifting, hyperextension of the body, jumping and other strenuous activities (e.g., athletes, gymnasts, weightlifters, persons engaging in extreme sports, etc.)

Anterolisthesis Diagnosis

There are several diagnostic procedures that can detect and confirm the medical diagnosis of anterolisthesis. Initially, a specialty doctor (Orthopedist) will take the patient’s medical history and perform a physical exam, including checking the patient’s reflexes.

X-rays of the spine will show if any of the vertebrae have fractures or cracks and have slipped out of place [5]. Magnetic resonance imaging (MRI) and CT scan can detect the extent of the slippage and involvement of nerve damage [10].

Anterolisthesis Grading

Extent, severity, and degree of anteroslisthesis is graded according to percentage as soon as diagnostic procedures are completed [4]

  • Grade I –25% of forward slippage and considered mild
  • Grade II –26% to 50% slippage
  • Grade III – about 51% to 75% of forward slippage.
  • Grade IV – due to the extent of slippage percentage presented, between 76% to 100% of slippage, this is considered the severe case of anterolisthesis.
  • Grade V – a complete fall off from the next vertebra.

Grading of anterolisthesis

Figure 3: Grading of anterolisthesis.

(Image source:

Anterolisthesis Treatment

Treatment for anterolisthesis can be divided into two types, depending on the degree or extent of the vertebrae slippage.

Conservative Treatments

If the condition is mild, the doctor may advise with stopping any physical activity that may have led to vertebrae damage. This will also allow the body to heal naturally, because with sufficient rest, inflammation and pain can be minimized.

Medication Administration and Management of Pain

  • It is important to remember that medications can alleviate one’s pain experience, however, patients should also be instructed to watch out for side effects and overuse or dependence to medications.
  • Doctors recommend NSAIDS or non-steroidal anti-inflammatory drugs like aspirin, ibuprofen and naproxen.
  • These medications provide pain relief without the worries of drug-dependence [11].
  • For chronic back pain, opioid therapy is given if the patient does not respond to the first-line of drugs. Take note, this therapy is less ideal because of the danger of dependence and potential toxicity to the body.
  • Other medications that are prescribed are muscle relaxants, anti-seizure pain drugs, antidepressants, and steroids taken orally.

Physical Therapy

  • Together with medications, doctor would also be recommending physical rehabilitation therapy to help ease the pain, decrease inflammation, increase and promote vitality [11].
  • Physical therapy also helps build up stomach and back muscles (core strengthening) [5].
  • The physiotherapist may include therapeutic exercises, use of heat and electrotherapy treatments to help achieve the goal of recuperation.

Chiropractic Treatment

  • Another traditional treatment that can be considered for anterolisthesis is the manipulation of the bones of the spine to achieve correct alignment.
  • Initial physical assessment and medical history taking is conducted to determine if you are qualified for this treatment. Not all persons can receive chiropractic treatment, thus an initial screening is done to detect “red flags”. These would refer to the following conditions [12]:
  1. Abdominal aortic aneurysm (AAA) – enlargement of the aorta characterized by pulsating mass in the abdomen and pain at rest.
  2. Cancer
  3. Infection
  4. Cauda equina syndrome [4,5,6]
  5. Compression fractures

If conservative treatment does not help at all, surgery is the next option and the type of surgery will depend on the diagnosis, extent and severity of anterolisthesis.

The goals of surgical procedures are:

  • Decompression – this is to remove bone or other tissue to release the pressure in the vertebrae
  • To fuse the bones in position
  • Both decompression and fusion

  1. Spine-Health –
  2. Neuroscience Online – Chapter 3: Anatomy of the Spinal Cord –
  3. Mayfield Brain & Spine – Anatomy of the Human Spine –
  4. Anterolisthesis – Grading, Symptoms, Treatment, Causes, Diagnosis –
  5. Spondylolisthesis – Topic Overview –
  6. Cauda Equina Sndrome –
  7. Spondylolisthesis: Back Condition and Treatment-
  8. What is Anterolisthesis? –
  9. Lumbar Spondylolisthesis or Anterolisthesis: Patient Educational Information
  10. Cedars-Sinai: Anterolisthesis –
  11. The American Center for Spine & Neurosurgery: Spondylolisthesis (Cervical)
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Cocaine Drug Tests and Facts Sun, 10 Jul 2016 08:43:26 +0000 Cocaine Facts

Cocaine is a highly addictive drug, popularly known as coke, candy, crack, snow or flake. Once it is introduced into the human body, the drug makes the brain release high levels of bio-chemicals.

This results in an extreme feeling of joy and excitement [3, 9, 10].

How is Cocaine taken?

Cocaine can be administered orally, intravenously, intranasal and through inhalation.

  • When inhaled through the nose, the nasal tissue absorbs it into the individual’s bloodstream.
  • Injecting the drug into the body directly releases it into the bloodstream, intensifying the effects.
  • Smoking cocaine involves inhaling the vapor into the lungs. Absorption after smoking is as fast as when the drug is injected. [9, 10]

Why do people smoke Cocaine?

For most people, cocaine is used for the following:

  • Recreational benefits
  • It can increase one’s alertness; significantly reduce fatigue, increase decisiveness and sometimes strength.
  • The cocaine drug is often abused due to its euphoric effects.
  • In some instances, it is used as a local anesthetic during nose, ear and throat surgeries.
  • In the past, coca leaves were chewed and sometimes brewed into tea for refreshment.

Peak levels and half-life of flake

  • Cocaine is believed to be made from the leaves of a plant known as coca.
  • It has a half- life of around 0.2 to 0.8 hours.
  • The primary metabolite is known as benzoylecgonine, and its half -life is around 6 hours.
  • The route of administration highly influences cocaine performance in the human body For instance; snorting 160mg can bring peak levels in the body after thirty minutes.
  • If the cocaine is taken orally, the peak levels occur after one hour. When a dose of 32mg is injected into the body, it produces the peak plasma concentration in a duration of five minutes. [5,6]

Cocaine Drug Testing

Cocaine drug testing is the evaluation of blood, urine or any other biological sample to determine whether an individual has been using cocaine [6,9,10]. Many circumstances can lead to cocaine testing.

An individual will most probably go for the test when applying for positions that involve airline industries, federal transportation, railways and any other place where safety is crucial.

What laboratory tests are used for testing cocaine?

If you need to go for a cocaine drug test, the most important thing is to ensure that the laboratory is certified and reputable. A credible screening should have two primary processes:

  1. Immunoassay
  2. Confirmatory

These two tests have a high sensitivity level, and you will have minimal chances of getting false negatives or false positives.

  • The screening method is the immunoassay, and it is performed first.
  • If you test negative for this test, you will not require any more tests. The results will be ruled out as negative.
  • If your samples test positive, the confirmatory GC-MS test will be performed on a different portion of the sample. [5,6]

How long does coca stay in the hair?

  • Cocaine concentration in the individual’s hair will be detectable after 90 days. The drug, however, will not leave any marks on the root of the air [5].
  • The marks will be at a particular area. This means that it will remain on the hair until you cut it or may be falls out.[5,6]

How long does flake stay in the body?

  • Coca is known to be extensively metabolized to different types of compounds that are centrally inactive.
  • The drug will most likely be metabolized in duration of four hours. However, the drug is still detectable in most drug tests after one week. Some individual tests can detect the drug after over three months. [5,6]

How long does cocaine stay in the urine?

  • Just like any other drug, cocaine does not have an exact detection period for urine.
  • Extracts of the drug can be excreted from the urine after several weeks.
  • During the first few hours after administration, low concentrations of the drug might be detected in the urine.
  • Benzoylecgonine concentrations in the body are increased after some time, and they are detectable from 2-4 days.
  • Heavy and chronic use of the drug can result in detectable levels for a longer time. [5,6]

How long does flake stay in the blood?

  • After the administration of the drug, some parts of the dose might remain in the system for 48 hours, and they can be detected in the blood. Some users of the drug might develop cocaine tolerance.
  • The changes in the cocaine concentration in the storage can be paramount for blood testing.
  • Cocaine is believed to have a bigger overlap between lethal, toxic and therapeutic concentrations, unlike all the other drugs. Some individuals might not have cocaine present in their blood, even when they have used it for a long time.[5,6]

How long does cocaine stay in sweat or the saliva after use?

  • Flake traces in the saliva have a half-life of around 2 hours.
  • In some cases, cocaine concentration in the saliva can be visible after 19 hours. In sweat, the peak levels of cocaine concentration will be 4.5 to 24 hours [5,6]

How to pass a drug test for cocaine

Many people do not know how to get rid of the cocaine in their system. Removing this drug from the body will be determined by several factors like sex, frequency of use, age, and the body’s metabolic rate [1]. Using the drug can bring several health complications. If you take the drug in large quantities, you have higher chances of getting high blood pressure and higher heart rate.

If you want to minimize the coke in your system so that you can pass a drug test, there are several methods to use. Here are some of them:

  • Drinking a lot of water is one way of eliminating cocaine traces in the body. These traces will be excreted through sweat and urine
  • If you want to remove the drug traces in your hair, it is important to use detox spray or the detox shampoo to wash the hair.
  • It is also advisable to take any detox drink or even pills. If taken a day before the test, they will remove the cocaine traces in the system.
  • To remove traces of cocaine in the mouth, you can use mouthwashes and cleansers.
  • If you have been using the drug, exfoliate the dead skin cells on your body using a brush. This will eliminate the dead cells in your body, and the traces of cocaine of the surface will also be removed.
  • Foods that contain fat, caffeine and sugar should be avoided all the time. Instead of this foods, eat more fruits and salads.
  • To speed up the detoxification process, people can also opt for the waster fasting or the juice fasting foods.
  • These foods should have a lot of Vitamin B, and they should be taken consecutively for one week.
  • The body naturally gets rid of toxins through perspiration. This can be a good way to remove traces of the drug in your system. Increase the rate of perspiration, and you will have removed the drug from the body. A steam bath will be very helpful.

You must also stop using the addictive drug if you want to test negative. This will enhance the process of eliminating it. [8,7]

Cocaine and Addiction

  • Many people underestimate how cocaine can be addictive.
  • Once your body is used to the drug, you will have more desire for the drug, despite the negative results it has on you [1,3,4,9,10].
  • Cocaine addiction is very common among drug users, regardless of the route of administration used.

Treatment for cocaine addiction

If you discover that you have been abusing cocaine, it is crucial to seek help and cut off the drug and its effects on your life [3]. There are different types of treatments available today, and you will only have to choose the treatment that suits your needs.

Most of the treatment approaches will combine cognitive-behavioral therapy, detox, group and individual therapy [8]. The treatment should contain relapse prevention and aftercare planning so that the patients get cured completely.

  1. National Surveillance of Cocaine Useand Related Health Consequences [Internet]. 2016 [cited 5 July 2016]. Available from:
  2. Cocaine and Crack [Internet]. 2016 [cited 5 July 2016]. Available from:
  3. Cocaine (Topical Route) Description and Brand Names – Mayo Clinic [Internet]. 2016 [cited 5 July 2016]. Available from:
  4. Cocaine: MedlinePlus [Internet]. 2016 [cited 5 July 2016]. Available from:
  5. How Long Does Cocaine Stay in Your System? [Internet]. 2016 [cited 2 July 2016].Available from:
  6. Cocaine Urine Test – Drugs Forum [Internet]. 2016 [cited 2 July 2016]. Available from:
  7. [Internet]. 2016 [cited 2 July 2016]. Available from:
  8. Cocaine Abuse [Internet]. 2012 [cited 2 July 2016]. Available from:
  9. Cocaine Addiction Symptoms and Effects – Timberline Knolls [Internet]. 2016 [cited 2 July 2016]. Available from:
  10. Cocaine Use and Its Effects [Internet]. WebMD. 2016 [cited 2 July 2016]. Available from:
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Colorado Will Spend $10 Million Researching Marijuana's Medical Benefits

'Colorado Gov. John Hickenlooper (D) signed a bill Wednesday that will fund up to $10 million for research into the medical efficacy of marijuana.

"SB 155 invests the dollars collected from medical marijuana fees into a meaningful effort to study the therapeutic and medical benefits of the drug," state Rep. Crisanta Duran (D), a co-sponsor of the bill, told The Huffington Post. "Patients will benefit from this investment and Colorado will become a national leader in developing medical marijuana research."'

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Friday, 16 August 2013

If you want to be healthy which everybody should want then you should first analyze your diet and lifestyle. Being inactive for the best part of the day is really not good because if you sit around all day not doing much then when are you actually active? when you go to sleep? Be more active! It is very important remember your bosses dont care if you die of hear disease so long as you carry on working in the office sat down not moving.... so that why you must do something about this and be more active when your not at work if you carnt be bothered to quit that boring office job... If you have a office job then you MUST run, walk or cycle to work and DO NOT EVEN THINK ABOUT TAKING TRANSPORT TO WORK!... if it is a long way away then your best bet is to cycle... if it is a hours drive away then move move house closer to work! You health is the most important thing not a job..

Don't eat junk food either it tastes horrible and all the same. boring. Eating junk food.. guess what? is really bad and will harm your health! junk food will give you spikes in blood sugar levels resulting in insulin being released into your blood which causes fat sotrage to reduce sugar levels in your blood which aint good.. also these blood sugar spikes will give you boosts in energy very quickly and will be gone just as quickly leaving you tired and wanting more food...

Running and walking the best exercises

Running and walking helps to keep the heart healthy circulating blood efficiently throughout your body. Not being active and walking places causes poor health and a unhealthy heart which can cause all sort of problems.

Say no to being a slave and being un healthy

Do not slave away risking your health and life working a in office making someone else rich. Instead be more active and live life to the full that's what i say. The capitalists really do make life harder for people demanding we work more hours sat on a computer working away whilst our health suffers. Don't be a slave to these greedy morons and instead be more active and have fun playing sports and doing fun stuff instead!

How to improve your fitness

Really it is quite simple eat better, exercise more effectivly dont be lazy.

Laziness causes us not to bother to cook healthy and yummy meals, time is of the essence in most of our modern lifestyles... how easy it is to make and cost too that is why many of us choose to buy cheap quick and easy fast food meals that have been cooked in trans fats, rich in sugar and have no other nutrients except from maybe grease. But it is this lazy attitude toward not cooking healthy foods and not being active enough that is detrimental to our health. A better healthier lifestyle where we look after ourselves by eating meals that have nutritional value and having a wide variety of foods in a balanced diet, being more active and not sitting around working on a computer in a office and then going home and just watching tv all day is something you should stop if you want to be more healthy. If you take transport to work either a bus, or a car or train stop! Try instead walking or running to work.... or if it is a bit far at least cycle there.... doing this to and from work will make you more alert and less tired too... as it is not activity that makes you tired and lazy more inactivity in simple terms because your body has no reason to be awake.

Make sure you atleast do some exercise..... People forget to do exercise and should! Running or just taking long walks can be enough if you dont want to do to much. But it is very important that you do some as keeping your heart healthy is very important. You heart is needed to pump blood and nutrients to different parts of your body. It also needs to be healthy to pump more efficiently too causing less stress on the heart. A healthy heart reduces the chances of heart diseases dramatically.

Cook tasty but healthy food. Not all healthy food taste yucky ya know in fact there are tons of healthy food you can cook.. Chicken is healthy would you say that was disgusting? quite a lot of fruit is nice to eat which aint yucky either there really is a lot of tasty food available giving you a lot of choice.. there is more to tasty food than just chips everyday...chips again.. boring! Make sure that you cook the food right, use the right kind of oil like olive oil to fry things and not to much either.. stay away from fats to fry stuff and if you cook chicken or meat try grilling it instead as grilling doesn't add anymore fat to the meal, more healthy and tastes great too!

I hope that you take the points posted in this article and actually put them into practice as it isn't hard to be more healthy and live longer you just dont have to be lazy that's all.. and eat better and exercise!

feet hurt whilst running? how about some running insoles

 Isn't it really annoying when you go running and find that what lets you down isn't being out of breathe and not being able to run anymore but actually foot cramp or pain that halts your run or jog.

I mentioned running insoles in one of my other posts.. cant remember which one but I am sure I did. But just to tell those who didn't read that post and to explain in more detail how running insoles work and how they can stop pain whilst running.

Running insoles adapted for runners from orthotic arch support insoles to better cope in running conditions and situations running insoles will stabilize balance and footing position making you run much more efficiently. Less energy is lost on impact with the ground thus this also make the efficiency of your run far better too making you tire less. Stress on the knee is also greatly reduced. Running insoles create less fatigue on the knee and muscles in the leg making foot and leg cramp a thing of the past. Leave foot problem behind when you set of for your run in a pair of running insoles. the shock absorbing running insoles are the best as over time with constant impacts whilst you run this can cause shock which can become damaging and can even cause damage in your knee as well. Shock absorbing insoles stop this!
Why do you think all the greatest runner use them? no not just for endorsements but to help protect themselves and their running careers as they know a foot injury can ruin their running carreers quite easily and the best way to prevent on is to wear running insoles! Combat the effects that shock whilst running can have on your feet. No need to spend a whole wod of cash eithier as running insoles are quite inexpensive ranging from £10-£15.

By wearing running insoles you are helping to reduce the rick of injury and a pair will mean you will be able to run for longer without fatigue because of how the insoles work.

Running insoles have orthotic in their design.. and orthotics are used mainly as a way to ease pain and increase recovery time when injured so you know you cannot go wrong and these running insoles will help to prevent injury instead of just treating it.

Running insoles aren't just for the professional runners as lots of sports require a lot of movement and running running insoles can also be bought for sports too! In many contact sports there is a higher rick of collision and injury to so protecting yourself is even more important in sports as their is a higher risk.

A good diet is always the best option to stay healthy

What you eat is important reducing calories will not do! Just thinking if you reduce what you eat rather than just not eating empty calorie and unhealthy foods isn't the right way to go. Remember a 1000 calories or healthy fruit and vegetables is a lot different to 1000 of junk fast food! But people seem to forget this very simple fact that's why you shouldn't make the same mistake. Eating healthy is the only way to be really healthy... second is to be more active and exercise. But it is the food that you eat which will determine how much energy you will have for you to be able to exercise properly. Eat healthy foods and dont eat junk......... SO SIMPLE!

Need extra height?

If you are looking or wanting to be a little bit taller I have just the solution for you and the solution will also provide comfort and support to your feet as well something high heels doesn't do. Height increasing shoe lift insoles is the answer! What are these insoles? Well they do exactly what the name describe you place them in ya shoes and see how when you put on your shoes your much much taller than you should be. It doesn't stop there because of how the insoles work.. ie by elevating the heel with stacks mean that you are in control of what some say is impossible... just how tall you are! By adding or taking away stack you have complete control. I suggest that over time you adjust your height up adding a stack every once in a while this way you will seem to other that your growing taller! The comfort of these insoles is very important as how can you wear something that is uncomfortable or even damaging like high heels all day? Well a pair of these insoles wont be uncomfortable one bit quite the opposite in fact! Why is simply because... they are made with orthotics! Cool hey! Watch as people stop talking down to you and your confidence increases when you wear them that is what extra height can do! Dont beleive me then why not buy a pair and see if i am right or wrong.... dont worry they dont cost much AT ALL...£10 ONLINE! BARGAIN OF THE CENTURY!

Pick up a pair of these height increasing insoles

Nuovahealth is a good place to go to buy some of these insoles with a extensive collection to pick from and in a whole range of different sizes to fit you you'll be able to find the best pair for you no problems.

Oh yeah because of these insoles i was able to get.. well i bet you wont be able to guess how much taller i was able to get with them....? No not a few centimeters.. 3 whole inches thats how much taller you can get with all the stacks put in them. But it doesn't end there as you can always improve your posture too making you look even taller as well!! LOL no really this is all true.

Thursday, 15 August 2013

Footcare insole products

Looking after you feet is important because it is you feet that must support you and your body weight all day! But how can you look after them? Well there are various insoles that you can buy that are not too expensive which will help you avoid injury and look after your feet.

Arch support insoles
Arch support insoles are just one type of insole which can be bought. Some say that it is best to get custom insoles but custom ones are far too expensive and it makes no difference at all. Instead it best to get ones that are made out of a material which will mold to the shape the foot anyway and are the right shoe size.
Arch support insoles help give extra support to the arch which helps ease the stress and pressure that can cause damage on the arch which can cause plantar fasciitis.

Running insoles
Runnign insoles is a great choice to buy if you are a runner. these insoles are specially made to cope under the powerfull shocks that happen when playing sport or running... with shock absorbing qualities these shocks no longer will damage your foot.

Gel insoles
these insoles are both afford-ably priced  and for everyday use. lightweight and can be quickly added to your shoes these are the best bet if you dont want to spend to much money and want to avoid getting foot cramp at the end of the day of being on your feet all day.

There you have it 3 types of insoles which you can buy which will help prevent foot problems and help you better look after your feet!

Welcome to the healthyliving blog

The healthy living blog helps you by telling you some great health information and facts, plus with great health product reviews you will never go wrong! This blog is provided free for everyone to read... We dont offer serious medical advice though and recommend if you are suffering from a serious medical condition that you go see you doctor.


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Saturday, February 21, 2015

A Jaguar's Touch by Lacey Thorn

Each book gets better and better as the series goes on and I think our boy Tah has some competition in the alpha attitude department, Vic that girl will kick anyone's a** ten ways to Sunday if they cross her. She's pretty bossy in the bedroom as well, "eat it or move your a** up and slam that c*** deep inside me. I don't effing care. Just make me come." I wasn't expecting as much playfulness between Gideon and Vic but it was always there, "his hand smacked her smartly on the a**. "Be quiet, hellcat, before someone else comes out to delay us." I'm thinking Gideon has his own meaning of 'hanging out', "just going over this," he said. "And there's nothing I'd rather do than spend the evening..." His gaze dipped to her breasts. "hanging out with you." I really liked this book and am anticipating more.

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Thursday, January 14, 2010

Wonderful Christmas!

We had a lovely Christmas! My father-in-law (from New Jersey) and my brother-in-law (from Maryland) joined us for the holidays. Pop was actually able to spend New Year's with us as well. It was the first time that we had spent Christmas with Brian's side of the family in nearly 10 years!

Our tree wasn't as big as Janet's and Erik's (see previous post) but it was the largest one we had ever put up. And Santa was very good to us, as you can see:

Brian received an antique Missouri-Pacific china dinner plate from Pop. It looks great in our dining room, especially next to my lime green tinsel tree:

And as usual, Boomer enjoyed the whole experience. He loved the crunched up wrapping paper, the tree (although he is very well behaved. He doesn't climb it or play with the ornaments, he just loves to sit under it) and of course his presents. He gets lots of presents!

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how to clean up your life

Nurturing Your Whole, Happy Heart

Compassionate article about how to be happy and successful through self-awareness and self-improvement - the ultimate New Years Resolution! | Nurturing Your Whole, Happy Heart this New Year | Heirloom Soul

That’s my dear friend, Lindsey, up there.  She climbed to the 14,000 ft summit of Mt. Sneffels in 2013, and in this photo, she’s totally at peace, happy and wild and free, in her element.   As we begin another new year with open minds and hearts, it marks the perfect time to work on becoming better people.  Rather than mustering up some quick-fix resolutions on how to be happier and more successful (turns out that’s a real popular Google search), I suggest we spend the whole year on self-improvement and making room in our hearts for ourselves and the people who love and need us. Happiness and success can...