HUMAN KNEE ANATOMY

Symptoms of knee arthritis are often painful and debilitating, especially if the problem is left untreated. However, unlike most diseases, symptoms can fade or disappear altogether some days, and strike fiercely and unexpectedly other days.

There are three main types of knee arthritis. Osteoarthritis is the most common form, and generally strikes people who are middle-aged. This type of knee arthritis usually gets worse as time goes on. Gradually, the cartilage that surrounds the knee is worn away, causing your bones to rub together.

Rheumatoid arthritis is an inflammation of the knee that can destroy the cartilage surrounding the knee. This type of knee arthritis can strike at any age, and it generally strikes both knees and not just one.

Post-traumatic arthritis is the final, main type of knee arthritis. As mentioned, this type of knee arthritis occurs after an injury. It may not show up for years after you have sustained an injury to the knee, but once it does, it can be painful.

Symptoms of knee arthritis are different from patient to patient. You may experience "good days", or "bad days". In some cases, knee arthritis sufferers complain that the weather affects their symptoms. If it is damp or cold outside, your symptoms may increase in severity compared to when it is dry and more warm outside.

Symptoms of knee arthritis include:

A weakness in the knee

Joint swelling

Knee area feels stiff

Range of motion is reduced

Knee can become deformed

The knee and surrounding area becomes sore to the touch

Do not allow knee arthritis to ruin your mobility. If you notice any of the symptoms of knee arthritis listed above, see your doctor. The longer you leave it, the worse the symptoms can become.

While visiting with your physician is important there are a number of things you can do to alleviate the pain in your knees, if you are suffering from knee arthritis.

First and foremost, if you are overweight, you should strongly consider losing weight in order to take some of the pressure off your knees.

Staying away from any exercise that may exert extra, unneeded pressure on your knee is also recommended. In extreme cases of knee arthritis, you may be required to undergo knee replacement surgery.

A knee brace can also be used to lend extra support to the knee. If you tend to have more pain when certain knee movements occur you should highly consider the support a knee brace can provide. A low profile knee brace can prevent excessive movements and as a result reduce your pain. This is extremely important when you forget about your arthritic symptoms and make a movement without thinking. This is when the knee brace can be your aid.

If you have osteoarthritis a knee brace can also helpful. If you have malalignment due to arthritic anatomy changes at your knee joint. An "OA" (osteoarthritis) knee brace can help maintain proper alignment, thus reducing your pain.

Standard Anatomical Position

The first thing to be aware of is the standard anatomical position. This is the position all movements are derived from of the human body. This position is important to remember; when we use terms of direction to explain limbs assuming that they're in the standard anatomical position.

In human anatomy 'left' and 'right' refer to the left and right of the topic of observation not the observer, for example if I were to refer to the left arm I would be referring to the arm on our (the observer's) right.

Planes

In human anatomy often hear planes used to describe modes of movement or the location of structures (in relation to other structures). A plane is essentially an imaginary line through the human body. Different planes divide the body into different sections. There are 3 basic planes:

Sagittal (median) Plane

This is any vertical plane which runs from the front of the body to the back. As a result it partitions the body into right (dexter) and left (sinister) sections.

It is important to remember this doesn't just apply to the human body as a whole; it can be applied to the orientation of any individual body part.

Coronal (frontal) Plane

The coronal plane is another vertical plane, but it runs at a right angle to the Sagittal plane. It runs from left to right dividing the body into front (ventral) and back (dorsal) sections.

As with the Sagittal plane, it can be applied to individual body parts as well as the whole body.

Transverse (axial, transaxial) Plane

The transverse plane is a horizontal plane that runs perpendicular to the Sagittal and Coronal planes. It separates the body into upper (superior) and lower (inferior) sections.

As always this plane can be applied to individual body parts.

Glossary of directional terms

Below are listed a number of commonly used directional terms relating to human anatomy. It is important to consider that whilst these terms are commonly used they can vary significantly between disciplines. It should be noted that these terms apply to human (medical) anatomy and physiology not veterinary (or zoological) anatomy.

Proximal and Distal: Proximal and distal are terms used primarily in the description of limbs. Distal means further away from the torso whilst Proximal refers to the point where an appendage or limb attaches to the torso. To connect the two points creates the Proximodistal Axis. It is important to remember that these terms are relative; for example, the elbow is distal to the shoulder but it is proximal to the hand.

Lateral (externo), Medial (interno) and Intermediate: These terms are used in reference to the mid-line of the human body (the line through which the sagittal plane runs). Medial refers to structures closer to the medial line (i.e. the centre) whilst lateral refers to structures further away. Intermediate describes a structure between a medial and lateral structure. It is important to remember these terms are relative. For example, the nose is medial to the eyes. The eyes are medial to the ears. The ears and eyes are both lateral to the nose, and the cheeks are intermediate between the nose and the ears.

Anterior and Posterior: The term anterior (or ventral) refers to the front of the body (as split by the coronal plane). Posterior (or dorsal refers to the back of the body. These terms are generally used in conjunction (i.e. anterior and posterior, not anterior and dorsal). Over the whole of the body these terms can be used interchangeably with the exception of the brain (where dorsal means toward the top of the head and ventral means toward the bottom).

Cephalic and Caudal: The term cephalic (also known as cranial, rostral or superior) means toward the upper section or head whilst Caudal (inferior) refers to the lower part of the structure or away from the head. These terms are used in conjunction (cephalic and caudal, superior and inferior, not cephalic and inferior). They are once again relative and can refer to individual body parts as well as the human body as a whole. For example the knee is inferior to the hip, but superior to the foot.

Superficial: This refers to structures close to the surface of the body. The opposing term is deep. For example the brain is deep to the skull whilst the skull is superficial to the brain.

Types of movement

Flexion and Extension: These terms are used to describe movements in the sagittal plane (i.e. movements forwards and backwards rather than side to side). Flexion decreases the angle between to bones at a joint, an example is when the knee is raised. Extension is the straightening of a limb (it increases the angle between two bones at a joint), for example bringing the hand down from the shoulder.

Additionally, flexion and extension in the ankle are know as Plantarflexion and Dorsiflection

Hyper-extension is the action of extending the joint beyond 180 degrees. Hyper-extension is most commonly associated with joint injury.

Protraction and Retraction: Protraction is the action of moving a part of the body forward along the transverse plane by movement of anterior muscles. Retraction is the exact opposite.

Abduction and Adduction: Abduction is the movement of a limb away from the coronal plane of the body. Raising the arms from the hips so a 'T' shaped is formed is an example of abduction, as is the spreading of the fingers. Adduction is movement of a limb back toward the coronal plane.

Rotation: This is movement around its axis without lateral or medial displacement, for the turning of the head to look left or right.

Circumduction: This term describes the actions of flexion, abduction, extension, adduction performed one after the other. The over all movement means that the proximal end of the limb remains stationary whilst the distal moves in a circel (the limb thus outlines a cone).

Pronation and Suppination: Pronation is the movement of the hand from upward facing palm (anterior position) to a downward facing (posterior) position. The rotation is in no way as a result of movement of the arm. Suppination is the exact opposite movement.

Elevation and Depression: Depression describes the movement at a joint which results in downward (inferior) movement. Elevation is the exact opposite of this and results in superior movement. The action of shrugging the shoulders is an example of elevation followed by depression.

Inversion and Eversion: These terms primarily refer to movements of the feet, often in relation to injury (e.g.sprains). Inversion is the movement in the sole inwards (toward the sagittal plane). Eversion is the movement of the sole to face outward (away from the sagittal plane).

Opposition, Aposition and Reposition: Opposition (a term used expressly to describe the thumb) occurs when the hand assumes a holding position. It is important to consider that this term is used with varying specificity (i.e. some anatomists may use this term only to describe the thumb in contact with the little finger, whilst others may be less specific). Aposition (again unique to the thumb) is a broader term used to describe numerous positions of the thumb whilst holding (some anatomists consider these positions to be covered by opposition). Reposition is the movement back to the standard position.

Testing yourself will speed up how quickly you're able to retain these terms and thus increase your understanding of anatomy.

First of all, both the lower end of the femur and the upper end of the tibia are covered with a layer of cartilage, called articular cartilage. Secondly, there are two ring-like pads of cartilage inserted between the articular cartilage of the femur and the articular cartilage of the tibia. One of these is located between the curved surfaces on the medial side (closer to the midline of the body) of the knee and is called the medial meniscus. The other one is located between the curved surfaces on the lateral side (farther from the midline of the body) of the knee and is called the lateral meniscus. Thirdly, there is synovial fluid lubricating all of these cartilage surfaces.

There are also many ligaments associated with the knee. Ligaments are cords of connective tissue which pass from one bone to another across a joint. Their function is to make the joint stronger. Two of these knee ligaments form an X in the area between the medial meniscus and the lateral meniscus. They are called cruciate ligaments, from the latin word for an X. The anterior cruciate ligament (ACL) begins on the middle of the front of the tibia and attaches near the back of the femur. The posterior cruciate ligament (PCL) begins near the middle of the back of the tibia and attaches near the front of the femur.

Two other ligaments of the knee are called collateral ligaments. The medial collateral ligament (MCL) begins on the medial side of the femur and attaches on the medial side of the tibia. The lateral collateral ligament (LCL) begins on the lateral side of the femur and attaches on the lateral side of the tibia. Two more knee ligaments are called popliteal ligaments. They both begin on the back of the femur and provide strength to the back of the knee. The patellar ligament begins at the patella (knee cap) and attaches to the front of the tibia. It adds strength to the front of the knee. There are also other ligaments associated with the knee.

One type of knee injury is called a torn cartilage. This refers to a tear in either the medial meniscus or the lateral meniscus. The medial meniscus is much more likely to be torn than the lateral meniscus. The reason for this is that the medial collateral ligament (MCL) is actually attached to the medial meniscus. The anterior cruciate ligament (ACL) is also attached to the medial meniscus. If the knee is hit from the side or twisted, the force pulls on the medial collateral ligament (MCL), which in turn pulls on the medial meniscus, which in turn pulls on the anterior cruciate ligament (ACL). As a result, the 2 ligaments may stretch or tear. Since the meniscus is composed of cartilage, it cannot stretch; so it tears.

A torn lateral meniscus is much less likely to occur, but it is not impossible. The lateral meniscus is not attached to the lateral collateral ligament (LCL), but it is attached to the posterior cruciate ligament.

Another type of knee injury is a dislocation. This refers to a situation in which the upper end of the tibia is pushed out of its normal position, directly under the lower end of the femur. The tibia could be displaced in any direction -- forward, backward, to the medial side, or the the lateral side, or it could be twisted in place. With a dislocation, there is the possibility of damage to any of the structures associated with the knee or to any of the blood vessels in the knee area.

We will start from the top to the bottom and I have to say that the head is filled with such places. First of all, the eyes represent one of the weakest points in the human body. It will sound cruel however in a life or death situation you must act. A direct blow with the fingers to the attackers eyes will leave him in extreme pain and complete incapacity. He will most likely run away or collapse from the pain. Also behind the ears there is a bone that in placed directly over the balance center of the body or the inner ear. A direct blow with your palm or elbow to that area will leave an attacker with limited or no balance, causing him to fall.

Another weak point the human body has is located directly under the nose. A cartilage is located there and if receiving a direct blow, that cartilage will send out extreme pain sensations to the brain and activate the tear glands of the eyes, thus the attacker will not see and will be temporarily incapacitated. Also a special spot which only men have is the Adam's apple in the neck. A straight punch to that are will leave a man without breath and can actually be fatal if delivered with too much power.

Moving down a bit on the body, we reach the liver. It is considered to be regenerating organ and filters all the impurities in your body. It is located in the lower right side of the abdominal cavity and when punched properly, can cause the attacker to collapse in extreme pain, have almost total lack of breath and even loss of consciousness.

The last weak point taught by self defence classes on the human body, is represented by the knee. It holds you leg together as a principle joint and is covered by a very hard cartilage known as the patella or the knee cap. Upon receiving a direct blow, this injury can cause an attacker to instantly drop and experience pain. All these techniques may seem cruel and unfair, however they must be used only in critical situations and are only for protection.

One of the main complaints of both first-time runners and their seasoned counterparts is knee pain. Running puts considerable strain on the knee joint. If a runner is new to the sport, it is easy to over-train at the beginning. Take it slow, build your leg and joint strength. Establish a base of knee stability to prevent injury down the road. Experienced runners who are working on adding mileage for a new race distance should also take care: 10-kilometer conditioning and strength needs to be carefully modified if a 26-mile marathon is the goal. Knees will adapt to this new challenge if given the stability to do so. If two miles of moderate running cause pain at first, back off and rest. Give the knees time to stabilize.

Stability is essential to keep the knee working properly. Correct leg muscle development, obtained through gradual increase of mileage and intensity, will create stability. The quadriceps (on the front of the thighs) and hamstrings (on the back of the thighs) work in conjunction with each other, pulling on different areas of the knee at the same time. If these muscles are developed correctly, the knee joint will glide over and under itself without undue strain. Let's not forget the tiny, yet indispensable patella, as well. This engineering marvel glides over the front of the knee, adding stability and providing a liaison between thigh and lower leg bones. Thus the knee has been described by medical literature as being three articulations in one: draw a circle in the air with your toe, and you get the idea.

If more than a casual couple of miles per week are the runner's goal, it is mandatory that he or she invest in correct running shoes. People come in all shapes and sizes. Some people pronate, or roll the weight of their body to the inside edge of the foot. Others supinate, or roll the weight to the outside edge. Men and women even have different angles from hip to knee. This is why there are specific running shoes by gender. The best way to be fitted for running shoes is to visit a store that provides treadmill analysis. A shoe fitter will watch, or even video, the runner's heel strike to determine what kind of shoe is best to support the customer's body and running style. Yes, these shoes will probably be twice as expensive as the bargain-rack pair. However, to a runner, healthy, pain-free knees are well worth the price.

When you learn to ride a bicycle, some one tells you to hold onto the handle bars, sit in the seat and put your feet on the peddles. Horse riding is very much the same. When you are around horses people are going to be using the language of horses including the parts of a horse that make up his anatomy.

The most common ones to know are head, back, tail, hooves. Pretty straight forward, knowing the parts of a horse really pays off in a number of areas. For example when you take riding lessons, the instructor may say to "engage the hindquarters". What are hindquarters exactly?

When you tack up a horse, certain straps and buckles go in specific places on a horse. If you read any book on fitting tack correctly, it will tell you exactly how and where with the use of the parts of a horse. For example a sentence in a book may say something like this: The headpiece should lie comfortably behind the horse's poll. When you are putting on a bridle you do not want the headpiece to go anywhere else, so it helps to know exactly where the poll is.

Anytime your horse injures himself, it is very useful and helpful to be able to tell the veterinarian in horse terms, where on his body he hurt himself. "He hurt himself on his leg"; the foreleg, the hindleg, the knee or the hock; where exactly?

The most significant time to know the parts of a horse is when you are buying a horse. When you buy a horse, you have to look at his conformation. How well is his body put together? Does he have sickle hocks, is he over at the knee?

Conformation goes hand in hand with body parts and the horse's anatomy. If the horse has conformational faults and you can point them out to the owner, with the correct use of 'horse lingo', you may be able to negotiate a lower price.

By no means buy a horse that's anatomy is less than desirable, if his fetlock sinks to the floor when he is walking, walk away from the horse and do not look back. Some conformation faults can be overlooked and forgiven, some must be avoided at all costs. You'll only know what faults to look for and where to look for them by knowing basic horse anatomy - the parts of a horse.

People who are around horses will not think that you are showing off when you start naming or using the names of parts of the horse. In fact more than likely they will expect any horse person simply to know them. When you know the horse, you'll know all the parts that make him whole.

Before exploring ways to prevent ankle sprains it is important to discuss what an ankle sprain is and how it occurs. The ankle joint is unique because it is built to bear and stabilize the majority of the body's weight while still being relatively mobile. This seeming contradiction in requirements for stability and mobility is one reason the ankle can be injured so easily.

To understand the injury one must first understand the anatomy of the joint. There are two bones in the lower leg. The larger of the two bones is called the tibia. This bone goes from the knee joint down to the ankle and makes up the bony knob found on the inside portion of the ankle. The other bone is the fibula, which is a long skinny bone that travels with the tibia from the knee down to the ankle. The fibula, however, is the outer bone in the leg and makes up the outer bony knob of the ankle joint. If you feel your ankle right now you can feel these bones, the tibia on the inside and the fibula on the outside. Each knob is called a malleolus. The tibia and fibula are joined together near the knee joint and also just above the ankle joint. The ligament which attaches the tibia and fibula above the ankle is called the distal tibiofibular ligament.

Anatomically the ankle is classified as a complex joint because it is made up of more than two bones. The first two bones are the tibia and fibula. The third bone is irregularly shaped and called the talus. The talus fits perfectly in the space between the two malleoli (which is the word for more than one malleolus). The talus pivots in this space allowing you to point your toes toward the floor or toward your nose. This is the main motion of the ankle but it also allows for a little bit of turning inward and outward.

There are ligaments that attach each malleolus to the talus so that the talus doesn't come loose and the joint can be stable. On the inside of the ankle there is a series of ligaments that go from the malleolus of the tibia to the talus. These ligaments together are called the deltoid ligament. On the other side of the joint the malleolus of the fibula is connected to the talus by three ligaments: the anterior talofibular ligament (on the front part of the malleolus), the calcaneofibular ligament (on the bottom part of the malleolus) and the posterior talofibular ligament (on the back part of the malleolus).

There are two more ligaments that are important to know about when learning about ankle sprains. These ligaments are bands that wrap around the entire joint called the flexor retinaculum and the extensor retinaculum. These ligaments hold the tendons that travel from the leg to the foot down close to the bones. They also help to stabilize the ankle joint.

The last piece of anatomy to consider is the muscles that control the motion of the ankle. The tendons of several muscles cross the ankle joint. Some of these muscles, like the peronei muscles located on the outer portion of the leg, function mainly to move the foot while others mainly move the toes.

Now that you have a basic understanding of the anatomy involved. The next article in this series will describe the different types and grades of ankle sprain. In addition you will learn how these injuries are caused.

Following the basic proportions of the human anatomy will improve the way that your wood carvings look and will please the eye of people that are seeing your wood carvings. There are several sources of information about anatomy that go into extremely detailed information about how long or how wide various parts of the body should be, to be considered ideal. After researching several proportional guidelines, I prefer to follow the basic proportions rules that are described by Don Mertz the "Woodbee Carver". Mr. Mertz teaches what he calls the "Rule Of Three" that basically divides various areas of the body into thirds to allow for an easy conversion for all sizes of wood carving figures.

• Head and Face Proportions

In the study of the "Rule Of Three", the head is divided into thirds from top to bottom, with the top 1/3 being the area from the hairline to the eyebrows. The second 1/3 is the area from the eyebrows down to the bottom of the nose and finally the third 1/3 is from the bottom of the nose to the bottom of the chin. You can then further break down the area below the nose into thirds. The first 1/3 is from the nose to the separation of the lips, second 1/3 from the divide of the lips to the indention above the chin, and the third 1/3 is from the indention to the bottom of the chin. Viewing the face from the front, it is generally 2/3 as wide as the height of the face.

The side view of the head can also be divided into thirds, with the eyes falling along the center line from top of the head to the bottom of the jaw. If you divide the side view of the head in half, the ear begins on the center line, laying to the back of the head, and is usually positioned in the second 1/3 (top of ear at eyebrow level and bottom of ear at base of nose).

• Body Proportions

The rest of the body can also be divided by using the same "Rule Of Three" principle. From the bottom of the head to the bottom of the feet, the body is divided three times. The top 1/3 is from the shoulder area to the belt line, the second 1/3 from the belt line to the middle of the knee, and the third 1/3 from the middle of the knee to the bottom of the feet. It is generally accepted in drawing and wood carving that the body without the head is approximately the length of seven heads stacked on top of each other. Some wood carving caricatures are eight heads tall, in which you would make the torso (shoulders down to the belt line) three heads long and the area below the belt line five heads long. Experiment with the two and see what length you prefer for the body.

Looking front on or from the rear straight on at the figure, the shoulders are approximately the width of three heads wide and are the widest spot of the body. The wider the shoulders, the larger and more intimidating the figure will appear.

With these wonderful proportional principles from Mr. Mertz, you will be able to make your wood carving figures look more human and correct. Like I said above, being exact is not important, because not many of are really exactly proportionally correct. Just using these general proportions could change your wood carving caricatures from mediocre to very pleasing to view.

Thank you Mr. Mertz for this priceless information!

Each person is different and fat gets stored in the body in a certain order. That order is determined by gender and genetics. It's a myth that women can selectively lose fat in the hip region. In fact, 'spot reduction' is something that advertisers use to prey on unsuspecting customers desperate to try anything to shape up certain areas of the body. You have probably wasted time and money on gadgets, weight loss creams and other gimmicks. When one loses weight, the 'reduction' is general i.e all over the body, but never in one 'spot'. Think of the body as if it was a balloon, which inflates and deflates every time, you gain / lose weight.

Here's the good news - specific exercises for the hip, as outlined below will help tone the hip muscles (but not spot reduce them). The following exercise routine has been designed to tone the hip muscles. It works best when combined with an aerobic exercise program and a healthy diet.

Combining hip toning exercises with a well rounded aerobic exercise and weight training program requires more energy and more strength. Your body responds to high intensity execises by adding lean muscle. This increases the rate at which the body burns calories and helps use up excess stored fat. You cna burn more calories by doing a variety of activities, and mixing up the exercises, intensity and duration every 2-3 weeks. All weight training exercises are not created equal. Exercises that involve large muscle groups such as squats and lunges for your legs, bench presses for your chest, overhead presses for your shoulders and lat pull-downs for your back build more muscle mass. A combination of cardiovascular exercise and weight lifting will make you stronger and leaner. This kind of effort takes time, but the results are permanent.

The following routine has been specially designed for toning hip muscles.

For best results, start with 15-20 repetitions and one set. Increase gradually to 2 sets. Complete the routine at least 2 times a week and you will see results within the first few weeks. These numbers are general guidelines. For best results, consult a personal trainer. If you have any injuries or medical ailments, please obtain a physicians clearance before starting any exercise program.

Side Lying Hip Raises - Hip toning.

Starting Position: Lie on your left side on a mat with the legs straight. Support your heard in your hands and keep the left leg bent. Movement: Slowly raise the right leg 8-12 inches up in the air, keeping the knee straight. Lower it gradually. Complete 15-20 repetitions and repeat on the opposite side. To make this exercise harder, you can try using weight cuffs around the ankles. Start with 1 lb and work your way up to 5 lbs within 4-6 weeks. Another way to make the exercise harder is to raise the leg and then trace large circles clockwise 10 times, followed by another 10 repetitions anticlockwise.

Seated Hip Toning - Hip toning.

Starting Position: Sit on an exercise matt with your legs together and your palms on the matt for support. Movement: Lift your right foot 8-12 inches off of the matt. Point your toes and moving only at your ankle trace a large circle in the air. Complete fifteen circles clockwise and fifteen circles counter clockwise. Repeat as required on other side. To make this exercise harder, you can try using weight cuffs around the ankles. Start with 1 lb and work your way up to 5 lbs within 4-6 weeks. Another way to make the exercise harder is to trace smaller circles.

Standing Single Leg Wall Squat (Advanced) - Hip And Thigh Toning

This is an advanced exercise since it shapes the hips and thighs. Starting Position: - Place your upper back against a smooth wall. Stand on one foot and lean back against the wall. Movement: - Inhale, keeping your heel in contact with the floor at all times, slowly lower into a squat position while sliding down the wall. Exhale as you slowly straighten your leg, keeping your head and chest up, returning to the starting position. Repeat as required. This is an advanced exercise. Please discontinue the exercises if you have any pain and consult a physician prior to this exercise routine if you have a history of hip or knee pain.

Standing Single Leg Dumbbell Squats (Advanced) - Hip And Thigh Toning.

Starting Position: - Stand on one leg with a slight bend in your knees. Hold a dumbbell in each hand and allow them to hang down at your sides. Movement: - Inhale, keeping your heel in contact with the floor at all times, slowly lower into a squat position. Exhale as you slowly straighten your leg, keeping your head and chest up, returning to the starting position. Repeat as required. You can start with 2 lb dumbbells and work your way up to 5 lbs within 3-4 weeks.

Lying Leg Bridge - Hip Toning.

Starting Position: - On an exercise matt, lie with your feet on a plank or a board with a 4-6 inch elevation. Keep the knees bent and both feet flat on the floor. Lay your hands on the matt palms down on either side of your body for support. Movement: - Exhale as you push your hips up into the air, keeping your spine straight. Hold this position as long as you can, continuously keeping your hips in the air. Lower slowly. Repeat for 15 - 20 repetitions.

Lying Face Down Plank - Hip, Thigh And Ab Toning.

Starting Position: Get on an exercise matt on all fours, with your elbows touching the matt directly underneath your shoulders. Extend your legs back as far as you can, and keep the toes on the floor. Movement: Raise the hips up and hold yourself in this 'plank position' with your back completely flat. This is an excellent exercise for the hips, thighs and abdominal muscles. Since it involves so many muscles, it is strenuous in nature. Lower the hips slowly down to the mat. Repeat for 15-20 repetitions. (Most individuals find it hard to complete 15-20 reps for this exercise and 8-10 might be a more suitable starting point).

When overuse occurs, nerve entrapments, muscle adhesion, inflammation and scar tissue, carpal tunnel and impingement syndrome, among many other problems, can manifest. This is because overuse causes injury or other situations where the tissue actually changes detrimentally in three important ways.

· First of all, the tissue itself does not get enough oxygen, a condition also called "hypoxia."

· Second of all, there can be an accumulation of small tears, also called a micro-trauma.

· And third of all, this can cause acute conditions, such as pulls, tears, and collisions.

No matter the cause, what happens is that these three types of changes cause the body to heal by producing tough, dense scar tissue in the area that has been injured, which replaces the healthy tissue. The scar tissue itself then binds up the surrounding tissues, so that they can no longer move freely. As more scar tissue builds up, muscles themselves can become shorter and weaker. Scar tissue in not as strong and stable as healthy tissue, there for an advanced massage therapist is needed to help break down muscle adhesions and scar tissue.

Without treatment this results in tension on tendons, which in turn causes tendinitis, and nerves can become "trapped." This in turn can cause pain, loss of strength, and reduced range of motion. In some cases, when a nerve becomes trapped, you can also feel numbness, tingling or weakness.

A massage therapist who uses these ART techniques can help clients with these muscles adhesions and scar tissue [http://think-diagonal.com/2008/03/04/massage-therapy-techniques-for-scar-tissue-removal/] build up, that restrict proper muscle function. When one receives ART treatment, a therapist first evaluates the tenderness, tightness and texture of underlying tissues, such as the fascia, muscles, tendons, nerves and ligaments. Then, the therapist provides specific advanced massage therapy techniques along with ART techniques.

This type of treatment is effective because a trained therapist can break up the scar tissue causing the nerve entrapment, reduced carpal tunnel syndrome symptoms, nerve impingement or muscle adhesions. The therapist directs very specific tension at the affected area usually focusing on or around muscle attachments and the patient works in tandem with the therapist by moving in specific ways to help break up the scar tissue.

There are over 500 different movements specifically in ART that is meant to break down the scar tissue, muscle tension and entrapped nerves. For example, with carpal tunnel syndrome, the median nerve is trapped in scar tissue (also known as "nerve entrapment), which has been caused by repetitive movement, a poor diet or a host of many other inflammation causing factors. Carpal Tunnel Syndrome also known as "cumulative injury," because the injury itself (in this case, entrapment to the median nerve) occurs over a period of time. In many cases, ART can reduce or eliminate the need for surgery to correct these problems and restore function.

Impingement syndrome can also be helped with ART.

Another type of injury, impingement syndrome, occurs when those who do a lot of lifting have pain in the shoulder area. Most often, care for this problem involves having surgery to shave off a small part of the rotator cuff and make it flat, ensuring that there's nothing to "catch" the muscle or muscle adhesion on. However, most often, the problem is in the muscle itself and not in the rotator cuff, so ART can cure this problem if the problem is indeed occurring in the muscle and not in the rotator cuff itself. This determination needs to be carefully identified before any massage therapy or ART treatments are implemented. Be sure to seek a professional massage therapist who is certified in ART techniques and has a very firm knowledge of the human anatomy.

With these questions you can test your knowledge on each body system throughout the year. In my experience the best set of Anatomy and Physiology test questions to use are in the format of multiple choice.

With multiple choice you have four possible answers and you must choose only one answer. There is no room for error with this format, you must know the answer therefore they are ideal to use.

Some examples of multiple choice questions are as follows:
1. Cuboidal epithelium is found in;
a) Circulatory system
b) Kidneys - Answer
c) Lymph vessels
d) Stomach & Intestines

2. What part of the hair lies above the skin's surface?
a) Root
b) Bulb
c) Shaft - Answer
d) Matrix

3. How many carpals are there in each wrist?
a) 5
b) 14
c) 6
d) 8 - Answer

4. What is the position of the vastus lateralis?
a) Medial and front of thigh
b) Front of thigh
c) Medial side of the knee
d) Lateral and front of thigh - Answer

5. What hormone is not produced by the anterior lobe of the pituitary gland?
a) TSH
b) ACTH
c) Calcitonin - Answer
d) Gonadotrophins

When you are studying you should divide each body system up and learn it on its own. So for eg, take The Skeletal System and learn this one week, at the end of that week give yourself a little exam to see how confident you are on the subject, and so on. Always remember that you need to be consistent when it comes to studying Anatomy and Physiology.

Now switching over to another topic just for a moment, let me talk about curiosity. We are nosy creatures by habit, and thrive on learning interesting things. It doesn't matter on what topic for the most part, if has something to do with us either direct or indirectly, then we want to here it. Only however if it simple to understand.

Now back to the skeletal system. This is definitely all about us, in fact it is us. Its not up to someone else to look after what belongs to us. The human anatomy is really not nearly as complex as we make it out to be. That statement only holds true for those that are not doing an in-depth study of the body. In those cases, yes it is complex, but not beyond understanding. Its just a matter of how much knowledge is necessary for the purpose we need it for. So in the case of the individual that wants to go into the medical profession, he needs a lot more knowledge than the average person who just want to take care of what he owns. Namely our body.

So not only are we going to talk about some interesting facts about your bones, we are going to learn some things that are important to our everyday living. Do you know that you have been losing things from your skeletal system over the years?

When you were born you had about 350 brand new bones. Now if you could peek inside yourself you'd count around 206 or so. That's 90 less then what you started with. You know darn well you haven't had any surgery that removed 90 of your bones, and you also know that you were born perfectly healthy. This truly is a mystery, and now you're curious. Well actually it really isn't all that much of a mystery. Many of our bones simply fuse together throughout out lifespan. Part of the reason this happens is so those bones fusing together, can perform the functions we need as adults, which we didn't require as children.

Here is another point that may be of interest. Most of us reach our peak bone density or strength around the age of 20. So the adage that its "all down hill after 40" is misleading. Now don't let this thought depress you, and lead you to think that now that you're past twenty that you are past the prime of you life. It simply means that you need to ensure you are taking care of your body. particularly your skeletal system right from that age on. Not waiting till you reach 40 before you start thinking about what's good for your bones.

Lets cover one more interesting fact. There are so many to choose from its hard to decide which to share with you. How about those starvation diets that many of us have tried at some point in our life. We figure whatever damage they could cause is temporary right? Not so. you are damaging your bones because they are not being nourished properly. Who knows what lasting effects this could have.

So a little bit of basic knowledge about the body can mean a lot of good health through the years. You have to admit that some of the facts we covered here were quite interesting and did raise your curiosity.

Rotator Cuff Surgery

Surgery for a torn rotator cuff is done as an outpatient procedure. Generally, staying overnight in the hospital is not required. The actual procedure should only take a few hours to perform, depending of course on the extent of work that must be done to repair the tendons. Following rotator cuff surgery, you will have to keep your arm in an abduction sling, which will keep your arm slightly away from your side. The sling is necessary to keep the tendons in a relaxed position. Once your pain is controlled adequately, you will be released from the hospital.

Beginning To Recuperate

The first few days following surgery to repair a torn rotator cuff will be spent working on pain management. To help with the discomfort, you doctor will most likely prescribe a mild pain medication. The best way to prevent severe pain is to take small doses of pain medication as soon as you become uncomfortable, as opposed to waiting until the pain is unbearable and taking a large dose. In addition, many doctors recommend a variety of medication, such as alternating anti-inflammatory medication with a prescribed narcotic. You will also need to ice your shoulder. In fact, proper ice application may prove to be crucial to controlling the pain.

A Good Night's Sleep

You will discover that getting a good night's sleep following rotator cuff surgery can be rather challenging. Even if the ache in your shoulder is moderate, it can still prevent you from resting properly. A number of shoulder surgery patients have found that sleeping in a semi-upright position is best, such as in a recliner. If you do not have a recliner, try arranging several pillows on your bed, creating a makeshift back rest that will allow you to rest with your elbow in a downward position. If you just cannot seem to get an adequate amount of rest, talk to your doctor about taking a sleep aid medication.

Passive Motion

The first phase to rehab your shoulder following a torn rotator cuff is passive motion. Depending on the size of the tear and the repair strength, this phase can take up to six weeks after your surgery. With passive motion, the tendons and muscles of the cuff do not do any work. This type of motion allows the shoulder to move without placing any tension on the repair. During this phase, a therapist will move the shoulder for you, which does not require muscle contraction. Your therapist will also teach you how to move on your own without contracting the muscles of your rotator cuff.

Active Motion

The next stage of rehab involves active motion once the tendons have healed sufficiently to allow movement of the arm. However, no additional resistance is applied during this phase of the recovery. You may be limited to active motion for as long as twelve weeks after rotator cuff surgery. You will be able to move your arm on your own, but not against any type of resistance.

Strengthening

The third phase of your rehabilitation is the strengthening phase. Because your movements have been limited since the tear occurred, your rotator cuff muscles will be weakened. As soon as the repair has had time to heal adequately, you need to begin building strength back up in the muscle so you will be able to achieve your normal level of activity. In order to strengthen the muscles of the shoulder effectively, you do not need to use heavy weights. Your therapist will instruct you on exercises that you can use to isolate specific muscles, such as with light weights or resistance bands.

Fully Recovered

You should be fully recovered from your rotator cuff injury in four to six months; however, it may take longer in some cases. The primary factors to determining recovery time include the size of the tear, the efficiency of the repair as well as your commitment to rehabilitation. Not everyone who suffers a rotator cuff tear will progress through the stages of rehabilitation at the same rate. It is important to work with your doctor and your therapist to ensure you are on the right track to recovery at a pace that suits you.

So far, the treatment of osteoarthritis is mostly symptomatic. Various medicines, called non-steroidal anti-inflammatory drugs (NSAIDS), exercises, physical therapy, and injections are used to provide palliative relief. Ultimately, patients will go on to have knee replacement surgery.

More recently, attempts at cartilage repair through the use of autologous (a patient's own) mesenchymal stem cells (MSCs) has shown promise.

Noted initially in animal models such as goats, sheep, and rabbits, the reparative benefit of autologous stem cells has also been reported anecdotally in humans.

There are multiple descriptions regarding technique. The most common is to centrifuge bone marrow or fat to concentrate the stem cells and then inject them into the joint.

While the simplicity of this approach is appealing, it is probably not effective.

MSCs migrate to areas of new injury. If the surrounding environment is conducive to their survival, they will undergo multiplication and differentiation and populate any framework that is provided in order to begin the reparative process.

That being said, all of the above factors need to be in place in order to achieve the desired outcome.

There must be an area of new injury that attracts the MSCs; there must be a favorable environment with growth factors that stimulate MSC differentiation and multiplication; and finally, there must be a suitable framework that provides sanctuary for the MSCs in a hostile environment.

A proper MSC procedure will require the expert use of various anesthetics. Anesthetic needs to be administered in the form of both local soft tissue as well as regional block. Knowledge of anatomy as well as the use of diagnostic ultrasound to localize nerves is important. Also, knowledge of the pharmacokinetics of the various anesthetics is important in order to avoid toxicity.

Finally, if arthroscopy is needed in order to better visualize the area or to deliver the acute injury at a specific site, the use of intra-articular anesthesia is critical.

General anesthesia is not required.

Obviously, there is some discomfort associated with the administration of anesthetics. After all, how can a needle stick be rendered absolutely painless? However, when properly done for OA, a MSC procedure will be somewhat uncomfortable but should not be overwhelmingly painful.

Ironically, most of the discomfort occurs after the procedure because the nature of a regenerative procedure requires the aid of a robust inflammatory response to deliver healing.

Your body is incredible when it comes to our health and well-being. If you treat your body right and pay attention to it, your body will not hesitate to tell you when it feels good or bad. There are actually seven signs that an observant person cannot miss that will aid in the anti aging process. There is research to suggest that the length of a person's fingers might determine future joint deterioration. Osteoarthritis is a painful degenerative disease that gets worse as we age. Estrogen and progesterone can biologically influence a person's risk for this disease. In conjunction with osteoarthritis, and some times the cause of, is pain behind the knee. Identifying the source of this pain is somewhat complex, given the anatomy of the knee. Nevertheless, marked pain in this area is a sign for concern.

Belly fat puts both men and women at risk for developing medical conditions such as Type 2 diabetes that can speed up the aging process. Also, the risk of having dementia is 3.6 times higher for people with an expanded waistline. So, regular exercise and eating a balanced diet are perfect anti aging actions that individuals can take. You will look good and feel great. Exercising may also improve your balance. Vision, inner ear balance, muscles, bones and joints all play a huge part in preventing falls.

Tooth loss and dentures are easily associated with aging. However, not many people think about dry mouth as another indicator. The lack of saliva production is a prime symptom for many diseases such as thyroid, Parkinson's, and Sjogren's syndrome, an autoimmune disease that can affect the salivary glands. Another unexpected sign is an ear lobe crease that is a possible indication of heart disease.

The human body has its own way of giving signs early on that may help to determine future issues. The key is to be in tune with your body well enough, and to know what you can do to slow the aging process.

The brain is undeniably the most complex organ of the human body. Beyond controlling virtually all body functions, the brain is the source of the mind, which is but an ethereal concept, so hard to grasp that even the language of mental theory requires methodical parsing. Treatments for diseases of the mind and brain require the intricate understanding of chemistry, physiology, and anatomy common to all branches of medicine, as well as the ability to step outside of oneself to objectively observe personality and emotion. The psychiatrist must tolerate the unsettling awareness of the mysterious relationship between mind and matter, and must help others find their own answers to the mysteries of the human condition. The shortage of physicians willing to engage in this area of study reflects the enormity of the challenges. Some medical students become cardiovascular surgeons, the plumbers of medicine. Others choose to nail bones together, taking pleasure in the simplicity of hand tools. Still others find a good living looking at see-through images of body parts; often a day or two after the images have been used for their intended purpose. These tasks pale in comparison to the labors of understanding and treating diseases based in the final frontiers of medical knowledge. No wonder that the masters of medicine--those who work in the vast field of interventional psychiatry--are so valued by society.

The time has come for my transition from psychiatric residency to psychiatric practice. Not surprisingly, we graduates have encountered great demand for our services; the posting of resumes on internet boards results in a slew of telephone calls from eager recruiters. For my younger colleagues the prospect of six-figure incomes suggests reward, at last, for years of work and debt. Most job offers come from healthcare systems looking for someone to prescribe medication as counterpoint to their bevy of lesser-paid psychotherapists. Under the guarantee of income and benefits lies the expectation of productivity. This productivity is not measured by patient satisfaction, symptom improvement, or reduced morbidity. Rather the name of the game is the RVU, and the way to get more RVUs is to see more patients in whatever time is available. While many residents long for the independence to practice as they see fit, their debt loads require more practical approaches. Concerns over production and practice limitations pale in comparison to long-delayed plans to start families and buy houses.

For my part, I am grateful for the opportunity to earn good money in the service of a challenging and rewarding career. But I am also aware of the striking difference between the salaries of psychiatrists and the salaries of many other physicians. As a former practitioner of one of medicine's more lucrative specialties, I find myself comparing my apparent value now with my value then. Why is my work now worth less than half as much as my work as an anesthesiologist?

At the end of a night in the crisis service last week I walked past a group of patients huddled in the cold, waiting for the doors of the walk-in clinic to open. As I looked at their tired faces, I realized the desperation they must feel to leave homes or homeless shelters at such a cold and early hour, and make the trek to the clinic by foot or by bus. Their pains were certainly as great as the pains of any of my patients presenting for surgery. But for some reason there is less outrage over their lack of care than would be the case for a group of patients with untreated diabetes, appendicitis, or heart disease standing outside a hospital. I realized that like many in society, I had unwittingly accepted the scene before me as adequate care for the mentally ill.

The RBRVS, or resource-based relative value scale, was instituted by Medicare in 1992 in an attempt to standardize payments for physician services. Relative value units, or RVU's, are assigned to physician services based on three main factors: physician work, practice expenses, and the cost of liability insurance. Physician work is determined by several factors including time required for the service, the technical skill and physical effort, the mental effort and judgment, and the amount of stress experienced by the physician due to the risk to the patient. To arrive at the 'fair value' of services, the number of relative value units is multiplied by a universal dollar value, and adjusted slightly for practice location according to regional cost of living indices.

In theory, this approach to payment provides a level playing field for physicians. Payments for a cholecystectomy, for example, reflect the fortitude one must have to cut into someone's body and the time required for surgery and postoperative care. Payments for neonatal critical care reflect the higher level of stress that comes with working in an alarm-filled environment, as well as the need for proficient technical skills. Medicare strictly adheres to this formula, but in the world of private insurance some physicians' relative value units are more valuable than others. In my region, for example, Medicare has decided that the relative value of a unit of physician work is about . The largest third-party payer in the area will pay psychiatrists, pediatricians, or family physicians about per value unit. But orthopedists and radiologists, or podiatrists providing orthopedic services, are paid 0 per value unit.

Given that the relative value of a service has been predetermined, what accounts for the difference in payment? If not due to stress, physical or mental effort, risk, technical proficiency, or practice cost, where does the difference come from? Certainly not from supply and demand, as in my area it is much easier to see an orthopedist this week than to see a psychiatrist within the next month. There must be other factors that affect the perceived value of the services of a psychiatrist. Does the lower reimbursement reflect decades of poor negotiating? Are psychiatrists more likely to succumb to modesty and self-effacement? Do psychiatrists have so great a level of job satisfaction that they don't worry about money? I wonder if the difference reflects a much larger problem-- that psychiatrists have bought into a societal impression that mental health is less valuable than physical health.

Support for this last concern can be found when one looks at the funding of mental health services in general, and the tacit acceptance of the funding situation by psychiatrists and other mental health caregivers. My insurer is required by statute to provide coverage for mental health services up to about 00 per year. This is the total amount provided for all services, and is not paid for any treatment deemed 'residential'. On the other hand, there is no limit on payment for orthopedic injuries. The insured alcoholic is covered for the 00 surgeon's fee for a fractured kneecap- and more for the incidental hospital bill and the bills for physical therapy. If the alcoholic strikes his head, the radiologist receives 00 to look at the MRI. And if he abruptly stops drinking for a week, the hospital is paid tens of thousands of dollars to help him through withdrawal-- only to turn him out to drink again. Yet to treat the primary alcoholism, the insurer will pay...00. Unless the patient has been placed in a more effective residential treatment center, in which case there is no payment at all. And if the patient has spent 00 for treatment of depression earlier in the year, the insurer will continue to pay for kneecap fractures and MRIs, but not for treatment of the underlying cause of these injuries--alcoholism.

There is no shortage of evidence for the notion that society places a low value on the treatment of mental illness. My insurer will pay ,000 or more for cardiac bypass to reduce a person's risk of a heart attack, but only 00 per year for treatment of the same person's depression, to reduce risk of suicide. The narcotic addict is allowed 00 for treatment of heroin addiction, vs. hundreds of thousands of dollars for a secondary HIV infection. Our insurers face no uprising when they decide that an insured businessman deserves a new ACL to allow a bit more knee stability, yet an unfortunate computer operator who develops schizophrenia deserves less than one-tenth as much to prevent delusions and hallucinations.

The relatively low payments received by psychiatrists can be blamed to some extent on psychiatrists themselves. They accept their own devaluation when they sign for lower salaries or when they accept limitations on their ability to practice psychotherapy. They allow administrators and others without medical training to dictate treatment plans. And they follow the Pied Piper of pill pushing, happy to become simple prescribers, even as state legislatures grant similar privileges to those with minimal medical qualifications. I am reminded of the late 1980's when anesthesia was becoming perceived as a technical trade, and was challenged by the expanding statutory roles of nurse anesthetists. Rather than narrowing anesthesiology, the answer to devaluation was found by moving into critical care and pain medicine and asserting the roles of anesthesiologists as physicians. Similarly, cardiologists did themselves and their patients well when they laid claim to angioplasty, and called themselves 'interventional'. The new technology brought public respect and money, which then yielded an explosion of new treatments. Likewise, at some point radiologists decided that they could stick needles into kidneys as accurately as any surgeon, and soon radiologists were awash in black ink, and learning to stick needles pretty much anywhere. I don't know what the parallel path for psychiatrists will be, but it is vital that as insights develop into brain function, psychiatrists lay claim to them, grasp them, and never let them go. There is nothing like a brain procedure to grab society's interest and respect. In fact, I posit that the simple adoption of the term 'Interventional Psychiatry' would increase the funding of psychiatrists and psychiatric research by 20%.

The low priority of mental health services to society is, of course, a complex issue. Stigma, lack of lobbying resources, and denial of the impact of mental illness certainly play roles in the lack of public interest and investment in mental health. Resources are thin for the unemployed and uninsured mentally ill, and the field of psychiatry deserves kudos for attempting to meet the needs of this population in return for little financial gain. But for patients with resources, we must recognize and advocate that mental health care is as important as treatment for a torn ACL, and deserves equitable reimbursement. The abilities to laugh, to work, and to love are as vital as the ability to return to beach volleyball. Psychiatrists must realize that at some point, expectations of relatively low reimbursements and medical standing become self-fulfilling prophecies, as our capitalist society tends to value those most who value themselves. The correction of societal bias and the resultant devaluation of our services will require constant efforts to educate, negotiate, and assert the value of mental health care in a healthy society. And as self-serving as it may be, psychiatrists, as the voices, faces, and business representatives of mental health, will raise the status and treatment of their patients as they work to raise the scientific, and yes, economic, status of themselves as physicians.

Any part of the body may be damaged in a workplace accident. The back is especially prone to injuries, ranging from mild soft tissue sprains to fractured or crushed vertebrae. The vertebrae protect the spinal cord, which itself controls all movement and sensation in the human body. Back injuries are normally caused by the lifting of heavy weights, or the repetitive performance of motions which place strain on the back, such as bending and twisting. Head and neck injuries at work may result from falls from height, objects falling, or work vehicle accidents. The head is the most sensitive part of the human anatomy as the skull shields the brain, and traumatic injuries to the head may cause unconsciousness or death. Injuries to the neck may have severe repercussions if the vertebrae or spinal cord become damaged. The spinal cord carries messages between the brain and the body, and serious injuries in this area may involve paralysis and loss of bodily functions. Injuries to the face can be extremely traumatic, combining as they do physical and psychological factors. Compensation awards in this area normally reflect the extent of any facial scarring and residual disfigurement. Loss of one of the major senses such as sight or hearing will also lead to higher damages being awarded by a court.

Other upper body injuries include sprains, strains, burns, lacerations, bruising, fractures and dislocations. Arm, wrist and hand injuries are commonly the result of a person seeking to break a fall or attempting to protect themselves from a falling object. Limbs may also become caught in machinery, on a factory production line for example, or may become trapped between two heavy objects. The resulting crush injuries from this type of accident are often particularly severe, and may require the amputation of limbs in extreme cases. The most serious types of leg injury at work involve simple or compound fractures and dislocations. These are most commonly caused by slips, trips and falls. A fractured or dislocated hip will normally take months to heal, while damage to the knee may render an injured person completely immobile. Injuries such as these, along with sprained ankles and damaged Achilles tendons, are usually the result of a sudden movement which forcibly stretches the joint in an abnormal direction. Any working environment that involves physical exertion will have a higher incidence rate of injury, particularly factories, construction sites and warehouses. Bartletts Solicitors have experience with all types of injury at work compensation claims.

Over the weeks, I felt more flexible, slightly, and got good results, experiencing less aches and pains, and overall tension.

I used yoga to stretch the ballet way - forcing every position and deep breathing to distract myself from the pain. I thought I was getting into much better positions.

Vone, however, did yoga the gentle yoga way. She picked a few yoga positions and stretched comfortably with a stretchy feeling, but no pain. A few weeks later her positions were drastically more flexible than mine. She had no workout routines, no warm up routines, she'd just show up and do it.

That does not seem fair. I thought I was working much harder. But that was the way I was trained. Take it to the limit.

In recent years I've read much that has been written by dancer/dance medicine specialists who have a very different view on how dancers should treat their bodies. How to stretch the foot and ankle joints to improve the curve that is part of ballet fashion, is important.

Another moment I remember is watching Swan lake with Vone and her husband. Karen Kain was performing. Vone, an artist and student of human anatomy, leaned over and whispered "What's wrong with her feet?" Huh? What ballet student would not like to have feet like that?

It's a matter of perspective. So what is safe stretching for the top of the arch curve?

Author Deborah Vogel describes how to relax and knead out muscle tension down the front of the calves to the ankle area, using a Pinky ball. This is a small,dense, high bounce sports ball. If you sit down on your feet, you can roll the ball under the top of your calf muscle, below the knee joint. You will feel some very tender spots where the muscle is especially tense. If you lean into the ball on those spots, you will feel some release there. Do not push too hard, because you can do this every day, and gradually condition the muscle.

Working your way down the leg, you can knead and massage tension out of the muscles.

Now, you can do a stretch recommended by Lisa Howell, another dancer/dance medicine specialist who has written much about care of the feet for ballet dancers. Staying in this position (or stretching out for a few minutes if your feet are going to sleep) you can now slide your hand under one knee, and gently raise the lower leg up. Make sure your ankle is in a straight line, not sickled in or out. You will feel a stretch along the arch curve. Hold the stretch, relax and repeat 10 times, each side, every day.

This is a gentle stretch that produces results. You can also put the Pinky ball just higher than the tops of the metatarsal joints, and gently lean into it for an extra stretch.

None of this should produce pain. Look at an x-ray of the human foot and the many tiny foot bones. These bones and the soft tissues supporting them need to be treated gently in between your ballet classes. They are tough, but as you push them as far as they can go every day in the ballet studio, they deserve rest and care.

With these two exercises you can increase flexibility, avoid muscle sprain and foot injuries, and improve your look in pointe shoes.

Back pain is the most common complaint among adults under 45. Back pain brings their activities to a complete halt and intervenes in the progress of their career. Researchers say that it is really a challenge to a physician to find out the true cause of back pain.

Here is a quick take on the anatomy of the human back. Our body depends on the spinal column for structural stability and mobility. We twist, bend and flex with the help of spinal column. The spinal column is made up of 24 vertebrae, 7 in the neck (the cervical vertebrae), 12 in the thorax (the thoracic vertebrae), and 5 in the lower back (the lumbar vertebrae). The sacrum, located just below the lumbar vertebrae, consists of 5 fused vertebrae. The tailbone, or coccyx, with its 3 to 5 fused vertebrae, lies just beneath the sacrum. These vertebrae are placed one on another from skull to pelvis. Spongy discs are present in between vertebrae .The spinal column is tightly wrapped by muscles and ligaments.

The spinal cord is enclosed within vertebral canal which is formed by alignment of vertebrae.

Acharya sushruta describes anatomy of spinal column as follows.
Prushte trimshat - The number of back bones are 30 (Cervical-7, Thoracic - 12, Lumbar- 5, vertebrae fused in sacrum -5 , coccyx -1 ). While describing the joints in spinal column it has been said as "Chaturvimshatihi prishta vamshe." This means there are 24 joints in spinal column.

Maamsaanyatra nibaddhani siraabhihi snaayubhistatha. |
Asthinyaalambanam kritwaa ||
The ligaments and tendons hold the bones and muscles together.

Causes for back ache

Bones and thighs are mainly occupied by Vata. Vata controls and directs the body movements.Back pain occurs when vata in this region gets aggravated due to unwise physical activities (mithya yoga of karma), exaggerated physical activities (Ati yoga of karma ) or less physical activities (hina yoga of karma).

1. Back ache usually arises from spasm of muscles that support our spine. The muscles supporting spine go into spasm when we lift things unwisely, bending over too sharply, sitting in a unsuitable chair, etc.

These type of movements are called as "Mithyaa yoga of karma or action " in ayurveda.

2. Back pain can be triggered when we sneeze, climb into a car, or bend down to pick up the newspaper.

3. Osteoporosis, osteoarthritis, viral infection, bladder or kidney infection, gynecological problems in women, tumors and trauma may also cause back pain.

4. Lack of motion or hina yoga of karma and bad posture may affect us when we sit or stand for long periods of time. On the other hand repetitive motion or Ati yoga of karma like too much of bending, lifting or twisting also affects our back.

5. Other potential causes for back ache are:

o Overweight

o Wearing high heeled shoes

o Carrying heavy weight

The vitiated vata causes stiffness of joints, pain and limits the movements of back.

Solutions for back pain

1. Stay calm.

2. A complete bed rest for 24 - 48 hrs relieves back pain in most of the instances. Walk a little every few hours to keep the blood flowing and the muscles toned.

3. Applying vata balancing oil like ksheerabala oil on affected region and Naadi sweda (mild steam bath on affected area ) of affected region relives the pain quickly.

See your doctor immediately if you have any of the following symptoms:

1. If you are above 50 and sudden onset of severe pain or pain localized to spine.

2. Pain due to recent fall or trauma.

3. Pain in hip and leg.

4. Back pain unrelated to posture.

5. Bowel or bladder control problems.

6. Numbness in the groin or rectal area.

7. Extreme weakness in legs.

8. Unsteadiness while walking

9. Fever or weight loss accompanying the pain.

10. Pain that does not lessen over time even after rest

Prevention of back pain

1. Keep the muscles well conditioned by improving sitting, standing, stretching postures. Well-conditioned muscles are less susceptible to injury.

2. Never bend at the waist or stoop to pick up an object.
Instead, lower the body to the level of the object by bending the knees. Grasp the item, hold it close to the body, and raise yourself with your legs while keeping your back straight.

3. Do not lift very heavy objects.

4. Whenever possible, prop yourself up.

5. Lean against a wall or pillar while waiting for a bus or standing in line at the bank.

6. Keep footstools around the house. Alternatively prop up one leg on stool while doing standing chores.

7. Sleep on a firm mattress and find a comfortable position.

8. Wear low-heeled shoes.

9. Standing straight will do wonders for your back.

10. Sit on a comfortable chair that supports the curve of lower back.

11. While sitting for long hours rest feet on a low stool so that knees are above hips.

12. Do not sit or stand in one position for a very long time. Get up periodically and walk for a while.

13. Avoid activities which hurt back.

14. Do not sit in same position for long hours. It may prove hazardous to back. Take break in between and move around.

15. Avoid becoming overweight. Overweight increases the risk of back pain.

Tips for software professionals to avoid back pain:

1. Select a correct chair, with a relatively straight back and good lower back support. If the chair doesn't offer lower back support, keep a rolled up towel or cushion to support the back.

2. Correctly position the chair, keyboard, and monitor. Feet should be on the floor, with knees at hip level; forearms should form a right angle with upper arms; and the computer terminal should be at eye level.

3. Adopt a relaxed, upright working posture and allow the chair to support.

4. Avoid slouching forward or leaning back too far.

5. When you are at work stand up, walk around, stretch forward, backward, and side to side once in 30 minutes.

6. Increased stress and strain enhances the chances of back pain. Hence remember to relax! Yoga and meditation are best techniques to relax

7. Eat healthy food which is rich in fiber. Avoid sweets, oil, soft drinks and overeating to reduce the chances of weight gain.

8. Sex should be avoided during acute stage of back pain as it exaggerates the condition.

Ayurvedic Home remedy for backache
Remedy

Ingredients

o Nirgundi leaves (hindi - samhaalu) (Bot- Vitex negundo) (Eng - Five leaved chaste)

o Karanja leaves ( hindi - Ditauri) (Bot - Pongamia pinnata) (Eng - Indian beech)

Collect fresh leaves of Nirgundi and Karanja. Tie them in a thin cotton cloth to form a big ball. Boil this leaves' ball in water and when it is tolerably hot apply this on affected part. When the leaves become cold reheat them by putting the leaves' ball in boiling water. After half an hour take out the leaves from ball, grind them to a paste and bind it on affected area.

The use of these points, regardless of the mechanism that causes them to work, is an in depth study that is not just limited to remembering where the dots are located. Some points can only be used if you set them up by the activation of other points. Some points are hard to access due to their location on the body. Some points are effective only if you strike them, others only if you press, rub or knead them. Getting accurate and reliable information is difficult.

Examining an 8" x 10" page with the outline of a person on it, covered with dots and a generic description of the point, its location and resultant effects just does not cut it. It is too generalized. In acupuncture the tsubos are stimulated with a needle. Accuracy is a must. In striking the points there is a little leeway but you still need to be accurate and employ the right angle and direction of the strike. How hard you hit is also a factor in determining the effectiveness of the strike.

Another problem is too little knowledge is a dangerous thing. Learning the points then blasting a training partner just to see if it works is not a good idea. Severe and permanent damage can occur and death is a real possibility. DON'T HIT SOMEBODY JUST TO SEE IF IT WORKS. You also need to know the revival techniques of restoring energy flow. If you don't know, don't do it.

THE HEAD

The head is a massive arena for pressure points. Even the ear is a cornucopia of pressure points, yea, a microcosm of the entire human body's points. Let us examine just a few of the more effective points.

FACE

Starting at the crown of the skull the following points are available:

1. Governing Vessel 21, 22, 23, 24

Strike is downward toward the center of the head.

Weapon: Hammer fist, elbow,

Loss of consciousness/death can result due to over stimulation of the cranial nerves.

2. Governing Vessel 26

The point is located below the nose and above the upper lip. This is generally used as a rub point. Severe injury can result if struck in a down and inward motion. I'm not going to tell you the position it must be struck from for liability purposes but it will break the neck.

Weapon: Back fist, knife hand, elbow

3. Conception Vessel 24

The point is located below the lower lip, centered on the jawbone. It is struck toward the center of the head and downward.

Loss of consciousness: over stimulation of the cranial nerves.

Weapons: Hammer fist, regular fist, knife hand

4. Conception Vessel 23

The point is located above the hyoid bone. If struck with sufficient force death is instant. It is one of the eight magic points. If you break the hyoid bone and it severs the Vagus nerve the heart and lungs stop working.

Weapon: knife hand, regular fist, ridge hand, spear hand.

5. Gall Bladder 1

This point is located at the outside corner of the eye. It is the beginning of the Gall Bladder meridian. A strike here can be done from a 45° angle to the head in an upward and inward direction.

Unconsciousness is caused by over stimulation of the cranial nerves. The orbital bone in this area is one of the easiest, if not the easiest bones in the human body to break.

Weapons: regular fist, palm heel, elbow, knee, back fist.

6. Triple Warmer 23

This point is also located at the outside corner of the eye. It is struck at a 45° angle to the head in an upward and inward direction. If this point is used in conjunction with GB 1 and the strike is from rear to front of the skull it may dislodge the eyeball from its socket.

Unconsciousness is caused by over stimulation of the cranial nerves.

Weapons: Regular fist, palm heel, elbow, knee, back fist.

7. Gall Bladder 14

This point is located just above the center of the eyebrow. It is struck with an inward direction to the skull.

Loss of consciousness is a result of over stimulation of the cranial nerves.

Weapons: regular fist, palm heel, elbow, knee.

8. Gall Bladder 3

This point is located one inch in front and one inch up from where the top of the earlobe joins the skull. This is the thinnest part of the skull. There is no known resuscitation technique for a temple strike. You get to go to the hospital and have holes drilled in your head to relieve the pressure from a ruptured temporal artery.

Weapons: regular fist, single knuckle fist, palm heel, elbow, knee.

BACK OF HEAD

BASE OF SKULL

1. Gall Bladder 20

This point is located bilaterally on the outside base of the skull. Also known as the Plane of Willis. It is the flat spot at the base of the skull. It is struck at a 45° angle inward and upward to the center of the head.

Unconsciousness is due to overstimulation of the cranial nerves.

Weapons: Hammer fist, elbow, regular fist, Willow Leaf Palm (cupped palm), back fist.

2. Triple Warmer 17

This point is located behind and below the ear in that little grove behind the jawbone. Some authorities indicate that this is an extreme death point. It is utilized with both strikes and presses. If you strike this point from rear to front there is a good possibility of dislocating the jaw. It is best pressed with a single knuckle fist. Grind back and forth as you press inward to the center of the skull.

Loss of consciousness is a result of overstimulation of the cranial nerves.

Weapons: Regular fist, one knuckle fist, back fist (open hand strike).

3. Bladder 10

This point is located bilaterally on the spine below the skull. Strike inward to the center of the head.

Loss of consciousness is due to over stimulation of the cranial nerves.

Weapons: Palm heel, regular fist, elbow, Willow Leaf Palm.

4. Governing Vessel 17

This is the occipital notch. Strike this point in an upward and inward direction.

Loss of consciousness is due to the overstimulation of the cranial nerves. A strike here may also cause a severe concussion.

Weapons: Willow leaf palm, palm heel, regular fist, elbow, knee

NECK

1. Stomach 9/10

These two points are struck at the same time. They are located over the carotid sinus on the medial anterior portion of the neck.

Loss of consciousness can be explained by several mechanisms. Pick one.

a. Striking two points on the same meridian can cause unconsciousness.

b. Disrupting the blood flow to the brain. A strike can cause backpressure that the brain cannot handle and unconsciousness ensues.

c. Below the carotid sinus is a bareceptor that monitors blood pressure. When struck with sufficient force it sends a message to the brain that the blood pressure is too high. A message is then sent to the heart to slow down or stop and the result is unconsciousness.

Weapons: regular fist, one knuckle fist, knife hand, spear hand, elbow.

2. Large Intestine 18

This point is located on the leading edge of the Sternocleoidmastoid muscle about half way up the neck. This is a good grab point for Spirit Throw and Japanese Full Nelson.

Weapons: regular fist, one knuckle fist, elbow, fingertips.

This is not an all-inclusive list. There are a multitude of points in this region of the neck. These are just the ones I use on a regular basis.

TORSO

1. Conception Vessel 22

This point is located at the top of the sternum in the notch. The strike to this point is done with the fingertips generally inward and downward. It is fairly safe to press this location but strikes can be serious.

Loss of consciousness is caused by trauma to the trachea.

Weapons: Fingertips, single knuckle punch.

2. Conception Vessel 15

This point is the solar plexus. It is called the solar plexus because of its central location. Organs affected would include heart, lungs, liver, kidneys, and stomach. Breaking the xiphoid process can lacerate the liver and cause internal bleeding, which if not treated, can be fatal.

Loss of consciousness is from trauma to the above named organs. There can also be a loss of motor function.

Weapons: regular fist, single knuckle fist, elbow, knee, ball of foot.

3. Conception Vessel 4

This point is located about two inches below the umbilicus (belly button). It is struck in a 45° downward direction. If struck with sufficient force you can cause an opponent to soil their shorts.

Loss of consciousness is caused by trauma to the small intestine and bladder.

Weapons: regular fist, palm heel.

4. Spleen 21

This point is located in the medial lateral portion of the rib cage. An easy way to find this point is to place two fingers under your nipple and trace a line straight around to the center of the rib cage. If you locate this point on a partner and press on it with a single knuckle fist you will get a substantial reaction.

Loss of consciousness results from trauma to the lungs and associated nerves. It will also shut down the lungs, stop breathing and circulation.

Weapons: regular fist, one knuckle fist, heel, palm heel, elbow, back of hand/wrist, knee and just about anything else you have!

5. Stomach 28

This point is located two finger widths below the nipple. Strike this point in a downward angle of 45°.

Loss of consciousness is cause by trauma to the lungs and associated nerves. You may also break some ribs in the process.

Weapons: regular fist, single knuckle fist, palm heel. Knife hand, front kick (kick them in the knees first!).

6. Liver 13

This point is located on the tip of the 11th rib. An attack to this point is from a 45° angle to the body and downward at a 45° angle. If struck in an upward motion with sufficient force to break the rib (and they break easily!) the blow can be lethal if it lacerates the liver.

BACK

1. Governing Vessel 15

This point is located on the spine between the shoulder blades. Attack this point in an inward direction.

Loss of consciousness is a result of trauma to the spinal cord, aorta, heart and lungs. A heel stomp as in Rear Reverse [ Ushiro gyaku a.k.a. Wellington Sheep Hold] can be fatal.

Weapons: regular fist, elbow, palm heel, heel, knee.

2. Gall Bladder 25

This point is located over the kidney just below the rib cage. This is a nasty point to get hit on all by itself. Used in conjunction with a GB 20 strike produces a knockout that I can personally attest to. Strike is done from a 45° degree angle to the body from the rear.

Loss of consciousness is a result of trauma to the kidney and associated nerves.

Weapons: regular fist, shin kick, roundhouse kick, elbows, back of hand.

3. Governing Vessel 3

This point is located on the tip of the coccyx. Attack this point in an upward motion.

Loss of consciousness is caused by trauma to the entire spinal cord.

Weapons: front kick, knee strike.

LEGS

1. Gall Bladder 31

This point is located medially on the outer thigh. It is located over the Ilio-tibial tract of ligaments and the vastus muscle. This is a favorite target for kick boxers and when kicked properly can cause the leg to quit functioning.

Weapons: Shin kick, knee, regular fist.

The knee has a multitude of points on and around it. A solid side thrust kick will hit something!

2. Spleen 10

This point is located on the inner thigh about three inches above the knee. Strike inward toward the center of the leg and downward. This will cause the knee to collapse. I have heard of ki sickness being caused by kicking this point with the ball of your foot.

Weapons: knees, instep, shin, heel, regular fist.

3. Bladder 57

This point is located at the juncture of the gastrocnemius muscle and the Achilles tendon. The point is attacked from the rear of the leg to the front. According to the Bubishi if this muscle is split it causes dementia.

Loss of consciousness is trauma to the tibial artery and nerve.

Weapons: side thrust kick, front kick.

There are a multitude of points on the foot but accessing them in the dynamics of a fight is not likely. A good stomp to the instep can do wondrous things to the attitude of an opponent.

The last point I want to indicate out is Kidney 1. It is located in the center of the foot. Ashi Katsu is performed on the left foot. By slapping this point vigorously you may be able to quickly restore someone about to faint. I can personally attest to this as I used it on my team sergeant, who was about to faint, after getting shots prior to going to jungle training in Guam, 1985 (watch the trailer on my website).

This is by no means an inclusive list. These are just the points I use in my martial art. There is much to learn in applying the Kyusho techniques to the various arts. It requires study of not only TCM but also western medicine, physiology, physics, anatomy, and a great deal of practice. It requires the conscious effort during practice to apply the principles to your techniques and a concerted effort to make the art your own. The study of the martial arts is a harsh mistress, but worth it.

Train hard!